Carolyn Cheasman at London's City Lit introduces a new course based on the mindfulness approach and describes the value of connecting with the full experience of stammering.
For some time now I have been interested in the relevance of mindfulness based approaches (MBA's) for stammering. I have been training to teach a programme developed by Jon Kabat-Zinn (1994). His course is called mindfulness based stress reduction (MBSR) and this has been developed by workers in the UK (Segal et al, 2002) into mindfulness based cognitive therapy (MBCT). There is now a growing body of evidence describing the efficacy of these programmes with a wide range of groups including those suffering from chronic fatigue, cancer, eating disorders, chronic pain and people recovering from depression. There is also a strong evidence base supporting the use of MBA's for those who do not have a particular named problem but present with the 21st century disorder known as stress!
Kabatt-Zinn recognised the potential benefits of meditation for people suffering either physically or psychologically. He has cleverly synthesised a collection of meditation practices into a course which, although based on ancient eastern wisdoms, is readily accessible to people living contemporary western lives. Although some of the practices are derived from Buddhism this is not a religious programme and is offered as a secular approach.
What is mindfulness?
Put simply, mindfulness is paying attention to our experience as it occurs in the present moment, without judgement. Although this sounds simple it is actually very different to how we live much of our lives when we are often thinking about the past or worrying about/planning the future. We find it hard to just 'be' with what is and are often judging our experience. If we judge it to be 'good' we want more of it and if we decide it is 'bad' we want to push it away. Within mindfulness this aversion or clinging to experience is seen as the major source of human suffering. We can develop mindfulness in relation to thoughts, feeling and behaviours both through formal meditation practices and in ordinary day to day activities. Have a go at showering mindfully and start noticing where your mind goes to!
How can mindfulness help?
We live a lot of our lives on 'autopilot'. Through becoming more aware we increase the possibility of 'responding' to an experience rather than simply 'reacting' in the old, knee-jerk fashion. However, in mindfulness we are cultivating a particular kind of awareness - an uncritical and compassionate awareness of ourselves. This is very different to the judgemental voice we often bring to our experience and in itself this can be a healing process. Many people find an inner strength through this work and develop resources to help them live their lives more fully. Mindfulness leads to change in a radically different way to most approaches. Often when we try to change we struggle against our experience in unhelpful ways. The struggle often leads to increases in tension and dissatisfaction. Mindfulness invites us to just be with what it is and paradoxically this being with often leads to shifts and changes. It seems as though sometimes the best way of getting from A to B is to just allow ourselves to be at A!
How might mindfulness help people who stammer?
I have identified three aspects of MBA's that could be helpful:
Working on acceptance is likely to be helpful no matter what approach to therapy you are undertaking. It is an integral part of the desensitisation phase of block modification therapy. Many people find it hard to be more open about stammering and this struggle often feeds the difficulty. While speech therapy programmes offer tools to work on this process, mindfulness practices directly help to cultivate an accepting stance towards ourselves. During guided meditation practices we are frequently encouraged to notice our experience and just let it be - not to try to change anything. While this is counterintuitive, I think it is very relevant to stammering where the attempt to 'not to do it' seems to play a big part in maintaining the stammering dynamic. Acceptance is not the same as resignation but is about developing a radically different relationship to our experience. Change can often flow from this.
The development of non-judgemental awareness can help people who stammer both to identify moments of stammering and to respond to these moments differently. This might be a different emotional, cognitive or behavioural response. People can find it hard to implement previously learned speech therapy techniques, either because they do not recognise moments of stammering, or more commonly because they respond to these moments in ways which are incompatible with using the technique - for example, through rushing or struggling. Negative automatic thoughts can play a big part in the maintenance of habitual stammering reactions and becoming aware of these thinking patterns can be the key to finding new ways to respond. Specific mindfulness practices help us to become aware of our thinking patterns and through cultivating an 'observer stance' help us to get less 'carried away' by our thoughts. MBA's also involve work specifically on developing awareness of breathing and this might have particular relevance for people who stammer.
Calmness and relaxation
Managing stress more effectively could clearly be of benefit but it is important to be aware that mindfulness is not a relaxation technique. In fact through working on being more mindful we may become more aware of how tense or stressed we are. The benefits come not through 'trying to relax', but through developing a different relationship to what you are experiencing.
Mindfulness and City Lit courses
So far we have introduced mindfulness through teaching short practices during our existing courses. However, a world first will be that in May 2007 we are offering an eight week MBCT course specifically for people who stammer. This will consist of eight 2.5 hour evening sessions and so there will be lots of opportunity to really experience the practices. The course also involves regular daily practice which will be supported by CD's.
More information: City Lit page.
Kabat-Zinn, J. 1996, Full Catastrophe Living, Piatkus, London
Segal, Z.V., Williams, J.M.G. & Teasdale, J.D. 2002, Mindfulness-Based Cognitive Therapy for Depression, Guildford Press, New York
From the Spring 2007 issue of 'Speaking Out', pages 9-10