I thought I knew it all, how and why I stammered, that sort of thing.
How wrong can you be? I have recently discovered that there is not just one but two separate physical causes of my stammer. And different physical causes respond to different types of therapy.After years of doing nothing, I came back to therapy 12 years ago.

My first modern course was an intensive course at the City Lit on 'prolonged speech with soft contacts', what they called 'smooth speech'. This taught a method of speaking which was fine if you were already in full flow but was of little help in teaching you how to get going from a standing start or how to deal with anticipated blocks. As virtually all my blocks are anticipated, in that I know about a second ahead of time when I am going to stammer, surely there must be something I can do, some technique, to stave off what is otherwise inevitable?

My second course, 'block modification' based on the methods of Charles Van Riper, was more hopeful.

After all, pre-block modification is all about dealing with the anticipated block. The pre-block technique says that before an anticipated block you should stop, pause and relax the throat and mouth muscles completely, almost yawn. The trouble with block mod and the way it is taught is that most people never get this far. They concentrate exclusively on in-block modification. This strikes me as akin to shutting the stable door after the horse has bolted. Why wait until you are into a full block situation before you do anything about it? Having said that, there are times when I must admit to using in-block pull-outs, but I am trying to give them up.

My third course was with Dr Martin Schwartz who believes that the physical cause initiating stammering is locking of the vocal cords.

In his 'passive airflow' method you learn to breathe out very gently prior to speaking because the vocal cords cannot remain locked while air is passing between them. I found I could use the passive airflow technique well in low stress speaking situations but had limited success in high stress situations. I now understand why, and will explain later. In due course I began to pay more attention to Schwartz's third principle which says, before speaking or before an anticipated block, be aware of a 'powerful intent to rest'. In effect, Schwartz is saying exactly the same as Van Riper namely stop, pause and relax or rest the throat completely.

My fourth course, with Dave McGuire, contained much useful psychology and non-avoidance therapy but is physically based on deep costal breathing using both rib cage and diaphragm.

This part is copied from the method of Len Del Ferro, though not absolutely identical. They believe that the physical cause of stammering lies within the diaphragm: control your diaphragm and you will control your stammering.

I made steady progress with the McGuire method for six months after the course, attending a self-help support group in London each week. Then....

I had the misfortune to have three traumatic incidents occur at about the same time which upset my whole emotional equilibrium. My speech fell to pieces, I was in relapse. I worked hard and regained most of my speaking skills except for one thing, I could no longer say my name on the telephone as McGuire expected. My name had become a super-feared word. I blocked every time. I tried everything I could think of-to no avail. One friend even phoned me up a dozen times one afternoon in an attempt to help me sort things out. I tried voluntary stuttering recommended by both Van Riper and McGuire: Van Riper calls it desensitisation, McGuire says it reduces the fear. It helped marginally but was not the real solution.

My dreaded name was sapping my overall confidence.

Having got so far, I was determined not to succumb to the slavery of stammering again. I hit upon a plan to find out what was going wrong with my speech and why my name was proving to be such an insurmountable obstacle.

I enlisted the help of a colleague at work and told her I was going to phone her up and attempt to say my name.

I knew a block would be inevitable but I wanted to slow the process down to see what was happening. Being a research scientist myself it seemed a viable experiment. I had a method of producing a block on demand and at the same time could virtually exclude the one ingredient that tends to ruin everything, time pressure. My friend was happy to hang onto the phone whether I took two or twenty-two seconds to respond. An anticipated block starts life with me scanning ahead and latching onto a word. This word might already be a feared word, but if it is not it soon becomes a feared word as it draws closer. A short time before I attempt to say it, I know that I will block. I found the physical processes start with a nasty feeling inside, in the pit of my stomach, a feeling of deja vu, 'Oh dear, here we go again, another block.' Going through the actions in slow motion this feeling is violent and very nasty.

Then I became aware of a small but very definite tension high in my throat.

I was unable to localise it precisely but it was certainly in the region of the larynx. Was it locking of the vocal cords? Probably not because I could breathe in and out with the tension still there. When I tried to say my name this small tension rapidly grew into a much larger tension involving my whole tongue and other parts of my throat. I had obviously flipped into a full scale block. What I was doing was expanded in time. In normal circumstances everything would have happened so quickly that the onset of a block would have seemed instantaneous and beyond comprehension why I was suddenly behaving in this curious way.

A bit later during my experimental phone calls I decided to try and relax out of the small tension in my throat.

The first time it took considerable concentration and many seconds: I breathed in and out three times. Eventually I felt the tension evaporate, my throat was free. I tried to say my name and was astonished when the words, 'David Creek', popped out with complete fluency. I was astonished because I still had the nasty feeling in the pit of my stomach signaling a block. I was expecting to block and gearing up my mind, my whole body, to deal with the unpleasant experience.

Total fluency was an amazing result.

Further tests indicated the simple rule that with tension in my throat I would block, without tension I was fluent. I felt I had the beginnings of an answer to my throat blocking problem.

Confirmation that I was on the right lines occurred on a McGuire refresher course when we enacted a 'cocktail party' scenario by introducing ourselves to all and sundry in the room. I concentrated on keeping my throat relaxed: if successful I could say my name fluently, if unsuccessful I had a minor block which I immediately released. All this happened towards the end of 1996. At the beginning of 1997 I realised I had to put in much more effort. I formed a circle of friends and colleagues at work and asking them if I could phone them up to practise saying my name. Everyone has been most supportive. I have also used answering machines to good effect leaving trails of messages wherever the phone lines took me.

Putting the Van Riper-Schwartz pause with total throat relaxation into practice has been far from easy.

Telling someone who is tensed up to relax is frustrating, because the advice, taking away rather than adding, is negative. However, try as I may, I cannot think of an alternative. Fluent people do not go around tensing the wrong muscles in their throats. If I really want to attain fluency I have to unlearn my bad habit and teach myself to stay relaxed.

The hard work is paying off.

A year after my throat block discovery I continue to be pleasantly surprised at my improving fluency. More work is needed to nail the problem completely.

However, this is not the whole story.

While all this was going on, I was becoming increasingly aware that in stressful situations my breathing was apt to become erratic and irregular. I could not make sense of it at first but then it struck me in a flash. This erratic breathing was a product of fear, pure panic reaction. My particular foible was a perceived fear of authority figures. When I had to ask for information from someone who knew more than I did, when I was being questioned or thought I was the underdog, I was literally quaking with fear. When fear was dominant, my breathing, my diaphragm, went out of control and the quality of my speech took a very dramatic downturn.

This was illustrated over a weekend when I went to visit relatives, for me not the most stressful of situations.

I spoke very fluently, managing to control my anticipated blocks using pausing and throat relaxation. The next day back at work I went to see my boss, a pleasant and relaxed fellow. Just before I started to speak I was overwhelmed by this panic breathing. I was almost hyper-ventilating. I stammered catastrophically for about half a minute until I got it under control.

Now McGuire-Del Ferro breathing is tailor-made to deal with diaphragm instabilities and, quite honestly, it works well.

Occasionally I have found that the level of fear can be so great that an enormously long pause, saying absolutely nothing, is the only way towards a calmer state. Nowadays I find on average that this erratic breathing only occurs about once or twice a day in higher stress situations, often when speaking to strangers. As such it is susceptible to reason. When I find my breathing going out of control, I suggest to myself that it is not really stressful but a perfectly normal speaking situation. I am sure that in the past erratic breathing due to fear was a much more frequent occurrence and contributed to lack of success with 'block modification', 'passive airflow' and other techniques.

My most frequent problem remains the throat block which seem to be caused by the fear of individual words.

Blocks can occur every few seconds. They are independent of the diaphragm in the sense that I can remain breathing perfectly regularly and yet have problems in the throat. I tend to deal with them by a series of mini pauses during which I rapidly relax. The end result might sound like hesitant speech, or if I am holding back, whereas in fact I am pausing and relaxing. McGuire emphasises to 'keep the voice in the chest, keep the problems out of the throat and mouth'. This is fine advice if you can do it, but I find I need something stronger, more geared to dealing with throat problems directly.

It is something of a discovery to realise that there are two very distinct physical effects initiating my stammering behaviour.

Firstly, tension in the throat, the start of the conditioned blocking reflex, is amenable to the Van Riper-Schwartz pause and relax. Secondly, panic breathing and instabilities of the diaphragm are more appropriately handled by the methods of Del Ferro-McGuire.

I have concentrated in this article on physical aspects of stammering because I believe the most effective place to cut the vicious circle of fear and stammering behaviour is at the point where stammering behaviour begins to break through to the surface. If you are near to 100% confident in your physical technique you will succeed in your speaking and the accompanying fear will diminish eventually.

Whether it will vanish entirely I do not know, only time will tell.

What I have said will not be applicable to all stammerers. Some are avoiders, some do not anticipate and some do not block in the same way as I do. However, I feel that there is a vast body of stammerers out there who do behave in a similar manner to myself.

By-passing psychology for the moment, the physical aspects of stammering are clearly complex. I find it satisfying to see that the methods of Van Riper, Schwartz, Del Ferro and McGuire are not totally opposed to each other. Choosing appropriate parts here and there, they form a complementary set.