In the other case a neurological basis for the pathology exists upon which is superimposed a complex of emotional conflicts which have amplified the pristine neurological tendencies. In an adult case it is often difficult to ascertain with any accuracy the relative importance of the biological and sociopsychological factors interacting in the overt symptoms. The primacy of neurological factors in a certain proportion of cases has been established by observational studies of children which show, for example, in the case of stuttering, that simple repetitive speech blocks of short duration or brief prolongations appear at relatively early ages, at a time when awareness of self and other consciousness are but vaguely developed. Usually the small child will talk right through these primary blocks, especially if this aspect of his family role is accepted by other members of the group or if they disguise their anxieties or hostilities towards the child's behavior. Withdrawal from traumatic social contacts, with a further interruption of social communication and inadequate compensations, are the frequent result.
Authorities differ on the curability of stuttering.
Once this surplus has been stripped away the client comes to accept in an unemotional way the minimal neurologicals or the irreducible residual of symptoms having an exclusively psychogenic origin. It differs also in the element of spontaneity. Its conceptual kinship in this latter respect, to free association methods, finger painting and certain forms of occupational therapy is not hard to discern. Psychodramatic therapy based upon role reversals is often used in speech correction. For example, a boy treated at our clinic had acquired a grotesque habit of opening and closing his mouth as if he were gasping, just before speaking.