It is human nature to resist change, especially when that means moving outside your comfort zone. We look to someone else to change for us; anything but doing something differently ourselves. Indeed, many human problems are successfully treated by others; if your child has an ear infection, you take them to the doctor who prescribes an antibiotic and the uncomfortable symptoms of the problem is gone within a few days. But look for a moment at some common everyday problems that seem to defy successful treatment, such as dieting and weight loss. Upwards of 90% of people who have lost weight return to or surpass their previous weight within the first year after their diet. Why? The formula for weight loss is simple -- intake fewer calories through eating and expend more calories through exercising. Many however, look to more 'drastic measures' to lose weight, having their stomach stapled, relying on diet pills, or liposuction surgery -- anything but taking responsibility to do something differently! Those who are successful at making changes take responsibility. The prognosis for those who don't is poor.

Responsibility may be reflected by a client's word choice. For example, describing a stuttering moment as "…something happened to me" implies that the client isn't responsible. "I didn't do it, it happened to me." It may sincerely feel that way to the client (which is explained in another section of this site). The client is revealing that he or she feels victimized or is out of control during moments of stuttering. As a consequence they also feel there is little they can do to prevent or even modify their stuttering. This belief is incompatible with a successful outcome in therapy.

The clinician may subtly counter the client's beliefs by asking a question such as "What are you doing when you stutter?" or "Do you feel yourself trying to force air out while you are holding your vocal folds tightly closed?" This wording places responsibility for behaviors with the client/speaker. Being responsible for stuttering also empowers the person who stutters to act is such as way so not to stutter. Thus the language of responsibility is also the language of empowerment. This is a primary premise of therapy. "I stutter; I can change. I don't need a pill, I can do it."

In truth, people have misgivings about taking medications anyhow. There is always the potential of serious side effects (such as with halperdol, sometimes used to treat stuttering). Subjects taking halperdol reported the side effects of the drug worse then stuttering and discontinued taking the medication. But from a broader perspective, many people dislike feeling personally weak or helpless and being reliant upon a pill to effect personal change. While medications may be appropriate, useful and necessary for treating numerous problems such as heart disease and depression, for the vast majority who stutter, medications have not been developed which successfully change stuttering. Research on promising psychiatric drugs such as resperdol have demonstrated improvement in as many as 50% of subjects; but 25% of subjects in the study demonstrated a decrease in their stuttering taking a "sugar pill".

Other forms of denying responsibility include hypnosis. Some clients seek the aid of a hypnotist in helping them to be more relaxed while speaking and consequently more fluent. Any beneficial effect of post-hypnotic suggestion is usually short-lived, as it does nothing to engage the clients willful participation of the client in being fluent.

Most clients experience the phenomenon of being very fluent in the therapy room but very disfluent everywhere else. This usually is a reflection of the client being responsible for their fluency during therapy, but not at other times. As the client accepts responsibility for change, their fluency gradually follows them to other situations. At the beginning of therapy, the clinician assumes the vast majority of the responsibility for implementing fluency targets and making change. As therapy progresses, responsibility is gradually transferred, more and more, to the client to effect changes in their speaking patterns.

Gaining a sense of being able to effect change in one's stuttering is very empowering and a fundamental enlightenment toward managing fluency.

© Rentschler, 2001