An excerpt of chapter 2 from the book Advice to Those Who Stutter
By Dorvan H. Breitenfeldt, Ph.D.
Having been on a farm in Minnesota, I had the good fortune of attending a one room schoolhouse in which all eight grades were taught by one teacher. My stuttering began in the preschool years and continued to increase in severity. I compensated for my stuttering by becoming an academic over achiever. Because of my stuttering I quit school after completion of eighth grade and remained out of school for three years, during which time my stuttering increased greatly in severity. I did not use the telephone until I was seventeen, and my parents did my shopping for me. My speech consisted of long silent blocks. I frequently avoided talking altogether, or only said what I could without stuttering by using word substitution and circumlocution. I felt great shame and guilt, avoided outward stuttering at all costs, and often felt “why me?” Many times I cried alone about my stuttering, and even contemplated suicide because my stuttering had crept into all aspects of my life and brought it to a standstill. My stuttering was truly an “iceberg,” with most of it beneath the surface. 
Fortunately, I attended a six-week intensive group therapy program at the University of Minnesota at age seventeen. Unfortunately, I developed what is known as “lucky fluency” halfway through the session and returned home with essentially fluent speech, but with very little practice for managing my stuttering behaviors. At age seventeen I began my freshman year in high school where I remained fluent for about three months, after which time I experienced a sad relapse. I attended the same intensive therapy program one year later and fortunately returned home with the same amount of stuttering that I had before beginning the program. However, this time I obtained a great deal of experience in managing and con­trolling my stuttering, as well as the healthy attitude that I would likely be a lifetime stutterer and could not depend on fluency.
At the time of this writing, as I proceed into retirement from university teaching and administration, I find that my stuttering is still all there, in cycles, and can still be just as severe as it was prior to my first therapy. It looks as if chronic/advanced stut­tering is truly “incur­able” for most of us, therefore, we need to learn to live successful, fulfilling lives in spite of this constant companion.
Since stuttering is only partially a communication problem, but more importantly a problem in human living, it must be attacked from all angles. We must work with the person who stutters, not just the stuttering. Due to the magnitude of the problem, my experience has been that the (chronic/confirmed) stutterer ideally needs intensive therapy to make changes rapidly and then be provided with the tools for an ongoing, and perhaps lifetime, maintenance program.
The three broad goals of a good therapeutic program are:
1. Reduce Fear: Strive to reduce word and situation fears, to change attitudes toward stuttering, and to objectively understand stuttering and build a good self image.
2. Alter the stuttering pattern: Study the stuttering symptoms. Let the stuttering out, develop an outward stuttering pattern, and learn techniques to manage the stuttering.
3. Develop a maintenance program following therapy… Stuttering, like so many human “illnesses/diseases/disorders/conditions” demands continuing self therapy and/or professional therapy.
The ideal treatment environment is frequently not available to many stutterers for various reasons. Some may be time restraints, availability of programs, finances, and perhaps the readiness of the stutterer to commit to participate on a full time basis. Nevertheless, there are many things the stutterer can do in self treatment or with limited professional help. By far the most important thera­peutic principle is ad­vertising, or acknowl­edging the fact that you are a stutterer. In every speaking situa­tion, letting people know that you stutter creates a “stutter friendly” environment. At first you may feel awkward admitting what you have tried so hard to hide, but after the dreaded “secret” is out, and you know that you don’t have to worry so much about hiding your stuttering, you will begin to feel more at ease. Advertising is a lifetime technique and you should never attempt to pose as a fluent speaker. Honesty is always the best policy and is “cleansing for the soul.”
Maintaining eye contact with your listener, especially dur­ing your stuttering blocks, is essential. Stutterers with poor eye contact show their feelings of embarrass­ment and negative reactions to their own stuttering. Eye contact is something the stutterer can work on without professional assistance. The best way to begin this practice is to maintain eye contact with yourself in front of a mirror while making phone calls and/or with someone else present. After the mirror sessions, then transfer the eye contact to all speaking situations. Good eye contact not only helps us become more effective speakers, but it also gives our listeners a better impression of us and our feelings toward our stuttering.
Before you can change your stuttering into more acceptable speech, you must first identify and analyze your particular stuttering symptoms. Two ways of accomplishing this are to observe your stuttering in the mirror and on video tape. Both the mirror work and the video must be done in the presence of others, as you will probably have very little stuttering, if any, when just talking to yourself.
Make a list of the specific things you do when you stutter. To do this you must give up the avoidance and postponement tricks you have been using to avoid your stuttering, and develop a nice, clean outward pattern of stuttering by going directly into your blocks. This will be the most difficult aspect of your self therapy, as most stutterers may never have exhibited all of their stuttering. Your outward stuttering will likely become much more severe; however, you know that it has always been that severe inwardly. To help you identify exactly when your stuttering blocks occur, which is absolutely necessary if you are going to change them, you need to use the tallying technique.
The steps in tallying are:
1. Go directly into the block without the use of starters, postponements, and other avoidance tricks
2. Stutter all the way through without retrial.
3. Stop immediately after the stuttered word.
4. Tally the block in a 335 memo book as: 1 2 3 4 5 6 7 8 9 10 etc.
5. Regain eye contact and continue until your next block, then mark (step 4.) in your tally book again, etc.
You should tally in all speaking situations, including talking on the telephone.
Word and situation fear reduction should be a part of every stuttering therapy program, since fears constitute a major portion of every stutterer’s problems. The only known way to reduce fears is to confront them directly. Now you must deliberately go into your feared situations and go directly into all of your feared words. This will mean making many telephone calls, talking to many clerks in stores, stopping strangers and asking directions to various places, talking to groups and confronting all of your other feared situations. Always begin every speaking situation with “My name is _____. I am a stutterer and I am working to improve my speech.” Maintain eye contact with your listener and tally all stuttering blocks. You will find that people are really very kind and helpful, as you have already established your “stutter friendly” environment by advertising your stuttering. In order to get your stuttering out in the open, tally your blocks effectively, develop good eye contact, and reduce your word and situation fears. You should expect to make at least 100 telephone calls and talk in 100 or more face to face speaking situations.
You are now ready to learn Handling Techniques to develop control of your stuttering so it no longer controls you. The handling technique which almost all stutterers find most effective is prolongation. Prolongation is starting the first sound of the word with a very light contact with your articulators (no tight lips, teeth, jaw or vocal cords) and prolonging or holding that first sound. Then say the rest of the word crisply and at a normal rate. Be sure not to prolong the second or other sounds in the word, unless you have a block on them. Do not slow down the overall rate of your speech, as it is highly unlikely that your stuttering has anything to do with talking too fast. Keep in mind that speech should always be easy and forward moving. Prolongation is a skill which will need a lot of practice. Prolonging on the first sound of every word, while first reading aloud to yourself and then to another person (so that you have real stuttering,) is an excellent way to practice. You will need to practice prolongation in many outside situations and on the telephone. Of course, the tallying is discontinued as soon as you begin to use your handling techniques. Another excellent handling technique is a “pull-out,” also known as an “in-block correction.” When you are “stuck in a block,” you need to gain voluntary control during that block by intentionally releasing the tense structures, changing the tense­ness to a light contact and moving forward through the rest of the word.
May I also encourage you to consider some Lifestyle Changes such as:
1. Personal organization. By structuring and organizing your daily routine, your cognitive abilities will be enhanced for more effective management of your stuttering.
2. Outward appearance. Develop an alert demeanor, friendly smile, and perhaps even make some changes in hair style and dress.
3. Interpersonal and social relationships. Develop an active social life to help you maintain control of your stuttering. Join groups such as Toastmasters or Toastmixers. Take a public speaking class. Humans are “pack animals,” and it is important that the stutterer learn to “run with the pack.”
4. Personal health care. Good physical fitness and a healthy diet improve the quality of life. We know that stutterers have a more difficult time managing their stuttering when they are not in good health.
5. Take charge of your life. This is paramount. You are a stutterer and it is your problem. Don’t blame others. Plan to be a winner, not a loser.
Experience has demonstrated that stutterers who continue to manage their stuttering are those who also make major lifestyle changes.
The program summarized here sounds like an insur­mountable task, but stuttering is a formidable opponent and the treatment must match, and even exceed, the size of the problem. You, who confront and conquer this adversary, have my greatest admiration and respect. 
I wish you the very best as you continue through this venture called life.