# Speech-Language Pathology/Stuttering/Response Selection Under Stress/Personal Construct Therapy

   No one needs to be completely hemmed in by circumstances; no one needs to be the victim of his biography.
In every situation, you always have a choice of how to react. This insight is the basis of personal construct therapy (PCT). The goal of PCT is to develop awareness of your choices in every situation. The antithesis is to always react the same way to stressful situations.
If you make the same speech choices in high-stress situations, no amount of practice in a low-stress speech clinic will change your speech. E.g., if you always substitute words "when the going gets tough," you're not going to use gentle onsets in a difficult situations, even after practicing 5,000 gentle onsets in the speech clinic.
To develop awareness of your choices, describe a situation in which you stuttered. Imagine different ways you could have responded to the situation.
Role-play the scene with your speech-language pathologist or in your support group. When someone sees a choice that hasn't been played, switch roles, for that person to play the new choice. E.g., the situation is answering the telephone at work. One person pretends to be a caller, and the other pretends to be the employee answering at Pasquale's Pizza. The employee uses slow speech. But another choice might be to switch to voiced consonants, i.e., answering the phone Basdahllee's Bizza. You should be able to think of a half-dozen other possibilities. Role play every choice and see what feels best.

### Slow Down by Not Interrupting

Conscious choice requires slow reactions. In a fast reaction to environmental stimuli, your brain will select the most myelinated (habitual) open-loop motor program. Interrupting people, or responding quickly in a conversation, is a fast reaction.
Let people finish their sentences. Wait two seconds. Then start talking. Your fluency will improve.

### Verbal Aikido

Aikido is a Japanese martial art. Combatants focus not on punching or kicking opponents, but rather on using their own energy to gain control of them or to throw them away from you.
Verbal aikido is the art of not arguing, but instead agreeing with someone who is verbally attacking you. Then you help the assailant attack you, until&#151;surprise&#151;he realizes that he's just been made to look like a fool.
E.g., a middle-aged, overweight woman owned a chain of women-only health clubs. Middle-aged, overweight women could work out in these health clubs without feeling intimidated by young male bodybuilders.
A "shock jock" radio host invited the health club owner onto his show. He described her physical appearance, then asked why anyone would want to work out at a health club owned by a fat, ugly old lady.
She responded, "So we don't have to work out with boorish meatheads like you."
This silenced the radio host long enough for her to say that overweight, middle-aged ladies have to exercise too, and the radio host was a perfect example of the men she didn't want to have to be around when she exercised.
My example of the parents responding to their teenagers' four-letter words is another example of verbal aikido.
Use verbal aikido to turn around the stress. E.g., a highway patrol officer pulls you over for speeding. Instead of trying to hide your stuttering, you make a joke: "I stutter, so I'm not going to try to talk you out of giving me a ticket." Maybe this will put the officer in a good mood and let you go with a warning.

### Changing Self-Descriptions

Many stutterers improve their speech, yet continue to believe that their speech is worse than non-stutterers. Graduates of fluency shaping therapy programs sometimes have beautiful, clear speech that is easier and more pleasant to listen to than non-stutterers' speech. Yet they continue to believe that they can't do certain things, such as public speaking.
Conversely, stutterers who improve their speech attitudes have better speech a year after completing therapy, as compared to stutterers who maintain poor attitudes.
Write a description of yourself, and then describe who you expects to be in five years. Look for items that are opposite in the two descriptions. E.g., now you're now single, but in five years you hope to be married.
Then write a description of yourself as a stutterer, and then describe who you'd be if you didn't stutter. E.g., assertive vs. shy, or popular vs. lonely. These descriptions are your personal constructs.
Work on changing your personal constructs. Again, imagine specific situations for each personal construct. E.g., if you wrote that you'd be assertive instead of shy, describe a recent situation in which you weren't assertive. Now role-play the scene with your speech-language pathologist or your support group. Imagine different ways to react in the situation and switch roles.

### "Who Would I Be If I Didn't Stutter?"

This is a favorite conversation topic at stuttering support groups. People initially say, "I'd be more successful at work," "I'd be more assertive with my husband and family," and other negative aspects of stuttering.
After fifteen minutes, people start saying, "If I didn't stutter, I'd be less compassionate," or "I would never have developed my musical talent." People realize that they chose a career in a "helping profession" (e.g., nursing or teaching), or they developed non-verbal skills, such as athletics or painting, because they stutter. They realize positive aspects of stuttering. They see that stuttering can be a gift.
In contrast, a stutterer completed a speech therapy program, but refused to speak fluently. He said that his co-workers had listened to his stuttering for 20 years. He asked, "What would they think if I came to work speaking fluently?"
Another stutterer was earning $25,000/year as a computer programmer. His supervisor left, and the company wanted to promote the stutterer. He would receive a salary of $55,000/year. The management position required talking to clients on the telephone. The company offered to pay for speech therapy and an anti-stuttering device. The stutterer refused the promotion, saying that he didn't want to talk to anyone. The company instead hired a less-qualified manager from outside the company.
For these stutterers, the psychological issues surrounding stuttering are more disabling than their disfluencies.

### Change Your Lifestyle

As your improve your fluency, ask your supervisor for tasks that require talking. Do social activities that involve talking.
Training a new motor skill requires about three million repetitions. To say three million words, you must talk at least four hours a day for at least six months.
Take an acting class. Take singing lessons. You'll have fun, and meet new people. You'll get over your speech-related fears.
You'll find some things other people can easily do that you can't, but you'll also find things you can easily do that other people can't. E.g., I took a public speaking course. I was able to project your voice, when other students are afraid to raise their voices. I was able to switch emotions (anger, sadness) easily and convincingly, when other students couldn't. And there were simple presentations that you couldn't understand a word I said.
Volunteer to read to blind or elderly individuals. Volunteer at a hospital directing visitors where to go. Volunteer with your public radio station answering pledge week calls.
Or moonlight at a job that requires talking. Find a job that requires being charming and friendly.
Join social clubs that requires talking. Put Toastmasters at the top of your list. Members give a series of ten speeches, usually one speech per month. The speeches are four to ten minutes long. Each of the ten speeches teaches you a new skill, such as using gestures and body language, or being persuasive on a controversial topic. Judges always point out things you did well&#151;and award lots of ribbons&#151;as well as ways you can improve. You'll find that even if you stutter severely, you're better than non-stutterers at some aspects of public speaking.
The National Stuttering Association has its own public speaking training program, which is quite different from Toastmasters. Ask for the "Speaking Circles" video.

### References

* ^ Andrews, G., Cutler, J. "Stuttering Therapy: The relation between changes in symptom level and attitudes." Journal of Speech and Hearing Disorders, 39, 312-319, 1974.
* ^ Guitar, B. & Bass, C. (1978). "Stuttering therapy: The relation between attitude change and long-term outcome." Journal of Speech and Hearing Disorders, 43, 392-400.