Tips to improve stuttering according to a PhD researcher (Clinical adaptation by a person who stutters) - ignore doubt, errors and tension & instead of repeating, give up and skip the sound

Tips to improve stuttering according to a PhD researcher (Clinical adaptation by a person who stutters) - ignore doubt, errors and tension & instead of repeating, give up and skip the sound This is my attempt to summarize this [research](https://www.researchgate.net/publication/352157543_A_clinical_adaptation_of_the_Covert_Repair_Hypothesis_by_a_person_who_stutters). This is a follow-up on [this](https://www.reddit.com/r/Stutter/comments/113ks6i/tips_to_improve_stuttering_according_to_a_phd/) post that explains speech plans and the Covert-Repair hypothesis. **Theory**: * If people who stutter (PWS) detect an error in their inner speech, the speech plan is canceled. If we speak too fast, we won't be able to formulate a new speech plan fast enough - causing a speech block * If PWS engage in secondary characteristics, we use that as a reason to stop formulating a new speech plan (as a negative coping mechanism) * If Normal Fluent Speakers detect an error, they stop and reformulate the speech plan and the reformulated speech plan is usually error-free. However, stutterers have self-made conditions to avoid: 1. articulatory starting positions or 2. starting with a closed articulation \[defective speech programming\] - which leads to perceiving again errors \[vicious circle - infinite loop\] * If PWS only focus on other avoidance-behaviors like 1. not avoiding situations 2. and feared letters, then they maintain the stutter cycle by subconsciously applying avoidance-behaviors from *defective speech programming* * If PWS reformulate a speech plan and it ends up error-free, this could lead to executing the speech plan moments later. Because of intrusive thoughts and habitual responses \[*neurological weakness*\] that are activated moments later, PWS start to show secondary characteristics like tensing speech muscles. PWS perceive the activation of tensing speech muscles as an error, leading to stopping and reformulating the speech plan to make it error-free. However, the speech plan will never be error-free because of the habitual wired secondary characteristics. This could result in waiting out our speech plan until it's error-free (resulting in constantly repeating and reformulating a speech plan which can turn into severe stuttering) * If PWS experience the **secondary** characteristic of blinking eyes while speaking, then detecting an error-free speech plan, could lead to focusing on: 'I need to stop blinking my eyes right now', which cancels the error-free speech plan. Depending on how much you identify with your stutter mental state (and the urge to execute your stuttering way of speaking), the many error-free speech plan attempts to be executed, could eventually end up turning into an error itself * If speech plans contain the same errors as the plans that have just been cancelled, then continuing to try to reformulate the same speech plan is pointless, and counterproductive * There is likely no underlying physical weakness or impairment that had predisposed me to stuttering. Lacking any identifiable physical cause, made it difficult to fully accept my error-prone performance. The negative effect is that I feel like my speech is not as good as it could or should be, resulting in trying too hard to suppress my speech errors * If you are error-prone, you stutter more under stress * The tone of my voice sounds different to what I intended, which triggers the error-repair mechanism and leads to unsuccessful covert error repairs (resulting in speech blocks that are highly unnecessary) **Tips**: * Speak slowly and exercise patience in order to slowly and carefully execute helpful conditions (like closing articulators and positioning articulatory starting positions - when experiencing fear of executing speech plans) * Instead of going back and trying again (i.e., instead of reformulating the same plan) – give up trying to say the sound you couldn’t say – and instead, carry on, starting from the next sound that you can say and thus keep moving forward * Jump over sounds you can't say and carry on regardless, ignoring doubts, the tension in your voice and any errors in your pronunciation. On the odd occasions where the listener still doesn't understand, find a different way of saying it, or write it down, or simply give up * Positive effects of this strategy, are: * succeeding in getting your messages across more quickly and more successfully * feeling less anxious about speaking, which reduces speech errors * the tone of your voice starts to sound more relaxed * even with muscle tension you stop being undermined or thrown into a panic by the tense sound of your voice * it becomes easier to fully accept your speech as it comes out of your mouth: errors, tension, blocks and all * you no longer evaluate any of it negatively * your stress levels no longer rise excessively when speaking * you decrease the tendency to block * you become completely free of the fear of blocking * encountering speech blocks no longer disturb you, because you know how to deal with it now * you no longer interpret your blocks or your tense voice as signs of potential relapse * you simply understand, that repairing errors causes speech blocks * you perceive blocks in a completely new way * Only when it is evident that listeners don't understand you, and only when it is important that they do understand, repeat the phrase in its entirety; this time focussing entirely on the rhythm (just like an actor) * Unlearn avoidance-behaviors from *defective speech programming* * Don't use secondary characteristics as a reason to stop and reformulate a speech plan ​ **Aspects that I don't agree with**: * "***Instead of going back and trying again (i.e., instead of reformulating the same plan) – give up trying to say the sound I couldn’t say – and instead, carry on, starting from the next sound that I could say and thus keep moving forward***." - I agree and disagree. I agree because this reinforces effective communication and works for mild PWS. However, this is ineffective for severe PWS. **In my opinion**: it's more effective to change our attitude of defective speech programming by improving our unhelpful self-made conditions (that bring about speech blocks). I advocate that we cán reformulate the speech plan without blocking on it, we can learn from reformulating the speech plan until it works and by promising ourselves to never apply this avoidance-behavior (aka skipping letters) your instinct automatically aims for adapting a working mechanism leading to outgrowing stuttering * I agree with these intrusive thoughts that justify not outgrowing stuttering: * *"I notice/experience that I can't say the sounds"* * *"Being stuck gives me the impression of not being able to get the sound out"* * *"Getting the sound out is not worth it because I have reasons for this"* * *"I prioritize effective communication over getting the sound out"* * *"I don't aim for getting the sound out, because I won't wait for feelings of muscle tension to subside"* * **Conclusion**: an effective goal is to reinforce the feedforward process, instead of [sensory experiences](https://www.reddit.com/r/Stutter/comments/110b1co/important_to_learn_about_stuttering_how_does_the/) * "***Do PWS have more perfectionistic attitudes and beliefs?***" - Yes absolutely, especially defective speech plans (or self-made stutter conditions) bring about speech blocks. Additionally, these beliefs create doubt: * "People will probably think less of me if I make a mistake" * "If I do not do as well as other people, it means I am an inferior human being" * "If I do not do well all the time people will not respect me" * "I usually have doubts about the simple everyday things I do" * **Question**: Executing stutter speech plans & stop formulating fluency speech plans - lead to speech blocks in overt speech. Could this also lead to speech blocks in our inner speech? Are there people who block in their inner speech?