Many years ago, a rabid dog charged at us. I slipped into the car, closed the door and peeped out of the window! Another colleague of mine went out, took a stout stick and as the dog approached the car, he dropped it dead with one well placed blow to its head. Both approaches are fine. Yet, there is another approach: we could stay out, paralyzed with fear and be bitten! This last approach, many PWS have tried and found unsatisfactory in the long run.

The first approach is like fluency shaping techniques; You build up on your inherent fluency; actually, you stop interfering with your natural ability to produce normal fluent speech. Your desire to be fluent does the rest.

The second approach, stuttering modification, is a better one in my opinion because it teaches you to conquer your fear- not only of stammering- but of everything else on earth. Instead of running away from a pack of monkeys, you steadily walk towards them, and they scatter.

Finally, it will be good for most of us to learn and practice both kind of approaches since these techniques are not exclusive or antagonistic.

Stuttering modification

Self exposure

For many of us, denial becomes so ingrained that not even in dreams, will we accept our speech difficulties. So here we begin from simple to difficult tasks, in the following suggested order:

1. While in the shower (or anywhere private) whisper or say to yourself for some days - I stammer. Yes, I stammer. And this is fine...

2. When you are comfortable with the above, say that or something similar to your pet (dog, cat, bird, lizard or mamba!) or a child - You know, sometimes, I feel totally stuck; I can't say my own name..

3. Now say the same thing, after some days, to your nearest relative or friend (wife, mother, friend- but not to your boss yet!)- You know, sometimes, I get totally stuck; can't say the simplest things..
   If they ask a question, answer it briefly and objectively without excitement.

4. After you are comfortable with the above steps, try doing the same with a colleague, a chance acquaintance, someone sitting next to you in a bus. Make sure that you sound casual and that the occasion is appropriate, that the other person is not in a big rush. Having said it, make a note of their reaction. Was it different from what you expected?

5. Next, after some months of constant practice, when you have to give an informal presentation or group talk, start casually with something like this:
   You give me just two minutes. Unfair, because with my tongue (or my stammer) I am sure I am going to take four minutes. How many of you are willing to give me four minutes? Please raise your hands...
   And then begin full steam ahead, with a smile..
   
   Experiment with this and other ice breakers and ‘humorous’ opening lines for PWS listed on Judy Kuster’s home page. An important thing to remember, while talking about your stutter is to keep an eye on your emotions and remain calm. This will become easier as you do it frequently under different circumstances. Also, take note of your listener’s response. Almost always, they accept it as a matter of fact. This self exposure can take other forms too- a blog, messages to chat groups, letters to editors of local dailies, a poem or a story etc.

6. Rewards (the outcome): When you have done this enough, there will be complete acceptance in your heart and mind for your ‘stuttering self’. Then, when you open your mouth to speak, there will be no ‘role conflict’ between your ‘stuttering self’ and ‘fluent self’- and your speech will be quite smooth.

Bouncing

We have noticed that sometime, under stress, our mouth just runs away with words and we feel helpless, as if we have absolutely no control over our speech box. Bouncing is a technique which gives us back the control over our speech mechanism and related emotions. It also teaches us to stutter in a relaxed way- as very young children do. This is the purpose of the self-therapy here: to teach us to stammer as a four year old child does. That effortless stammering is less tiring to us and less distracting to the listener as well. Lastly, it is a nice way of self exposure- telling people that we stammer and getting used to their reactions.

Here are the main rules:

1. Start with easy, simple words. Bounce on difficult words only after 2-3 months of regular practice with easy words. By difficult words we mean sounds which pose problems regularly- for example for some of us, it could be K (as in Kanpur); for others it could be B (Bimal), P (Peepul) etc.

2. Practice alone for a few days; When comfortable, do it with a friend or in a self-help group or on phone with friends or strangers.

3. Read a story book or newspaper and bounce on every second or third word in every sentence. Finance m-m-m-minister has d-d-d-decided to l-l-l-lower the interest r-r-rates...
   You just repeat the first sound (syllable) slowly. SLOWLY is the key principle here.

4. Avoid bouncing rapidly, which happens sometimes during uncontrolled stammering:
   Finance mmmminister has ddddecided to llllower the interest rrrates..
   
   This is bad bouncing. This can be avoided by stopping completely and being totally relaxed between two bounces.

5. Vary the number of bounces. Start from 6 or more bounces and then gradually reduce it to 2-3. Then, again increase it to 5-6 or even more. The idea is to get totally comfortable with this technique and develop good control.

6. Finally after some months practice, you should be able to say a word with just one small relaxed unnoticeable bounce: Finance m-minister has d-decided to lower the interest r-rates...
   
   If you watch TV carefully, you will notice many speakers, anchors using this little (sometimes even bigger) bounce frequently.

7. While learning to bounce, pay close attention to your emotions. Bounce as a child does. No fear, no struggle and with total acceptance.

8. Now, is the time to start tackling difficult words in the same way and in the same order. Start with a close friend and then with colleagues and finally with strangers; first at home, then in the work-place and still later try it in a bus or train etc.
   
   Give me a ticket for Ha- Ha- Herbertpur.
   
   Gradually, try to bounce on a difficult word in a spontaneous conversation on the phone or in person.

9. Whenever you fail to bounce properly on a word go back a couple of steps and start again. Bounce on that very word, alone, then with a friend and then with strangers.

Voluntary stuttering

Voluntary stuttering involves- not bouncing- but actually reproducing your natural normal stutter at will. At will is the key word here. When you stutter, you have no control over it; And that is what is disturbing and painful. Now you have to study your stammer which you have already done, and reproduce it in all its detail and perfection. Don't exaggerate it, don't make it humorous or funny. Just mimic it.

Again start from - doing it alone, then with a trusted friend, then in your self-help group and then finally with someone in the street.

But why are we doing it? To get rid of the deep seated fear and shame and also to become conscious of all the things which we do, and which interfere with communication, our natural fluency.

If you can mimic your stutter perfectly, you can conquer it!

A good exercise is to read a book or a newspaper and stutter voluntarily on a word in each sentence and then immediately repeat that word with a relaxed bounce. This will teach our nervous system the big difference between ‘hard blocking’ and a gentle bounce.

While trying voluntary stuttering, try to relive everything associated with your stutter: the emotions of fear and shame, tightness in throat and chest, closing of throat, lowering of gaze, jerking of hands or head etc. Remember, all this has to be done at will and stopped at will.

This milestone signifies your conquering of fear of stammering. Many PWS live in chronic fear:
What will I do if I get totally stuck on a word or my own name in a formal meeting- and just cant get out of that block?

If you have come thus far, you exactly know what you will be doing in such a situation and so you can go back to sleep or whatever creative projects you are doing in your life!

Secondary Behaviors

Stuttering is not just fractured speech. There are secondary behaviors, which we have picked up over our growing years, in search of some relief. All these secondary behaviors have helped initially but now have turned into useless junk mannerisms. In fact, they interfere with efficient communication. And still we indulge in them. Why?

This is because most of us are not aware of these secondaries: raising of an eyebrow, blinking of eyes, flaring of nostrils, tilting of head back; pitch rising as we approach feared words, tightening of chest and holding the breath, fiddling with hands etc. Once we are aware of them, we slowly develop a conscious control over them, and with some persistence, can get rid of them.

Here are the steps:

1. First we must become aware of these. As in earlier steps, study them with the help of a video camera, mirror and or a trusted friend.

2. Develop a complete list of all such unconscious reactions to difficulties faced during verbal communication.

3. Study these behaviors under different circumstances, talking to different people, discussing various things (telling a joke, reading a formal report, role playing, during a verbal confrontation, when very angry or excited etc).

4. Now get down to changing these secondaries: Let us take the example of eye blinking. In front of a mirror or a video camera, change (and review) the rate and type of blinking through a wide range of settings. For example, blink very fast while talking; then slowly. Then, shut your eyes completely and say a complete sentence. Then, time your slow blinking with every pause in a sentence (comma, semi-colon etc). Then, stare without blinking and say a complete sentence or two. Then, do the full exercise with another person. Frequently replay the tape and review the behavior.

5. Gradually, this will help you to develop better awareness and conscious control over eye blinking and you will find that now, when you talk, you are able to control or even stop this particular secondary behavior. Similar exploration and experimentation should be done with every secondary behavior. Initially take them up alone and then try various combinations- eye blinking with hand movement; trembling of lips with head jerk etc.

Points to ponder

Almost all the above steps require a lot of courage, a sense of adventure, a spirit of inquiry and a determination to face the truth, however painful it may be. Almost always the first step is the most difficult one. Once you begin, it becomes easier. The old fears do return once in a while, but shooing them away becomes easier and easier.

Now the problem is- no one can thrust this journey on us. A point comes in our life, when we feel that we have suffered enough, in silence and alone; We become aware that this kind of suffering is meaningless; It neither turns us into a martyr nor does it lighten anybody else’s burden. We discover that our old way of dealing with our stammer is totally non-productive, non-creative. It offers only one plus point: it is familiar and therefore feels more secure.

When we reach this turning point in our life, we are ready for a quantum leap. This manual tells you how to land on both feet safely - but leap, YOU must.

Fluency shaping

Fluency shaping is the other approach to stammering: We all have noticed that sometimes we are quite fluent- like when talking to a child or a pet or on a topic well known to us. But when we are under stress (sometime even without stress) that fluency vanishes. Why? Because under anticipated stress, we do certain things which interfere with that fluency, like tensing our lips, holding our breath, tightening our throat muscles etc. Some of the main approaches under this are as follows.

Gentle onsets & Prolongation

Gentle onset means that we pay close attention to our beginning of a word or sentence. PWS often tense up, tighten their lips and jaw and start in a jerky uncontrolled fashion. With some practice and conscious attention, it is possible to start a sound gently. And then, prolong the sound. To a beginner it may seem like speaking with a foreign accent. It involves prolonging the vowels, especially the initial sounds. It helps us to slow our speech down and be comfortable with the act of speaking itself.

To begin the practice, read a newspaper or book with prolongation of vowels in every second word or more: Aai weel go too Kaaanpooor toooomorrow (I will go to Kanpur tomorrow). Then, practice it with a friend in general discussion. To understand what do prolongation means, you may have to talk to some PWS already practicing it or watch a video of the technique. The latter is available on the web.

You begin with non-feared words and situations and move to feared words and situations gradually-after some weeks or months. For example, you may talk like this to your pet dog and then gradually to your friends and family members for increasing durations. You may slide back once in a while, which is common. But regular and motivated practice is very much needed to turn this technique into a useful skill, you can rely on under stress.

Gentle onsets may even mean, to soften the hard consonants at times: Khum on- leeet us plaaay (Come on- let us play). Similarly, sounds consisting of double consonants may have to separate in the process of prolongation: Perroompt (Prompt); Currocin (Crocin).

Initially speaking like this might seem very strange to us but if we observe, many nationalities speak English (and other languages) in significantly different ways and are understood well enough: Pay attention to a Russian speaking in English for example.

Correct breathing

There is medical evidence that different types of breathing achieve different physiological goals- for example belly breathing ventilates the lower lobes of the lung and this promotes more efficient exchange of oxygen. There is also proof that when we anticipate stress, we tighten our chest and belly and our respiration becomes shallow, irregular or even ceases completely for short periods. Since we are no more breathing out, we are unable to speak.

Some children, on the other hand have discovered that breathing out might help them during a block. But when they breath out, sometimes, their lungs become totally emptied and still the phonation (voicing) does not begin. Finally, they may be able to whisper a few words with great difficulty with the little residual air.

It has also been noticed that there is a reverse cycle too: relaxed deep breathing can calm down a PWS and help her/ him gain better conscious control of his speech. Watching one’s own breath can also induce deeper states of inner consciousness, wherein one might see his or her avoidances, fears, habitual responses to anticipated stress and other emotional/ psychological issues associated with stammering. Over the months or years, it may be possible to heal oneself through this path. The technique itself should be learned from a qualified teacher or in a formal Vipassana course. The technique does not require one to believe in any supernatural deity. It only demands that one has faith in one’s own senses, mind and observation.

In practice, it means becoming aware of your breathing at different times of the day; In a traffic jam, were you using the chest (upper? lower?) or the belly muscles to breathe? As you thought of an important deadline, did you tighten your chest and stop breathing for a few seconds? As you approached a feared word, what happened to your breath? etc. To develop this awareness, lie flat on the ground and practice three kinds of breathing; Put one hand on the chest and the other on the navel (belly). If you practice belly breathing correctly, the hand on the chest will be still or will move very little. After a few days, put a thick book across your stomach and try pushing it up, with every inspiration. Later, you may discover the fine difference between breathing from the upper chest and lower chest.

Now onwards, whenever you notice that your breath is irregular, shallow or stopped, promptly and consciously go into gentle belly breathing. Read more.

Pausing

Many of us labor under this false notion that communication means talking non-stop. We think that a silence in a conversation must be an uncomfortable moment for both parties. PWS often feel under pressure to prove themselves by talking continuously. But silence is an essential and natural part of good communication. It should be practiced consciously as meaningful breaks in the flow where:

1. a clause ends, signified by a comma, colon etc.

2. a sentence ends, indicated by a full stop.

3. a new concept or thought is being introduced.

4. you wish to give a few moments for the information to sink in.

5. you expect a response (verbal or non-verbal) from your audience. Listening attentively to your partner is equally important. Many PWS are too caught up in formulating their response that they hardly listen to their partner, leading to confusion and communication failure.

Pausing should be unhurried, relaxed and can be used for taking a deep breath, formulating our thoughts and reviewing audience response, especially during a formal presentation. Such conscious meaningful pauses help by stopping our speech mechanism completely; otherwise it tends to gather momentum and become uncontrollable after a couple of sentences, leading to moments of stuttering eventually.

To practice pausing, begin with reading a newspaper or book, with full attention to punctuation. Stop completely and take a deep breath at every punctuation (comma, colon, semi-colon, full stop, hyphen etc.) - and then proceed further. After some weeks, practice conversation with a friend in a similar fashion: stop and breathe in gently wherever you think a punctuation mark should be, if you were writing it down. Still later, practice it with a larger group and under different circumstances.

While speaking in a formal setting, resist the time pressure. If you have been given only three minutes to present a long report- set up your priorities, leave out all the un (or not so) important details and present only the most salient information in a relaxed way, interspersed with meaningful pauses. You may preface your presentation with something like this: Since I have just th-th-three minutes, I will share the most r-r-relevant information with you.

The most important thing to remember is: during a pause your speech mechanism should really come to a stop and you should be completely relaxed. Here is a group exercise to develop power to resist time pressure, while speaking:

Sit down with some peanuts in the center, with members of your self-help group. You have to ask a question from the person sitting next to you (what is the color of your shirt? What is the day today? Etc). That member must answer after eating one peanut completely and then carry on asking the question from the next person and so on. Whoever forgets to eat the peanut before answering is out. Whoever lasts till the end could be titled 'King or Queen of Pausing'. This can be a fun game both for adults and children. (From 'Fifty Activities for the Children who stutter', by Dr Peter Reitzes.)