Stuttering’s Primary Paradox and how it tricks us

 

What I call the Primary Paradox, more than any other aspect of stuttering, accounts for the tremendous confusion that has always surrounded this perplexing disorder. It’s easy to fall into this pothole.

The paradox is this: If PWS can be fluent in some situations, why can’t they be fluent in all situations? That is, why can most PWS speak fluently when speaking alone or to a pet–but stutter when aware of a human listener? And why can most PWS speak fluently when chorus reading (reading aloud in unison with someone else)? What could explain this except some kind of emotional or psychological issue? (This seeming paradox can be explained neurologically–by the excitation feedback component of stuttering–as discussed in The two components of stuttering.)

This paradox has tricked PWS and speech-language pathologists (many of whom are PWS themselves) down through the ages. The stuttering literature is jam-packed with inaccurate theories and ideas due to misunderstandings based on this key element of stuttering. Even today, many SLPs, psychologists, and psychiatrists continue to leapfrog their reasoning ability when confronted with this apparent paradox.

When I first began chatting with other PWS at National Stuttering Association conventions, I was struck by the reluctance of so many of them to recognize or acknowledge the inborn neurologic basis of stuttering. Most PWS seemed to be stuck on the idea that stuttering is an environmentally acquired emotional or psychological disorder. They appeared to believe that, since they could be fluent some of the time (the Primary Paradox), this proved the cause is psychological. And most of the information they had been exposed to said so, too. And many seemed to think that if it’s psychological, the solution lay hidden but close at hand, and all they needed to do was find the proper key to peel back the layers of their psyches and the answer would pop out for them to grasp. I felt bad for them, because they were chasing a ghost. They were chasing with faithful certainty something that didn’t exist. I wanted to shake them and say “Listen to me! I know something that can really help you.” That frustration was the genesis of the neuropatterning Home Course. The information on the brain basis of stuttering is presented as background for the course.

This attitude by PWS made me take a step back and ask why? Something that seemed so obvious to me–that stuttering was caused by a neurologic flaw–was not at all obvious to so many others. Then I realized that in my younger days, I had fallen for the myths of stuttering as an emotional/psychological disorder, too–the idea that it resulted from some murky unresolved emotional issue. One book I read even convinced me to blame my mother.

But then I began to learn about the brain. I learned that other disorders that were once thought “emotional” or “psychological” in origin were being unmasked for what they truly are: biologic disorders based on a physical flaw/dysfunction in the brain. Such disorders include epilepsy, dyslexia, clinical depression, panic disorder, attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), eating disorders such as anorexia and bulimia, and the like. Why is stuttering the last bastion to fall?

Don’t get the wrong impression–many PWS and researchers do recognize the neurologic/biologic basis of stuttering and go quietly about their business. It’s just that they tend to be drowned out by the more vociferous defenders of the psychological turf. It may be a case in which the “wronger” you are, the louder you are.

There were two basic reasons that I was fooled. They may be the same reasons so many other PWS are fooled, too.

One of those reasons is that almost everything I read said that stuttering was an emotional/psychological disorder. That was all I was exposed to. Who was I to question the “experts?”

The other reason is the damned perplexing nature of stuttering, especially the Primary Paradox.

Predictably, many psychologists and other “experts” let their imaginations run wild. They made simplistic associations based on shaky premises and lack of accurate information. They came up with impossibly complex, convoluted psychological theories or paradigms to explain stuttering. Another myth was launched: stuttering was an emotional or psychological disorder. It found its way into textbooks and popular magazines and took on a life of its own. It seemed to make sense in a vague way, and there was no other explanation to fill the void. So the myth became firmly planted in a lot of minds. And it’s hard to pull away from cherished beliefs–especially for experts, who may have devoted a career (funding, publication in professional journals, etc.) to a certain belief system. (The same thing happens in other fields, too. Beware the “expert syndrome.”)