Cognitive-Behavior Therapy: The Missing Link

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Stuttering, to me, is a behavior of inaction and avoidance, rather than a stigma-laden disorder of speech. I fought for years against the inner life of stuttering and its side effects without a reprieve. I never won.

Until I did. 

After many years failing to become fluent, I fatefully found a different approach that had been missing from all of my previous attempts. Speech therapy based on the principles of cognitive-behavior therapy. It combined stuttering, cognitive, and behavior modification, meaning that it helped me change how I stuttered, thought about stuttering, and felt through doing so without constraints. 

Why had I never heard of this before in my twenty years of stuttering?

It wasn’t new but it quickly became clear that it was the missing link needed to address the inner life and side effects of stuttering that had paralyzed me for so long. 

Two sentences penned in 1970 by a renowned clinical psychologist changed my approach to stuttering forever. 

“Successful avoidance reinforces the instrumental acts leading to further avoidance, and increases the reservoir of fear. The eventual confrontation with feared words and situations is rendered more difficult.”

The therapy was more of a new operating system than a pursuit of fluent speech. Fluency was cast aside in favor of getting into situations that I feared and avoided to begin learning what happened when I did. This was key because the stuttering affliction is largely imagining what might happen if others see and hear us stutter. 

The therapy was also group therapy. The others held me accountable, showed that openly stuttering was okay, and served as mentors who were just far enough ahead in the therapy that I wanted to work hard to catch up. Their energy was catalyzing unlike going at it alone like I had in the past.

So, what is CBT and how was it applied to stuttering?

CBT illuminates and challenges unhealthy thoughts, feelings, and behaviors with the aim towards improving emotional regulation and cultivating a bias for action. 

To quote my speech therapist, “we are changed by what we do.” This was how I understood it. I hid my stuttering for so long that it made doing much of anything nearly impossible. It was like a switch that flipped on when I became aware of CBT, and knew right away that it was the way forward.

I took my list of fear and shame-inducing situations—which I wrote about two days ago—and got to work. By work I mean becoming aware of what happened in each and gradually decreasing my unhealthy reactions before, during, and after. 

For me, it was the act of getting into the situation by any means possible without worrying about how I stuttered. In time, I layered on other things like maintaining eye contact to see what happened, asking questions, interjecting into conversations, and, eventually, openly stuttering. It was a slow progression of busting through the fear and shame which generated momentum and redefined my comfort zones. 

Seeing what happened rather than relying on what could—but rarely did—happen changed me forever. With stuttering, I had to show myself that I would be okay every time, regardless of how I stuttered. 

How did I reinforce CBT as a lasting approach to stuttering?

It was a word from the earlier quote that I carry with me into each moment of stuttering, confrontation. To confront is an action taken to defy my vulnerability to harm. It is standing face to face with that which had paralyzed me in place. I think of confrontation in stuttering as a healthy opposition to the fear and shame that perpetuates it as an affliction. In that way, I am no longer the victim of what might happen if I stutter and instead become the perpetrator who has a say in the outcome. 

CBT, as part of speech therapy, was how I became a self-confident person who openly and freely stutters with very little internal reaction. 

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