How do you address self-esteem issues in people who stutter?

Stuttering can have an ongoing impact on the self-esteem of an individual.  When providing treatment, does any aspect of the treatment include the self-esteem issues that may be associated with stuttering?

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How do you address self-esteem issues in people who stutter? — 8 Comments

  1. Hello, Everyone,

    How appropriate to start the questioning with one about self-esteem.

    Building genuine self-esteem can be the task of a lifetime for anyone whether or not we have a stuttering problem. Without unshakable, positive self regard, it is almost impossible to be happy no matter how verbally fluent we become or how many things or accolades we may accumulate.

    To step back for a moment, let me begin by stating that building a healthy self-esteem well may be necessary for many who live in the so-called Western Society where we are bombarded daily with commercial messages suggesting we don’t measure up. We weigh too much. We don’t have white enough teeth. We haven’t partnered up with the right person. We’re looking old (Oh, God forbid!) And so on.

    The over-all message we get countless times daily is that if we want to fit in, we need to change something about ourselves because the way we are isn’t good enough to have a happy life. So, those of us who have stuttering problems and live in the West (and probably much of the westernized world) are more alike than different from most in a fundamental way. We need to find a way to know and to relate to ourselves, stuttering and all, as basically OK. The book title, “I’m OK. You’re OK,” comes to mind. It’s a down-to-earth classic and accessible presentation of Transactional Analysis and still a good read.

    The way I’ve come to resolve my stuttering problem is to find a way to accept myself as I am rather than wait, until some future time when I may be “just right.” As my friend the late Catherine Zimmer explained why she, as a speech therapist, approached therapy the way she did by helping clients learn to see themselves realistically and to appreciate themselves for all that they were is that by seeing themselves clearly and more fully their speech will improve. She put building self-esteem as a priority number one and found a way to do that individually, not mechanically, with those she helped.

    For me, the most obvious tools I use to build positive self esteem are certain mindfulness meditation practices. Two in particular – lovingkindness meditation, or as it is sometimes called, metta, and tonglen.

    The meditation practice of lovingkindness teaches us relate to ourselves tenderly and with genuine regard by following a series of steps repeated at least once daily to relate to ourselves and others with kindness and compassion. Since most find it difficult to start with themselves, the practice often begins with doing so for loved ones. The results arrive in their own way and on their own time table. And, in time, responding to ourselves and others with kindness and compassion in intentional practice rather than with harshness for letting ourselves down for whatever reason becomes a way of being.

    A mindfulness meditation practice related to that of lovinkindness is maitri, the practice of becoming friends with ourselves, all the bits and pieces that we come to know. The lovely and the not so lovely, the deplorable and despicable as well as the noble and endearing.

    The second practice that has helped me resolve my stuttering problem by establishing a more realistic self-concept is tonglen. At the basic level, this practice helps us to realize we are like others, “We Are Not the Only One.” This practice widens our awareness of the world and our genuine place in it. It helps us live and be more at ease.

    Shameless plug: I have written about the use of these practices in the book, “Mindfulness & Stuttering” and to a lesser extent in “Relief From Stuttering.”

    I hope your take-away from this post is that we who have or have had stuttering problems are more alike than different from people who do not or have not experienced them. That has always been true but easier to grasp now than when we were young.

    – Ellen-Marie Silverman

    That is very important to consider because we often think of ourselves as outsiders because when we were young we saw or heard few who had stuttering problems. Feeling different and like an “outsider” invariably crimps self-esteem. But the general reality as I’ve experienced it is that most feel like an outsider for one reason or another – having red hair, limping, having been adopted, being deaf, and so on.

  2. Hello,
    I would like to add my comment from my perspective – an SLP, who often works with families of small children who stutter.
    It is a very important issue even with early childhood stuttering treatment (also in preventive actions). In the case of therapy for a young – preschool stuttering child, that aspect of building the child’s confidence, not only about his / her speaking abilities but confidence in general is very important. In the therapy process the SLP helps parents to pay attention to the positives – how to be aware of and notice the good stuff, how to give the child positive feedback about it. It is important in the therapy process to redirect parents from thinking about the child’s problems, deficits, weaknesses and guide them towards the child’s potential, advantages and strengths.
    No less important is to desensitize the whole family towards stuttering. The more they know about stuttering and the more they understand, the less they are afraid of it and the more effectively they can help their child. When working on building good self-esteem with a stuttering client is also valuable to verify the therapy expectations of the family and the child – and make them realistic. It could also be very supportive to teach parents to apply ‘a model of imperfection’ – helping them to deal with the child’s high standards, letting the child understand that failures in life are something natural, and that the world will not end if the child makes a mistake.
    It is much easier to gradually build good self-esteem in a young child from an early stage, than to rebuild crushed self-esteem in a stuttering adult. Therefore, it seems that no matter what the therapeutic prognoses are for a small child who stutters, it should be a rule to apply family strategies for working with parents on improving self-esteem in the therapy process. Working with parents is essential for the success of this process (I would recommend the publiaction for parents: Faber A. & Mazlish E., 1980: “How to Talk so Kids will Listen and Listen so Kids will Talk”).

    Katarzyna Węsierska

  3. Since self-esteem reflects an overall subjective emotional evaluation of our own worth, self-esteem is to be an issue in nearly all aspects of life. Then self-esteem is to be an issue in the stuttering treatment too.

  4. I like to make a distinction between “self esteem” and “unconditional self-acceptance.” To me, self esteem implies that you need to see yourself as somehow “better” on some arbitrary continuum. To achieve self esteem, one might thing they need to achieve good things in order to get respect from others. Unconditional self acceptance includes recognizing that we all have strengths and faults, that there may be some things that we can’t change, but that we certainly can change many things of we so choose to. Self esteem requires a sense of diligence- always working to keep up doing and being “good” and one can easily become anxious and perfectionistic in that quest. When practicing self acceptance, you don’t necessarily have to change a single things except your attitude!

  5. Thank you for the interesting question. Yes of course in my opinion self-esteem should be one of the main priorities when treating people who stutter. Building confidence would have a direct influence on the quality of life. With school age children who stutter I usually use creativity and humor in activities to help children enjoy the fun and pleasure of speaking. Both creativity and humour broadens our perception. Changing the perception of ‘stuttering the monster’ to ‘stuttering the friend’ can help in realizing that stuttering can help people acquire better listening skills, more creative, better problem solvers, more caring….etc etc. Public Speaking skills can also help people who stutter improve their self esteem. With training, people who stutter can be excellent public speakers. Did you know that the World Champion of Public Speaking 2015 was a person who stutters? (Toastmasters International 2015). I rest my case 🙂

  6. Great question and dialogue here…and easily one of my favorite components of therapy on which to work with our school-aged kids who stutter. Of course, increasing self-esteem, communicative competence, and communicative confidence all are areas which must be included in comprehensive therapy. For our 8-week intensive summer program for school-aged kids who stutter, we do this by targeting resiliency within the framework of 3 primary areas of focus (or protective factors; Craig et al, 2011): enhancing self-efficacy, enhancing social functioning, and increasing social support. These protective factors have proven to stimulate resiliency in the adult population (Craig et al., 2011), and preliminary findings from research of our school-aged population have been positive as well.

  7. Great question and excellent replies. There is one important point that I would like to add. Although self-esteem can be a worthwhile aspect to focus on in therapy we must not assume that all people who stutter (PWS) have low self-esteem. In fact, research has shown that most PWS have normal levels of self-esteem. Most recently, Boyle (2013) found no significant difference between self-esteem scores of 279 PWS and normative standard scores. Normal levels of self-esteem have also been found in research involving school-age children who stutter (Yovetich, Leschied, & Flicht, 2000) and adolescents who stutter (Blood & Blood, 2004). To a young clinician it may come as a surprise that those who struggle to communicate can have normal levels of self-esteem, but we are very resilient people in indeed!

    Thales De Nardo

  8. Thanks everyone, great advice and nice to hear this issue is considered to be a significant issue! Interesting that not everyone who stutters have low self-esteem, but we are an interesting mix of people!

    I recall having low self-esteem at points (but not all the time), but I’m sure it’s different for everyone and of course self-esteem changes over time. I like to think that it is a matter that can be controlled by the individual and their own thoughts, but no doubt helpful guidance during treatment can be a good place to catch and address the issues with low self-esteem early.