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Valentina Carlile Osteopata
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  • Writer's pictureValentina Carlile DO

Osteopathy and Stuttering: and what can I do between one osteopathic treatment and another?

Often when patients are presented with stuttering, once an osteopathic treatment plan has been prepared and the first results of treatment seen, patients ask how they can collaborate by doing something on their own. Apart from some exercises to become aware of the glottal movement that I always recommend, I always suggest a 'self-study' if they have not already undertaken it with a speech therapist and / or psychotherapist. This self-study is not intended to be a substitute for a medical procedure but is useful for an osteopath to gather further information on the manifestation of stuttering. Each sound has its own setting and articulation and the repetition of spoiled attitudes, even of a respiratory type, only on certain sounds can help guide the search and resolution of the somatic dysfunctions underlying the problem. I have been dealing with stuttering osteopathically for about 6 years and research in the field is a continuous gesture and every time something is found, an important element is added.

Sure stammering creates frustration. One can feel discouraged and angry with oneself and the world. Often nothing you do seems to be effective in the long run. Whatever happens, stuttering can be 'only' annoying and in the worst case it greatly interferes with communication and our life. How can you collaborate with your therapist? By changing the attitude you have when you stutter! The ingredients for change are rooted in knowledge. What is needed is to have information on the process of speaking fluently, information on stuttering.

To begin with, you need to change your attention. One of the most difficult concepts to grasp is this: the common attitude is to try not to stutter, but this very often contributes to aggravating stuttering. Let's try the opposite behavior: try to stammer, or rather let the stutter express itself. You obviously want to stop stammering. They don't like repetitions. You don't want to physically hear or see or sense stuttering. The experiences of feeling "stuck" are frustrating and possibly frightening. Tremors of the lips or jaw can lead to panic situations. It's a hard work. More difficult than ever before. However, you can organize yourself to do some categorization and identification of behavior on your own if you want to collaborate. We must not exaggerate. Tomorrow is another day. It took years for stuttering to develop to a certain stage and pattern. The process of finding the mechanism and changing its disfluent behavior takes time.

First you need to study how to speak fluently. It is necessary to understand the way in which the activity of speaking takes place on a physical level. We need to look for information that provides an explanation of how breathing to live and breathing to speak are different mechanisms and therefore focus on breathing naturally. Discover how air flows in and out of the mouth. When you start talking, part of this process changes. Find out how the voice begins simply and gently when relaxed and without expressive rush. Notice how lips and tongue sim move and how you need to move your jaw to shape the air and voice into words. Feeling that it is possible to move smoothly through a word and move from word to word without stopping. It's fluidity, or at least part of it. Think about the number of words you can comfortably speak with in a sentence without straining for air. Focus on the speed of speaking. Some words in a sentence are spoken quickly, others are said slower to make the message meaningful. The tone of the voice goes up when you ask a question and the volume goes up when you are angry. When spoken fluently, many physical actions occur in a coordinated, sequenced manner. This is one of the keys. Study these actions. Speaking fluently is the behavior you are trying to achieve the most. A solid awareness of the model of fluidity is needed. Respect others when they speak fluently and observe yourself. Take notes. Don't just enjoy the fluency when it occurs. Learn from it. What does it sound like to speak fluently? What does it physically look like in your body? What does it look like emotionally in your head?

Secondly, set the attitude of study. Choose a book on an introduction to psychology. Read the chapters dealing with stimuli and responses and how they are chained together. Find out how a behavior can be strengthened or weakened, or counter-conditioned. The behavior of stuttering is certainly complex, but it behaves in legitimate or expected ways in exactly the same way as other behaviors. Stuttering is predictable and can be changed with the application of information based on your study of behavior. Incorporate this knowledge into your therapy plan.

Third, inquire about the nature of stuttering. A lot has been written. Experts have described the vocal characteristics of stuttering (repetitions, prolongations, stopping of airflow, voice or movement); the accompanying behavior (for example jerking of the jaw, eye blinking, saying 'uhm' or 'good'); typical feelings and attitudes; how stuttering develops over time; what is known about the causes, and so on. The depth of knowledge is your choice. Be guided by your level of interest and a desire to become as objective and neutral about the disease as possible.

Fourth, develop accuracy by analyzing stuttering in detail. Analysis is not about counting moments of stuttering, but determining what types of stuttering behavior you engage in, such as repetitions, prolongations, or stopping airflow, voice, or movement. Are there multiple types of behavior occurring in a sequence? Is there a model (scheme)? Take note. Simply observing that it repeats itself, for example, is not descriptive enough to be useful later on. Ask yourself what is the unity that repeats itself: a sound? a syllable? a word? How many times is a syllable repeated on average when moderately stammering? When do you stutter severely? When the repeated portion occurs within the word: at the beginning? Further in the word? At a fast pace? Does the repetition happen with effort?

Fifth, develop the ability to cope with the moment of stuttering itself. Direct the focus on stuttering as it is happening in the present time frame. Reliving past hardships or anticipating future failure is useless in this "job change" section. The residue of these negative emotions provides few clues to effectively cope with how stuttering is manifesting now. As you learn to listen, to see, and physically feel the stutter, keep asking, "What happened there" and "What should I do now?" And "So what happened?" Look for the consequences of your actions. Take notes on your results.

Experiment with stuttering. Choose a word. Then, say that word while holding your breath, you will find that it is impossible. But you can change this act of "apnea" just as you will be able to change other stuttering behaviors. How? Think back to how the word is pronounced evenly. Focus on the sensation of movement. Get a clear picture of that word. You can change a lot if you clearly know what you are doing and what you are trying to do.

Could this practice of "holding your breath" or any other specially made stutterer be used to activate control? Temporarily it can. Here's how to deal with it. You can finish your breath by holding it right before you "let it go." Don't finish the word. Just stop. Try to stay calm Try again later or the next day Stay in touch with stuttering, as much as possible in small doses Experiment similarly with other types of stuttering behaviors you usually do.

Sixth, understanding emotions. Look for sections in the popular psychology book that deal with emotions and their impact on performance and learning. Fear and embarrassment - two common negative emotions - are known to interfere with the ability to focus and do an activity. This applies to talking as well as to sports. What's the problem? Do such emotions prevent you from being completely in control of situations?

Develop a treatment plan to include a desensitization practice of disruptive emotions and stuttering. You will not totally eliminate reactions to events that trigger stress for you, but you will learn to reduce the stress level until communication is more manageable. It is difficult to try to speak and practice strategies once stuttering and fear seem to be out of control. Most people who stutter need the direction and support of a speech therapist in this aspect of "changing strategy."

Seventh, consider the possibility that you may have two fluency problems: stuttering and cluttering. More than half of those who stutter have both. It's very important? Absolutely. Your therapy program should be revised to include strategies for both, if any. Otherwise, stuttering improves very little.

Here is a clue: In stuttering you know what you want to say, but it is not possible to start the word. Does your stuttering occur in response to speaking too fast, having difficulty finding words or having difficulty organizing your thoughts? Many ideas flood your mind quickly, but do you let them go before you fix the concept? Determining whether you are cluttering in addition to stammering is not easy for a teenager or an adult. Cluttering can be masked by severe stuttering or confrontational behavior. Expect the combination of problems that occur with cluttering to vary and increase in severity just as they do with stuttering.

Here is a 'management' strategy for cluttering: slow down the frequency to have more time to organize thoughts and recover words. Then you will focus on the message of speaking and its mechanics.

This is nothing more than a bone-reduced structure on which to build, but certainly a valuable and necessary aid for any therapist who deals with stuttering, be it a speech therapist, a psychologist or an osteopath. Too tiring? The results are worth the time and effort you put into the task.

And now to work and… Good luck in your quest to achieve your goals!

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