Saturday, March 22, 2008

What is the problem?

Formulating any problem is really important to stop going off at a tangent and imposing 'solutions' which don't connect to the original problem.

Is getting the words out the core problem? Attempted advice - take time, breath deeply etc - you've been there - sticking plaster stuff and we do need sticking plasters at times! Gene stuff and pagoclone.

Is the presence of other people the problem? Different problem - values, standards, attitudes, beliefs, identity but all of these can be usefully updated.

What may have started as the first may have evolved into the second very quickly.

You may see them as connected but it is important to clarify the issues, and they are not the same: some therapies go for one some the other. To improve the cake we need to INVESTIGATE what is involved and can be changed in order to know what to change and then change it.

4 comments:

Ivan said...

Dear PM,

Thanks for all your informative posts, I could definitely relate to a number of them.

I am a 30 year old professional whose job requires frequent communication and the occasional media interviews. I do not recall stuttering during my childhood, and if I did it is buried under several years of fluency that characterized my school days and working life.

Then one year ago at 29, I began losing this fluency. I was giving a presentation to some clients (which I do all the time), when an unwelcome thought invade my consciousness and asked me "what if I can't speak fluently?" A voice in my head told me that my career would be jeopardized and if I lose my job, bills would start piling up. That fleeting thought created some anxiety but I managed to brush it off and got through the presentation anyway.

However, my subconscious kept revisiting that negative thought "what if I can't speak fluently?" and I became increasingly self-conscious of my speech. Then one day while talking on the phone to my boss, I got stuck on a two syllabus word and repeated the first syllabus for what seemed like a lifetime. From the moment on, my speech went downhill as the negative emotions and anticipatory anxiety fueled further stuttering fluency.

Today, I am a shadow of my former confident self afflicted with a fear of speaking and a more than noticeable stutter (although with minimal secondary symptoms except for looking away or breaking eye contact when I stutter).

Sorry for the long post but I did a lot of searching and the onset of stuttering in adults seem rare and not widely discussed. Any thoughts or experience you have on this subject would be most appreciated

PM said...

Hi Ivan

Thanks for the comment.

From what you say ( and there is often more ) I would put this into the category of stage fright.
I don't think stuttering/ speech production is your issue.

From your comment I am assuming there isn't a history of feeling fearful about things in general or of being 'highly strung' as we used to say in the old days. Because a generalised fear state is a different issue, but can be dealt with.

The fact that you started off being fearful of speaking and fluffing it would fit with a specific phobic type response.

Cognitive Behaviour Therapy, concentrating on your fear rather than your speech would help I think. The CBT book for Dummies I think is good if you want to read up before attending a therapist. Pity you don't live in Scotland!!

Stammering is, I think, a final common path for a variety of not useful ways of Thinking, Feeling and it is the resultant Doing. There are, after all, a limited number of ways we can produce sounds.

Look over some of the posts again and see if there is anything which you can begin to do - eg a journal, to challenge your beliefs which are not useful.

Let me know how you get on or if. I am interested.

All the Best

Peter

Ivan said...

Thanks for your response Peter.

The deterioration in my fluency has gone beyond "stage fright", and the stuttering monster has afflicted my daily conversations with colleagues, parents and friends even in a non-work setting. I am afraid this stuttering is a self-reinforcing mechanism of anticipatory anxiety, which triggers the failure to produce the intended sounds due to an unnatural tensing of the vocal cords, and which in turns creates more anxiety.

The mind functions in mysterious ways, and it is very frustrating that my sub-conscious mind seems to have a life of its own and has conspired to sabotage my speech, while my rational mind is losing the battle in shutting off the anticipatory anxiety of speaking (which I am sure if it did, fluency would naturally return).

Re your third paragraph "From your comment I am assuming there isn't a history of feeling fearful about things in general". In fact, I consider myself to be a highly-strung type "A" person who has excelled in school and career (up to this point, that is). Throughout my academic days as a straight As student to my current career as a analyst who is required to represent the company on CNN and other public media, I have worked hard to reach where I am.

Yet, despite all these, I was never a secure person. Before every media appearance, I memorized my lines and usually spent several sleepless nights worrying about how I will perform. During my university days, let me relate to you an incident; I was studying for my exams with a group of friends when I looked up and saw everyone concentrating intently on the textbook. A thought then came to me "What if I can't concentrate?" I tired to brush off the thought, but my sub-conscious continued to entertain it, creating in my mind the image of a student who constantly failed his exams and who, consequently, would have problems finding a job. (seeing the pattern yet?) These thoughts are neither useful nor rational, but for whatever reason - be it my genetic makeup or some excess/deficiency of neurotransmitters in my brain - they can't be shut off regardless of how hard I will it to. But despite this self-doubt, I continued to excel in every exam in school and every presentation in my career, as it forces one to put in extra preparatory effort to address one's insecurities.

I do not know if this fits in with what you would consider "a history of feeling fearful about things in general", but when I saw that statement I can't help but recount the above experiences as I gave more thought to it and dug deeper into my past and my personality.

If this is indeed the root of the stuttering, then perhaps I have been knocking on the wrong door by researching narrowly on stuttering. Again, I would appreciate any thoughts you might have on this matter.

Best Regards
Ivan

PM said...

Ivan

Isn't it interesting what turns up when the right question is asked? I could have just taken your initial statement at face value and got it all wrong!!

I think the issue is generalised fear and you have got yourself into a tangle. But just like wool a tangle can be sorted out. No one in the States does what I do so I think your best way to approach the problem is via CBT. Not going for the stammer initially but the underlying fear and sorting out the identity, standards and values issues that will underlie it. I suspect the stammer will dissolve when the fear is dealt with.

When I say fear I mean anything from mild concern to paralysing terror but for some folk it is very pervasive and may emerge in different ways at different times.

Read over my posts about emergence, August 07, and the cake analogy to get a sense of how these things actually work.

You need to get your thoughts outside yourself - there is another post on how to do that.

You can't shut off thoughts but you can shift what you are thinking about so think of other things to get away from the intruding thoughts - needs practice.

Keep in touch

All the Best

Peter