Breaking Out: Emotional Response Techniques in the Stuttering Moment (Nora O’Connor, Elizabeth Kapstein, Jeff Shames)

About the authors

Nora A. O’Connor is a person who stutters and a licensed clinical social worker living in Los Angeles, California. Nora is trained in Dialectical Behavior Therapy, Cognitive Behavioral Therapy, and Trauma Resiliency Model. During her career she began to recognize that interventions she was using with clients would be effective for people who stutter.  Nora now treats people who stutter in her private practice.  Nora and Elizabeth Kapstein have known each other for 20 years meeting at the San Diego NSA conference in 1995.  Learn more about Nora’s practice
Elizabeth Kapstein is a person who stutters and a licensed clinical social worker living in New York City.  Elizabeth has been involved locally /nationally with stuttering self-help organizations for 20+ years.   Elizabeth focuses on working with the whole person and specializes in trauma- and addictions-informed therapy using Cognitive Behavioral Therapy, Psychodynamic Relational Therapy, EMDR, Psychodrama, and expressive therapies at
Jeff Shames is a clinical social worker and writer who has presented at numerous conferences for people who stutter. With Elizabeth Kapstein, he co-founded the Manhattan Stuttering Group in 1994. A native of Tulsa, OK, in 2004 Jeff co-produced the award winning personal documentary film Spit It Out. In 2017 the film is being streamed online to reintroduce the film to new audiences in the stuttering and other communities. Sample footage can be seen on You Tube at “Spit It Out Jeff Shames.” He can be reached at ​He is a psychotherapist at Lighthouse Guild, and lives in New York City with his wife, Elisa DeCarlo.

What do worries and negative thoughts elicit? They can flood us to the point where we cannot think straight or only think in constricted, black and white terms.

Breaking Out is designed for participants to create and infuse supportive skills to manage emotional responses and frozen moments during the stuttering experience.  Combining therapeutic techniques from Dialectical Behavior Therapy, Psychodrama, and Relational therapies, this therapeutic model offers supportive techniques and tools that are useful for people who stutter.

You’ll be introduced to mindfulness skills to tolerate distress and regulate emotions.   Participants will be led in grounding and resourcing exercises that are shown to be effective in managing worries and negative thoughts and in developing resilience.

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Challenging Negative Thoughts

Depression, poor self-esteem, and anxiety are often the result of irrational negative thoughts. Someone who regularly receives positive feedback at work might feel that they are horrible at their job because of one criticism. Their irrational thought about job performance will dictate how they feel about themselves. Challenging irrational thoughts can help us change them.

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Inhalation Cleansing and Relaxing Breath

This technique stimulates oxygen flow, which cleanses, clears, and soothes your mind and your body. It focuses on the breath that moves in your upper chest. This technique focuses on 3 breaths. Each breath is comprised of 1 – 8 inhalations and one exhalation.

Try it: Open and lower our eyes to soften your focus. Take in 1 to 8 short, staccato, breathes through your nose, filling your chest. Then gently exhale through your mouth. Perform three sets of 1-8 inhalations to 1 exhalation.

Notes: Try to keep your shoulders down. You might notice at the end that you feel lightheaded.

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Positive Affirmations

A Positive Affirmation is a carefully formatted statement fostering a belief of a positive mental attitude. Positive statements can change your life for the better as they act as to void out or quiet your negative self-talk. Often, people who stutter, experience ongoing harsh and negative self-talk. Positive affirmations will help counter the negative chatter. The affirmation is present tense, positive, personal and specific. Positive affirmations are encouraged to be said out loud in front of the mirror in the morning, at night, and whenever else is needed. Say each affirmation at least 3 times before moving on to your next affirmation. This will allow the positive message to resonate deep in your mind, body and spirit. You can also create positive statements to say as well.

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Resourcing and Grounding

RESOURCING means naming and using positive things in your life to connect to calming sensations inside and bring yourself back to your Resilient Zone. When in the Resilient Zone we feel whole in mind, body and spirit. We are better able to handle the ups and downs of daily living. When you get bumped out of your resiliency zone (i.e. triggered by worries, anxiety, preoccupied with what others are thinking) then you need to use your resourcing skills.

GROUNDING is a set of strategies to detach from emotional pain, (i.e. racing and thoughts, negative talk, worries, anger, sadness). Distraction works by focusing outward on the external world, rather than inward toward the self. You rate yourself before and after the grounding (on a scale of 1 – 10).

Resourcing and Grounding Stuttering

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