By Christine Hyde
"Stammering is a resultant of approach - avoidance conflict - of opposed urges to speak and to hold back from speaking"
Joseph Sheehan's statement strikes me as a brilliant insight; a revelation which is so obvious that it is deeply profound. Yes, I know that pull-push conflict so well, occurring physically in my speech, and also internally. It is as if I am impelled simultaneously to move forwards and stay where I am; to share myself with others and hold back from sharing; to struggle very hard against a problem and to surrender to it; to try to make people understand me and to give up trying. Just as my speech gets "stuck", so I end up "stuck" psychologically. I would prefer to say that stammering is an expression of approach - avoidance conflict.
As a stammerer, dissatisfied with conventional therapy and the absence of any sound theoretical basis for therapy, I have revisited Sheehan's insight, daring to bring to it my own intuitive perceptions about my stammer, my inner life and my behaviour. I have also drawn on my knowledge of Transactional Analysis, a systematic psychotherapy which is readily accessible to the lay person, and on insights inspired by Jean Liedloff's Continuum Concept. The effect of my self-therapy, over some 15 years, has been dramatic in that I am able to experience my speech as fluent and free from struggle and feel that I have been set free in my inner life.
In order to understand the origins of stammering, I believe that we have to look back to our very first attempts to communicate. A new-born baby's crying is the forerunner of speech. It is during the early period of our lives that we make our most basic conclusions about the experience of communicating. An unfulfilling experience of the communication process at that time is likely to lead us to make erroneous basic conclusions and these will be the foundation of a disturbed experience of communication throughout our lives. Jean Liedloff argues that normal child-rearing practices, in the civilised world, leave the infant with an incomplete mothering experience from the point of view of our evolved nature. We do not need to look for any unusual neglect in our own histories.
I want to propose that a new-born baby has an innate expectation that the signal of her crying will be understood, and the need met. If the baby perceives that her signal is not understood, she feels that she is in terrible danger - that she will die. Her instinctive response is to signal harder: to Try Hard to be understood. Again, if the signal is not understood, she will try harder and harder until, acutely aware of her own dreadful wailing and her physical and emotional distress, she becomes overwhelmed by her own signalling. She now perceives that her own signalling is a danger to her, for she will go mad if she continues thus. She instinctively finds a way to cut herself off from her vocalisations - to stop listening to them - and her body finds a way to Hold Back her crying. But then she perceives that she is in danger because she is not signalling her need. So she has to Try Hard all over again.
Notice that neither Trying Hard nor Holding Back succeeds in assuring her that she is safe from something dreadful happening to her, and that the pattern of her experience is circular:
In an environment where her message is never understood, the very instincts which nature intended to keep her feeling safe are instead escalating her distress. Thus, she finds herself not just Holding Back, but Holding Back from Trying Hard; and not just Trying Hard, but Trying Hard to Hold Back! In the language of Transactional Analysis, she makes a script decision:
"I can be OK if I Try Hard to Hold Back from Trying Hard to Hold Back etc...".
She continues this strategy with increasing intensity because she perceives that otherwise she will go mad and die, and because it is perhaps the only instinctive strategy available to her. I suggest that, in terms of the overall effect, the Try Hard message tends to win the argument in those with a largely visible and audible Sheehan iceberg; whereas Hold Back tends to win in those with more avoidance.
The baby makes the script decision with her body as well as with her mind. In Transactional Analysis this is called a "bodyscript" decision. Thus, the Trying Hard to Hold Back etc is something she does with her body in relation to her crying. I propose that this is the forerunner of the physical tension experienced by the stammerer. It may also be the forerunner of physical differences in the way the stammerer uses her brain in relation to language, or receives aural or kinesthetic feedback from her speech.
The growing child might receive further experiences which seem to confirm that her needs are best met by Trying Hard to Hold Back etc. Indeed, she will begin to reinterpret reality to make it fit her script decision. Many little confirming experiences or a few big ones might cause her to adopt this script decision for life.
Later, the same person will often find herself in situations which seem to resemble her early experience in some way. There may be a sense of distance between herself and the person she is communicating with (e.g. using the telephone); a sense of urgency about getting a message across; a sense that a person (e.g. authority figure) is unlikely to understand her; or a sense of deep involvement in the communication, of something strongly felt or earnestly believed. At these times, she is likely to get thrown back into her early experience and to replay her script decision. At these times, she will find herself stammering, relying on the same survival strategy which she used in infancy.
In Transactional Analysis, Try Hard and Hold Back (usually denoted Be Strong) are examples of "drivers", so called because they make us feel driven to behave in a certain way. We feel driven because we believe that if we do not obey the driver, something terrible will happen to us. The idea in Transactional Analysis is that you can keep out of a driver by affirming the antidote or "allower". For Try Hard, the allower is "It's Ok to do it" (instead of trying to do it). For Hold Back, the allower is "It's OK to be open and express your wants" It seems to me that, when stammerers adopt "speak more fluently" techniques, they are attacking the Try Hard element in their stammer by affirming the allower "It's OK to do it'. When they adopt "stammer more fluently" techniques, they are attacking the Hold Back element by affirming the allower "It's OK to be open and express your wants'. The trouble is that, as they disobey their drivers, they will find themselves faced with that terrible thing which they believe, in their script, will happen to them; and it was my experience that my script beliefs fought back with a vengeance!
The other trouble lies in the circular nature of the script decision. Initially, when I got out of Hold Back, I ended up Trying Hard; and when I got out of Try Hard, I ended up Holding Back. Also, my perception that it was difficult to affirm the allowers tended to land me right back in Try Hard. This is why neither "speak more fluently" nor "stammer more fluently" approaches will effect a cure on their own. What a stammerer really needs is to get out of the whole circle: to step outside the whole business of approach -avoidance conflict.
... any use of the imagination will be helpful because it is the creative intuitive part of us which needs to make the redecision
One way in which the circular pattern manifests itself is in the way the stammerer thinks about a problem. For instance, one of my thinking patterns was:
"I stammer therefore I must try hard not to stammer But when I try hard I stammer worse, so I must hold back from trying and surrender to the stammer But when I do that, I feel inadequate and I cannot communicate, so I must try hard not to stammer?"
You will see that this circular way of thinking makes the problem seem insoluble. Nevertheless, it is as if the little Child inside us has dedicated her life to trying to solve this puzzle (and others like it), in the belief that, if only she can solve it, everything will be all right. What the Child in us needs to realise is that it is not necessary to solve the puzzle because her needs cannot be met in this way. The Child in us needs to see that there is a whole different world outside our circle where we can have a different kind of experience. For me, the moment of stepping outside my circle was accompanied by a feeling of complete bewilderment and disorientation. From inside my circle I had had no concept that there was any other way to experience the world. In his article, Dr Schmid recommends the use of metaphor to help the client to achieve a "meta-stance". I suggest that any use of the imagination will be helpful because it is the creative intuitive part of us which needs to make the redecision. A central assumption in Transactional Analysis is that we do not need to be bound and trapped by our early experience. When we perceive that our script decisions are not serving us well, we can choose to decide something else.
What the Child in us really still needs is to feel understood, empathised with, heard, listened to. She needs to have positive experiences of getting her message across about who she is, what she feels and what she needs. In place of always feeling misunderstood, she needs to feel valued and accepted in a way which is congruent with her self-image. The atmosphere of "understood" is like a catalyst within which healing can take place. In fact, there is a strong emphasis, in the literature about therapy for stammerers, on the helpfulness of empathy and listening. However it seems to me that empathy is required not as a means to facilitating therapy; it is therapy in itself. In the case of a child, the book How to Talk so Kids will Listen and Listen so Kids will Talk by Adele Faber and Elaine Mazlish (Avon Books, 1980) might help parents and teachers to develop an empathetic home and school environment.
Eric Berne, the founder of Transactional Analysis, believed that the aim of psychotherapy should be "to cure the patient", not to help him "make progress". I would like to see the day when the aim of therapy for stammerers is healing rather than improvement or learning to live more happily with the problem. In Eric Berne's words -let's put a whole "new show on the road".
© Christine Hyde 1997
"Theory and Treatment of Stuttering as an Approach - Avoidance Conflict", J. Sheehan in The Journal of Psychology, 1953: 36, 27 - 49.
The Continuum Concept, Jean Liedloff (Arkana 1989).
TA Today : A New Introduction to Transactional Analysis, I. Stewart and V. Joines (Lifespace Publishing, 1994).
"Breaking through the Dilemma Circle", Schmid and Jager, in TA: The State of the Art, ed. E. Stern (Dordrecht Foris Publications,1984).
From the Winter 1997-98 edition of Speaking Out