PARTNERS OF PEOPLE WHO STAMMER

What is stammering?

Stammering varies tremendously from person to person. Commonly it involves repeating or prolonging sounds or words, or getting stuck without any sound (silent blocking). Sometimes people put in extra sounds or words. Often people lose eye contact.

Stammering is typically recognised by a tense struggle to get words out. This makes it different from the non-fluency we all experience which includes hesitations and repetitions. Some people who stammer talk their way round difficult words so that you may not realise they stammer at all. This avoidance of words, and avoidance of speaking in some or many situations, is an important aspect of stammering.

'Stammering is like an Iceberg'

An American speech therapist called Sheehan, who himself stammered, described stammering as being like an iceberg. Only the tip of the iceberg shows above the surface while the bulk of it is hidden under the water. The hidden aspects of the stammer include avoidances such as those mentioned above, fear and anticipation of stammering, and other difficult - often strong - feelings about stammering such as frustration, anger, sadness, embarrassment, and shame. Stammering can affect people's sense of self-esteem or confidence. It can also be an important aspect of how they see themselves as people - it affects their sense of identity. Their stammering can mean they don't feel they can say what they really want to say.

Every person's stammering is different

It is important to recognise that everyone's stammering is different. Therefore every person is potentially the expert on their own stammering.

The causes of stammering

The causes of stammering are unclear, despite ongoing research. It seems that several factors influence the presence and development of stammering, and that the importance or effect of each factor differs for each person who stammers. For example, sometimes stammering runs in families and sometimes it apparently does not.

People who stammer, as a group, are neither more nor less intelligent than those who do not stammer. People who stammer, as a group, have the same range of personality characteristics as people who do not. There is no such thing as a 'stammering personality'.

Stammering is not necessarily related to nervousness or shyness. In fact your stammering partner may stammer more with you because he or she feels they can 'let their hair down' with you, be him or herself with you. (It should be noted that they may stammer less with you - talk to your partner to find out how it is for them!) Stammering is not necessarily related to mood - 'just because I'm fluent does not mean I'm happy!' or vice versa.

Situations that many people who stammer find particularly demanding include: meeting new people (including meeting your family for the first time!), introducing themselves or others, job interviews, starting a new job, telephone calls, asking for tickets with a queue behind them, speaking through glass as at a bank or the post office, ordering at a bar, talking above background noise, talking when others can overhear, talking to an authority-figure of some sort.

You may recognise that several of the above situations can be difficult even if you don't stammer. But someone who stammers may be especially concerned at these times about how people will react to their stammering and may be feeling a strong internal pressure to be or appear 'fluent'. It has been known for people who stammer to put off getting married because they are anxious about saying their vows.

Many people find they stammer more when they are ill or tired. Some people find they stammer less in those circumstances.

How you can help

• Accept that stammering is an important issue for your partner: your patience and understanding will be of the utmost support. Stammering is not about people 'pulling themselves together', 'thinking before they speak', simply 'relaxing' or 'taking a breath', or indeed just 'being more confident'. Be prepared to ask your partner how you can best help them and to say how you are feeling too.
• negotiate with your partner how to handle practical matters e.g. answering the phone, ordering in a restaurant. You or your partner may wish to handle such things differently on different occasions
• be prepared to talk and keep talking about stammering with your partner. A partnership with lots of (two-way) communication is most desirable.
• accept that you won't always understand what your stammering partner is going through - don't feel guilty about this. What you can do is to listen and acknowledge that it is important to your partner. The more you listen to your partner the more you will understand as time goes on.
• most people who stammer do not like people finishing their sentences for them.
• remain calm and relaxed yourself, remembering to breathe, and maintain natural eye contact with your partner, giving space and time for your partner to communicate. One non-stammering partner describes how he learned to listen 'with his whole body'.
• if you feel embarrassed or anxious in some situations because of your partner's stammering, learning to be comfortable with it (see above) will help you both. By doing so you will also be 'modelling' for other people how they can behave.

What help is available for people who stammer?

Specialist speech and language therapists offer individual and group therapy for people who stammer, much of which is provided through the NHS. Other provision is available through Adult Education or on a private basis. Some therapy is offered intensively, otherwise e.g. once a week. Non-speech therapists also offer courses for people who stammer, often people who themselves grew up stammering.

There are also self-help groups around the country.

The British Stammering Association has information about the range of help available across the country.

What might therapy involve?

• exploring stammering at the physical, behavioural, emotional and thinking levels.
• developing 'easy' stammering i.e. stammering without the tension and struggle.
• changing habits to do with the rate and rhythm of speech, breathing, voice, and speech sound production.
• allowing the stammer out - so much energy and emotion can be being used to try to keep the stammering hidden.
• reducing the amount of word or situation avoidance.
• encouraging people to say what they want to say, to express themselves, to claim their right to communicate, or simply to talk more.
• challenging the way people approach speaking situations and the way they think about themselves and their ability to communicate.
• improving other communication skills such as listening, eye contact and body language.
• providing people with the opportunity to express their feelings about stammering.
• identifying desirable changes and working towards those changes in a practical and supportive way.

Sometimes as people start to work on their stammering it can seem to get worse for a time before it gets better because people are more acutely aware of their stammering and/or are no longer hiding it. Successful therapy for your partner may mean that they are stammering more but feeling happier about it.

It is usually helpful to accept that working on stammering is a long-term undertaking, and to recognise that it requires commitment, courage, and self-acceptance.

How will my partner's therapy affect me?

You may wish to be involved in your partner's therapy. Talk about it with your partner. Your support will be invaluable. Speech therapists will be pleased to talk with you together about the support you can most usefully give your partner.

Remember that the person who stammers has to take responsibility for their own progress and will have to do a lot of the work on their own. Taking the time to listen to your partner explain the goals of therapy and offering encouragement when they are making changes are two of the helpful things you can do.

You may find it hard that your partner develops a close working relationship with their therapist or is enthusiastic about meeting up with fellow-stammerers. It may be that up to now you have been your partner's only support, and you may feel that your special relationship is threatened in some way.

It is true in any relationship that when one partner changes the relationship changes in some way. Through mutual openness, trust and flexibility you can allow the changes to strengthen the relationship. Someone who stammers who undertakes therapy may for example discover a new assertiveness, reveal vulnerabilities for the first time, or begin to express feelings such as anger that they have tended to bottle up. They may want to make the phone calls to book a doctor's appointment or a holiday. They may want to socialise more. They may even consider changing direction in their work.

Other common feelings for partners include: feeling protective of your partner; finding it hard to hear your partner stammering more or in new situations; finding it hard to adjust to a stammering partner becoming more independent, open, or confident.

Other topics for people who stammer and their partners to talk about

• some people who stammer may have had a bad experience of therapy in the past and may be wary of therapy of any kind.
• how the person feels about their stammering in relation to their family (parents, brothers and sisters, etc.) and how he or she behaves around them.
• partners love the whole person - the stammerer can tend to 'hive off speech as a specific undesirable part' (quote from a stammerer's partner).
• any concerns either of you may have about having children who stammer. Statistically, stammerers are a little more likely to have stammering children than non-stammerers. But if your child did stammer, your awareness and understanding of the difficulty could put you in a much better position than two non-stammering parents to give your child the help he or she might need.

Partners (just like other non-stammerers) tend to take their cue from the person who stammers. If the person who stammers is at ease with their own stammering, the partner tends to be too; if the person who stammers talks about stammering, their partner tends to feel they can talk about it as well. Perhaps therefore the initiative to start talking about it needs to come from the person who stammers. But don't be afraid of being the one to break the conspiracy of silence if you are the partner of a reluctant stammerer!

You may have to accept that at this time your partner who stammers does not want to talk about stammering or therapy, in which case their wishes need to be respected. However, something that affects your partner has an effect on you, and it is very understandable and acceptable to want to talk about it.