By Brian Berkenstock
Between individual therapy and going public comes group therapy, where stutterers share challenges and successes with one another and their therapists.
"I ordered a roast beef and cheese sandwich by making good eye contact," says Quennel DeVerteuil, a freshman from the Bronx studying at the University of Maryland. Amanda Hannaford, a doctoral candidate in oceanography, returned a rotten pear to her local supermarket and faked a stutter as she did it. One man in the group spoke so much during spring break that he got a sore throat. A grad student, wearing a shirt that reads "Physics is Phun," was the only student to speak on a scientific panel of full professors. "I kept thinking, 'What the hell am I doing here?'" And Kearn Williams, a business major, watched a bystander's reaction as his therapist imitated a stutter (the reaction wasn't as awful as Williams thought it would be, though he's seen his share of bad reactions).
Each week, a group of people who stutter meet with their clinicians in a session that's part therapy, part support group. Group therapy is the next step up from individual therapy on the fear scale. It's a safe haven where people who are normally very self-conscious about the way they speak can comfortably practice techniques they learn in individual sessions. The techniques deal with both attitudes about stuttering and the behaviors (some good, some bad) learned over the years to deal with stuttering.
Today's session is a bit of an exception to the "safe haven" tenet. Earlier in the day, Vivian Sisskin, the department instructor who trains student clinicians, delighted in telling me that my presence in the group would ratchet up the fear level. Normally the group is comprised entirely of people who stutter and people who are clearly sympathetic to the stutterer's plight, namely each client's therapist and Sisskin. But Sisskin says that only by using techniques learned in individual and group therapy in increasingly stressful situations will the client become desensitized to fear and anxiety. I tell her that as far as I know, I've never struck fear in the heart of anyone. I'm the kind of guy that babies smile at and kids clammer to in the park. She's looking forward to some flop sweat; I hope she won't be disappointed.
This week, the group starts by recounting their spring break success stories. Taking techniques practiced in the group session out into the world is one of the goals of therapy; that's why Hannaford deliberately stuttered when she returned her bad pear. By facing her fear of stuttering and going public with it in a controlled way, she gains confidence.
Hannaford, 35, has always stuttered. "I'm sure people noticed, but I don't have any memories of being laughed at or taunted or anything. I had a lot of friends and everything was fine, though stuttering was always stressful. It was something that made my life, internally, slightly harder."
She attended therapy in early grade school, but stayed with it for only a year. "I think if it had been working, my parents would have had me continue." As an adult, the lure of therapy became more tempting. "I had been thinking about joining for a long time, but never did because it's a major commitment of time and energy. I went in with the attitude that I'll be in therapy a long time." Part of the reason she likes therapy is that practicing techniques is easier when you know you have to report to the group.
During the group session, I struggled to hear any sign of a stutter in Hannaford's speech, though when we spoke on the phone a few weeks later, I could hear her stutter a bit more as our conversation went on. "Everyone's speech pattern is slightly different," she says. "Mine is about the same in class and out, but there are times when it's worse. It's harder when I'm tired or sick, but that's true for everyone; you just notice it more in people who stutter."
She rarely has any external evidence of a stutter, but internally, she does all sorts of things to compensate. "I only have a major speech block three or four times a day," Hannaford says. "That's not too serious, but it's still sort of a significant part of my life."
Did stuttering ever affect her dating or social life? "I don't think it did," she says. "My husband has said he never thought it was an issue because I never made it an issue, and we met long before I started therapy."
Practice What You Speak
The next task for today's class has each person picking a random question from a bowl and practicing the techniques outlined by their therapist while answering the question. When Hannaford tells the group what she'd do if she won a million dollars, the focus is on how she answers, not what she plans to do with the imaginary money. She works on pausing and phrasing, a technique that allows the stutterer to resist time pressure and slow rate in a realistic manner. According to Sisskin, this method is a vast improvement over an earlier therapy that had the person tap out each word on their leg and speak in an unnatural, metronome-like cadence. Sisskin says people who stutter typically do not allow for the normal pausing and phrasing that other speakers use. Stutterers feel rushed to get out what they're trying to say for fear they will be cut off by an impatient listener.
Throughout the session, each therapist "models" the behavior she wants her client to focus on. I witnessed classic modeling earlier in the day when 14-year-old Patrick McCabe's therapist worked with him on the technique known as sliding. She randomly slid words in her speech as examples for him to follow. She'd ask, "Wwwwwwwhy did you ssssssstop playing that game?" Patrick answered, "I sssstopped playing Quake because I got bbbbored with it." With sliding, as they name implies, there is not a repeat of the letter. It's not "b, b, b, bored." Sliding is a way of easing into a trouble word, and it focuses on moving forward, not backing up to repeat the word or find a substitution.
After each member of the group answers a question and practices the techniques outlined by their therapist, the television and videocassette recorder are fired up. "How are stutterers portrayed in the movies and how do you feel about it?" is the topic for tonight's support portion of the class. "My Cousin Vinny" features a defense attorney with a severe stutter. Clearly played for laughs, the scene with the stuttering attorney takes every stereotype about stuttering and pumps it up to an extreme level. He spits out words (literally), repeats the beginning of words, chooses new words to replace the ones he can't get out, and even grabs the arm of a juror in a physical manifestation of trying to gain control of a tough word he can't say.
I prepared myself for this part of the session by resting my chin in my hand. I'm hoping to be able to hide a smile or a laugh if one makes it passed my clenched jaws. Then I notice that Kearn Williams, who's sitting next to me, is snickering uncontrollably. "It's funny," he says, as if apologizing. He can laugh now, but when he first saw the movie, before he joined therapy, he was uncomfortable watching the film with friends. Hannaford says she had a similar experience watching "A Fish Called Wanda." Michael Palin's stutter is a source for laughs throughout the film, but she said it doesn't bother her too much anymore, particularly since every character in the film is portrayed as a moron, not just the stutterer.
The consensus seems to be that therapy has helped everyone gain enough confidence not to be insulted by the comedic portrayals. Finding a positive or even neutral portrayal of someone who stutters, however, has the group stumped. Fortunately, the therapist who compiled today's film clips has done some homework.
James Earl Jones, the velvety rich voice of Darth Vader, and a man who stutters in real life, starred in a film with Robert Duvall called "A Family Thing" in which Jones plays a Chicago cop with a stutter. His character's stutter is minor and never an issue in the film. The stutter is just there. Williams, 26, who started therapy for the first time only a semester ago, tells the group that he has always looked up to Jones as a model of a successful stutterer.
"When Vivian first diagnosed me, she said my dysfluency was mild to moderate," Williams says. "I knew I stuttered, and it had been bothering me my whole life, so when she said it was mild, I thought she was nuts." Since then, Williams has discovered that many people who stutter think that the reaction of bystanders is far worse than it really is. "I always felt ashamed about my stutter," he says. "It's easier now; maybe because I'm an adult and dealing with adults or maybe this culture is more accepting than the one I came from, but the reaction I see now is minimal."
Growing up on the islands of Trinidad and Tobago, Williams didn't have access to therapy as a child. "In primary school, kids made fun of my stutter," he says. "It was very difficult to go through that, but it made me a very self-reliant person. I would have preferred not to have gone through it, but I did gain some benefit from it."
The group sessions have helped him become comfortable as a person who stutters. "I highly recommend support groups," says Williams, "because therapy is not just a way to become more fluent, but a way to share problems you've encountered and to hear how others have handled their problems. It has helped me to realize that I'm not alone in the anxiety that I go through."
As the class wraps up, Sisskin asks me if I have any questions for the group. I bring up her assertion that having me attend this session might have rattled some members. A soft-spoken guy who wants to remain anonymous says he wasn't bothered by my attendance. He assumed that because I was coming into the group, I was sympathetic to the folks dealing with the disorder. Williams concurred: "You're in my world here." The "Physics is Phun" grad student admitted that had we met outside of class, his stuttering would have been greater. In the class, to an untrained ear like mine, any stutter he had was virtually nonexistent. He sounded to me like someone who spoke slowly and thoughtfully, a trait common among most of the group's members.