Do stutterers fear social interactions? How likely are stutterers likely to have mental illnesses? Should stutterers seek treatment from psychologists or from speech-language pathologists?
According to an old theory, stuttering is the “tip of an iceberg,” with 90% of the problem being fears and anxieties that listeners don’t see, and physical stuttering being only 10% of the problem.
I never believed that. I stuttered severely but I had little fear of listeners discovering that I stuttered. It was obvious every time I talked!
The Evidence
A study[ref]Huinck, W., Langevin, M., Kully, D., Graamansa, K., Peters, H., & Hulstijn, W. (2006) The relationship between pre-treatment clinical profile and treatment out-come in an integrated stuttering program. Journal of Fluency Disorders, 31, 1, 2006, 43–63. http://dx.doi.org/10.1016/j.jfludis.2005.12.001[/ref] of 25 adult participants in the Institute for Stuttering Treatment & Research (ISTAR) program, with one- and two-year follow-ups, found that:
- There was no relationship between stuttering severity and the severity of negative emotions and cognitions.
- The severe stuttering group had the largest treatment gains but also the highest level of regression.
- At post-treatment and both follow-up assessments the differences on measures of emotions between the mild and severe emotional group had disappeared, chiefly due to a large decrease in the latter group’s negative emotions and cognitions.
A study[ref]Ross G. Menzies, Sue O’Brian, Mark Onslow, Ann Packman, Tamsen St Clare, and Susan Block. (2008) An Experimental Clinical Trial of a Cognitive-Behavior Therapy Package for Chronic Stuttering. J Speech Lang Hear Res 2008 51: 1451-1464. doi:10.1044/1092-4388(2008/07-0070)[/ref] of 32 adult stutterers found that 60% had social phobia. Some received 14 hours of fluency shaping; the others received 15 hours of cognitive-behavior therapy focused on reducing speech-related fears and anxieties followed by 14 hours of fluency shaping. The subjects who did only speech therapy had no change in social phobia. The cognitive-behavior therapy had no effect on the subjects’ speech. The subjects who did both had no social phobia after treatment.
A study[ref]Lisa Iverach, Mark Jones, Sue O’Brian, Susan Block, Michelle Lincoln, Elisabeth Harrison, Sally Hewat, Angela Cream, Ross G. Menzies, Ann Packman, Mark Onslow. (2009) The relationship between mental health disorders and treatment outcomes among adults who stutter. Journal of Fluency Disorders, 34, 1, March 2009, 29–43. http://dx.doi.org/10.1016/j.jfludis.2009.02.002[/ref] of 64 adults who stutter found that two-thirds had mental health disorders. Before treatment, “stuttering frequency and situation avoidance were significantly worse for those participants who had been identified as having mental health disorders.” Six months after treatment, the third of subjects without mental health disorders had maintained the benefits of treatment; the two-thirds with mental health disorders had not.
A study[ref]Lisa Iverach, Mark Jones, Sue O’Brian, Susan Block, Michelle Lincoln, Elisabeth Harrison, Sally Hewat, Ross G. Menzies, Ann Packman, Mark Onslow. (2009) Screening for personality disorders among adults seeking speech treatment for stuttering. Journal of Fluency Disorders, Volume 34, Issue 3, September 2009, Pages 173–186. http://dx.doi.org/10.1016/j.jfludis.2009.09.001[/ref] of 94 adults who stutter and 920 non-stuttering adults found that stutterers are three times more likely to have personality disorders.
Examples
A woman called me about her husband, who stuttered. He had stopped talking. He asked for a demotion at work to a job that required only communicating by e-mail. He stopped speaking to his wife and children. He refused to see his friends. He refused to go to speech therapy. She was considering a divorce. She called me asking if there was anything he could do to talk fluently. I said yes, there are effective stuttering treatments, but if he didn’t want to talk then nothing could be done.
A man in his thirties has contacted me repeatedly for years asking for a free SmallTalk. He stutters severely. He has no job, few friends, and often tells me that he wants to kill himself. I gave him a free Basic Fluency System but he refuses to use it. He has never had speech therapy, even though several of the best stuttering clinics are within a few hours of his home. He called one day when Rick Huang was in my office. Rick stutters and is a Ph.D. candidate in speech-language pathology. Rick tried to get the man to do simple fluency shaping techniques over the telephone. He refused. I suggested that he try vitamin B-1. He refused. The man uses stuttering to mask a mental illness. I.e., when people meet him, their first impression is that he stutters severely, not that he has a mental illness. If he did something that resulted in fluency, people would see that he has a mental illness, and he would have to think about his mental illness. [Edit: I later gave him a free SmallTalk. Now he’s asking for another free Basic Fluency System.]
And then there are the French. Is the entire country mentally ill? I’ve sold several SmallTalks to stutterers in France, and each person returned the device for a refund. Each said the same thing: the device immediately made them talk fluently, which forced them to confront their psychological problems, and they’d rather stutter than deal with their psychological problems, so they returned the devices!
What It Means
About half of adult stutterers have speech-related fears and anxieties. About half don’t.
The adult stutterers who have speech-related fears and anxieties should be treated for social phobia. Teaching these adults fluent speech doesn’t work because they fear talking to people, minimize their social interactions, and the fluent speech motor skills are never learned on an autonomous (automatic, effortless) level.
The half of adult stutterers that don’t have speech-related fears and anxieties don’t need treatment for social phobia. Telling us to go to a shopping mall and do “voluntary stuttering” is a waste of our time. We want to learn to talk fluently.
No research has been done to see if children who stutter have social phobia. Among non-stutterers, social phobia is an adult disorder. Social phobia is ten times more prevalent among adults than among children. There’s no reason to assume that children who stutter have speech-related fears and anxieties, and no reason to tell children to accept their stuttering (i.e., to do stuttering modification therapy with children).
Stuttering is a problem for individuals with mental health disorders because psychological therapy requires talking. Speech therapy resulting in fluent speech can enable these individuals to get the counseling they need.
The use of evidence-based stuttering treatments could reduce the prevalence of stuttering in adults by 50% relatively easily, within five years. In other words, I believe that stutterers without mental illnesses can talk fluently, with treatments that are relatively simple and easy. But I also believe that stutterers with mental illnesses are much harder to treat. I doubt that the prevalence of stuttering could be reduced much more than 50%.
Some speech-language pathologists think they are capable of treating psychological disorders associated with stuttering. Most often these speech-language pathologists practice stuttering modification therapy. But speech-language pathologists aren’t any more qualified to treat psychological disorders than psychologists are qualified to treat speech disorders. Speech-language pathologists should teach stutterers to talk fluently. If a stutterer has a psychological disorder, the speech-language pathologist should refer the stutterer to a psychologist.
The way speech-language pathologists treat stutterers’ speech-related fears and anxieties (stuttering modification therapy) isn’t how psychologists treat social phobia. Psychologists using Cognitive Bias Modification (CBT) therapy don’t even treat social phobia, they have computer software that provides more effective treatment.
The way speech-language pathologists treat stutterers’ speech-related fears and anxieties (stuttering modification therapy) suggests that stutterers don’t have social phobia. Sending a stutterer to a shopping mall to do “voluntary stuttering” with strangers is like sending a soldier with PTSD back to the battlefield to voluntarily watch friends getting blown up. If a stutterer had social phobia, stuttering modification therapy would put the stutterer into the psychological ward of a hospital. Because thousands of stutterers have done stuttering modification therapy without apparent psychological damage, I suspect that stutterers’ speech-related fears and anxieties are something else. Social phobia is difficult to define, with large “gray areas,” especially in children who are naturally shy.
Hello, I am so happy I ran into this site because I always felt alone in this. I am someone who has a mild-moderate stutter, with horrible social anxiety. But here is the catch, my stutter is what CAUSED my social anxiety. I am an extrovert, which is hard to believe, but I am. I always hated my stutter a lot, and I’ve always had anxiety, but I could deal with it even though it was hard for me. I always had a lot of friends, life of the party, class clown kinda guy. This was during my school years. But bam, after grade 12, out in the REAL world, I couldn’t handle it, my stutter was too much of an obstacle for me to meet new people, do jobs/interviews. My anxiety grew worse, and I slowly over 2 years got more social isolated and now I have social PHOBIA. I am seeing a psychologist but I want your opinion, if stuttering is the reason I developed social anxiety/phobia, should I focus more on speech therapy? I do have a mental illness, because I have bad depression as well, but I’m depressed cause I’m scared to socialize and I’m scared to socialize because of my stutter! Lol! Do I focus more on cognitive/psychological therapy or do speech? Or both needed?
I think you literally just described what I deal with on a daily basis.
I have stuttered my whole life. Recently, I began experimenting with foods and drinking. When I drink alcohol I don’t stutter and when I fast I believe people that stutter have low oxygen.Eating food and digestion takes oxygen. I cut out meats, dairy and gluten and it seems to work. Also, when someone’s oxygen is low you will have anxiety and depression. Whether you are a stutterer or not. Your oxygen level is effected positively or negatively by everything. Pollution, cold weather, news ect. I believe possibly the left positive hemisphere of my brain is not fully developed or I have food allergies. Which would cause low oxygen.
I have stuttered since birth, I’m bipolar & I suffer from manic depression. When I’m having a really bad day communicating I can become highly aggressive & unpredictable. I’m unable to have many friends & sometimes I can’t leave my apartment for days In fear of someone trying to pick a fight with me, because when I’m fearful that’s when I’m at my most volatile, dangerous. My behavior at this point is primitive & almost uncontrollable so thankfully the intimidation tactics I use to ward people off still work.
I’m one of the more severe cases & all the medication I take can be ineffective from day to day. I’ve been on social security disability for almost 12 years & it’s been a brutal life. I just hope that my kids are spared this suffrage because I don’t think I can bear the shame… so much more to the story but it’s bedtime.
Hey there
I used to stutter but slowly got over it just after leaving highschool. I feel that im not a very confident person and my life goal is to be the most confident person i can be. I know i have a deep rooted insecurity! I have been facing my insecurity head on for about 5 years now. Talk out loud about it ect..
I know Now that im not the person i once was but its so hard to shun that old guy because Iv learn to grow up around it and shaped my whole belief system and how i fit into this world amongst people. I just wanna be the new me !!!
I can have quite the silver tongue. I’ve talked my way out of muggings, arrests, arguments etc. The art of communique and semantics are more complex than rocket science; not just delivering ideas – rather, presenting the right stimuli to achieve the desired results. Which brings me to the problem I have.
For 10 years I lied and manipulated my significant other. Nothing terrible or heinous, just a vast patchwork of small to complex lies and omissions in order to maintain optimal happiness for my partner. Note: For my partner, not for the relationship, let alone me. The commitment to my fabrications has fractured my personality, destroyed my self worth, and turned me into a slave within my own mental prison.
Then one day I quit telling her what she wanted to hear – specifically during an argument over wanting to call her back because I dont like using the phone while driving. I avoided, what would have been, a very fatal accident. I was very shaken. I could barely talk, I couldn’t blink, I couldn’t move. When she still refused to give me a breathe – I went off on her. I finally broke free of my cell. I was yelling so loud that everything in my vision was the color purple or blue.
Ever since that night, I quit telling her what she wants to hear. But when I do; I get a terrible stutter. Just this morning it took me about an hour to describe my error in budgeting which led to my phonebill being left out.
For awhile, I thought I had a stroke that night I described. The stutter will only happen when I have to tell her something that I know will upset her though. I couldn’t figure out this new depth of my insanity until reading this article.
Thank you.
I have stammered since the age of four and didn’t seek Speech Therapy treatment until 2014, when I was 45.
My last few years of secondary/high school, were an absolute nightmare, with clueless English teachers constantly exposing my stammer, with the constantly dreaded sessions of reading-around-the-class and other pointless rubbish, all to the rest of the class’s amusement and degrading ridicule.
My main reason for finally seeking treatment, was that I was made redundant at the age of 44 and also broke my arm, slipping on some ice, at the same time. This gave me a huge loss in confidence and a very long time out of work, which made my stammer a lot worse and also caused a huge lack of confidence, when it came to job interviews.
I’ve never been that bad at answering the phone, but when having to phone someone, who isn’t close to me, then I have always struggled, particularly when saying my name or if I have to ask to speak to a certain person.
After struggling to speak in some situations, I always feel frustrated and ashamed for an hour or two afterwards and just want to hide.
Despite having forty individual, one-to-one, Speech Therapy sessions and attending a regular monthly Speech Therapy group, with other people who stammer, my stammer is still up and down and I still struggle when having to phone someone, despite being advised to write everything down, like a script and then read it out when speaking on the phone. I also practice by using a small Dictaphone, which is very useful for me to hear how my voice actually sounds and can be bought for a very decent price.
According to my Speech Therapist, stammering is all about fear and the vocal cords getting blocked, also due to not breathing properly, but my problem goes much deeper than that and I also have a social phobia and sometimes prefer my own company and feel like I’m in my own comfort zone.
My Dad has quite a large outer-family and they are mostly loud and outgoing and some of them have always subtly accused me of being anti-social, including my ignorant brother, who knows that I have a stammer, but has still been accusing me of being not normal and anti-social for the past 30 odd years.
Too many people seem to think that people who stammer are slow, socially lazy and that the stammer is the fault of the person who stammers and not something which runs in families.
As I have found out through my treatment, stammering does run in particularly large families and I have also found out that my Grandma’s brother was the last person in the family to stammer before me.
I am improving, but I still feel very uncomfortable when meeting new people, but my treatment for stammering has been an eye-opener and has made me more aware and confident in job interviews, so much so, that I actually look forward to every job interview, instead of dreading them, like a few years ago, when I would apply for jobs and hope that nobody would get back in touch.
I would definitely recommend people who stammer to see a Speech Therapist, but people must remember that its not an instant fix and is more of an on-going process that you must persevere with, for however long it takes.
Brother I completely identify & feel every word you wrote deep within the pit of my stomach but it also made me feel super guilty because your suffering gave me solace in knowing that there are more of us out there. I never wanted to educate myself or even acknowledge that my problems are there but maybe this is step in the right direction. I’m happy that I found this website. Keep fighting the good fight brother! Hails from the Heartland.
After almost 20 years the memory has faded; like a dream that won’t come back in the morning no matter how hard I try. 55 years of fearing people’s reactions to my stuttering is far behind me today. I just talk now without thinking about feared words, feeling small, protecting myself from those around me by defensive walls.
I don’t know how or why I started stuttering, but observed my son and his daughter go through a stuttering phase that frightened the hell out of me. My speech therapist helped with good advice at the time. Within 6 months they both spoke fluently.
Growing up for me didn’t go that smoothly. With school came the bullying and sneers and being laughed at. I learned that I was different, not as good in every way that mattered. And yet I feared words, not people. It was so obvious. Words were impossible to say, no matter how much encouragement and help I received to get them out. Take a deep breath; relax; sing. A feared word may as well have been a narrow plank 20 meters up between two high buildings.
Looking back, I recognize that fear as irrational, especially since I was able to speak fluently when completely on my own. Logic would tell you that something else was wrong, that the only difference in that situation was the absence of people. In spite of assurances to the contrary by my Speech Therapists, nothing was wrong with my speech apparatus, my breathing, or my tongue. My speech was perfect in the bathroom.
But logic doesn’t work. Someone famously said, an emotion not put in place by logic can’t be removed by logic.
So how did you beat your stutter, I hear you ask. You should know by now that the harder you fight your stutter the worse it gets. There’s nothing effective or lasting you can or should do about it. Instead, with help from a Mens Group and a mentor, I dismantled the behaviour and belief system that kept the stutter in place. Imagine sitting amongst a group of men who have agreed to listen to your story, your worries, without interruption or criticism. In turn, you listen to everyone else’s stories. Not only do you discover that you are equal, you also learn how to listen with empathy. You might even learn to forget to observe yourself as you listen to someone pour his heart out.
Within a year, as a side benefit of my personal development work, my stutter drastically diminished. Well set in my ways, my brain took a long time to let go of the idea that I’m a stutterer. Now, at 72 years, I can write about this and not slip back into old habits. I don’t think about the possibility of stuttering when talking, don’t notice the usual hesitations of a normal speaker.
“But I want someone to invent a cure, a pill, a gadget that will remove my stutter right now”, you might say. Good luck waiting for that miracle cure. From personal experience, adult stuttering is not a physical disability or illness. It is a phobia, an irrational fear that has built up as a consequence of an early childhood stutter.
After telling the story, of my long journey from fear to freedom, to my old Stutter Support Group that I hadn’t been in touch with for many years, the general response was: “wouldn’t work for me, I’m different”, or “you probably didn’t have a real stutter”. A sad one was, “each of us has to travel his own journey in life”.
Only one man followed my advice. He’s half my age and became fluent within 18 months.
Why do I write this after all the knock-backs? I feel like the sole survivor of a huge disaster. Why me? What if I could have done something, reached out and saved someone?
Feel it’s all too unbelievable? I admit I would have thought so 50 years ago.
Hi! I also have a stutter, and I’m super curious as to your story! I believe you also commented on Brene Brown’s TED talk (The Power of Vulnerability)? I’d love to connect with you and talk more about how I can try what you did?
OMG. I came across this website. I had tears in my eyes reading the comments. I have had a stuttering problem since childhood. It is so crazy how one thing leads to another. Some think I stutter because I’m shy no I’m shy because I stutter. Some think I’m a alcoholic because I like to drink no I’m a alcoholic because I don’t stuttering as much when I’m drinking. Some think I have a bad temper no if they grew up being laughed at in school they just might have problems with anger too. Its so upsetting something that most find so easy just talking is so hard to some. Just the little things in life become the hardest task. Things like ordering food. There has been many days that I ordered something that I didn’t really want in fear of getting stuck and laughed at. I believe in God but sometimes it’s hard. This has to be some kind of curse on my life. How else can this be explained. Then people that don’t understand say just go to therapy. I was in therapy all my childhood into adult life. I still stuttered. Actually it seemed like when I was in therapy I stuttered more because that’s all I thought about. So stuttering>alcoholism>divorce>depression>social phobia>. Shit really does suck. OUT
I’m a 16 year old male and I’ve been stuttering every since I could remember. I took the time to read all of the comments and I can relate to mostly everything LMAO. I love being around people and having fun, I’m an extrovert at heart, but it hurts sometimes. I’m always in the background of conversations amongst my friends, not because I just don’t have shit to talk about, I have everything to talk about, I’m just scared. I started drinking alcohol when I was 14, and every since then it’s been a way out, I don’t think when I’m drunk, and it seems thinking makes me even less fluent. It’s come to the point where I’m not even scared of other peoples reactions, I’m scared of hearing my own voice, hell I can’t even talk to my own mother, it’s so bad with her, and she’s suppose to be the person I’m most comfortable with. I’m depressed, I think about my future. Things like job interviews…will they think I’m a dumbass if I suddenly can’t get out the next word, or maybe when I’m getting married, and I have to read my wedding vows outloud, will I stutter then? I never know when it’s going to happen I just know that it will. I haven’t given up on love tho. I have a girlfriend, she says she accepts me, but she’s never seen the worse side of me, the side I try so desperately to hide. Conversations are short most of the times, I don’t like my own voice, when I begin to stutter with her I just shut down. It really sucks haha. But thank you all for listening to me :)