Wrestling Words

Are stutterers better off learning to accept their impediment? Self-acceptance is a growing movement these days.

By Barry Yeoman, published on November 1, 1998 - last reviewed on May 19, 2005

For stutterers speaking is not just a devastating physical handicap but a crippling psychological problem. Now gaining popularity is a radical and controversial notion: that stutterers are better off learning to accept their impediment rather than striving to overcome it.

Head bobbing, face grimacing, Vicki Schutter stood before a
microphone in a Cleveland hotel and let everyone in on a childhood
secret: often, when she came home from school deeply discouraged, her
mother fled to the bathroom in tears and prayed that her daughter would
someday "get better." Now the 46-year-old secretary from Houston, Texas,
introduced her parent from the stage and declared proudly: "Mother, your
prayers were answered."

Many people would find that hard to believe. From the time she was
3 years old, Schutter has stuttered severely -- and she still does so
today. Giving her impromptu speech, she struggled through every sentence,
opening her mouth unnaturally wide and clamping it shut in the effort to
get out her words. But to her audience, members of the National
Stuttering Project meeting at their annual convention, Schutter was a
triumphant example of the organization's philosophy: that a stutterer's
goal should not be achieving fluency, which is nearly impossible, but
rather acquiring the coping skills that allow one to stammer openly and
to shed the shame and embarrassment that accompany the speech
impediment.

In a society where oral fluency is considered a mandatory life
skill, such a radical notion strikes many as heresy. And, in fact, the
vast majority of people who stutter remain committed to overcoming their
problem. Many speech-disorder experts, too, find it difficult to fathom
how anyone would willingly go through life wrestling with their words. "I
wonder if those people who feel there is no need for professional help or
a cure one day have the same feeling about any other disease -- cancer, for
example," says Ehud Yairi, a professor of speech and hearing
science at the University of Illinois at Urbana-Champaign. "Would they
say, 'Let's just learn to live with it?'"

In many cases, the answer is "Yes." Self-acceptance is a growing
movement these days. From the deaf to the obese, people with physical
differences are asserting themselves in new ways, challenging the
conventional wisdom that they have defects requiring correction and
sympathy "It's like everybody's saying, 'If you don't like me, fuck
you,'" says Lowell Handler, whose book and film Twitch and Shout chronicle the lives of people with Tourette's syndrome, including
himself. "For so many years, what happened was the opposite -- everybody
had to fit the mold of the Midwestern, all-American,
go-to-work-at-9-and-come-back-at-6-type person. People are finally
saying, 'This is the way I am. I don't want to fix myself to suit
everybody else.'"

Stutterers who subscribe to the idea of self-acceptance, as well as
speech pathologists who have aligned themselves with the movement, point
out that unlike cancer, which is a deadly yet treatable and often curable
disease, stuttering is a physical impediment for which little can be
done. In fact, fluency remains a pipe dream for most stutterers, despite
all the touted remedies. "When I think of successful outcomes, I don't
even think of words like 'stutter' or 'fluent,'" says Stephen Hood, a professor of speech pathology and audiology at the University of
South Alabama. "I think of being a good communicator -- someone who can talk
to anyone at anytime, with minimal negative emotion."

Stuttering afflicts about 2 million adult Americans, and
four-fifths of them are men. It also tends to run in families, which
suggests a genetic link. The incidence is higher in children, though most
seem to recover spontaneously for reasons scientists don't understand.
For some, stuttering means an intense and visible struggle to force
individual syllables through their lips, a phenomenon that is physically
exhausting for the speaker and mentally awkward for the listener. Others
stutter mildly, occasionally getting stuck or tripping on sounds. Some
manage to avoid outward symptoms by substituting words and feigning
ignorance. "They can be so good at avoidance that their coworkers
and even their spouses or family don't know that the person stutters,"
writes Thomas David Kehoe, author of Stuttering: Science, Therapy &
Practice. "Even though their speech sounds fine, these
'covert' stutterers can be crippled by severe psychological fear and
anxiety."

Accompanying the speech problems are often a whole host of
"secondary" behaviors that the stutterer has developed as gimmicks to
force out the words. Ward Harkavy, a 51-year-old newspaper editor in
Denver, recalls that for years he shut his office door every time he had
to make a telephone call. "I had to pound on my leg to get the sound
out," he says. A secondary behavior might help temporarily, but
eventually it stops working; then the stutterer is stuck with one more
socially inappropriate symptom.

Though stuttering is believed to be primarily a physical
phenomenon, the stigma attached to it creates a whole array of
psychological problems. Every person who grows up with the impediment
knows what it's like to feel defective, to break a parent's heart, to
have trouble navigating the social milieu of the schoolyard.

Drug and alcohol addiction are common; so is depression. As
recently as two years ago, "I'd wake in the mornings, get the girls off
to school with a smile and crawl into a ball position in bed," recalls
38-year-old Sally Butcher, a deputy court clerk in Cleveland. "I stayed
there until I heard my husband's car pull in the driveway and then would
jump up and paste that smile on for all to see. No one knew that anything
was wrong. One night, a friend called me and found me sitting here,
daydreaming of the way I was going to end my life."

Woody Starkweather, a communication sciences professor at
Temple University, calls stuttering a "disorder of the spirit" because it
forces so many' people to make unsatisfying life choices. "There's a guy
in our clinic who's married to somebody," Starkweather says, "He talks
about the woman he really wanted to marry but didn't -- because he couldn't
ask." Other stutterers choose careers that minimize their need to speak,
giving up their dreams of being teachers, lawyers, or journalists. "The
thing that makes stuttering a tragic disorder is that people lose touch
with where they want to go," he says. "We're all on a path. Stuttering can take you away from
that."

Much of this stems from the fear of listeners' reactions -- and, to a
degree, those fears are valid. As a stutterer myself, I've been laughed
at, mocked, hung up on; I had the host of an upscale restaurant refuse to
make a reservation because "we don't seat people with speech
impediments." I had a favorite professor tell me I'd never succeed
professionally until I could speak fluently. It's not surprising, then,
that most stutterers have looked desperately for the cure. "If you limp
and use a cane, people open doors for you. If you use a hearing aid, they
talk louder," says Jim McClure, a Chicago public-relations consultant.
"But if you stutter, people think you're very dumb or psychologically
disturbed or a homicidal maniac. That's had generations of us chasing
fluency."

Over a 20-year period, I sought help from a psychologist, a
hypnotist and myriad speech pathologists. I learned to bounce my hard
consonants and prolong my soft ones; talk with a breathy voice a la
Marilyn Monroe; "cancel" blocks by repeating the stuttered word; speak at
unnaturally slow rates; and let a tranquil air stream dribble from my
lips before talking. I've used biofeedback devices that measured my body
stress; delayed auditory feedback machines that repeated my own words
after a quarter-second pause; and all sorts of relaxation techniques.
Though I now have tools to make speaking less stressful, the fact is that
I still stutter.

The problem is that stuttering remains a medical mystery. Over the
years, there have been all sorts of bizarre explanations. In 1928, Freud
protege Isador Coriat suggested that the disorder stemmed from unresolved
oral-erotic needs. Two decades later, Otto Fenichel claimed in his book
The Psychoanalytic Theory of Neurosis that stuttering related to an
anal-sadistic fixation. Nowadays, scientists ascribe it to a variety of
neurological, biological and psychological factors. There's still no
definitive answer, partly because the nature of scientific research "has
made it hard for researchers to adopt a cross disciplinary approach,"
writes author Marty Jezer in his autobiographical Stuttering: A Life
Bound Up in Words. "Instead of trying to find points
of agreement, researchers tend to circle their academic wagons,
exaggerate their differences and ward off ideas that challenge or
undermine their certainty."

Even though there's no known cure, thousands have put their faith
in the latest fad -- then blamed themselves when they still stuttered.
Vicki Schutter started speech therapy during childhood and continued it
well into her 20s. "Back then, my goal was fluency because I thought
that was what my goal was supposed to be," she says. In the therapist's
office, "I would always get fluent fairly easily. The problem was that I
couldn't stay fluent. That pattern, which would happen over and over
again, was terribly debilitating to my self-esteem."

Michael Sugarman describes a 1977 disability rights sit-in at San
Francisco's Federal Building as a pivotal moment in his self-image as a
stutterer. "What I came away from the disability-rights movement with was
that I didn't want my behavior to represent who I was," he says. That
year, he helped found the National Stuttering Project (NSP), which, for
several years remained a small organization tightly focused on the Bay
Area. Today, with 4,000 members, it is the largest self-help organization
for people who stutter.

John Ahlbach, a northern California school teacher, recalls the
first meeting he attended around the same time. "The camaraderie, the
feeling was so deep, I would have walked from here to Bombay if the
Project needed it," he recalls. Ahlbach went on to attend some 500 NSP
meetings and in 1981 became the organization's director for the next 14
years. Over that time, he strived for one main goal at local gatherings:
"making the atmosphere stutterable." He wanted people to have permission
to stammer openly; after all, he says, "stuttering isn't something you
get over in a week. It's something you need to learn to live better with,
week after week and month after month, until guilt is replaced by
acceptance and solidarity."

That was not an idea most stutterers -- or speech
therapists -- subscribed to. To them, stuttering was a problem to be
eliminated, period. Around the same time, Martin Schwartz, a
professor at New York University, was claiming an 89 percent success rate in
curing stuttering, a feat he advertised in a book called Stuttering.
Solved. "My purpose in writing this book...is to put an end to
stuttering," Schwartz wrote in his foreword. "It is my hope that
stuttering as a clinical problem in the United States will become extinct
within the near future."

Two decades later, stuttering is hardly extinct. But the National
Stuttering Project has grown into a national organization. Its annual
conventions are three-day events without a common orthodoxy; they offer
seminars on topics ranging from Eastern healing to "How to Succeed in
Business With Stuttering." There are workshops for spouses of stutterers
as well as for Internet users and people struggling with addictions.
Successful role models, like sports photographer Howard Bingham, give
keynote addresses. Not-so-famous people, like Vicki Schutter, try their
hand at open-mike sessions, usually to thunderous applause and standing
ovations. And the atmosphere is still stutterable. "The weight of
perfection has been lifted from us," says Marty Jezer, the author.

Still, many NSP members attend speech therapy. The organization,
once perceived as being hostile to speech therapists, now welcomes them.
Part of the change comes from a concurrent trend in the profession: the
growing number of speech-language pathologists who have ditched the
fluency model and see groups like NSP as an important part of the healing
process for their clients.

Charlie Diggs, director of consumer advocacy for the
American Speech-Language-Hearing Association (ASHA), credits stutterers
themselves with helping change professional standards for therapy "The
trend is away from a medical model" where the doctor has all the power,
he says. "Rather, there's a trend toward a mentoring model -- the person
who treats the stuttering and the person who stutters are in it
together."

But not everyone in the profession has embraced the self-help
movement and its goal of self-actualization rather than total fluency.
While much of ASHA's leadership has proven sympathetic, that reaction
hasn't always filtered down to the rank and file. "The typical
generalist, they're so heavily trained in speech production and
behaviorism that they can't really see it another way" says Temple's
Starkweather. And the problem is self-perpetuating, because many
universities still teach wholly physical techniques such as relaxed
breathing, slowed speech and the fluent repetitions of stuttered words.
"You can teach someone how to do it in an hour," he says. "The graduate
students are up to their eyeballs with things to do, so the idea of
learning something quickly to deal with stuttering -- that's so
tempting."

Graduate students who want to take a more modern approach to
stuttering sometimes meet with hostility from their departments. Peter
Reitzes, a speech-pathology master student at New York University,
discovered last year that one of the conditions of being assigned to a
practicum was that his own speech needed to be absent of stuttering.
"Communication skills must be free from any identifiable disorders,"
wrote the associate dean in a 1997 letter to Reitzes. "In general, speech
must be free of sound and syllable repetitions, prolongations and
blocks."

Martin Schwartz, who now heads the National Center for Stuttering,
is downright hostile to groups like the NSE, which allow their members
individual choices about whether to proceed with speech therapy. "Since I
am committed to treating the problem, I would contend that the best
possible adjustment a person could make is not to stutter," Schwartz
says.

Russ Hicks, a jocular computer consultant from Dallas, begs to
differ. He credits his 12-year experience with NSP with helping him face
his fear of public speaking. Today, though he still stutters, Hicks is a
member of the Toastmasters club, entering and winning local and regional
speaking contests.

"This old concept of the gift of stuttering -- it's real," says
Hicks, 58. "We've gotta use it:. We've gotta get out there and let other
people hear us stutter. We can be role models. Being able to motivate people -- that's so cool. I wouldn't trade
that feeling for anything in the world." Anything? Even the chance not to
stutter? Declares Hick, "If a person were to say, 'OK, Russ, here's a
pink pill, you're going to 100 percent fluent now,' I would say, 'Take a flying
leap.'"