Just as each person's stutter may be different, PWS vary in how they relate to their stutter: how much they value fluency, how they want to be perceived by others, and the kind of treatment will most help them achieve their goals. While each person is unique, the ways in which people cope with a stutter falls on a spectrum between two philosophical poles: fluency, and freedom from fluency.
Fluency
Those who lean towards the fluency side don't identify the stutter as part of themselves; to them, the stutter is something external that gets in the way of their natural speech. While they will easily admit that the stutter is a large part of their experience, they don't see it as part of their self.
Someone who has a fluency mindset wants to speak as fluently as possible, because they want the stutter to be as little of an impediment as possible. Blocking during speech is an unpleasant instance of their body not cooperating with their mind. They are willing to put effort into managing their speech in order to have greater control over their ability to speak fluently. Their ultimate goal is to be the exact same person and live the exact same life they would have if they never had a stutter.
In a similar vein, these individuals often do not want to “out” themselves as having a stutter, or talk about stuttering. For them, putting attention on their stutter makes them feel self-conscious and different than everyone else.
From my observations, it seems those with a fluency mindset are less likely to attend a support group, because they don't want to be seen primarily through the lens of their speech impediment; even by fellow PWS and a sympathetic and informed audience.
When these individuals seek treatment, it is often because they lack control over their speech or are dissatisfied with their level of fluency. They want a speech pathologist to give them tools and strategies that can reliably give them more control over their ability to speak fluently. They are less interested in exploring or addressing the personal impact of their stutter, or at least not before they have improved their fluency or gained a certain amount of agency over their speech.
Freedom from Fluency
Alternatively, some PWS are happiest when they speak without any effort or intention towards fluency. People in this category – also labeled “acceptance” – desire “freedom from the need to be fluent.”
Freedom-minded individuals see the stutter as a core part of themselves; they feel that stuttering is the way they naturally speak, and that they should not have to change for the sake of others. They feel most comfortable stuttering openly because it feels like they are being themselves. They want to be seen as who they are, and who they are – to themselves – is a person who stutters. My friend Andy once told me that simply having the intention to speak more fluently felt to him like “acting.”
These individuals want to be able to stutter openly without facing judgment or pressure to be more fluent. When they have blocks, they want listeners to listen patiently and respectfully. For them, an environment where it is safe to stutter openly gives a tremendous sense of relief and acceptance. That may be why most of the people I have met at support groups – and the people who seem most attached to support groups – have a freedom mindset.
When these individuals seek treatment, it is not to “improve” or even change the way they speak, but rather to validate themselves and their experiences. They want to reduce shame or self-stigma they may feel about having a stutter. A large part of their treatment also is focused on the social aspect of stuttering, rather than themselves; they want to stutter more openly in their lives, they want to be able to disclose their stutter to more people.
Discovering Acceptance
It's not necessarily obvious where an individual may fall on this spectrum. The fluency mindset is intuitive: If stuttering is typified (most obviously) by speech blocks, and your stutter is causing you distress, then having fewer blocks would make your life better. That is exactly what my friend Lisa had in mind when she went to speech therapy as an adult.
During her first session with their speech therapist, when asked what she wanted from her speech therapy experience, she replied that she wanted to speak more fluently. Then her therapist asked “But why do you want to speak more fluently?” This therapist then explained the freedom mindset, and what freedom-oriented treatment would look like; to which Lisa said “Oh wait, yeah, that's what I actually want.” To me, Lisa seems like she has a natural affinity for the freedom mindset, but she couldn't articulate it until she heard it from someone else. Lisa followed that freedom-oriented treatment plan and had a great therapeutic experience.
For me, as a fluency person, when I was at a low point with my stutter and sought fluency-oriented speech therapy, if my speech therapist had explained the freedom mindset to me when I asked for fluency treatment, I would have replied “That's nice, but I still want to work on fluency.”
Common Ground
While these two mindsets are in some ways exclusive of each other, it's not necessarily the case that every individual always fits neatly into one category or the other. An individual may agree with some but not all of the statements that typify each philosophy, or their priorities may shift over time or depending on context.
Usually when I notice a block happening, I'll stop, relax and reset, and that usually gets me through the block without it noticeably interrupting the flow of conversation. However, I've had this experience several times: On the first day of a stuttering conference, I'll start triaging a block, but then I'll stop and think “Oh wait, I don't have to do that here.” and then stutter a little more openly from then on.
Conversely, my friend Darcy is strongly on the freedom side but will sometimes prioritize fluency. She works in healthcare, openly stutters, and wears an “I stutter” pin on her work lanyard. However, sometimes during a very dysfluent day at work she'll use a fluency technique or even word-swap if she's in a hurry or doesn't have the emotional bandwidth to deal with a long block.
Furthermore, there is actually quite a bit of overlap between the two. While the fluency side wants to speak fluently and the freedom side wants to stutter openly, neither wants to struggle with their speech. For freedom people “avoidance” may mean hiding their stutter when they speak, and for fluent people it may mean not speaking at all; but neither wants to use avoidance as a primary coping mechanism.
Where does the community stand?
There is a lot of debate and discussion within the community around which of these two mindsets is more prevalent. To get an idea where PWS fall on the spectrum between these two philosophies, we can reference a 2009 study by H.S. Venkatagiri.
Venkatagiri constructed a twenty-question survey where participants chose between statements that typified either the fluency or freedom mindset. For example:
#5 For speaking to be an enjoyable experience for me, I should:
A) Speak with few repetitions or blocks. (fluency)*
B) Speak without fear or a sense of shame. (freedom)
#6 I feel that I would be more confident when talking to strangers:
A) If I told them at the outset I stutter. (freedom)
B) If I could manage to speak without too many repetitions and blocks. (fluency)
#18 Speaking in a way that is different from my habitual speech is:
A) Something I would readily do if I could speak without repetitions and blocks. (fluency)
B) Something I would not want to do because it makes me feel artificial. (freedom)
*These labels were not displayed on the survey.
Venkatagiri, H. S. "What do people who stutter want—fluency or freedom?." Journal of Speech, Language, and Hearing Research 52.2 (2009): 500-515.
Venkatigiri gathered responses from 216 PWS, and the results suggested a rather even distribution: 20% of respondents demonstrated a strong fluency mindset, 34% had a mild fluency mindset, 23% reflected a mild freedom mindset, and 23% had a strong freedom mindset. Women demonstrated a slight preference for freedom and men for fluency, although the margins were not statistically significant. 58% of participants aged 19-30 preferred a fluency mindset over freedom.
These results show that the stuttering community is quite evenly split between the two mindsets; slightly less than half of participants were strongly aligned with one camp, while the others had interests in both fluency and freedom. I think this data is essential for understanding people who stutter at both the individual and community level.
Healing the Divide
To my mind, one's preference for one mentality over the other doesn't really seem to be a “choice” as much as it is a natural inclination. It also seems to me that one's preferences may change or evolve, but such a shift can only come from within. I fall heavily into the fluency category and I have many friends who are staunchly of the freedom mindset; we've had long discussions about our different approaches to life, and while it was enlightening for us to learn about one another's perspectives – and it cleared misconceptions on both sides – I don't think those conversations caused any of us to change how we relate to our own stutter.
However, there are some in each camp who believe that their philosophy is the “correct” way for PWS to feel; in their view, those on the other side are not only wrong, they are also hurting themselves in their ignorance. For the first ninety-plus years of the profession's history, speech pathology operated under the idea that fluency was the only thing that could reduce the social and internal distress caused by stuttering. Now the loudest voices – both PWS and speech pathologists – go in the opposite direction; individuals who proclaim that the word “fluency” itself is harmful and that any PWS who wants to improve their fluency – let alone “pass” as fluent – either has deeply-suppressed shame or has been criminally brainwashed. To these people, fluency is an outdated concept that should be discarded, and freedom the only “correct” way to treat stuttering.
Ideologues are onerous, whichever philosophy they support. My friend Lisa still gets upset today when speaking about her first experience with speech therapy twenty years ago, when the speech therapist insisted that the only goal was better fluency. As a fluency person, I have listened to ideologues from the freedom side as they tried to impose their views on the speech-pathology community. My freedom-minded friends enjoyed these talks, but for me – fervent and well-educated as they may have been – the speakers' belief that only their side was the “right” way left me feeling upset, not seen, and not understood. I felt that if I had been assigned one of these ideologues for speech therapy, not only would they have withheld the tools that would help me achieve my goals, they would also subject me to lectures on why my goals were “wrong” in the first place.
For this reason, I think it's best to understand and accept whichever way an individual copes with their stutter, rather than to try to convince them how they should feel. I would recommend meeting someone where they are and treating them the way they ask to be treated, even when it disagrees with your own preference. Trying to impose the alternate viewpoint is not likely to change a person's mind, but it may drive them away from treatment or the community. There are ways to help every PWS be more satisfied with themselves and their speech, wherever they fall on the fluency-freedom spectrum; and each PWS is likely to be the best source on what will work best for them.
For Speech Pathologists
People who stutter don't wake up one day and decide to seek speech therapy. People who seek treatment for their stutter may have been in the “contemplation phase” for months, years, or even decades; on one hand hoping that speech therapy will reduce their distress and improve their quality of life, but on the other hand worried that ineffective treatment will leave them feeling more hopeless, or that an unpleasant experience may exacerbate their suffering. For many PWS, going to speech therapy may be the first time they've ever sought help with their stutter; it may even be the first time they've ever spoken to someone about their stutter. So there is a great responsibility in taking on a client. If you don't respect your client's wishes, you may leave them feeling more hopeless and alone than when they first walked into the clinic.
For that reason, I encourage speech therapists to have the technical skills to deliver either treatment, and the maturity to deliver both. Every person with a stutter is different and will want different things; so have a conversation with each client and then develop a plan for what that client wants. You may have to explain freedom-oriented treatment if they're not familiar with it. Encourage the client to experiment with something that may not immediately appeal to them, but don't force them to stay on that path. A single experience with speech therapy can permanently change the course of a PWS' life for the better, but in order to do that, the client needs treatment that prioritizes their needs, not someone else's.
Tom Lovett is a PWS, software engineer and former Coast Guard machinery technician. He has read over 240 research articles, attended five academic conferences on stuttering and will be pursuing a PhD in Communication Sciences and Disorders starting in the Fall of 2007.