Ever had a day when your speech is a real dog's breakfast? Old psychological research into dogs' eating behaviour has some relevance in treating stuttering, Warren Brown discovered at the recent Australian Speak Easy Association convention near Melbourne.

Ross Menzies, is a psychologist from the University of Sydney who is studying the role of conditioned behaviour in stuttering.

Professor Menzies said his first experience with treating stuttering was about 10 years ago. A man who stuttered came into his office. He said he was feeling anxious. Professor Menzies pointed out the window to the university building where speech therapy was provided. But the client said he wanted treatment for his anxiety about stuttering.

Professor Menzies said he believed there is a link between anxiety and stuttering. If someone stutters on words and others laugh at the stuttering, ridicule it or act disinterested, then the person who stutters will feel fear or distress. He believes the anxiety arises from aversive conditioning during childhood.

He said he thought maybe half of people who stutter have a social phobia.

He defined social phobia as a marked fear of one or more social or performance situations in which the person is exposed to unfamiliar people or to possible scrutiny by others. The person fears he or she will act in a way (or show anxiety symptoms) that will be humiliating or embarrassing. Exposure to the feared social situation almost invariably provokes anxiety. The feared social situations are avoided - or else endured with intense distress.

He said the avoidance, anxious anticipation or distress in feared situations interferes significantly with the person's normal routine, occupational functioning or social situations or relationships, or there is marked distress about having the phobia.

He believed there are a number of ways to eliminate this fear:
Exposure to feared situations. (The person is taught to stop avoiding.)
Cognitive restructuring. (The person challenges the negative expectancies that have built up over time.)

He said conditioning occurs when you cause a conscious link. Conditioning is about expecting things.

Fear conditioning is when people are expecting the bad stuff to happen, such as: "What will someone think or say?" If people feel anxious, they think something bad will happen to them.

He said cognitive therapy looks at what happens when a person weighs up the probability of the threat and the cost of the threat.

He urged people to use four questions to challenge their maladaptive thoughts about stuttering:
1.What is the evidence for the negative thought?
2.What is the thought doing for you?
3.What would you tell a friend (to help them) if they had the same thought?
4.How bad is the feared outcome?

Suggested ways of applying cognitive restructuring in everyday life include:
Keep a pen and paper handy.
Identify maladaptive thoughts as they occur.
Challenge your maladaptive thoughts.
Writing, reading and repeating the process.
Professor Menzies urged people who stutter to respond to new variations of negative thoughts as they arrive. He said negative thoughts would not give up. New variations have to be written down and they have to be challenged.

He said cognitive restructuring is not positive thinking. Positive thinking is unrealistic and maladaptive. It is irrational and is nothing more than simple reassurance.

Instead, cognitive restructuring is realistic and adaptive. It is rational and much more than simple reassurance.

From the Summer 2002 edition of Speaking Out