>*"I am conducting a study for my PhD dissertation as a doctorol candidate. I'm researching how voluntary stuttering sometimes doesn't lead to desensitization, like fewer unhelpful (intrusive) thoughts or feelings.* Good luck with your PhD. I read the [research](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9231935/) that you did together with Seth and Yaruss: '*How the speaker's experience of stuttering can improve stuttering therapy*'. In [this](https://www.reddit.com/r/Stutter/comments/12d6s80/tips_to_improve_stuttering_from_two_phd/) post I actually summarized Yaruss' and Seth's statements, like '*Will there be a cure for stuttering one day?*' In your research you are applying the ICF framework: * Impairments in body Function or Structure leads to a sensation of: (1) being stuck, (2) loss of control and (3) unable to continue speaking with ease * Unhelpful perceptions (beliefs) and responses (attitudes) to experiences (aka environmental factors) lead to developing associations between stuttering, and *thoughts, feelings and behaviors* (e.g., developing the [stutter cycle](https://www.reddit.com/r/Stutter/comments/12mr71i/what_improves_your_stuttering_the_most/) and associating anticipatory fear to halting speech structures) * This then leads to Activity Limitation or Participation Restriction **In my opinion**: To find out more about why voluntary stuttering may (sometimes) not result in desensitization, I think it's important to adopt the ICF framework. Positive effects of voluntary stuttering could be: * desensitization * reducing avoidance-behaviors * developing helpful beliefs/attitudes, such as '*stuttering and speech errors are not a problem or to be avoided*' * reducing strong emotions * reducing the need to repair errors * reducing unhelpful corrections * reducing panic responses like improving calm breathing * and resisting other disruptions in the stutter cycle Reasons why voluntary stuttering may not result in desensitization: * As you (and Seth) correctly pointed out in this YT [video](https://www.youtube.com/watch?v=2JtG1akai6w), (1) some PWS experience fear or anxiety. **In my opinion**: I argue, that desensitization may not happen, * if some PWS don't notice or are not aware of this anxiety, for example because (a) they are not honest to themselves about their feelings, e.g., I argue that men hide their feelings more often than women (leading to holding back speech), which may be a contribution to the 4:1 men women ratio in stuttering * if some PWS focus on other feelings that distract them from observing the underlying root thoughts and feelings (that result in holding back speech * As you (and Seth) correctly pointed out in above video, (2) some things that the listener can do are: (a) maintain eye contact in a natural way, (b) not guessing what you are trying to say, or (c) listening like you would anyone else. **In my opinion**: many researchers found that it may be effective if parents, peers and other listeners change their attitude, such as 'not correcting the child' written in [this](https://www.reddit.com/r/Stutter/comments/zh3ywn/comment/j141z7s/?utm_source=share&utm_medium=web2x&context=3) list from another PhD researcher. **Conclusion**: I argue, that voluntary stuttering may not lead to desensitization, if PWS develop an unhelpful belief/attitude: "In order to not hold back speech, * 'I depend on change from environmental factors (instead of from the inner perception/attitude)' * 'I blame environmental factors' * 'I need to reduce environmental factors first'" * Very few researchers, on the other hand, found that correcting the child actually leads to more fluency. A PhD [researcher](https://books.google.nl/books/about/The_Perfect_Stutter.html?hl=fr&id=_u8vEAAAQBAJ&redir_esc=y) mentioned, that this could lead to the conclusion that, if PWS perceive '*parents correcting the child e.g., asking to slow down during a stutter*' as **stuttering is not a problem and not to be avoided**, then it likely won't develop in a stutter disorder. **In my opinion**: this could suggest that, voluntary stuttering may not lead to desensitization, if PWS maintain the unhelpful attitude/belief: * 'Stuttering is a problem and to be avoided', * 'I need to prove to listeners that I can speak fluently', * 'I need to try unhelpful corrections (like avoiding fluency laws such as avoiding focusing on prosody, avoiding speaking on the timing of the intention) (like reinforcing overreliance on [sensory feedback](https://www.reddit.com/r/Stutter/comments/129z9q3/tips_to_improve_stuttering_do_we_notice_too_many/), such as speaking on the timing of glottal air pressure against the speech structures) * A study found that Adults Who Stutter mostly block because of stuttering anticipation, whereas Children Who Stutter (CWS) mostly block because of anticipation of negative listeners responses. This falls under anticipatory anxiety (in other words: intrusive thoughts and feelings). Before you read further, I suggest to watch these YT [videos](https://www.youtube.com/results?search_query=anticipatory+anxiety) about explanations, interventions, conclusions and limitations of anticipatory anxiety. Some researchers found that AWS are able to predict a stutter 90% of the times where it actually resulted in a stutter. **In my opinion**: I argue, that intrusive thoughts and feelings by itself can never lead to holding back speech. **Conclusion**: However, I argue, voluntary stuttering may not lead to desensitization, if PWS develop an unhelpful belief/attitude (1) to depend/need anticipatory fear to hold back speech (e.g., scanning for speech errors in the phonological encoding in order to manage fluency or avoid problems (which may happen if PWS perceive stuttering as something dangerous, a handicap or disease; which may happen if PWS [identify](https://www.reddit.com/r/Stutter/comments/12pruqu/have_you_ever_felt_like_your_stuttering_defines/) themselves with stuttering)), or (2) blame anticipatory fear to hold back speech. * The ICF framework contains: "*Sensation of: (1) being stuck, (2) loss of control and (3) unable to continue speaking with ease*". **In my opinion**: These three sensations fall under anticipatory fear (aka intrusive thoughts and feelings). I argue that the action of speaking does not require thoughts or feelings. I argue that PWS apply thoughts and feelings to manage fluency, but actually, immersing ourselves in intrusive thoughts and feelings will only: * enable PWS to pay more attention to sensory feedback, giving them the impression that they are stuck, when the speech muscles were never stuck to begin with, it only gave the impression that they were stuck. This then leads to perceiving that the Execution Threshold (or VRT) as too high, resulting in canceling and reformulating the [speech plan](https://www.reddit.com/r/Stutter/comments/11fn406/poll_do_you_understand_this_one_of_the_most/) and then we hold back speech, and then we do a speech block. * lead to losing faith in the automatic feedforward system, and instead, lead to developing unhelpful beliefs/attitudes to directly operate the feedforward system (which is impossible for Normal Fluent Speakers (NFS) and PWS). This then results in prioritizing feedback (, negative coping mechanisms, secondaries, avoidance-behaviors and anticipatory fear) over the forward flow of speech. * voluntary stuttering could lead to more confidence. However, the action of speaking doesn't require confident thoughts or feelings. In this viewpoint, stuttering may exacerbate if PWS develop an unhelpful belief/attitude to (1) need to feel confident to not hold back speech, or (2) replace '*focusing on maintaining the forward flow of speech*' with '*scanning for confidence*'. In this viewpoint, PWS overestimate the need for confidence and are ignorant of the fact that confidence is not a fluency law. I argue that the 20% of people that did not outgrow stuttering, may have a distorted definition of confidence e.g., (1) I'm confident, if I don't experience anticipatory fear, (2) I define it as confidence, if I know or feel that I will speak fluently. These are unhelpful beliefs/attitudes that could lead to holding back speech (such as halting the movement of speech structures and avoiding fluency laws). * **Conclusion**: I argue, that voluntary stuttering may not lead to desensitization, if we develop (or maintain) unhelpful beliefs/attitudes to (1) identify ourselves with anticipatory fear, and (2) applying thoughts or feelings to reinforce the action of speaking (such as trying to move respiratory, laryngeal and articulatory muscles during a speech block by applying thoughts and feelings) * In Van Riper's 4th track stutterers appear to choose to stutter. **In my opinion**: Van Riper phrases it as 'choose to stutter', but I argue that a better phrase is 'justify the stutter program' or 'justify the defective speech plan'. Van Riper hypothesizes that only a very few chooses to stutter, however, I argue that 'justifying the stutter program' is likely adopted by most PWS, especially people with severe silent speech blocks. I prefer to categorize between speech blocks resulted from unhelpful beliefs/attitudes that: (1) justify a defective phonological encoding, or (2) disrupt a fluency speech plan. **Conclusion**: I argue that voluntary stuttering may not lead to desensitization, if we maintain the unhelpful belief/attitude (1) to justify a defective speech plan, or (2) prioritize disrupting a fluency speech plan over the forward flow.