About the authors:
|Dan Hudock, Ph.D., Certificate of Clinical Competence of Speech-Language Pathology (CCC-SLP), is an Associate Professor at Idaho State University in Pocatello, Idaho, USA. As a person who stutters himself, he is very passionate about fluency disorders and helping those with fluency disorders. One aspect of his research interests is in exploring effective collaborations between Speech-Language Pathologists and Mental Health Professionals for the treatment of people who stutter. He is also Director of the Northwest Center for Fluency Disorders, which hosts a two-week interprofessional intensive clinic that uses Acceptance and Commitment Therapy (ACT). For more information about research, clinical, or support opportunities please visit http://www.northwestfluency.org/ .|
Chad M. Yates, Ph.D., Licensed Professional Counselor (LPC), is an Assistant Professor in the Idaho State University’s Department of Counseling. At ISU Chad teaches group counseling, basic counseling skills, addictions, and assessment and research procedures. Chad’s counseling experience includes working with individuals with substance abuse disorders, batterers and survivors of domestic violence, families, and as a generalist treating many diverse client concerns. Chad has served as the mental health coordinator for the Northwest Center for Fluency Disorders at ISU over several years. He has helped to develop the Acceptance and Commitment Therapy (ACT) manuals and procedures for clients and clinicians at the clinic and supervises the counselors providing ACT.
|Xiaomeng (Mona) Xu, Ph.D., is an Assistant Professor of Experimental Psychology at Idaho State University. Mona’s research and teaching focuses on social psychology (especially romantic relationships), behavioral health, and neuroimaging. She collaborates with the Northwest Center for Fluency Disorders at ISU on research investigating psychosocial factors in people who stutter and people with communication disorders as well as the role of psychosocial variables in treatment (e.g., the quality of relationships among clients, between clients and clinicians, and between clinicians and supervisors). She has also led presentations, discussions, and activities on social and romantic relationships in the clinic.|
|Rebecca Chidester, M.Ed., LPS-S, is a school-based counselor in Idaho Falls, Idaho. As a public school employee, Rebecca is passionate about interprofessional collaboration with other employees in the field to provide comprehensive services that will enhance the holistic well-being of her students She has participated Northwest Center for Fluency Disorders Interprofessional Intensive Stuttering Clinic since its beginning four years ago – first as a counselor and most recently as a counseling supervisor. She is both a practitioner and proponent on mindful self-compassion and loves nothing more than watching her clients learning to encounter themselves with compassion.|
|Karissa Colbrunn, M.S., CF-SLP is a school-based Speech-Language pathologist in Pocatello, Idaho. She is passionate about merging the values of the stuttering community with the field of Speech-Language Pathology. She considers herself a lifelong learner whose research interests, while based around stuttering, are continuously growing and developing alongside her own personal journey.|
|Kristin Stewart Yates Ph.D LCPC-S graduated from Kent State University with a doctorate in Counseling Education and Supervision. She is currently working as a licensed clinical professional counselor at ISU Counseling and Testing Service. Kristin specializes in mindfulness based approaches in her clinical practice as well as teaches mindfulness classes through Health Education. Kristin has also has been trained in Mindful Self Compassion and implements this in her teaching, clinical practice, and personal life.|
|Paige Newland is second year graduate student in Speech-Language Pathology at Idaho State University. She is Dr. Hudock’s Graduate Teaching Assistant and is currently doing a thesis with him using high-density Electroencephalography (EEG) to examine neural time-frequency aspects of sensorimotor processing in people who stutter and fluent speakers. She was a student clinician at the 2017 Northwest Center for Fluency Disorders Interprofessional Intensive Stuttering Clinic (NWCFD-IISC), which uses mindfulness and Acceptance and Commitment Therapy (ACT) to target the psycho-social-emotional aspects of stuttering and since has developed a growing interest in mindfulness, ACT, and fluency disorders. She’s originally from Minnesota but grew up in rural Montana and has recently made Idaho her home. She loves doing anything that has to do with adventures and being outside, so she is in a great area to do those kinds of things!|
The theme for this year’s International Stuttering Awareness Day (ISAD) online conference is “A World that Understands Stuttering”. As people who stutter (PWS) have likely experienced many negative consequences from a world that does not understanding stuttering, it is our hope and desire to eventually create a world that does truly understand stuttering and ourselves as individuals. However, to get to the point of helping create a world that truly understands stuttering, we as individuals must first better understand ourselves. By better understanding ourselves, our thoughts, our emotions, and our behaviors we can change how the world see us, by changing how we see, and portray, ourselves. For example, there are well over 1,000 published studies regarding stereotypes that people from across the world, including PWS themselves, hold towards stuttering and those who stutter. It is frequently found that PWS are stereotyped as being more tense, anxious, shy, and withdrawn than their fluent peers and that repeated exposure to people who hold these beliefs increases self-stigmatization (PWS themselves believing more strongly that these stereotypes are true) (St. Louis, 2015). Increased self-stigma then leads PWS to use more behaviors that align with these stereotyped beliefs (e.g., avoiding eye-contact, displaying signs of shame and guilt for one’s stuttering, or not participating socially), which in turn cycles over and over in a vicious circle (one thought or behavior strengthening the belief in the stereotype). Use of mindful self-compassion can help break this cycle and can help us bring our non-judgmental awareness to our thoughts, emotions, and behaviors. Once we gain increased awareness about these aspects, we can then alter our adherence to these beliefs and start portraying ourselves differently to others. Regardless of the negative stories that we tell ourselves, or the emotions that we feel about communicating, we can allow ourselves to connect to those thoughts and emotions and then choose to move forward how we desire to not being controlled by such beliefs. We can lean into the discomfort, mindfully connect to the emotion and experience, and portray ourselves as easy-going, confident, open, and social people, which will in turn start breaking the stereotypes that others and the world have toward stuttering. But again, before we can change how the world sees us, we must take the first step in changing how we see ourselves, which can be done using mindful self-compassion.
As many of the people reading this article are likely to intuitively understand, stuttering or being someone who stutters, is not easy. The lives of PWS may often be filled with negative self-perceptions, self-doubt, self-judgment, and rumination about what may be perceived as failed attempts at communication, or negative reactions that have been experienced because of stuttering. These experiences may even limit deep connection with others, or create feelings of not being understood or accepted. PWS may tell themselves stories, fully believing that they aren’t good communicators and don’t have the same rights or value as other people. Experiences with stuttering, and life, shape perceptions, identities, and worldviews, so it isn’t surprising that they may feel that the world doesn’t understand stuttering, or them, individually, as PWS. Or they may feel constantly out of place within a world full of fluent speakers. This article is about how mindful self-compassion can help us better understand ourselves, our thoughts, and our emotions and how that increased self-understanding may help others to better understand us and help the world better understand stuttering.
People who stutter may become entirely entrenched in perceptions or beliefs, that they have to survive from day to day, not truly being understood, connecting with others, or needing to isolate themselves from others. For example, the fear associated with stuttering may be so severe that individuals don’t interact socially with others to the extent that they think they should. Going up to a stranger to ask them a question or raising a hand to participate in class may seem completely impossible. Making a telephone call and running the risk of being hung up on or experiencing the dreaded, “I think we have a poor connection” statement. Dan’s thought: “You’re telling me that we have a poor connection, try living my life as someone who stutters!”
The fear of failures or anticipated rejections may consume every waking thought of the day. The moment of stuttering itself is not much better! Heightened anxiety experienced during the moment of stuttering is often described analogous to the level of fear experienced while almost downing. PWS routinely experience time standing still, being frozen in that moment, or believing everyone around is judging them. They may momentarily escape seeing what they perceive as a reflection of shame and guilt portrayed on the faces of their listeners due to their stuttering by looking away or avoiding stuttering by switching words, talking around what they truly intend on saying, and using secondary behaviors to get unstuck in that moment of survival… but are the consequences experienced after that “successful battle” worth it? After the conversation is over PWS may mentally beat themselves up about feeling that they stuttered “badly”, or the inverse that they tricked the person into believing that they were a fluent speaker. They may find themselves ruminating on all the ways they failed and messed up during the situation for hours, days, weeks, or months. For example, Dan recalls this personal experience from a few years ago:
“I was introducing myself to a new class of graduate Speech-Language Pathology (SLP) students at Idaho State University during an initial orientation and stuttered while saying my name, which is not uncommon for me! Though I don’t remember stuttering long or severely while saying my name, many of the students presumably thought I was joking, and proceeded to laugh. I had a very hard time with this and cognitively beat myself up about it for a few months after the fact (e.g., I should have pseudostuttered, I should have used techniques more, I should have…). I spent a lot of time and energy dwelling on the past and letting it affect how I anticipated my future to occur. I wasn’t letting myself enjoy the present because I was so worried about the past and the future.”
So again, stuttering isn’t easy. We as humans spend much of our time ruminating over past events or worrying about the future because of past experiences, often setting very unrealistic expectations for ourselves. That’s where mindful self-compassion comes into play. Practicing mindful self-compassion can help allow people experience stuttering, and communication, differently by reducing the negative impacts that it has on them. This may allow for deeper connections in more meaningful ways with others and changing how people understand stuttering. In order to get to a world that truly understands stuttering, one of the first steps that should taken is an internal self-reflection via mindful self-compassion.
Mindful self-compassion has seen a recent re-emergence in mental-health fields. As a practice, mindful self-compassion is comprised of three key elements: mindfulness, self-kindness, and common humanity. Each of these elements plays a role in the practice of retraining and redirecting our attention from the negative stories that we tell ourselves and connecting more fully with what is currently happening in the physical world that we are experiencing at that moment. Mindfulness has been conceptualized as a bird with two wings – awareness and non-judgement. In practicing mindful self-compassion, we must not only learn to connect with our present moment, but to do so without self-judgement and self-criticism. As an example, using the Defusion principle of Acceptance and Commitment Therapy (ACT), we can acknowledge “I notice that I’m having the thought that…”, thereby allowing ourselves to accept that we are having the thought and connecting to it instead of suppressing, running away from, trying to change, or judging ourselves for having the thought or emotion; we can connect to it in a non-judgmental way. This helps us reduce our fusion to the belief, thought, or emotion, thereby making it easier to move forward with our lives and decisions.
Repeatedly drawing our non-judgmental mindful attention to our experiences in this way helps us more easily recognize the stories that we often tell ourselves that shape our beliefs. The act of mindfulness, or present moment awareness, is not sustaining attention to the non-existent blank slate in our heads, but is rather the ability to redirect our attention from our many streams of consciousness to something else (and something useful). By focusing on the sensation of breathing (how the air physically feels entering and leaving our nose or mouth, or how our chest and abdomen move while we inhale and exhale) we reconnect to the physical world at that moment. We are finally able to experience the moment in which we physically spend all of our time, the present. Connecting to the present moment helps train us to be able to redirect our attention and connect to an emotion, thought, or physical sensation in a different non-judging way. This practice requires us to pay conscious attention to how we are experiencing life and the barrage of our never-ending internal monologue, which has its challenges. Mindfulness allows us to connect to the present moment, in the previous example through conscious attention to physical sensation, but this requires us to be in our heads redirecting our attention. You may say, WAIT, didn’t you just write that you want us to get out of our heads, to connect to the physical world at that moment in time, and now you are saying I should be in my head… This is the paradox of mindfulness.
We often spend much of the time judging ourselves when we are in our heads, but a way to reduce that is to be in our heads in a different way with more directive meaningful attention. This is one of the areas where self-compassion comes into play. We as humans mostly believe that people are worthwhile and are inherently good. We believe that people should be loved and should experience love. As PWS may yearn for this also but may notice their minds telling themselves a different, incongruent, story. If we believe in the goodness of people and that we, as humans, should experience love, why don’t we often allow ourselves to express that love and compassion internally? It is often easier for us to direct the love and self-compassion to others, but have a much more difficult time directing it to ourselves. Self-compassion is directing the empathic, supportive, and positive regard we have for others inwards, extending to ourselves the generosity and friendliness that we often provide to others. It is encountering ourselves in our difficult and disappointing moments with the same kindness that we would offer a beloved child who had just scraped their knee. Having that self-compassion allows disengagement from the anxious rumination that may surround stuttering or perceptions of how speech is being received. Self-compassion also helps us not beat ourselves up when we struggle, provides us with validation for our feelings (whether they are positive or negative), and encourages us to try to enjoy the present moment as it is. It allows us to strive towards a future that we want, even if this may involve doing things that we find scary. For PWS that may include: introducing themselves to strangers or deepening their connections with important people in their lives, perhaps even talking about experiences and challenges with stuttering and life.
Mindful self-compassion can help us, as PWS or humans in general, connect more meaningfully to our beliefs, thoughts, and emotions in a different, more intentional, way. In this experience we call life, things may not always be good and we may not always be happy, in contradiction to the stories we tell ourselves about the society – and that’s okay. Knowing that we don’t always have to be happy, nor do we have to constantly chase the illusion of happiness, may provide us relief from self-judgment and unrealistic expectations. Humans have a wide range of emotions that have evolved for different purposes. When we are sad, it helps us grieve and feel connected to and supported by others. If we don’t allow ourselves to feel sadness, or other emotions, it suppresses the degree of happiness we experience and may have us feeling isolated and not well understood. By practicing non-judgmental mindful self-compassion we can allow ourselves to connect to the experience of fear in a different way and then decide what behaviors and actions to do from there, regardless of the presence of doubt, fear, or anxiety. We may choose to connect with and lean into the emotion or sharing something vulnerable about ourselves. We can start to form a more objective sense of reality by understanding what stories we are telling ourselves, connecting to our emotions, and knowing that not every story we tell ourselves is in fact true in a black and white sense; exploring that there may be other alternative explanations that we didn’t think of. For example, a story in a group from a perspective of someone who stutters could be “People in the group aren’t making eye contact with me because they’re uncomfortable with my stutter”, when another possibility could be that the group members weren’t looking at the PWS because they weren’t the one speaking at that moment, and it has nothing to do with their stuttering at all. Doing these intentional mindful practices not only help decrease our fusion to the beliefs, thoughts, and elicited emotions, but also helps reduce the sensation of the emotion and experience itself.
Another way to connect to the moment is through a practice known as grounding, where we connect to the physical world tactically – focusing on touch, pressure, texture, etc. of items you are physically connected to or the ways in which your body connects to the space around you. Grounding can also occur mentally as we focus our brains on tasks like naming as many items as we can think of from a specific category or naming all of the items in our physical environment from a specific category – for example, all of the colors that are in the room. When engaging in this practice, while redirecting attention from the anxiety or self-judgment, to focusing on touch, it is very difficult to focus on the anxiety or judgment. This practice also helps decrease rumination of perceived failures after communication exchanges. By experiencing communication, or the present moment, differently with more intention we allow more connection to ourselves and others. Mindful self-compassion can help us better understand ourselves, our emotions, thoughts, and beliefs, which will allow us to connect more fully with others. Our understanding guides our actions, which therefore changes how others understand us. Let’s better understand ourselves, so we can help others, and the world, better understand stuttering.
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