Speech Language and Therapy

Beyond Hardship: Reimagining Stuttering with Dr. Chris Constantino

March 06, 2024 Kyle
Beyond Hardship: Reimagining Stuttering with Dr. Chris Constantino
Speech Language and Therapy
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Speech Language and Therapy
Beyond Hardship: Reimagining Stuttering with Dr. Chris Constantino
Mar 06, 2024
Kyle

I am very excited to share my conversation with Dr. Chris Constantino of Florida State University. I invited Chris to the show because I found his work as an advocate for changing how we perceive and engage with stuttering to be extremely important and fascinating. As you'll hear, Chris challenges us to rethink stuttering, urging us to see it not just as a hardship to overcome but as a unique aspect of identity with unexpected benefits. He's been developing a groundbreaking treatment framework known as stutter-affirming therapy. His insights inspired me greatly, and I believe this episode is a must-listen for all SLPs. I thoroughly enjoyed my conversation with Chris, and I'm confident you will too.

Links to the book: Stammering Pride and Prejudice: Difference Not Defect

Kindle Version (Affiliate Link)

Physical Book for United States Residents

Physical Book for Readers Outside of the United States


I launched the Speech, Language, and Therapy Podcast with a mission to develop a deep understanding of the connection between speech therapy and overall well-being, especially in the area of stuttering. Inspired by my guests, I founded Brouwer Therapy to translate these insights into action.If you would like more information about connecting with me and my private practice: www.brouwertherapy.com

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Show Notes Transcript

I am very excited to share my conversation with Dr. Chris Constantino of Florida State University. I invited Chris to the show because I found his work as an advocate for changing how we perceive and engage with stuttering to be extremely important and fascinating. As you'll hear, Chris challenges us to rethink stuttering, urging us to see it not just as a hardship to overcome but as a unique aspect of identity with unexpected benefits. He's been developing a groundbreaking treatment framework known as stutter-affirming therapy. His insights inspired me greatly, and I believe this episode is a must-listen for all SLPs. I thoroughly enjoyed my conversation with Chris, and I'm confident you will too.

Links to the book: Stammering Pride and Prejudice: Difference Not Defect

Kindle Version (Affiliate Link)

Physical Book for United States Residents

Physical Book for Readers Outside of the United States


I launched the Speech, Language, and Therapy Podcast with a mission to develop a deep understanding of the connection between speech therapy and overall well-being, especially in the area of stuttering. Inspired by my guests, I founded Brouwer Therapy to translate these insights into action.If you would like more information about connecting with me and my private practice: www.brouwertherapy.com

Support the Show.

Buy Me A Coffee

  Welcome to the show, Chris. Just really glad you're here.  

I'm really glad to be here. 



I've been really enjoying reading your work. And, my first  article I read of yours was the stutter naked chapter . And it's got a really, really interesting discussion on stuttering as hardship. So could you start off by just giving us a little personal background and  go into your insights in terms of framing stuttering within that narrative? 

Yeah. So  I think an important part of my background is that I stutter. Um, I have the sort of normal stuttering arc that started as a young kid, um,  got progressively more difficult, uh, especially through adolescence, um,  I would say really struggled with my speech as a teenager and young adult, and then  through finding speech language pathology and the stuttering self help movement, and Just really,  embracing my stutter, have  really changed how I speak and how I feel about speaking.

And I think the, that's a, that's a lot of people's stories.  And I think the reason I, I preface this for saying that's a lot of people's stories is that  a lot of people have the story of  starting to think about their stuttering as, as something that they may have. Uh, gained from,  and I've, I've, I've used the term stuttering gain in some of my writing. 

And in that particular chapter you mentioned, which is from the book Stammering Pride and Prejudice,  it opens with me at a stuttering self help meeting. And This very common discussion is coming up, like, what, how is your stuttering a gift? And something I noticed, and how a lot of people who stutter talk about their stuttering, and this isn't a bad thing, I don't, I don't want to start this by, by making this narrative sound negative, is that their way that they're framing their stuttering as a gift, is that it was something challenging and difficult that they have overcome.

And through that overcoming,  they grew as a person.  And I think that's very real, right? I think anybody who's gone through something difficult experiences that. And so I, I call that narrative, uh, stuttering as hardship.  And in my chapter, I'm a little critical of it. Not because I think it's bad. But because I want to push my fellow stutterers a little bit further, right, is, is stuttering simply something that's good because when we come out the other side,  we're stronger? 

Meaning there's nothing actually good about stuttering. It's just, it's just something tough. And so we mature  through learning how to deal with it, which I think is true of many, many, many  experiences that human beings have.  And so what I'm, when I'm asking my readers to think about is, is there anything that's actually  special about stuttering?

Is there anything that we gain  from stuttering that we would lose?  If we didn't stutter,  and I, I'm less interested in things like, well, I would care more about what people think, or I wouldn't have met the friends I met through the stuttering community. Because chances are you would have met friends some other way if you didn't stutter, right?

You would have  maybe learned to be less vain  some other way, right? So is there anything specific about the stuttering experience that is, uh,  beneficial or meaningful or that we gain from?  It's how I'm trying to build off that narrative.  

Yeah. I, I really appreciate that. Like you said, I really think it's a, a worthwhile thought exercise to continue to go down that road and really think about that.

 One way that , your article also helped me kind of frame it in my own mind  📍 is  you discussed the medical and social models.  How would you  📍 explain the medical and social views of stuttering and what what impact that has? 

So, yeah, I always like to preface these discussions because they can get  just like everything else nowadays They can get contentious and I don't think they need to Right. I think this becomes like a,  like Democrat versus Republican discussion. And I don't think it need be that. I think when we're talking about models,  it's important to understand that models are.

Attempts to simplify reality so that we can wrap our head around it, right? That's a that's that's what a model is. It's it's a Simplification of what's actually going on and depending on what you're doing. You might need to use a different model  and so I think the  classic model that we use in speech language pathology is it's what's come to be known as the medical model  and  But by the name, this, this generally comes from the field of medicine.

The idea is you compare,  typically healthy people to, to people with various disorders or diseases, um, that, that difference becomes seen as a pathology and, uh, and the way to help that person is to alleviate the difference, right? So it's, it's, it's a curative model.  A little, uh, disclosure here,   I have benefited greatly from, from the medical model, right?

My, my, my son  about a year and a couple months ago had a heart transplant, right? And, um, I am grateful that, that there is, that there was doctors who were able to do that, that, that kind of work. However, um, for, for.  Conditions like stuttering or like autism, right? A lot of my work is influenced by, by the work of, uh,  autistic writers writing from a neurodiversity perspective.

A lot of my thinking is influenced by deaf writers for, for conditions that are persistent, right? That are chronic, that, that aren't curable. Um, I think sometimes the medical model leads us down some dead ends, right, because we start  looking at how do we make this person appear more normal, how do we make this person fit in better, right, because, because we're stuck with seeing that, seeing what's wrong is the pathology.

Mm hmm. And I think what the social model brings in  is it suggests that, that there's actually two things going on here.  In like classical social model literature, like from the 90s,  they'll make a distinction between the impairment and the disability, and, and the impairment is your bodily function, your anatomy and physiology.

The disability is the consequences you experience. Because of that impairment. Actually, they would say it's not because of the impairment. It's because of the way society treats that impairment. Right. And so the, the classic example, a lot of the people doing this work in the nineties, um,  were, um, had, had paralysis  of some sort.

They used wheel chairs to get around and they got around quite well in the wheelchairs until they  encountered something in their environment that was not built for them.  Now, both somebody who walks and somebody who  rolls cannot fly,  right? And so both people need to get up somehow.  And if there's a choice made to build a flight of stairs and not a ramp, that's a choice made to allow one type of person up and not another. 

And so the social model was suggesting that, uh, there's different kinds of people in the world. But the way we, we construe the world actually puts some of us at a disadvantage.  And I think that's really easy to wrap your head around for something physical. But  for things like stuttering, for things like autism, uh, we're often dealing with, not necessarily like a physical flight of steps, but expectations of how one Should speak right and when we encounter a communication breakdown right when it's when somebody's stuttering and somebody's listening  I think a purely medical model perspective would suggest in order to fix this communication breakdown We need to get rid of that pathology We need to get rid of that stuttering  the social model I think would would nuance that by saying well, is it possible to communicate while stuttering?

Right, and I think the answer is clearly yes. And so what's, what's not allowing that? Oh, the,  the person listening to that stuttering is maybe being impatient, or maybe they're expecting something from the speaker that's an impossible expectation, right? So it brings into, I think, a critical lens the expectations of those around the stutterer. 

That it takes two people to communicate and the responsibility for passing that message is not only on the speaker, but on the receiver.  And so the challenge, I think, is how do we,  uh, lower, reduce the barriers? to communicating with stuttering. The assumption being that most of us will continue to stutter to some extent.

So, be that as it may, how can we, structure society's expectations so that we can communicate as, as easily and joyfully as possible?  

Yes, that's so well said. I really appreciate that,  Chris.  That is a really important question. And I think that there obviously is quite a ways to go.  What are some of the ways that we can move society forward in that?  

Yeah. I mean, I think, I think in some ways this idea of like,  uh, like the. buzzwords in the culture, right? Like diversity, inclusion, equity, all those concepts  are actually all gesturing in this direction.

I don't know that people are necessarily thinking about disability when they're using those words, but the idea that, um, We all have a responsibility for each other  and that, um, 

we need to be critical of our reactions to other people.  So I think actually the  social moment is conducive to some change here.  Stuttering is 1 percent of the population, right? That's, that's a lot, but it's not  so much that there's like a mass movement around stuttering.  People with disabilities though, depending on how you count disabilities, could be 15, 20, 30 percent of the population, right?

And so I think there's a great deal of power and solidarity, right, in, in people who stutter making common cause with. With people with autism, with,  deaf speakers, with, anybody and everybody who would like to see,  their, their conditions less stigmatized and more accepted.   But I think more specifically, and, and we can talk about this when we talk about therapy, I think because stutters are, are such a small percentage of the population, a lot of the responsibility comes down to them and, and those who care about them,  that by  doing things like stuttering more openly, talking about stuttering, showing stuttering, disclosing voluntary stuttering. 

You begin to  pepper your environment with stutters, right? You begin to like plant little stuttering seeds around  and so many people cope with stuttering by hiding it, by avoiding stuttering, by, by passing as fluent, that, uh,  the world doesn't even know what's going on, right? Others don't know that you're struggling, they don't know why, and if you tell them they don't really get it because they've never heard you stutter.

And so by,  I think, simply stuttering, More as much as possible  We can we can begin to show that change right one in a hundred is actually quite a bit like if you go to a  Supermarket like like a big grocery store. There's probably often a hundred people in there Yeah, if every time you walk into a grocery store, there was somebody stuttering right eventually you would hear it  and and the more others hear stuttering the more stuttering is like  Portrayed in media or in fiction and nonfiction as, as just another human trait rather than like a  trope, uh, the more it'll just become something that  people expect to hear occasionally.

And like, that sounds like such a low bar, but if, if people just expected to hear stuttering occasionally, I think it would solve much of this, right? All we need is for, uh, people to hear stuttering and recognize it as stutter.  Right. 

I, yeah. Yeah. I love that answer. I I absolutely love that.  But what about even, like, not just thinking about me,  what if I stuttered on purpose in community in the c.  What are your thoughts 

on that? I'm not a person who stutters.

Like a fluent speaker? Yeah. Um,  I think that's, no, I think that's wonderful.  This is actually a hot  button issue in the stuttering world because, um, for decades, speech language pathology programs have, have used what they call the pseudo stuttering assignment. Yeah. Which is. Asking their graduate students to go out and stutter  and  we were talking about the, the, the, the cultural moment earlier and how I think there's some good things about it.

I also think there's some bad things about it and that people are, uh,  A little scared sometimes and, and very sensitive and they're worried that like this might be the equivalent of say, like black face or, you know,  they call it, there's, there's a lot of issues around disability simulations, especially when it comes to blindness and deafness and that kind of thing. 

And so for professors who might be listening, who, who, who use that assignment for, for graduate students who might be listening, who've been assigned this, I think.

By and large, people who stutter are very supportive of these exercises, right? We're not a monolithic group, right? We, we, we, we disagree with each other. I don't, I don't own the voice of the stuttering community. Yeah. But, um, I think many of these exercises were recommended by, Like people in our field who  stuttered, right, Wendell Johnson, Charles Van Riper, Dean, Dean Williams, uh, Joseph Sheehan, like there's  speech language pathology is, I think, fairly unique in that stutters have had a presence here  for, uh, half a century, right?

Um, more than that.  And so  we can, we can speak for ourselves, I think, within this realm. And I  think there's, I think there's reasons to be cautious, right? I think the student's knee jerk response is that this is, this feels icky, um, is not without merit.  Just because you've done a pseudo stutter assignment does not mean you know what it's like to stutter. 

But I don't think anybody's saying that.  I think what we're saying is the value of these assignments is that you're learning a little bit about what people who stutter experience in terms of societal reactions. You're also learning a little bit about what they experience internally,  in that much about stuttering is  reactions to a fear, and making choices in response to those reactions.

And in the same way that they do not want to do this assignment, in the same way that they go into the grocery store and they avoid,  uh, their peers, right, they choose to do it with a grandmotherly. figure, right? People who stutter are making all those same decisions, right? So you're, you're not only getting a, a peek into  the, the social interactions, but you're getting a peek into like all the mental gymnastics that people who stutter are, are using in their everyday life. 

Furthermore, and this I think gets back to what you were saying,  If there's more stuttering around, I think that's wonderful,  right? That, that, uh,  that my, my thesis from earlier was that the more people here stuttering, the less stigma there will be. Yes. And so while this is not the point of the assignment, the point of the assignment is if you have stuttering clients, you're likely going to have to do this with them.

And so it behooves you to practice  in class.  But I think a secondary benefit is that like. The area around the college just heard a lot more stuttering. That's right.  Right. And, uh, again, stutterers will disagree with me, but I think that's a good thing. 



 All right. I really appreciate that perspective. Yeah, that, that was the spirit in which I was offering it. And I really appreciate your thoughtful response on that.  

In your recent article on stutter affirming therapy, you talked about identity.  Identity and stuttering. Uh, it's a very complex relationship. And so what would you like people to know about identity and stuttering?



yeah. So  a lot of how I've been influenced with, with that thinking and that work comes from the literature on racial identity.  There's some. Like landmark studies from like the early 90s where  there were sort of competing theories about how racial identity worked. These researchers were specifically studying African American identity within the American context. 

And the two competing theories were that,  black people in this country are necessarily at a disadvantage because society at large, uh, does not value their identity, their, their racial identity  and, and that must be psychologically damaging,  right?   That was actually taken for like a given and then the, the response to that was then should.

Should shh.  Should the  person try to reduce this identity that is, that is causing them harm because, you know, changing societies is such a big lift? Should they then try to assimilate or, or do we need to, um, like almost have like a cartoonish pride, right? Like a, like a sort of, um, Like really, really double  down on, on trying to bolster this identity. 

The way I describe it is, are we rejecting society or rejecting  ourselves, right? Like, how do we, how do we make that  choice?  But what the research showed was that, um, it's entirely possible to have a  Uh, strong  identity as an African American person within a society that stigmatizes them without rejecting either, 

and the way that they measure this is they ask people  how, how central your race is to your identity. They, they call that centrality.  They ask them, how they feel about that racial identity and they call that regard. So you could have a higher regard or a lower regard.   📍 And then  they ask how salient their identity is in various situations.

So like  in terms of race, if, uh, I'm. Surrounded by a bunch of people who share my race. My race might be very salient to me.  If I'm just walking through the grocery store and there's lots of different people, my race might not be very salient to me.  And what they found was, if somebody had high centrality and high private regard, so that's how they feel about their race, it didn't matter what they thought other people thought. 

When their race was salient, they had psychological benefit,  right? And so actually, feeling good about being a black person in America  was beneficial, even when everybody else thought being black was a bad  thing.  And so you didn't need to reject the culture, you didn't need to reject your  self,  but you needed to have a sort of strong,  positive  Identity about who you were. 

And so I was wondering, in some of the research I've been doing, is does stuttering identity work in a similar way? Right? Because I think stutterers are kind of presented with a similar proposition. Do we embrace fluency? Right? Do we, do we use fluency shaping strategies? Do we, do we hide our stuttering?

Um, or do we take sort of a radical route and say, you know, uh, We don't have to do anything about our stuttering. Everybody else is wrong. We should be allowed to talk however we want. Um, and sort of say, you know, the, the problem is everybody else but us.  And if, if stuttering identity is similar to racial identity, which I haven't proved that yet, but  I have no reason to think it isn't, then the idea would be that if you have high centrality and higher private regard,  then it's possible to  get benefit from stuttering regardless of what other people think. 

And so  in that article, the, the stutter affirming therapy article, I'm  trying to outline like how, how, how might we help people do this? How might we help people who stutter develop a Uh, positive identity around stuttering,  one that, one that, that doesn't need to be, doesn't need to put up walls, right?

That I think I leave lots of room for, for learning to speak easier, right? Because I, I, those who are listening are hearing me speak fairly easily, right? I, I, I would be a hypocrite if I said I didn't value that, right? I, I very much value the changes I made to my speech, but I think they've largely been made because.

I stopped chasing fluency, right, because I embrace the identity of a person who stutters. And so,  I think that dichotomy between, like, rejecting culture or rejecting self is actually a false one. That, that if we just We  are able to honestly share ourselves with others.  We not only protect ourselves psychologically,  but we actually learn to speak in a more spontaneous way.

 Yeah, that's so interesting. And I think from there, I'd love to move into some of the core principles of stutter, firming therapy.  And so could you take us a little deeper into those core principles, Chris?

 

So there's three that I write about. The first one is what I call re re rejecting fluency. The second one I call embracing stuttering. And the third I call, um, like modifying your environment, making it more stutter friendly.  And that That first one, when I talk about rejecting fluency, and this comes from a long line of, you know,  stuttering, therapy approaches through Johnson, Van Riper, Sheehan, now Vivian Siskin is, I think, a very wonderful advocate of these ideas, but most of our struggle in stuttering  comes from trying to be fluent, that we experience a lot.

So, for the listeners who maybe don't work with stuttering, aren't as familiar with stuttering, uh, stuttering is not a motor speech disorder, right, and, and what makes it different is that  the  person who's speaking with a stutter.  What you're hearing is them react to a feeling of being stuck,  right? There is nothing in their brain that says they will repeat the syllable twice or they will Hold the syllable for three seconds and then it'll it will release, right?

It's it's an active process and that's why it's so variable. You might stutter one way one moment a different way the next an example. I often use is if we communicated by writing instead of speaking  Imagine you had a condition A condition, I say that with quotes, air quotes, where there was a ghost grabbing your hand as you were writing. 

What people would see would be you jerking around, uh, you getting really tense, maybe you stopping and started writing, but you don't have like a stopping and starting disorder, right? You don't have a jerky disorder. What you have is a feeling of losing control of your arm that you're, that you're wrestling with.

And you try different things as you wrestle, and you develop different habits in response to this. And so, the behaviors of stuttering, I think, can be very confusing, because they're not actually the problem. The problem is that you feel stuck, and it's really hard to get unstuck.  And  the more you want to not appear like you're stuck, the more you want to appear fluent, the harder it is to get unstuck in a reasonable way.

  And so  people develop what I call in this article stutter phobic reactions  to stuttering.  They, they stutter like they don't want to be stuttering. They stutter like they hate stuttering. They're fighting with it. They're wrestling with it. They're avoiding it.  And as we know from decades and decades of stuttering literature,  these habits become automatic.

It's like the person is just digging a hole and making their speech more and more tense.  And so My,  my, my way out of this is to, instead of thinking about fluency, to think about  Trying to shift from a, from a stutter phobic reaction, where the person's moving away from stuttering, to, uh, what I call a stutter phelic reaction, where the person's moving towards stuttering.

Stuttering like you, like you want to stutter. Stuttering like you might enjoy it, that you might like it. Um, and so,  I mean, I, I have very specific examples that I use where it might start with simply saying a word you weren't going to say.  And then maybe, maybe now you're, you're not avoiding your words so much, but, but you're having like very long silent blocks.

Well, it would, it would be more stutter feel like if, if instead of tensing up until you knew the sound was going to come out,  you, you allowed that sound to come out stuttered. Right? You, you allowed some audible dysfluency out. So maybe you, you, you begin to, uh, play with letting some, some stutters out. Um, so maybe that shifts from avoidance to an inaudible block to maybe  some repetition, some prolongations. 

And you just keep moving more and more towards the stuttering. What would this sound like if I wasn't fighting it? What would this sound like if I wanted my listener to hear this? And so, hopefully, slowly through that process, your stutters  probably get more obvious,  They'll probably get more audible, um, but they'll probably also get easier, and hopefully shorter, and less tense, because you're not fighting with them anymore. 

The second tenet of the therapy is embracing stuttering because I think the first tenet's really hard.   I  📍 think replacing  stutter phobic reactions with stutter philic reactions is an easy thing to say on a podcast, but is a very hard thing to do in practice. And so my, my motto is always that stuttering is easier if we have a reason to stutter.

We talked earlier about, you know, what is, what is good about stuttering and this is where I think that, that comes back into play is if we have a reason to stutter and this will probably be different for, for all of our clients, then  It's easier to, to, to trust your stutter with your listener. Right?

It's easier to, to offer it to them. 'cause it's not just like gritting your teeth. You're, you're actually expecting to get something in return, something good. And so  the example I've used for myself in a lot of my writing is that, uh, for me,  stuttering, like, because you're, you're lo you're stuck, right?

You've, you've lost control. You're, you're actually showing yourself in a, in a very vulnerable. position, right? You're, you're allowing somebody to witness you, uh, I wouldn't say at your worst, right? But, but you're, you're witnessing something, that's very delicate, right? It's, it's  very vulnerable.  And if the person accepts that, right?

If, If they reciprocate  that vulnerability, if they don't reject you,  there's sort of a mutual vulnerability there, right? They, they kind of meet you where you're at.  And for me, that, that is,  that, that, that mutual reciprocated vulnerability is, is the ingredients for intimacy, right? And so,  by stuttering, if, if I allow it, if I don't shut it down, if I don't avoid,  if I don't restart my sentence as I approach a moment of stuttering, Um, I'm actually able to have a, a greater connection with the person listening to me  because my stutters create these little moments of intimacy. 

Now,  vulnerability comes with risks, right, otherwise it wouldn't be.  And so people might reject that, right? I might not create intimacy, the person might reject it.  But that's not up to me, right? That's not  All I can do is offer it.  And so, my stuttering creates opportunities, I would say, for intimacy. In  📍 that article  I do a little case study with a client of mine, he was a, he was a 12 year old adolescent boy, and  he, he struggled with this idea for a little bit, I mean he, he, he listened to it, he didn't like say that's stupid, but, you know, it was really hard for him to come up with something, I, and  for homework I would usually just, you know, go, you know, I would  Go home, stutter to people, try to think about, you know, what's, what's different in the situation when you're stuttering that, what, what do you, what do you gain here that you wouldn't have if you didn't?

And one day he comes in  and he says, I have an answer,  right? Stuttering helps you make friends is what he says. And, and the way he does it, he said it is he'll, he'll go up to a stranger and tell them,  hi, my name is so and so.  Something interesting about me is that I stutter.  Tell me something interesting about you. 

And like, that's such a cool thing for a 12 year old to be  doing, right? Just cutting through the small talk, getting into, like, simultaneously disclosing that he stutters while also, , having an interesting conversation. and so. It's hard, right, because we're so used to seeing our stuttering as a hardship, as we talked about earlier.

We're so used to seeing it as something terrible. Um, but I think most of us will find  that Stuttering is like every other human attribute, right, that it's nuanced.  And there's bad things about it, but there's also things that we gain from it. And, uh, I'm not saying on the net that we would all choose to stutter. 

I think most of us wouldn't. But if we're going to be stuttering anyway, we might as well mine this experience for,  what good there is in it. Mm hmm. 

, I think stuttering needs to be more than just hardship. 

Yes. Yes. 

And in my, in that book chapter, Stuttering Naked, I, I, I, I offer an alternative narrative, 

that's stuttering as delight. And that, that might be a stretch for a lot  📍 of people.  And so  that, that need not be your narrative,  but, I do think it's worth figuring it out for yourself because then that, that, that first part of stutter affirming therapy, trying to, trying to move towards, trying to change your reaction from, from moving away from stuttering to moving towards stuttering becomes much easier because  primarily, I think we're trying to make our speech easier, right? We're trying to speak more spontaneously. But not only do you achieve that goal, but you also achieve a goal of, say, for me, intimacy with the person I'm talking to. For my client, making a new friend, or what have you.  And so it's a, it's a way of, hopefully making the therapy process more meaningful. 

Speaking of that, I would imagine it's important for clinicians to have some basic counseling skills to help their clients through that process.  Because it certainly, isn't going to be like, okay, it's time to embrace stuttering. And all of a sudden there he embraced stuttering. 

Cause you said, so. It's a process. And so. what are some basic counseling skills that you feel go along with that process? 

Well, yeah, I mean, I think, I think much of therapy, I feel like we're, we're, we're always counseling,   especially in stuttering.  I, I teach the counseling class here at FSU and I think something my students struggle with the most is like they want to fix everything,  Like they want to know when my client is crying, how do I make them stop crying when they're sad?

How do I make them happy?  And, It's always amusing to me, because I don't know how to make myself happy, right? Let alone how to make somebody else happy. And so, I don't know where they think they have these powers. Like, where these powers are coming from. but the ability to stay with somebody,  our clients are coming to us because they're suffering. Nobody wants to be in speech therapy. People have better things to do than spend hours and money, hanging out with us. they, they'd rather be seeing their friends or being with their family or playing a game that they like. and so, they're with us because something is wrong. 

And if we're honest, we can't fix it immediately, And so to be able to  stay with them through the, through that suffering, hear what they're saying, help them to come to their own conclusions, reflect what they're feeling, be empathetic.  But understand that like,  just because Chris Constantino said this doesn't mean that like that's going to mean anything to them,  right?

You can offer ideas, but that ultimately the person is,  uh, making their own meaning of their stuttering. And you're there to assist them and  try to help  them in the direction that you think is helpful as the person with that experience. And so, we're gesturing towards these stutter phelic responses, right?

We're trying to help the person embrace their stuttering.  But it's not as simple as just saying, like, you should embrace your stuttering. . Otherwise we wouldn't need to have this podcast conversation. You would just do that.  Yeah. So I think, I think patients, the ability to listen to, to, to really hear what your client is saying,  to resist the urge to try to take that pain away,  that pain is valid.  And, um,  I think often being able to witness it  and,   Encourage your client to come up with their solutions rather than you having all the answers all the time. 



 Yeah, exactly.   And that's a great example with your teenage client. You didn't tell him this is the way. You gave him patience. And then he came up with it, which seemed like it was much more effective because it was his wisdom. He was the expert on his life.

Right. I would never have come up with that. Right. Right. Um, my, my clients frequently surprised me because things, things that I think would be the easy way to do it,  they think is the hard way to do it.

And then they have this other way that I was like, that sounds so much harder than what I was going to say. Right. You know, whatever, whatever works for you is what works for me.  So, um, they will surprise you. They will have good ideas.  And that's actually, me. Much more fun than having the answer anyway, 

 

Yeah. It's always interesting how that works out and that's a really, a really cool way to approach it.  I'm thinking about,  the social systems of people,  who stutter. Maybe family members,  friends, community members. I, I would think  that's an important piece too. 

Yeah, something I talk a lot with my clients about is, recruiting others to, to, to help you and not to help you avoid, right? Like not to talk for you,  but that, those who are important in your life ought to know that you're in therapy,   they, they, they ought to know what you're working on.

to some extent to hold you accountable, but that's not really what I'm  driving at. I'm more driving at you're going to be talking differently,  you're going to be trying to stutter more openly to move towards the stuttering.  They're used to you talking another way,  if you pass this fluent, they're not even, they might not even know that you stutter,  right?

They're used to you speaking fluently, or they're used to you starting your sentences over and over again instead of just staying in a prolongation. And so If you can, like, let them know, here's, here's what I'm working on, here's what you're going to be seeing, that gives you permission to do that with them. 

And then when you're out with them, it gives you permission to do it with strangers when, when they're watching. sometimes our hardest audiences are those who know us best, because  they expect the status quo,  they expect what we've given them in the past. 

And so the more we can teach them about stuttering, about what we're working on, then the more they can advocate for us too,  they can recognize  thoughts that they had about stuttering that were inaccurate or maybe,  prejudiced. They can, they can stand up for that when they see it and they hear it.

so I think recruiting allies is, is a really important part of, of the therapy process. 



 Yeah, and I can speak from personal experience that that really is an important part of the therapy process.  Another area that I think is interesting is the developmental considerations of this approach.  We've been talking about some really mature psychological dispositions in terms of embracing stuttering.  And I'm wondering about younger kids who stutter, are there some difficulties in taking a stutter affirming approach with younger kids? 

I have found that, young kids can take this quite easily, And parents, too. I, I think sometimes, like, when I'm talking to other speech language pathologists about, like, a more acceptance based approach to stuttering, there is a fear that  parents are going to bring their kids, their stuttering children to them, and when they say, we're going to try to accept it to speak more easier.

That the parents will leave because that's not what they want to hear. That might be true for some parents, but my experience has been  that Especially when the kids are older, 10, they've been trying to make their kids fluent.  They've done the fluency therapies. They have been feeling guilty that they're not doing enough.

Their child is still stuttering. They're wondering if they've done enough therapy, if they've spent enough time practicing their techniques. They're  not pushing fluency because  that's all they care about. They're pushing fluency because they think as their parent that's what they're supposed to do. to do, 

and so when you tell them, you know, actually, we don't have to do that  anymore. I don't think your kid's going to get fluent. And if he does, it'll be not because he's, you know, been practicing his techniques, but because he's minimized his reactions to that, that feeling of loss of con  I think more often than not, parents express relief, like, oh, thank goodness, you know, we don't have to like spend every afternoon  drilling techniques.

We can let him go out and play with his friends, right? And every time he stutters, I don't, my heart doesn't sink, but this is my fault, I didn't do enough. And so, I think. One, we owe it to our parent, our families, to be honest with them, that we cannot take this away, after a certain age.

Two,  that is not always received as bad news, that that's sometimes met with a, sense of relief.  And,  and a lot of parents actually want to respond to their kids.  Stuttering in a positive way,  They don't want to hear their kids stutter and think, Oh, I have to correct this. They just want to hear their kids talk.

And it can completely change their parental child relationship in a way that's very positive. And so, I think from the  parent's side, many parents respond to this with relief and joy. From the kid's side, it is  I've worked with kids who, like, this is very difficult and they don't want to hear this, 

they're sort of stuck in  their adolescent web of self consciousness,  and they sort of get the ideas intellectually, but it's very hard to put into practice. Mm hmm. But I've also worked with very young kids who,  like, this just clicks, and they understand it,  you know, I had a young seven year old who, we did a lot of, like, role playing responses to,  Bullies and you know, he said the way most people would make fun of him is that they would like imitate him  and like they would imitate his stuttering and the response.

He came to really like the  best was see isn't stuttering great.  Like, did you enjoy that?  Didn't that feel good? Yeah. Um, and he, he was, he was really funny and uh, he, he got really quick with it. Um, you know, and he was, he went from being sort of,  uncertain about talking to, you know, he, he does plays now. He just won a, uh, uh, public speaking competition.

He's, he's still stuttering, but he's, you know, talking and that's what really matters. And, um,  I think, I think kids can get this.  He's still young,   I'm sure it's going to get hard again once he hits 12, 13, 14, right those are tough years, but.  You know, it's tough for everybody.  It's not like stutterers are the only ones going through puberty who are having a hard time. 

It's everybody hitting those ages, is self conscious. And so, obviously preschool therapy looks a little different. I think most of what we've been talking about is more school age, you know, seven, eight, nine adolescence through  adults. But when they're that age, when they're able, when they have that, the sort of metacognitive skills, they're, they're self conscious of who they are and what they're doing.

I think they can all work on, on,  on acceptance. 

Yeah. Yeah. That makes a lot of sense.  Chris, I'm just curious. Is there  anything else you wanted to say about the role that listeners can play in changing this narrative around stuttering in society and building supportive communities?



I think  mostly what people who stutter on is just patience. Just to, just to listen and, be accepting. My,  my clients will often comment on how much their listener reactions change how they speak, That when the listener is patient and kind,  their stuttering is so much easier. When the listener is hostile, it's, it's so much harder. And  📍 I think,  many of us who stutter have this experience of going to stuttering support meetings, like the National Stuttering Association, or friends, or, you know, you go to a meeting or a conference,  and there's this really radical thing that happens where  speaking in these spaces is easier.

  And you're, you know, you're talking, you have this, you're the same person, you have the same brain, the same bad stuttering habits. Yet, I'm in this hotel with these people, with these other people who stutter, and I'm not struggling as much. I'm stuttering less frequently, I'm better able to express myself. 

And it's like, there's this, like, radicalization, I think, that happens, that like, oh, it's not just me. That like, when I'm talking to this person who stutters, and they stutter too. And they know what's happening, and I don't feel judged. I don't react in those stutter phobic ways as much.  And then when I come home And I'm out and about, and I think the person I'm talking to is hostile, my speech gets much harder. 

And, so there's, there's a, there's like a feedback system for the, for, for the speaker. And so,  not, not only is the person listening  jointly responsible for the communication of the message, but they're also somewhat responsible for the experience of stuttering. in the speaker and that they can make it better or worse.

and so just that it's, you know, it's, it's, it's important to have patience, but also it's, it's okay to ask, like, if you don't know,  how would you like me to respond when you're stuttering?   Most likely the person would just say, Oh, uh, you know,  just stay with me and listen. It's like, it's, if you don't know what to do.

It's okay to ask. I think people started would appreciate that.   Starting doesn't have to be tab. 

Boo. 

 Love it. Love it.  Well, as we get towards the end here, Chris, what would be some key takeaways you want listeners to take from our conversation?

I think that,  some key takeaways are that, People who stutter can speak,  very well while stuttering,  that we don't need to get rid of the stutter. That,  the more we lean into our stutter, the more we embrace that stutter, the more we learn to like that stutter. Generally,  the more spontaneously we'll speak, the easier our speech will be. 

That's facilitated by, these, these strong stuttering identities that we were talking about,  finding something you like about stuttering, finding what stuttering does for you.  And that,  stuttering  doesn't happen in a vacuum, , it's, it's a, it's a communication thing.

Happens between two people or multiple people, and so the listener is not innocent,   the listener needs to take some responsibility for, Communication breakdowns and, maybe question their listening skills.  Yeah, 

exactly. Thank you.    Are there any resources you'd like to recommend?

Websites, books, articles for those that might be interested in learning more?  

 Let me start with organizations,    if you're a younger kid or if you know somebody who's a young kid who stutters, school age, adolescence,  friends is a fantastic organization.

Um If you're a person who stutters, if there's a local National Stuttering Association support group in your area, I highly recommend joining it.  The NSA chapters do wonderful, wonderful work.  In terms of resources and websites,  Stutter Talk I think is a, is a great, uh,  Uh, audio resource, just because you hear stuttering,  you hear people who stutter talking, and I think that's, as we were talking about earlier, I think the more you hear stuttering, the, the better it'll be for everybody.  Books, this is a shameless plug, uh, Stammering Pride and Prejudice is, is a book I edited with two colleagues, uh, Sam Simpson and Patrick Campbell.

That's where that stutter naked chapter is that, that we were talking about earlier.  

Very cool. , and I'll put those links in the description. So, all right, cool. Oh, this has been a great conversation, Chris. I, like I said before, I just really appreciate the work you're doing and wish you just the best on that. And I think this, this podcast will help a lot of people. So thanks so much for taking the time to join us today. Thanks 

for having me, Kyle.