Self-Improvement After Unsuccessful Treatments

An excerpt of chapter 13 from the book Advice to Those Who Stutter
 
By Henry Freund, M.D.
 
Like most adult stutterers in this country, you have probably been subjected to some form of therapy at one time or another. This therapy was either totally ineffective or resulted in only temporary improvement. Maybe it even resulted in a “cure,” only to be followed by a relapse. Such an experience may have provoked in you an attitude of pessimism as far as the possibility of a more effective treatment is concerned. Or, it may have strengthened your desire for the “miracle,” the perfect cure which would eradicate every trace of stuttering. Both these attitudes are unjustified.
 
For those who are pessimistic about the possibility of help, it may be encouraging to learn that some stutterers have been able to help themselves either in spite of, or possibly because of, repeated and unsuccessful treatments. Some of the contributors to this book will give you specific and practical advice about what to do in times of trouble. I want to give you a short description of my own attempts at self-improvement, after many unsuccessful treatments, and the principles on which they were based. This is my own strictly personal way of helping myself and should not be considered as a blueprint to be followed rigidly. Each individual must go his own way.
 
For those who are overly optimistic, a few words of caution are needed. I am intentionally talking only about improvements and not about cures. I am of the opinion that for the adult stutterer the best we can expect is long-term, even lifelong improvement, which renders him a less unhappy and less socially withdrawn person. This is not a perfect cure. Traces of the disorder usually remain and relapses occur. This applies equally to those who were treated by others and to those who treated themselves. It seems to me that those “former stutterers” who really don’t have any trace of stuttering left did not recover as a result of planning and conscious efforts but actually outgrew their disorder without knowing how and why. Their cure is, as we say, a spontaneous recovery and not the result of therapy.
 
I was definitely a severe stutterer and was treated unsuccessfully by leading European authorities during my elementary school and high school years, as a student in medical school and even after graduation. Without the knowledge I acquired as a result of all these futile attempts at therapy, however, I probably never would have succeeded in helping myself overcome the worst of my stuttering. As an eight year old child I experienced a short-lived and almost miraculous improvement by using a smooth, melodic manner of speech and prolonged syllables; sentences were uttered as units. It was a manner of speech akin to singing. I noticed that I could apply this method in front of strangers with perfect ease and confidence when accompanied by my therapist. But he accompanied me only rarely, and never made any systematic attempt to enlarge the range of situations I could master. I returned home as “cured,” only to relapse quickly. The next two authorities conducted therapy strictly within the walls of their office. The first one, after many tricks and much logical persuasion, finally stumbled upon rhythmic speech; again I felt an almost miraculous ease, but no attempt was made to help me apply this in front of others. The last therapist totally rejected my request to accompany me into real life situations. He wanted me to have the courage to do it alone. My numerous attempts to approach people alone and to conquer my fear of stuttering all ended in failure and my stuttering grew worse. From bitter experience I learned how futile it is to make demands upon the stutterer without giving him a helping hand. What I needed was not an authority but a friend and collaborator genuinely interested in me and ready to help me. I was fortunate to have a brother who could be this friend.
 
At age 35 I gave up my practice as general practitioner of medicine and moved from Yugoslavia to Berlin for postgraduate training and specialization. My shyness to approach people had reached a point where something had to be done about it, and I was now given an opportunity to make a new start. My chances for a successful attempt at treating myself were favorable. Not only had I accumulated an ex­tensive knowledge on stuttering, but through my many unsuccessful treatments in the past I had developed definite ideas of what was necessary to do to bridge the gap between theory and practice. I tried to follow these main principles.
 
1. I determined to make full use of the opportunity to devote myself completely to the task of self-improvement. The chances of success would be better if I were able to live completely for this one task. I had to make full use of a new environment where nobody knew me as “stutterer” and where nothing reminded me of my past defeats and humiliating experiences.
 
2. I knew by now that I possessed a normal ability to speak. Speaking is an automatic act and most of the time I did speak normally. I knew that stuttering occurred situationally, that it resulted from fear and the expectation of failure, and that this lead to an inhibition or stoppage of the voice. I talked under the illusion that speech sounds are difficult and that an enormous amount of force was necessary to overcome my self-created obstacles. Talking was a highly emotional experience which gave me a feeling of helplessness, failure and defeat. But I also knew that the method I used as a child which stressed all the positive aspects of speech (the stream of breath and voice, the unity of the sentence as a whole, the singing-like, melodic aspects of speech) was in the past prone to draw my attention away from the dreaded speech sounds, tended to calm and relax me, and rendered my speech more pleasurable. As a first step I would now start again to use this method with those persons closest to me and regain my old confidence in it. I could use this as a stepping stone to contacts with others.
 
3. I would discuss with my brother my daily predicaments, fears, doubts, successes, defeats and other personal problems. After establishing a good and trusting relationship I explained my strategy. He should accompany me wherever and whenever I needed his help; he should remain silent when I was sure of myself but should take over when I stumbled; or he could start to talk and then I could gradually take over. In this manner I could slowly expand the variety of people and situations where I could talk methodically, calmly and confidently.
 
4. After establishing a greater degree of security and confidence I would be able to reduce and finally discard the need for my brother to accompany me. I would be on my own and would expand the range of situations I wanted to master. I would do this gradually and would not ask for too much too soon. In times of trouble, I should not be too proud to discuss my problems with others.
 
5. Having widened somewhat the range of situations and people that I could handle without fear, I had to secure my newly won abilities by preparing myself for the inevitable reversals. Relapses would be unavoidable and had to be expected, for there would be no foolproof method to eliminate them. In the past relapses were prone to shatter my belief not only in a certain method, but also in ever being able to overcome my stuttering. This would not happen again if I were prepared to meet them in the right spirit. Situations and circumstances would arise when the magical power of any method would be overpowered by old fears and self-doubts, and when some outposts of the liberated area might get again lost. The right spirit to meet relapses and reversals is a philosophy of self-tolerance, of the acceptance of your own weaknesses and limitations, and of a greater objectivity toward self and others. This results in a lessened sensitivity. Here, too, an open discussion with an understanding person sometimes helps to clarify issues which subjectively you are unable to see clearly.
 
I followed these and other similar guidelines. The break-through occurred when, after a period of preparation and accompanied by my brother, I for the first time dared to approach a stranger for the purpose of experimenting on him. In spite of a panic-like fear and desire to run away, I heard myself asking him a question in a surprisingly calm and methodic fashion. This first breakthrough shattered the walls of fear and avoidance. It was a positive emotional experience of strong impact; it created a new confidence and opened up new vistas. The world became a friendlier place to live in and I felt closer to other human beings. Many similar positive experiences followed. My liberated verbal territory became too big to ever again fall prey to the demons of fear and doubt. For the next six years I spoke practically without conscious fear of stuttering and was able to engage in activities like counseling, lecturing and teaching as head of several speech clinics. These tasks I could not have possibly performed before. Then minor relapses, especially during exceptionally difficult life-situations, started to occur. While traces of the disorder have remained, and while with advancing age I have again become slightly more socially handicapped, the disorder never again assumed the severity it had prior to age 35. But even now, 40 years later, I still not only continue to study myself but also to treat myself. I still work to normalize my relationship to others and on my life-philosophy. For me, this is a lifelong task.
 
This is my story of self-improvement after unsuccessful treatment. Maybe there are some ideas which will prove helpful to you. I hope so!