Stammering For

Dummies

A self Help manual

from

The Indian Stammering Association

(Second Draft 10th March 2009)

Table of Contents
Introduction..................................................................................................................3

This Manual..................................................................................................................4

Know thy stammer........................................................................................................5

Step 1 (Play with a tape or a video camera)

Step 2 (replay and review)

Step 3 (get in touch with emotions)

Step 4 (wider explorations)

Working on your speech................................................................................................8

Stuttering modification

Self exposure

Bouncing

Voluntary stuttering

Secondary Behaviors

Fluency shaping

Gentle onsets & Prolongation

Correct breathing

Pausing

Working on your emotions & Attitudes..........................................................................18

Karma theory

God’s glory

The House is Empty

Little Versus Big cross

Transfer to outside world.............................................................................................21

Maintaining the gains- SHGs........................................................................................22

Zen of stammering......................................................................................................24

Beyond Stuttering: Deeper Issues of Life......................................................................26

TISA: Philosophy & Approach ......................................................................................28

Introduction

Stuttering affects both the speaker and the listener. But both parties do not acknowledge it
under some kind of unsaid convention or arrangement. Yet, there is a significant
frustration on both sides. On the speaker's part, because he feels that he has failed one of
the most basic requirements of social transaction. On the listener's side- because they
have no precedent or understanding to make sense of what just transpired; nor did they
feel free to ask questions. Stammering has often been compared to a hippo sitting
between two conversationalists at a coffee table: unwelcome and unacknowledged- but
very much there (see the cartoon below).

About 1 to 3 people in any adult population of hundred may stammer. The incidence is
higher than that of HIV+ people in India, three out of a thousand males1. Yet we know
more about AIDS than about stuttering. Most of us stammerers and non-stammerers, alike
have erroneously believed that the problem will go away if we do not acknowledge it, if
we do not talk about it. It usually does - by going underground- but always returns with a
greater force.

Few Speech Language Pathologists (SLPs or Speech Therapists) specialize in stammering-

so called fluency disorders. Even these few are forced to migrate elsewhere for lack of
enough work and recognition in India. Why dont PWS come forward for therapy? Even
when it is offered for free? They have explored every bit of their mind and mouth, speech
and various strategies but have failed to answer the basic question: why do I stammer
sometimes? Not all the time? How can I help myself?

Since we are dysfluent some times and fluent the rest of the time, we intuitively realize
that the problem and solution both lie in our own mouth. And yet nothing seems to work

1 0.3%: Estimated percentage of adults (ages 15-49) living with HIV/AIDS by the end of 2007 (UNAIDS
2008 Report on the Global AIDS Epidemic. July 2008.)
consistently. The result is: we give up hope and become skeptical. Haven't we tried
everything? What can a Speech Therapist tell us that is new? Either we withdraw in to a
receding shell of denial or go about life with fatalistic acceptance of our speech and
associated issues.

Today most PWS seeking professional help are young. They are at a stage in life when
developing associations, building relationships and excelling at academics and career is of
great importance. All this requires communication skills. Hence most such young clients
are desperate for a fast “cure” as they understand it. Even when SLPs are able to convince
them for the need to work on a long term therapy goal of managing their stutter rather
than eradicating it, few persist with the therapy and relapse into old ways of
communicating. The reason is: few PWS are able to keep their motivational level high
once they are out of the therapy program and secondly, there are no self help groups,
where they can practice their new skills and get ongoing support.

The Indian Stammering Association (TISA) tries to fulfill these needs through this self help
book. Use it as a manual and start a self help group in your neighborhood, workplace or
on the web. Stuttering is one health condition, where your well-being is truly connected
with that of the others. It has been termed a disorder of social presentation of oneself (-
we don't stammer when we are alone and talk to ourselves-); Hence the “cure” too has to
be found in social settings. One last word, this book will absolutely do nothing for you if
you do not practice the concepts described here in! Instead of reading it as an informative
book, work with it like a 'Do it yourself manual' over a period of 1-2 years or even longer.

This Manual
This manual is primarily meant for PWS, especially covert stutterers and those who suffer
from so called “mild” stuttering; Those with a greater degree of stuttering or related
problems, should consider other approaches: consulting a SLP, joining a self help group,
talking to an older PWS etc. Finally those PWS who can not do any of these, even they
may learn some helpful ideas from this manual.

Equipments : These equipments will be needed for some of the exercises. A simple tape-
recorder; a video camera (even the cell-phones with a video camera will do), a diary to
keep notes (you could even blog if you are a ‘leo’ and courageous!), a mirror. Finally,
having a sympathetic friend or a support group can help tremendously- by offering us
objective feedback and other support, as we go along on this path of self-discovery and
self-mastery.

Know thy stammer

Know thy stammer and thy stammer shall set you free

This might seem like stretching an old adage a little bit too far- but nothing could be truer
than this. We live in a bubble of denial where we do not know our stutter and the related
behaviors, feelings and attitudes at all. All we do know is the uncomfortable response we
get occasionally from our audience. Uncomfortable response? to what? To our speech, that
is about all we know. But what did we do with our speech mechanism, our breathing
muscles, facial muscles, our eyes, our limbs, posture – in that passing (-our judgment of
time also is impaired-) moment of great difficulty- this we do not know. Some PWS
compare that moment to the confusion and desperation of someone suddenly drowning.
How did we psychologically react to that moment of difficulty? Did we give up the forward
movement of speech in our confusion and distress? Did we exaggerate the movements of
our hand or head to get the word out? Did we feel irritated by the listener and hold them
'responsible' for our difficulties? What exactly transpired through our body and mind in
those moments- this we do not know. All that we are aware of is a vague ache and
tension in the throat, chest, face and a sense of failure, embarrassment and helplessness.

We have learned from our childhood to despise and shun our stammering. But since it
does happen in spite of this, our conscious mind plays a trick and 'erases' these
uncomfortable moments from the 'tape' of our day to day memory- some kind of on-line
editing of a live show. The conscious mind denies the problem and takes no cognizance of
the events. It is relegated to the realm of 'unconscious' behavior or reactions. Many PWS
believe that it is not they who do their stuttering: it just happens by itself! And hence, how
can they do anything about it? So, there is no cure for it!

In this first step, we will learn how to regain control of the 'lost kingdom' and discover that
it is we who stutter and not our mouth doing it on its own. To do this, we record, review,
study and analyze our speech in following steps. A word of caution, this is the most
difficult and painful step, but if you can do it, three quarters of the battle is won:
Step 1 (Play with a tape or a video camera)

Record your speech under different circumstances: reading a newspaper or a book; talking
to yourself or children, talking with a friend or in a small group. Start with the most
comfortable situation, like reading alone. Use a simple audio tape or a cell-phone with
camera, whichever is convenient. The latter will have the advantage of recording both
your speech as well as your facial expressions.

For the first few minutes, you might be too conscious of the recording but later you will
get used to it and speak in your normal style. So let the recording be long enough, 5-6
minutes or more. In your diary, record the date, time and situation (reading alone, using
phone, discussing in group etc) under which you recorded. If you are using the phone
camera, you may use a friend. If this friend is a PWS, all the better. Essentially it can be
anyone you trust.

Step 2 (replay and review)

Replay the tape- listen to your speech, study your body language, facial expressions,
hands etc. if it is a video recording; review these even in those moments when you are
speaking fluently. Compare this, with those moments when you are having a little
hesitation or difficulty. As a listener now, try to guess how you are coming through as a
speaker. Confident? Comfortable with yourself and the subject? Enjoying every moment of
it? Or in a hurry to finish? Based on what you see and hear, try to guess, and feel, your
emotional and psychological states as you were speaking those words on the tape. Replay
the moments when you think you were not very comfortable. Pause the tape frequently to
see and hear: did your pitch go up as you came across a 'difficult' word? Was there a
struggle to push out a difficult sound? Did your lip press together with greater force and
for longer duration than you would normally expect? Record your observations in the
diary, against the entries you made in step one above.

Step 3 (get in touch with emotions)

Review these recordings over a long period- 3-6 months and try to note down, what you
do differently, in the moments of difficulty as opposed to when you are speaking fluently.
It will be even more useful, if you could review these tapes with a trusted friend or a
recovering stutterer. You could go a step further and fake your stutter while alone- and
stay in that moment for a couple of minutes- to know what it actually feels like, in mouth,
in body and in mind. In other words- consciously reproduce a moment of your stuttering
and hold it (freeze) there: My name is s-------------achin. I live in K-k-k-k.....Kanpur. Etc.

If you could do it in a normal conversation with a pet, children and friends (in this order),
you would even discover unique emotions associated with your stuttering, but completely
unknown to you till then; buried deep in your core. So, later on, when you start to deal
with your stutter, you address not only what your mouth does, but also what your mind,
your emotions do in those moments of difficulties.

Step 4 (wider explorations)

Meet other PWS, read their posts on chat groups, their biographies on web. While reading,
try to compare your life with theirs; your observations with theirs; your problem-solving
approaches with theirs. This will help you to understand that:

1. Your experiences as PWS are not unique and

2. your responses to your problems are also not unique.

You can learn form their experiments. Knowing your 'speech' is not enough; you must
know yourself as a total human being: your attitude towards life, relationships,
responsibilities, career, recreation, creativity - and how these have been influenced by your
speech; your deepest fears and aspirations. One way is to meet others on the same path
and compare notes and the second complimentary path is diving within yourself: sitting
quiet and reviewing your life, contemplation, meditation. Vipassana meditation has helped
some people in this regard. Read more about it later in this manual.

Step 1-3 should be repeated as often as you want, with your review and analysis
becoming deeper and deeper. It needs courage, determination and some 'quality' time to
go deeper. Finally, a time should come when you know your stammer so well that you can
reproduce it 100% at will in a mimicry contest among friends! This signifies complete
emotional healing- an important stage in the long journey. But there is more to be done,
so that your audience is able to understand what you are saying. You still have to become
a good communicator( if not 'orator').
Working on your speech
Many years ago, a rabid dog charged at us. I slipped in to 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; cant 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 boss yet!)- You know, sometime, I get totally stuck; cant
say the simplest things..
 If they ask a question, answer that briefly, 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 page2. 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

2 http://www.mnsu.edu/comdis/kuster/publicrelations/pr.html#presentations
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 the self
help group or on phone with friends or strangers.

3. Read a story book or news paper 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
(sometime 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 phone

or in person.

9. Whenever you fail to bounce properly on a word go back 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. Dont exaggerate it,
dont 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 news paper 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 mile stone signifies your conquering of fear of stammer. 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 / 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 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 does
prolongation mean, you may have to talk to some PWS already practicing it or watch a
video of the technique. The latter is available on web.

You begin with non-feared words and situations to feared words and situations gradually.
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.

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, sometime, lungs get 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 stopped 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 chest and the other on 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 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.

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 un-comfortable 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
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 three minutes, I will share the most 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 pea-nuts 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 pea-nut
completely and then carry on asking the question from the next person and so on.
Whoever forgets to eat the pea-nut 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.)
Working on your emotions &
Attitudes
Many people dealing with long term
disabilities or ill-health often wonder why it
was their lot to suffer. Not knowing what
caused the suffering in the first place, the
original cause, becomes an additional
burden. Many of us try to fill this void by
vaguely believing half baked explanations
offered by our culture and faith. This inner
confusion and suffering constitutes a
significant part of the load one carries.

Sheehan’s iceberg is a good way of

explaining that part of stammering which can
neither be seen nor heard. This is quite a
substantial part of the problem called stammering. Nine tenths of an iceberg is hidden
under water and this is the part which can do considerable damage to a ship passing by
(this is what happened to the Titanic in the Nineteenth century!). This again, is the reason
why traditional speech therapy fails frequently: it deals only with the stuttered speech and
fails to deal with the deeper issues.

Case study

A child who was learning to cope with his stammering and its social repercussions, was
one day told about the ‘Karma theory’ by another child. He was already struggling with the
'cross' that stammering represented for him. Now, suddenly he realized that he himself -
and not his 'over-bearing' father, must have been responsible for his stammer: he must
have done some evil karma in his previous births. May be he was a tyrant king who never
allowed his subjects to talk! May be he was a cruel teacher who punished students
severely for talking in the class room! It must have been something truly ugly and sinful to
deserve his lot in the present birth! Suddenly the child was carrying two crosses now: one
for stammering in this life and the other for doing something evil in the last one. Was this
necessary? was this correct?
Many children and people who stammer, struggle to understand, why it has been their lot
to stammer since in most cases they have siblings with normal speech. Quite often they
turn to traditions they have been brought up in. Here under we offer three explanations
and alternative views from different traditions.

Karma theory

Karma theory has often been misunderstood grossly, as in the above case study. Many
people take just the half and ignore the rest. If bad karma generates bad samskar
(tendencies) in this birth, good actions in this birth can and must generate good samskars
and results in this and next birth. If twisting the strands one way can produce a strong
rope, which ties us up, twisting it the other way can undo it and turn a strong rope into
weak strands. This is the 'whole' of the Karma theory. It offers hope. A PWS can get down
to hard work of changing the way he speaks, perceives the world and himself; he can
start a self help group to help himself and others etc. All the good fruits can be reaped in
this very birth if we are committed enough.

God’s glory

Jesus was once passing through a village. A man, who was blind since birth was brought
to him. Someone asked: Is this man blind because of his sins or his parent’s sins? He
replied: Neither. He is blind to fulfill God’s glory.

According to this ‘non-dual’ position, everything is God’s manifestation. We need not hold
ourselves guilty for our imperfections, if we take up this position. In fact, we figure
nowhere in this scheme of things since ‘God has become all the three- the sacrifice, the
sacrificial block and the sacrificer’ according to an Indian saint. Who could complain? Who
is there to complain?

So, what it means is - everything is an appearance. We are given roles to play. These roles
are changing all the time. They do not reflect our truth, our reality. In other words, our
disabilities and our abilities, both are just an appearance, just a temporary role. This may
sound heartless and cruel but many have sincerely believed this and found solace and
peace.
The House is Empty

There is undeniable suffering in this world- as there is joy and happiness. But all these
belong to Nature, not to you or me. There are no entities like your 'self' and my 'self'. Pain
and pleasure exist but do so in a generic sense. Great joy, great pain- all this is there but
the problem starts when we start thinking in terms of 'my joy', 'my pain'. They do not
belong to anyone. The same could be said about ability or disability. This is the third and
Buddhist position.

As a child I had read a children's adventure story, about a haunted house. People's voices
and all kind of noises were heard at night. A group of children had stumbled upon it and
they were intrigued. They thought it was haunted. But when they began exploring, they
found a series of hidden speakers and a tape recorder only. The house was empty! No one
was there, ghosts or living - the sounds were just a trick. Similarly, this body and this idea
of self is empty of any real ‘self’. This is what we find when we go looking for this ‘self’ in
real earnest: The house is empty. The house and the idea of ‘self’ has been put together
by Nature. Then, whose disabilities and suffering are we talking about?

Buddha said, there is a state beyond suffering and there is a path leading to it. But the
first step is to realize that suffering and happiness are both impersonal. This brings a
sense of freedom: we are neither pained by our so called 'failings', nor do we pride
ourselves on our 'achievements'.

There is another, fourth, way of looking at our disabilities.

Little Versus Big cross

Case study: There was a flash flood one night in a village in north Bihar. The family tied up
all their belongings in sheets. The father called the eldest son and put the biggest bundle
on his head and gave smaller ones to younger children. The little one who could not walk
well, he put him on his shoulder. This is how the whole family waded through the water to
a high ground.

Everyone in life has to carry a cross. This is what we discover when we step out of our
'personal' suffering and observe the world around us. Obviously it stands to reason that if
we credit this creation with an intelligent creator, we must accept that It gives us a cross
matching our innate strength. Our trials can never exceed our inner resources. Until we
become aware of that inner strength, life can be difficult, no doubt. But all life is a
preparation for that final flowering.

Finally, when we accept ourselves wholeheartedly, as we are, the world too accepts us and
feels comfortable in our company. That becomes a new basis for communication.

Transfer to outside world

Transfer simply means practicing our new skills in real life situations, moving from simple
challenges to increasingly complex and difficult ones. This is an important step in self
therapy. There is always the temptation to limit your practice of, for example, bouncing or
prolongation to Self Help Group alone. This is simply no good! It is like a ship leaving the
harbor, only to drop anchor two kilometer away in safe waters! But then, this step requires
more of the same qualities, which we needed to launch ourselves on this journey: courage
and a deep sense of adventure. Here are some practical tips:

1. Take along a friend or senior person who stammers, on the initial transfer
assignments. Say, you wish to practice some voluntary bouncing in the local grocery
store, having done it many times in the self help group or just with a friend. Plan
the steps, rehearse mentally and then take a friend with you, to grocery store.
Later, ask the friend to give you feed back about your body language, emotional
states, speech and the reaction of the other person.

2. Keeping a diary can be a tremendous help and boost to motivation. Quite often, we
are so caught up with day to day life, that we may not realize the big leaps we have
taken, the sea change which has come over our thoughts and perceptions and the
improvement in our self-awareness etc. But when we read a diary, we become
aware of these changes and become hopeful for even bigger ones.

3. Writing a blog is the same as writing a diary (or journal). You may make it private
or public or open to just your ‘speech friends’. Advantages are that you can access
it from anywhere and from any computer while working.

4. Phone- You can start using the phone more often now. Many PWS and CWS have a
deep seated fear of using a phone, especially when others are around. You may
phone friends, colleagues and others on various pretexts. You may also call various
help lines or service numbers, since they deal with inquiries all the time and will
most likely be patient with us. For example, if LG is offering Televisions at special
price during some festival, pick up the phone and ask them various questions about
 their offer. Finally, what should you say, if anybody asks you about such phone
calls? Be honest and say- I am practicing my speech therapy goals!

5. Get back to your community with volunteer help in various public roles, on various
committees- Durga Puja committee, Neighborhood Cleanliness committee, Swajal
user's group etc. Consider doing so in your work organization too. Earlier you shied
away form such roles. Now is the time to get back in to these roles and give back
to the society at large.

Maintaining the gains- SHGs

In 19th century southern France, many deaf people were working in vine yards. It gave rise
to a sub-culture, wherein deafness was not considered a disability and deaf workers had
no problem in social interactions and finding work. Many people with visible or audible
departure from the 'expected' norms in a society, search for acceptance more, than mere
'cure'. Many gay and lesbian couples prefer living in communes for the same reasons
today. People who stammer are just about 1-2 per hundred among the general population.
They are scattered. They can not start a commune for a variety of practical reasons. If
they did so, society would lose yet one more opportunity of coming to grips with the
diversity hidden in its bosom.

A good compromise seems to be the self help groups. A self help group can be good
strategy to maintain the gains of self therapy. SHG is based on the following principles:

1. True acceptance to a CWS or PWS can be offered by people who stammer

themselves, who accept it and are not ashamed of it.

2. Such people, having tried out various therapies and management approaches, can
share their experiences, coach and guide others. They carry more credibility as
counselors.

3. Their motivation is more likely to be self less and not based on commercial
considerations.

4. They can provide a suitable atmosphere for the younger PWS/ CWS to practice new
speech motor / cognitive / affective skills.

5. Such groups, consisting of PWS, is likely to be free from other divisive influences:
church affiliations, allegiance to commercial interest groups or therapy approaches
 (McGuire Versus Speech Easy, for example).

Some practical modalities to start a self help group are as follows.

1. It can be started even with just two PWS. When the number goes above 10, ideally
a second support group should be started. This is so because, if a group meets for
an hour or so, then, not more then ten members will be able to get 3-5 minutes of
talking time. It is important that every member in a SHG gets a chance to talk and
share his thoughts.

2. The self help group should be convened or facilitated by a recovering PWS. While
there is no known 'cure' for stammering, when a PWS starts to accept that he or
she has a communication problem and starts to do actively something about it, she
or he should be termed 'recovering PWS'. Now, if she or he can spare sometime, to
organize such a group and facilitate it, they will be the ideal SHG coordinators.

3. Role of SHG coordinators: A SHG coordinator needs good 'people' skills (counseling,
motivating, facilitation, problem solving etc) and information management skills.
They will be gathering objective self help information and sharing it in the group 2-
4 times a month. They will be conducting various interactive speech (motor,
Cognitive, affective) exercises in the group, ensuring that everyone gets equal
opportunity to participate- paying close attention to the special needs of girls/
women and young children. TISA can help provide necessary training and skills to
such volunteers. Essentially, they have to play the role of an elder, a coach and a
sympathetic (but well informed) friend.

4. What activities should a group do, month after month? There is no end to the
creativity and imagination of the group. There are many good documents on the
web, which give specific details of activities to be conducted in a SHG. Check
following links.
Inter-group visits, contacts, inviting subject experts or other relevant people
(principal or teachers from a local school) could be good ideas when a group has
started functioning regularly.

5. Individual participation in such a group may not be regular. This is because

stammering is a variable condition. When we are passing through a bad patch or
when we are facing a specific challenge like upcoming job interview, our motivation
to take part in SHG may be high. Later on, it may fall, when we are having no
 problem with speech for days. But as long as a core group is available to welcome
and induct a new member, it is not a problem.

6. A Self help group can also be based on Internet or telephones- with occasional face
to face meetings. This is especially true of big cities, where members may find
commuting very time consuming. Such a group can be set up by the coordinator
easily at Yahoo and other social networking sites. Check this one group, which has
been functioning since 2001 and has 400+ members:
http://health.groups.yahoo.com/group/IndianPWS

Skype and other VOIP technologies can also help such tele-groups and may become
popular in near future, when poor bandwidth and connectivity problems have been
removed.

Zen of stammering
“Adversity is Opportunity turned inside out”

Here is what a stammerer has to say, when he looks back at his life:

“As someone who commenced stuttering during early childhood, I developed a host
of strategies to protect myself from embarrassment. I avoided words that appeared
to cause me particular difficulty, and developed the expertise to (almost
unconsciously) substitute synonyms that I felt more confident in using. I became a
'walking thesaurus'. Habitual use of word substitution meant that I amassed an
extensive and varied vocabulary, which I put to good use in many different
situations.

My struggles with the spoken word encouraged me to cultivate useful writing skills.
In many instances, transferring my thoughts to paper was the only effective way in
which I could meaningfully express myself. The written option allowed me to
communicate exactly what I wanted to say...

Over the years, my writing skills have taken me in many interesting and exciting
directions. I have edited several magazines; held the secretaryship of numerous
organizations; and undertaken the role of advisor to a fictional crime series on
British television. I have also written humorous verse and other poetry. During
 recent years, I have composed several poems about stuttering, which are used in
many parts of the world.

In addition, my slogans have enabled me to win hundreds of prizes (including cars

and exotic holidays) in consumer competitions. My reputation as a wordsmith has
also created many other opportunities. Over the years, I have been invited to
prepare speeches/poems for use by other people at a variety of events... “3

Does this happen to every PWS? No. But it can- if we, the stutterer, can take courage and
get the ball rolling. Neither God nor society can be held responsible for what has
happened to us. Therefore, it is we ourselves who can and should do something about it.
Once we begin, both God and society help us. For many of us, the first step is - to stop
feeling bad for ourselves, to get out of the bog of self-pity. This is a huge task and few
attempt it on their own. Many have found Self help groups, whether physical or web-
based, which is a good place to undertake this first major step on the road to recovery.

As we walk, this road full of ups and downs, we discover that Nature is constituted on the
principle of duality. Every phenomena has an obverse and reverse aspect. Our disability is
no exception. What we had considered for a long time to be our 'weakness' is our
'strength' too. It just needs a little shift in our perception. These little 'shifts' come during
stress- for example a bungled interview: An interview where we knew the subject matter
very well, but made a mess while replying to a simple question (what is your name?); the
panel asked no further questions and asked us to leave. When something like this
happens, let us stop to think and review our communication and our coping strategies,
instead of blaming others, fate etc.

Stammering has another explanation. It is an exaggerated reaction to 'perceived' threat,

manifesting through speech: Perceived threat- as opposed to 'real' threat. Our biology has
inherited three kinds of response to danger: fight, flight or freeze. When a PWS decides to
fight, he tends to tighten his chest and throat muscles and forces the word out, as if they
were a piece of cork, jammed in this throat. If he decides to fly away from threat, he uses
avoidance- like changing the word, the topic or even keeping quiet. Lastly, sometimes, the
fear of the approaching difficulty is so great, that we do nothing- we simply freeze in
terror- a silent block. Our thoughts, speech, breathing- everything freezes for those
moments, which appear to be never ending.

3 Alan Badmington, member, British Stammering Association

We can see that all three responses do not really help the process of communication. But
how can we change these knee-jerk reactions? It is like re-living a moment of great
danger faced by one of our hunter-gatherer ancestors ages ago: She was happily picking
berries in a bush and suddenly she was face to face with an angry bear! Can you think
rationally at such moments? You dont think. You just react at such moments.

But there is a way out. In our case, most often the bear is not there or if it is there it is
certainly not angry! Our body is reacting to a threat, which is actually an interpretation (if
not pure imagination) put together by our mind. Can we retrain our mind to interpret
outer reality in a different way? Yes, we can. Imagine, our young PWS going back to the
interview, but with a different set of thoughts in his head:

“..This is just an interview- not a matter of life and death. There will be many more
interviews beyond this. I will never stop until I succeed. Moreover, I know my
subject well . Even if I stumble on a word, I will get back into communication mode
and explain what I am trying to say. The people out there in the interview panel are
looking for a good candidate, which I am... So, whatever is the outcome of this
interview, It is fine by me...

So, if he goes to the interview, with such thoughts, chances are he will stammer very little
and will be able to get his point across. He might even get selected like many PWS all over
and every year. This is called 'cognitive restructuring' in the West and 'positive thinking' in
the East. It can be cultivated through deep and regular meditation and positive self talk
(reaffirmations).

So, essentially, we can act differently, only if we can think and feel differently- about
speech, communication, self and others. You can think and feel differently only if you can
become a different person. The most stable and significant changes come from within, to
without. Such changes improve not only our communication, but everything else. A time
comes when even we ourselves marvel at the person we have become! Do you believe
this?

Beyond Stuttering: Deeper Issues of Life

Here is the testimony of an 'internalized' (covert) stutterer:

For many years, I did not know- for sure- who I was. Sometime I stammered
uncontrollably- sometime I spoke normally, even fluently. Was I a stutterer or was I
 a normal person? This was a big question, I went to sleep with; and wondered
again every morning, as a child and adolescent. Stakes were high. And the world
responded differently to these two different kind of persons. Who was I? Whenever
I spoke, I was a little confused- am I going to stammer or am I going to speak
normally?

Sometimes, I will try to forcibly push this question out of my mind – and into the
subconscious- and will try to focus at the task at hand: speaking. Sometimes this
trick worked. So, I decided to disown my stammering self – leave it behind in a
dungeon of indifference, in a limbo. My motto was: if you want to speak like normal
people, BELIEVE that you are a normally speaking person! It worked for years- but
every once in a while, I will feel as if something is missing. Kunti may have felt it in
her latter years- because she too had disowned her son, Karna for years. Like Kunti
in the epic Mahabharat, one day, I too approached my stuttering self in the dark
dungeon- with understanding, compassion and acceptance.

Some more years passed by, and then, one day I said- of course I am beyond my
both stuttering self and fluent self. These are just two roles I am playing on this
world stage. My real Self, with a capital S, is beyond both and can never be
compromised by whatever the world grants or holds back..

This was the turning point in my life.. and a very 'spiritual' moment. There are
many ways to approach 'God'. I chose the stuttering way..

To many of us, stuttering has an ethical dimension. We are hiding something in every
social transaction. Is hiding our disfluency, same as hiding our bodies under clothes?
Immaterial? Is hiding our stammer same as hiding our income during an income tax
assessment? Which is more unethical? If so, who are we sinning against?

As we grow older, we understand, the fine difference: we do 'short change' our listeners,
when we try to pass off for a 'fluent' person, not our true selves- but he or she may not
hold it against us; they may not even notice it many times. But we do ourselves
considerable injustice in the process. We restrict our possibilities for growth and true
communication.

Now, how does one come out of this dilemma? A little humility and a lot of courage is
what one needs to step out of the conditioned responses. We need to ask ourselves, how
much do I allow myself to be influenced by society. Is there anything beyond the society
and the world, whose approval and acceptance should matter to me? This is how a
spiritual inquiry begins. If we persist we find answers not only to our stammering but to a
much deeper question: what is the purpose of my life? How do I make it more meaningful,
to myself?

TISA: Philosophy & Approach

‘..The way our “worthy” alcoholics have sometime tried to judge the “less worthy” is, as
we look back on it, rather comical. Imagine, if you can, one alcoholic judging another.. ‘

(A quote from Bill Wilson, from “Spirituality of Imperfection”)

Judge not: We have been judged for our speech. We have judged others similarly on
superficial grounds. Some of us, who stammered less have judged others who stammered
more. But “imperfection” is our nature and there is something quite “spiritual” about it,
provided we accept ourselves as we are; then, accepting others with their “imperfections”
comes easy. This is the basis of self help group movement. TISA’s mandate is to promote
self help groups - both the physical ones and the web based ones. Through such a
movement, which generates exchange of information, we hope to influence attitudes all
round- both of those who stutter and those who do not: “Better attitudes through
knowledge” - this is TISA’s motto.

Acceptance & Action: Information and acceptance is not enough. Affirmative action is
the final step which gives meaning to our journey out of our personal prisons of suffering.
So following three steps or affirmations constitute the guiding principles of TISA SHGs.

 I accept my SELF with my STAMMER

 I accept others who STAMMER

 I will try my best to help myself and serve others who STAMMER

Acceptance does not mean that we do not seek and practice whatever therapy or self help
is available to us. It does not mean that we do not work at our communication, career,
attitude and relationships. It only means that we do not think less of ourselves when we
stammer and are not apologetic about it.

A safe environment: Self help groups provide a safe environment to explore our speech
and related emotions, beliefs and attitudes as well as a supportive atmosphere to practice
new skills. We also discover in a group that we are not alone, facing this problem. We feel
empowered to approach or invite others and talk to them about this little understood
problem. For children and adolescents, this support can be life changing.

Finally support group is not only to support us, who stutter but also to provide support to
our family members who may be passing through a difficult time because of our
communication difficulties. It can also be a venue for students of Speech pathology and
young SLPs to learn from PWS and share their skills. A good facilitator of SHG will also try
to extend the horizons of her or his group by inviting people suffering from other rare
disorders like Tourrette syndrome, Neurological Stammering, Albinism, Dyslexia etc. Such
cross-learning can help a group formulate its own advocacy efforts in the long run.

Structure : TISA currently is an association of individual PWS from different parts of

country. We are in touch with each other through web, phone and personal meetings. Our
current focus is on functional groups led by individuals of exceptional motivation and
organizational skills- rather than a physical organization concentrated in one place. These
individuals are nominated as the Coordinator of the regional chapters (state or city based).
These regional chapters are encouraged to raise local contributions and use it to promote
SHG movement and better understanding of stammering in general public. At national
level, there is a two person Coordination team currently. TISA is at an early stage of
evolution and if we get more volunteers, these posts will be rotated over next three years.
We are looking for more PWS to join the core team- people with skills and experience of
advocacy / legal action, fund raising, media campaigns, writing and translation etc.

Members: TISA has some NRI PWS too as our core group members. More such NRIs are
welcome. PWS, who practice as SLPs or Speech counselors too are welcome. People who
do not stammer, but have promoted better understanding of our issues will always be
welcome to join as honorary / special members. Family members of PWS are also welcome
to join TISA. People promoting or representing commercial interest (drugs or electronic
aids) or exclusive therapy groups, should not be invited to TISA meetings, since TISA is all
about self help based on altruism.

Working with SLPs: TISA values and wishes to work with selected SLPs across the
country but on fair and transparent terms; the current fee structure and therapy schedules
are obviously un-sustainable for an average PWS in India. New modalities need to be
worked out. Secondly, many therapists make situation worse by claiming that stammering
is ‘curable’. Modern research disproves such claims. And those who continue to stammer
openly are made to feel bad, because the society is led to believe that this person is too
lazy to work on his speech, that is why he or she still continues to stammer. SLPs should
have the courage and honesty to say that there is no known ‘cure’ but yes, successful
management can be learned.

An Indian Organization: Even though we are an Indian association, we are in touch

with other national stammering associations, and wish to record our thanks to
International Stammering Association (ISA) for the help it extended to TISA in the
formative years (2006-07) through valuable services of Mr Keith Boss.

TISA blog is our public notice board, announcing regional meetings, advocacy campaigns
and sharing general information:

http://t-tisa.blogspot.com/

The chat group where TISA offers more specific counseling, self help material and other
specific information for PWS is located at Yahoo:

http://health.groups.yahoo.com/group/IndianPWS

Financing: If you appreciate the efforts done by TISA, make a contribution to the local
chapter and do ask for a progress report! Some of the major activities which need funds
urgently are:

 Media campaigns (to change attitudes through sharing of correct information);

Observation of 22nd October (International Stammering awareness Day)

 Travel and logistics for young PWS to participate in SHG in nearby cities;

 2-3 day intensive residential camps for PWS.

 Translation and publication of informational booklets and pamphlets on stammering

 Production of educational video projects dealing objectively with stammering

 Regional meets, inviting Speech pathology experts, educationists, media and policy
makers to take affirmative steps

Let us conclude with a thought from Aesop, who stammered and left behind many tales of
wisdom: What you think is not enough: what you do, however, does change your today
and influences your tomorrow..

Feedback: sachin at satksri@rediffmail.com, satksri@gmail.com,Phone +91(0)9412058272