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Interview between a clinical psychologist and her client, a stutterer:

Psychologist (P): Hi Lukas.  My name is Dr. Samson.  Just to give you a little background information on myself, I received my undergraduate degree in communication disorders and then went on to get my PhD in clinical psychology.  Since this is our first session together, I just want to get some background information about you and try to get a better sense of what has been troubling you.  So tell me, why are you here today?

Lukas (L): Well, I am 23 years old, and I have been a stutterer for as long as I can remember.  Over the course of my life, I have to watch the pain in listeners' faces as I struggle with dysfluent moments.  People look away, try to finish my sentences, and some people act like they don’t even want to talk to me.  My whole life I have struggled with social anxiety and I also feel shame and depression; I feel as though all of these problems have stemmed from my stuttering experiences.  I actually am to the point that I don’t even want to talk to anyone. 

P: I want you to know that you are not alone.  There has been a considerable amount of research done on the attitudes of people who stutter.  Research has proven that both children and adults who stutter tend to have more negative attitudes toward speaking than nonstutterers (Murphy, 1999).  You feelings are totally understandable and very typical of other stutterers.

L: Well, I am definitely not very outgoing.  I tend to avoid social situations because I am afraid that people are going to react negatively to my stuttering (Silverman, 1996).  I have an extremely high level of anxiety when talking to others, because I am trying to conceal the fact that I am a stutterer.

P: Well, anxiety can result from anticipating stuttering in a speaking situation and desiring to avoid it (Silverman, 1996, p. 71).  You are not alone in your feelings.  As you continue to come to sessions with me, we are going to work through this feeling of anxiety you experience, and hopefully come to the point where you do not feel overwhelmed by anxiety during conversational speech.  Earlier, you mentioned that you feel some shame about your stuttering.  Can you tell me a little bit more about that comment? 

L: Well I am ashamed of my stuttering for numerous reasons.  I feel so powerless, small and useless, and this in turn makes me want to avoid situations.  I am ashamed that I speak the way I do and am powerless to do anything to stop my moments of dysfluency.

P: Shame is a very powerful emotion.  With shame, a person focuses his evaluation on the whole self, so if failure occurs, the person feels utterly defective.  Shame can cause feelings of worthlessness and powerlessness, leaving a person feeling exposed.  Shame is also a behavior highly correlated to avoidance behaviors (Murphy, 1999, p.132).  It is very understandable that if you are experiencing high levels of shame, this in turn will result in avoidance behaviors within numerous contexts.  Have you ever taken the time to think about what might have caused your feeling of shame to develop?  Can you think back to the first time that you felt this emotion?

L: Well, I think a lot of this started when I was a child.  When I was in middle school, I was teased by school friends.  I also felt like my parents were embarrassed about my stuttering because they never attempted to speak about it with me.  Then whenever I talked to my mother, it sometimes appeared that she had a pained expression on her face during my moments of dysfluency.

P: All of these factors may very well have contributed to your feelings of shame.  Your parents failing to speak about your stuttering has been described as a “conspiracy of silence” by several researchers, and this silence may actually suggest to the child that stuttering is something too awful to be discussed (Murphy, 1999, p. 138).  In many cases the parents feel that speaking about the stuttering would in turn upset the child, when in actuality, speaking about stuttering can benefit the child.  Before we end this session, I also want you to elaborate on your comment about depression.  You said that you have struggled with depression; can you tell me a little bit more about this?

L: I just feel depressed a lot.

P: Have you ever taken the time to consider what might be causing these feelings? 

L: Not really.  I do get upset when I think about how I do not have much emotional contact with people.  I also get depressed because sometimes I believe my failure to overcome my stuttering is my fault.  Maybe I am not trying hard enough or too weak to overcome my speech problem (Silverman, 1996, p. 70).

P: Thank you for being so honest with me.  In our future sessions, we are going to address the emotional repercussions of your stuttering of which you have so openly shared with me today.  Together, we are going to target the negative way you are viewing yourself and hopefully move toward more self-confidence.  Before you leave, I just have one more question.  Have you ever received any form of speech therapy?   

L: When I was 4 years old, I went to speech therapy for a few months, but I my parents felt there was no significant improvement, so I quit going.

P: Well, as we conclude our first therapy session, I would like to recommend that you consider again going to a speech-language pathologist.  There are several therapy forms that focus on desensitization.  Desensitization therapy’s purpose is to reduce the anxiety component of the stuttering problem.  “The goal is to disassociate stuttering responses from the stimuli that seem to evoke them” (Hulit, 2004, p. 221).  This type of therapy would more than likely be very beneficial to you because it does address the role of anxiety in stuttering.  I feel that speech therapy as well as continued counseling here will be the most successful plan of action for targeting the multi-dimensional aspects of stuttering.  As you leave, I will give you a list of several good speech-language pathologists in this area that primarily deal with fluency disorders.  I hope that you will consider attempting speech therapy again.  It was a pleasure meeting you and talking with you today.  You can schedule your next appointment out front with the receptionist.

L: Thank you so much.

References used within the interview:

Hulit, L. M. (2004). Straight talk on stuttering (2^nd ed.). Springfield, IL: 

            Publisher, LTD.

Murphy, B. (1999). A preliminary look at shame, guilt, and stuttering. In 

            N. B. Ratner, & E. C. Healey (Eds.), Stuttering research and

            practice: Bridging the gap (pp.131-143). Mahwah, NJ:

            Lawrence Erlbaum Associates, Inc.

Silverman, F. H. (1996). Stuttering and other fluency disorders (2^nd

            ed.). Needham Heights, MA: Allyn & Bacon.

Taken from the journal of Katherine Haynes

November 18, 2005

            I wish I could take Lukas’s pain away.  He is such a wonderful man, but his stuttering prevents others from knowing him the way I do.  I remember how we first met back in college; I had to be the one to approach him after class.  He was so shy, and when he tried to speak to me, he was extremely dysfluent.  Now that we are so comfortable around each other, his stuttering moments are not as bad around me. 

To this day, Lukas is still plagued with social anxiety as he approaches people he does not know.  He tells me that his heart begins to beat faster because he is worried about the reactions he will receive from someone new.  One time he told me that he can see pity in people’s eyes, and this in turn causes him to feel overly unnerved.   He is very leery to engage in social interactions.  The first time he went to meet my parents, I remember what a wreck he was!  Besides being nervous about meeting them, he was so worried that his communication abilities would cause my parents to feel uncomfortable.  My parents love Lukas, but my father did say that the first day that they met, he had trouble watching Lukas as he struggled through his dysfluent moments.  My father still sometimes tends to avert his eyes and not look at Lukas directly during conversation.  I hate when he does that!

I wish that Lukas’s stuttering did not bother him… I wish others could see what a great person he is and not focus on the fact that he stutters.  I wish Lukas could look past his stuttering too…

December 13, 2005

Planning our wedding has been one of joy and sorrow.  Lukas is so apprehensive about reciting his vowels.  He is also bothered about the thought of greeting family and friends.  I pray that our wedding day next week will be remembered as blissful and not worrisome for Lukas.

The rehearsal dinner had some flukes… Lukas’s brother starting chanting, “Toast! Toast!” so Lukas reluctantly stood up with glass in hand.  I could see the fear in his eyes and the sweat start to form on his brow.  As he started his toast, he had a period of repetitions of the sound “t.”  As I glanced around the table, many family and friends averted their eyes from Lukas’s by looking around the room or down at the floor.  He was finally able to get past his dyfluent moment, but he quickly finished his sentence and sat down.  Later that night, Lukas told me he was totally humiliated by his inability to effortlessly say exactly what he is thinking.  He said, “I will never be able to forget how I ruined a toast that I wanted to be perfect for you.”  My heart aches for him.  I tell him that I love him for the person he is, and it does not matter to me if he stutters.  Me telling him that doesn’t seem to matter.  The social anxiety he has dealt with due to his stuttering is like a tumor, growing from childhood to adulthood, unable to be cut out.  Maybe once I am married to Lukas, I can help him….  This is my prayer….

I Am a Stutterer

I am a stuttering young man.

I wonder what I could have done to prevent this stuttering fate.

I hear the mocking.

I see loathing in others’ eyes.

I want God to take this plight from me.

I am a stuttering young man.

I pretend that I am not consumed by this burden.

I feel anticipatory anxiety when attempting to speak. 

I touch my hand to my heart for fear that it may explode.

I worry about approaching new acquaintances. 

I cry at night within my own self pity.

I am a stuttering young man.

I understand that stuttering is my fate.

I say that each day will make me a stronger person.

I dream that I can recite my wedding vows flawlessly.

I try to practice my wedding vows every night.

I hope that I am not going to be an embarrassment to my future wife.

I am a stuttering young man.

Essential Question:

What factors contribute to the development of a negative self image in stuttering young adults?

Foundation Questions:

1. What is stuttering?
2. How do people develop self image?

Tentative Point:

Through this research project, I hope to provide a general understanding of stuttering and how it ultimately affects the self concept of the stutterer. Stuttering is a communication disorder that is greatly linked to a large gamut of emotions which can ultimately result in negative social repercussions throughout the entire spectrum of a stutterer’s life. By observing a stutterer’s experiences throughout his early adulthood, I hope to give readers a more intimate portrait of the effects of stuttering.

Genres:

1. Webliography

Voice: Speech-language pathologist

Audience: General public, individuals who stutter, and family/friends of those who stutter

Rationale: This webliography will provide readers with some background information about me and it will allow readers to easily access informative resources about stuttering.

2. Powerpoint presentation

Voice: Speech-language pathologist

Audience: General public, individuals who stutter, family/friends of those who stutter, and other professionals

Rationale: This Powerpoint presentation will be used to provide viewers with a more intimate understanding of what stuttering is and the physiological effects/characteristics associated with stuttering.

3. Screenplay in digital format

Voice: A nonstuttering young adult who has a stuttering sister

Audience: General public, individuals who stutter, family/friends of those who stutter, and other professionals

Rationale: This will give viewers a first-hand look into how a non-stuttering young adult develops self image, and adversely, how self image is affected by being a young adult that stutters.

4. Interview transcript

Voice: Clinical psychologist and a stutterer (Lukas Smith) who is in his early twenties

Audience: General public, individuals who stutter, family/friends of those who stutter, and other professionals

Rationale: This personal interview will encapsulate the emotional issues a young adult must deal with due to stuttering.

5. Poem

Voice: A young adult (Lukas Smith) that stutters

Audience: Family members of a stuttering child and the general public

Rationale: This poem will allow readers to get a more thorough understanding of how stuttering affects the individual

6. Journal entry

Voice: Fiancé of a young adult stutterer (Lukas Smith)

Audience:  Fiancé of a young adult stutterer (Lukas Smith)

Rationale: This personal journal entry will allow readers to gain an intimate understanding of the social struggles a stutterer goes through daily as seen through the eyes of a loved one.

7. Letter (Unifying genre)

Voice: A young adult that stutters

Audience: A friend who’s child has a stuttering problem

Rationale: This letter will be used so that a stutterer can tell his friend about his experiences with stuttering so that she in turn can help her dysfluent son.

Integration of Genres:

This letter will incorporate all genres by tying together both the physical aspects of stuttering as well as encapsulate the factors that contribute to the development of self-concept of a stuttering individual.

Tentative Resources:

Alm, P.A. (2004). Stuttering, emotions, and heart rate during anticipatory anxiety: A critical review. Journal of Fluency Disorders, 29 (2), 123-133. Retrieved September 22, 2005, from Academic Search Premier database.

Ezrati-Vinacour, R., & Levni, I. (2004). The relationship between anxiety and stuttering: A multidimensional approach. Journal of Fluency Disorders, 29 (2), 135-148. Retrieved September 22, 2005, from Academic Search Premier database.

Fitzgerald, H. E. (1992). Assessment of sensitivity to interpersonal stress in stutterers. Journal of Communication Disorders, 25 (1), 31-42. Retrieved October 8, 2005, from ERIC database.

Green, T. (1999). The relationship of self-conception to perceived stuttering severity in children and adults who stutter. Journal of Fluency Disorders, 24 (2), 281-292. Retrieved October 8, 2005, from PsycINFO database.

Hugh-Jones, S., & Smith, P.K. (1999). Self-reports of short- and long-term effects of bullying on children who stammer. British Journal of Educational Psychology, 69 (2), 141-158. Retrieved on September 22, 2005, from PsycINFO database.

Hulit, L.M. (1989). A stutter like me. Journal of Fluency Disorders, 14 (3), 209-214. Retrieved September 22, 2005, from PsycINFO database.

Kraaimaat, F.W., Vanryckeghem, M., & Van Dam-Baggen, R. (2002). Stuttering and social anxiety. Journal of Fluency Disorders, 27 (4), 319-332. Retrieved September 22, 2005, from Academic Search Premier database.

Lev-Wiesel, R., Sheva, I., Shabat, A., & Tsur, A. (2005). Stuttering as reflected in adults’ self-figure drawings. Journal of Development & Physical Disabilities, 17 (1), 85-93. Retrieved October 8, 2005, from PsycINFO database.

Mahr, G.C., & Torosian, T. (1999). Anxiety and social phobia in stuttering. Journal of Fluency Disorders, 24 (2), 119-126. Retrieved October 8, 2005, from PsycINFO database.

Messenger, M., Onslow, M., Packman, A., Menzies, R. (2004). Social anxiety in stuttering: Measuring negative social expectancies. Journal of Fluency Disorders, 29 (3), 201-212. Retrieved October 8, 2005, from PsycINFO database.