Stutterlogging: A 3 year self-tracking experiment & a review of the MPI-2 programme

Stutterlogging: A 3 year self-tracking experiment & a review of the MPI-2 programme \*Long Post. My review of the MPI-2 programme is at the bottom\* Why do stutterer’s have good days and bad days? For the past 3 years I’ve been trying to answer this question by becoming my own experimental subject and measuring my stuttering severity alongside variables I think affect my stutter. Using self-reporting questionnaires and personal monitoring devices in total I’ve captured data on over 300 potential factors ranging from dreams to alcohol. An analysis of this data will hopefully reveal some of the habits and substances that affect stuttering, allowing us to design a lifestyle optimised for fluency. \*The following lists are based on my own subjective experience; I am not recommending any of these practises\* **What worked** Although the data I’ve captured is unanalysed, during its collection I thought several practises correlated with an improvement in fluency. They were; 1. Eliminating certain foods (particularly high GI, gluten, dairy) 2. Fasting 3. Eating organic as much as possible 4. No jogging. Boxing, sprinting etc instead. 5. Carnivore diet (which is essentially a variant of the first two points) 6. No alcohol (although if I must drink to specifically avoid beer and wine) 7. L-Theanine. The anxiolytic organic psychoactive found in tea (which makes tea more calming than coffee) 8. Spending time outdoors 9. Believing in God In my experience, following these methods also seemed to correlate with greater mental clarity. But whether this relationship is causal or correlative I cannot tell. **What didn't work** I also found methods which in my experience I thought didn't help, or if they did help were outweighed by their side effects. Again, I do not recommend the use or application of any of these methods. These were: 1. CBD Oil aka. Snake oil. 2. Eastern Meditation. I am in a minority here ([https://www.newscientist.com/article/2251840-mindfulness-and-meditation-can-worsen-depression-and-anxiety/](https://www.newscientist.com/article/2251840-mindfulness-and-meditation-can-worsen-depression-and-anxiety/)). Eastern style meditation and mindfulness (emptying the mind/observing thoughts) in my experience seems to make me depressed (the nihilistic kind) and overly sensitive to my stutter. 3. Exposure/Desensitisation therapy. Immediately rewarding but exhausting and unsustainable in the long run. Unless you have Herculean willpower you will inevitably fall back to your baseline. 4. Phenibut. 24 hrs of liquid confidence and total fluency. Casanova for a day. But found it could only be administered once a week otherwise I'd feel very peculiar. 5. Olanzapine. Automatic fluency. First time I ever felt my stutter just wasn’t there. BUT it induced somnolence and killed my creativity. Despite excellent sustained fluency with great reluctance I had to stop. 6. SSRI’s. Speech deteriorated; depression thickened. Horrible, horrible stuff. 7. Other antipsychotics. Aripiprazole, Asenapine, Risperidone. All seemed to improve fluency but somnolence and stymying of creativity made them unusable. Olanzapine remains the most effective antipsychotic in. my experience. 8. Drinking coffee/Caffeine. Anxiogenic drug. 9. Nicotine. Anxiogenic and dopamine agonist (PWS have excessive dopaminergic activity (see Dopamine hypothesis of stuttering ) **What also might have worked** There are other practises which I have a strong hunch have been helping me but because I began practising them before I began capturing the data it would be impossible to tell as I have no baseline to compare them with. These are: 1. Nofap 2. Taking cold showers 3. Exercising a lot, particularly high intensity and with emphasis on developing the upper body. Boxing is the best for this. 4. Attending a support group 5. Bibliotherapy 6. Travelling abroad. **The Data** I captured my subjective data with a variety of different devices and applications. These are : • Fitbit (heartrate) • Emfit Quantified Sleep monitor (sleep) • Freestyle libre Blood Glucose monitor (blood sugar) • GlucoRx HCT Ketone Meter (ketone levels) • Quantified Mind (cognitive test) • RescueTime (computer usage). • Dreams app (dreams) • [Last.fm](https://Last.fm) Music scrobbler (listening habits) • Cronometer (food) • Reporter App (self-reporting) The data captured from these devices can be found [here](https://drive.google.com/drive/folders/1sbfsMPjw_5Y8ZEAN4svHOfpOSfyYVdce?usp=sharing). Most of it is in csv format. \*I used these devices at different times over the three years so their data doesn't often overlap. A lot of the self-reported data is trapped in a hard drive in China so a complete picture of all the data from November 2017 to January 2021 is currently inaccessible. But hopefully there is enough there for those interested.\* **Data Analysis** I’m an artist by trade and try as I might I do not possess the skills necessary to conduct an in-depth analysis of the data. I currently do not have enough money to pay for an analyst (I am applying for grants to complete this project which has so far been entirely self-funded), so for the time being I am very much leaving it out there for anyone with an interest in data analysis or stuttering research (ideally both, hence the post on a public forum) to give it a go at their own pace. Most of the data has been encrypted to protect my identity and make the analysis more objective (the blinding principle) but I can give some pointers should you require it. **MPI2 review** I could have carried on with self-reporting indefinitely and was in a position to do so, but then something good happened. After returning from teaching English abroad I was removing myself from stuttering Facebook groups and I stumbled across a post on a support group page detailing a new treatment programme with promising results. Initially I was skeptical, I’d been through enough programmes and spoken to enough stuttering veterans to know that ultimately such programmes failed in the long run and I didn’t want to waste another year on a course I’d eventually abandon. But then I saw the research page, the programme had the strongest empirical evidence of any comparable treatment on the market. Crucially it offered long term success with the majority of the participants in the [2015 study](https://logera.files.wordpress.com/2014/10/ingham-ingham-bothe-wang-kilgo-2015.pdf) ‘almost always’ feeling like a normal speaker and maintaining a sub 0.5% rate of stuttered syllables at 12 months post-treatment. This was truly remarkable, all the other programmes either did not have long term validity (most programmes can achieve a degree of short term success but aren’t able to carry it over beyond 12 months) or don’t have any empirical evidence at all (e.g. The McGuire Programme, because their directors know the results of a peer-reviewed study wouldn't be marketable). But I still had reservations, how hard do MPI-2 graduates have to practise to maintain fluency at the 12 month follow up? I asked the Ingham’s (the benevolent couple who founded the programme) and some former participants how much they practised and whether their day to day experience aligned with the study’s impressive findings. From several different voices I learnt that people typically practise for a few hours a day in the initial month and then for an hour a day in the months after, the time in which you’re implementing the technique in the real world, at the end of the 12 months when all the speaking challenges have been overcome, would involve practise only when you notice your speech deteriorating, which for most appears to be infrequent if ever at all. Six months later I can confirm that (in my subjective experience) the MPI-2 programme is an effective treatment strategy for stuttering. I can now speak with strangers on the phone without stuttering and crucially without thinking about stuttering. I still have some way to go, COVID has delayed a lot of the speaking challenges that I need to overcome to improve my speech to the level where I consider stuttering a non-issue in most speaking situations. However, the empirical evidence speaks for itself and I have faith in the end result being roughly as promised. The practise to get there is no walk in the park but it’s considerably easier than others I’ve tried. It’s more time consuming than effortful, I typically have to spend an hour every morning practising the technique which I do not begrudge as I can practise speaking a foreign language (its testament to the efficacy of the programme that I now feel confident enough to learn a second language) and it isn’t physically taxing like other therapy routines. There is no prescribed technique as such and you have to learn it intuitively, but the main pointers are during practise (which primarily involves reading aloud) to talk slower and to emphasise speaking from the Adam’s apple almost like speaking with a constant drone or bass note underneath the words, like [how a hurdy-gurdy plays](https://www.youtube.com/watch?v=tYrolrI30_c) . Oli Cheadle (the UK based MPI-2 clinician I work with) gives a demonstration of how it works (without an esoteric analogy) [here](https://www.youtube.com/watch?v=hpGt3PanhN0&t=215s). Instructions aside, this is a skill you feel your way into, and although it takes time and you’ll fall down a few times before you can walk, the techniques will stick and become automatic in the end. I shall close by saying that while I cannot be truly certain that the MPI-2 programme is an effective long-term treatment strategy for stuttering (as I haven’t completed the programme), the clinical evidence, the testimony of the programme’s graduates and my experience thus far suggest (but do not confirm) it’s **most probable**. PS. I’ve encountered a few MPI-2 clinicians who stutter who do not appear to be using the technique, I’m not sure if this is because they haven’t completed the course because of lockdown or because they only administer MPI-2 and do not use it in their daily lives much like a smoking doctor who advises people not to smoke. Make of this what you will. \*PPS: **The Edinburgh Masker** A few months before I found the MPI-2 programme I found some success using a Masked Auditory Feedback (MAF) device called 'The Edinburgh Masker'. The Edinburgh Masker consists of a throat microphone, a control unit and a pair of headphones, when you speak it picks up your voice from the throat mic, scrambles it in the control unit and relays a 'masked' noise (akin to a radio static) into your ears. It works by severing the auditory feedback connection which seems to be related to speech processing ([Auditory processing deficits and stuttering](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663969/)). This induces fluency, a demonstration of which can be seen [here](https://www.youtube.com/watch?v=tnP8Oz0V1dI&t=192s) with an accompanying interview with its inventor. The Masker had been a popular and effective treatment strategy since the 70s but it fell out of use as a frontline treatment strategy sometime in the late 90s after the principal manufacturer sold it to a smaller manufacturer (I believe this smaller company is Jedcom, the one featured at the end of the video) they never reentered it into production (for reasons that escape me). However, I was aware from meeting someone who had owned one at an ISA conference that the original maskers still existed and still worked, I just needed to track one down. With some extensive research I struck gold by finding the one man in the world who sells and repairs them; Dave Germeyer. Dave is a wonderful guy and it's testament to the beauty of his soul that he's been the only go-to man for Edinburgh Maskers for 20 years even though he doesn't stutter, doesn't have anyone in his family who stutters, nor makes a profit from what he does! He offered one for cheap and I was off. Admittedly, using the device was awkward at first, I spoke too loudly and was shy about wearing it in public but realised that upon speaking to people I was generally fluent, I grew into it and wore it openly without much thought. Sure, I still stuttered now and again but it didn't bother me as much as before as I couldn't hear it. I made some conscious adjustments to my voice (lowering the volume to make me less obnoxious and keeping my throat vibrating longer to keep the masker noise going (intriguingly a technique quite similar to that used on MPI-2 technique!) and stuttered even less. In time I found myself feeling more and more like a fluent person. I still struggled on Zoom calls, in airports and work related stuff but I didn't have that fear, that gut-wrenching anxiety before speaking which so crippled me. And crucially there was no hesitancy! I'd speak and if I stuttered there was nothing to hold it back. But was this just my experience? Empirically the Edinburgh Masker remains one of the most effective long term treatment strategies. Two clinical trials ([Dewer, 1979;](https://onlinelibrary.wiley.com/doi/abs/10.3109/13682827909011361) [Ingham, 1996](https://www.researchgate.net/profile/Roger-Ingham-2/publication/280323390_The_Effects_of_the_Edinburgh_Masker_on_Stuttering/links/55e44ec008ae2fac47216df9/The-Effects-of-the-Edinburgh-Masker-on-Stuttering.pdf) ) found the device reduces stuttering severity on average by 50% (efficacy range from 38-73%) over a period of six months and testimonials from a number of users indicate these effects remain, and sometimes improve to near total fluency ,over a duration of many years. However, it has to be acknowledged that like any other treatment programme, these effects aren't universal. In the '96 study several participants did not exhibit a significant reduction in stuttering, although it is not mentioned I would presume they were those who experience silent or unvoiced blocking (as the throat microphone does not pick up unvoiced speech). There was also a diversity in responses with some improving in beyond clinic speaking tasks but regressing within clinic. You can read some accounts illustrating how different people respond to the Masker after long-term use [here](https://casafuturatech.com/edinburgh-masker/) and [here](https://www.mnsu.edu/comdis/kuster/edinburghmaskerexperience.html). (In the second link I'm aware of Leys and Alan through their involvement in the British stuttering community and I’ve met Doug in person at an ISA conference in 2019, so I trust their testimonials. But there is hope for those seeking to obtain a masker. Thankfully Fred Fenig, a long term successful user of the device (second review on this page [https://casafuturatech.com/edinburgh-masker/](https://casafuturatech.com/edinburgh-masker/) under ‘My Life Has 2 Parts - Before And After The Edinburgh Masker’), has recently made it his goal to reintroduce the Masker to the stuttering community and with his new company 'Fluency Dynamics' has manufactured 100 new devices as a test-pilot to see if the device is economically viable. Judging by the empirical evidence and the testimonials it could be worth making an enquiry about obtaining one at [fluency4u@gmail.com](mailto:fluency4u@gmail.com).