Why is covert stuttering so hard to understand?

Hi all – many of you know from previous ISAD years that I was extremely covert for many years, almost 30 to be exact. It was an exhausting, “imposter like” experience that I just couldn’t take anymore and I “came out of the covert closet” about 10 years ago. It is an understatement to say it has been so much easier to “just stutter.”

When I entered into therapy for a very short stint from 2006-2008, the graduate student clinicians had a really hard time knowing what to do with me. I didn’t stutter, so they didn’t know what to work on. Since they were mostly being trained in fluency shaping, that’s the approach that was taken with me, until I said, “enough, this is not working, it’s not what I need.” I needed to stutter and after leaving therapy after just close to two years, I basically figured it out on my own, after finding support and regularly interacting with other people who stutter.

Recently, I had an interaction with an individual in a virtual support group where my story of being covert for so long and then transitioning from covert to overt was challenged. A relative newcomer to the virtual group  had asked about this “covert stuttering thing.” A couple of people shared what their experience was with being covert and then I shared mine. Well, this guy “called bullshit” and said there was no way I had hid stuttering for so long, that it was impossible and that I was “kidding myself” if I believed that. The room went silent and I was greatly upset, as I felt this new guy had completely diminished my “lived experience.”  I took a deep breath, composed myself and responded with something like, “Gee, that felt incredibly disrespectful.” That got his back up even more and he spewed a couple more unsupportive comments.

I felt tears sting and I desperately did not want to cry in front of a full house, including two first timers, so I asked if anyone had anything to add or share in conclusion. No one did and we ended 5 minutes early. After signing off, I’ll admit – I dissolved into tears.

So, why is the “covert experience” so hard to wrap one’s brain around? Even SLPs and SLP students seem very uncomfortable with it and don’t always seem equipped to help.

I am co-presenting at ASHA in Boston on covert stuttering and hope to shed some light for students and maybe even seasoned SLPs on the fact that hiding, to all extremes, is indeed very real.

Any thoughts on this much appreciated and may be helpful for other readers too! 🙂

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Comments

Why is covert stuttering so hard to understand? — 15 Comments

  1. Hi Pamela,

    As a PWS myself, I’ve very sorry to hear that happened to you. The issue of covert stuttering aside (and, yes, it does exist), the behavior exhibited toward you by that individual on the online forum was inappropriate and unacceptable. What kind of a support group is that?? If that happened at a “live” support group meeting, he would have been asked to leave and not return. It seems that some people feel justified in behaving rudely and profanely because it’s an online or internet forum. They suddenly become brave when hiding behind a computer screen and a fake user id. That individual should have been blocked from that website by the site administrator.

    That being said, I understand your frustration regarding covert stuttering. It’s very difficult for SLPs to grasp the concept of treating something that “isn’t there.” I did a diagnostic in grad school on a gentleman who was self-referred for a stuttering evaluation, but who exhibited no overt disfluencies in a three-hour evaluation. My supervisor, who was very experienced but not in the area of stuttering, made it clear that the clinic could not provide him with treatment since there was “nothing to treat.” The client was very disappointed and said “so, that’s it?”

    When I gently pressed my supervisor on the issue (in private), she asked me how I would handle the situation if I was seeing him in a private practice. I told her that I would invite him to engage in one or more of the speaking situations that he mentioned avoiding (e.g., teaching larger lecture classes for a salary increase). I would have instructed him to tape record it (we had tape recorders back in the Stone Age) and bring the tape back to the clinic for a re-evaluation, if there was a noticeable increase in the level of overt stuttering. My supervisor listened politely, but was unable to oblige due to the constraints placed on her, which I understood and still do.

    As a result of that experience and several others, I try to emphasize to my students the importance of uncovering avoidance behaviors in cases where the client is self-referred and is stuttering covertly. There are many techniques for helping bring the covert stuttering to the surface, such as self-disclosure of stuttering, voluntary stuttering, freezing, delayed auditory feedback, etc. etc.

    But, the most effective and efficient strategy, in my opinion, is to use elements of cognitive behavioral therapy. For example, what speaking situations does the client avoid and what strategies does he or she utilize to try not to stutter in those situations? What speaking activities would he or she like to engage in, but are afraid to for fear of stuttering? What is the worse thing that would happen if they were to attempt those activities, even if they stuttered during them? Why don’t we role play those situations and gradually work up to attempting the “real thing”?

    Regardless of the specific strategies employed by the SLP, the most important thing is to take the client’s concerns very seriously and not to invalidate their feelings. As Carl Rogers would say, we should always display “unconditional positive regard” for every client we work with, in order to foster empathy and trust. I hope I get to hear your talk at ASHA, as I’m very interested in this topic. Best of luck to you!!

  2. Hi Paul – thanks for your kind words and insights. And for sharing your own tough lessons on why covert stuttering is so hard to understand.

    I really hope that SLP students continue to learn about covert stuttering from people who have really experienced it – and all o the accompanying challenges that go along with it – the exhaustion, the feelings of being inauthentic, the feelings that no one really believes that you stutter, the feelings of feeling “caught between two worlds – not fluent enough for most of the world, not stuttery enough for the stuttering community.”

    I do hope you’ll find your way to our talk at ASHA. Friday 11/16 2:30-3:30. I’m presenting with Charley Adams. I think we have a lot of important stuff to share. 🙂

  3. Dear Pamela,
    I am so sorry to hear about your recent experience. That sounds very tough. Thank you for sharing this difficult experience and how vulnerable it made you feel with us.

    I’ve been pondering for a while how to respond to your post, and have decided to respond from two perspectives. One, as myself, a PWS with my own personal journey and history of covert stuttering, and two, as an SLP. I wish I was more eloquent, but here goes…

    My own journey
    I can’t remember when I first knew that I stuttered, but the realisation had certainly dawned by the time I was in my early teens as I quietly became a member of the British Stammering Association. No-one else really knew though, and it wasn’t something I spoke about with my parents particularly. Over the years, I developed quite a lot of situation avoidance, complete with telling a huge number of lies, to get out of situations where I feared I would stutter and be ‘unmasked’. As the avoidances escalated, they became associated with lots of shame and, by the time I was about 27, I reached breaking point. This led me to seek Speech & Language Therapy. I remember going for my first speech therapy session which was held at a hospital outpatient clinic. Walking across the hospital car park, I genuinely felt like I was about to have a heart attack, I was so scared. Terrified of hearing those words come out of my mouth…. “I stutter”….. because I knew that I didn’t stutter when I talked. But I did. But I didn’t. But I did. I didn’t know how to show my stutter, because I couldn’t stop avoiding. And here’s the thing….. I couldn’t wrap my brain around the covert experience, but here I was, hoping that someone else could.
    I’d love to be able to say that the Speech & Language Therapist I saw at the time was great with me. But she wasn’t. Similar to your own experience, the therapist didn’t really know what to do with me and, after two sessions, I stopped going to therapy. (Somewhat counter-intuitively, the experience did inspire me to become a speech therapist myself, though!)
    Some 17 years later, I’m much further along my journey and, after unpacking all the “junk” I’d built on top of my speech patterns, find that underneath it all is what is possibly a candidate for world’s mildest stutter. But it is a stutter, nonetheless. And it’s my stutter.
    I guess my personal perspective is that the invisibility of covert stuttering can make it difficult for some people to wrap their brain around it. It certainly did for me. This doesn’t make it any less real though, and certainly doesn’t give someone the right to belittle my concerns and deny my lived experience. My friends still accidentally do it, though, albeit with kind intentions. “You don’t stutter. You just have a Kirsten-way of talking” is my particular (non)-favourite comment.
    With regard to the particular individual who challenged you so hard, why do you think that individual finds it so hard to believe there was a time when you “successfully” hid your stuttering? Does that individual’s pattern of stuttering, personality and circumstances combine such that “covertness” is an impossibility, and that it therefore is difficult for that individual to imagine covertness as an option for anyone else?

    Wearing my SLP hat
    In my experience, many SLPs are now much more aware of the concept of covert stuttering than they were 20 years ago. This doesn’t necessarily mean that all these SLPs feel confident about offering therapy to this group, however. I think part of the difficulty is the tension that can exist between the desire of some people with covert stuttering to focus on fluency techniques and stay ‘hidden’ and the therapist’s belief that greater openness can lead to psychological relief over time. Creating a safe environment to discuss the balance between these two opposing forces, whilst building the therapeutic relationship, facilitating and respecting the client as the expert in their own stuttering, can be a delicate dance and a challenge for the therapist in the initial period. Linked to this, I also believe there remains a psychological challenge for therapists to overcome, in terms of encouraging clients to do more of a “disordered” behaviour, to do more stuttering as a route to change, well-being and living life as an authentic self. It’s quite a swipe at the traditional medical model of treatment and cure!

    • Wow Kirsten – thanks so much for such a thoughtful, “two-headed” reply.

      I agree with you, that most clinicians certainly seem more equipped to work with stuttering than those 20 years ago did and seem aware of covert stuttering. But it still strikes me as one area of the stuttering experience that makes SLPs uncomfortable.

      Two years ago, I did a workshop at our state’s speech and language association’s annual conference. I was given a two hour time slot – yay! – but it was the last of the day on the last day, Saturday, so there weren’t as many people as I had hoped. But still, about 30, many students, several seasoned SLPs. I’ll never forget this comment that one of the seasoned SLP’s made, after I had shared a bit about my covert experience and had hard it had been to hide for so long.

      I also talked a little about the journey from fiercely covert to being much more open. At the end, after several exercises I had the group do to illustrate covert stuttering and I was taking questions, she said, “If you were able to be fluent for so long, why don’t you just continue doing what you were doing?” To be honest, I was dumbfounded – it seemed she had missed the whole point and I just couldn’t believe that she asked that and seemed to honestly think that was an OK suggestion to make. I remember thinking, “Oh, God, what does she tell her clients?”

      I’ve also talked to lots of SLP students and they just seem really intimidated by covert stuttering.

      That said, I guess it really is up to those of us that have the experience of hiding at all costs and then finally reaching the “I can’t do it anymore moment” to try and help others understand it.

      I am so grateful that you shared your personal experience. It’s really hard to acknowledge all I did to keep myself from being exposed. It’s good to hear someone else’s very authentic experience and that you went on to become a SLP.

      I had a jarring experience in college when I was forced to make a presentation when I really did not feel ready to stutter in front of people I didn’t know well. I asked my professor to consider allowing me to prove my knowledge of the topic in some other way. I told her I stuttered and that was the first time I had ever disclosed that to a teacher and asked for help. She flat out denied my request, saying I either did it or take a zero for that assignment. So I did it and it was so humiliating. I stuttered on just about every word, as I was using notes and always stuttered more when reading aloud. By the end, I felt tears welling up in my eyes and I was determined to not cry in front of the class. So as I walked back to my seat, I decided to actually leave the room and went into a bathroom right next door. There, I had a full blown panic attack and was crying and hyperventilating. I used one of the brown paper bags in the stall (that are designed for something else) and breathed into it until I was finally able to calm down and regulate my breathing. I estimated I was in there for about 15 minutes. NO ONE CAME TO CHECK ON ME.

      Where was the professor? Hadn’t she noticed that, seconds after having a very tough time speaking in front of the class, I had just disappeared? Why didn’t someone come find out if I was OK?

      Some of the details immediately after that are fuzzy – I can’t recall if I ever actually went back into the classroom or what. But I do recall that I vowed never to feel humiliation like that again. That 10 minute presentation and the feeling of having been abandoned and that no one cared, stayed with me. That caused me to take a deeper dive I think into my covert spiral and it took me 20 years and lots of “aha” moments to “recover” from that and actually want to, and began to. shed all that hiding stuff.

      As for the guy who challenged me and said I was kidding myself if I believed I had hidden my stuttering all that time, I don’t know his story. To me, he is extremely mild and the 4 or 5 times I’ve interacted with him before, I did not hear him physically stutter. So he may be covert too! I am sure he has his own internal stuff happening or else he wouldn’t have been there, seeking support and trying to understand stuttering more. Maybe you’re right – his own patterns may suggest that hiding stuttering is impossible and therefore he can’t “see” someone else having done that. Who knows?

      This can be so complex, huh?

      • Dear Pamela,

        Several others have responded to your legitimate concerns regarding understanding of covert stuttering amongst student and qualified SLPs and the role of clinical educators in addressing this, so I won’t add to that. I do, however, want to respond to your description of what sounds like a very traumatic experience back in college. I am so sorry that you went through this. It sounds lonely and frightening. And your description suggests that it is still something that haunts you. Why did nobody come to find out if you were ok? Why did nobody help?

        Of course, I don’t know. I wasn’t there. I don’t know the people involved. And even if I had been there, I would have the answers. As you said, it’s all so complex, huh? Something did occur to me, though, whilst my thoughts have been percolating. I wonder if it could be an example of what’s known as “bystander inhibition” or “the bystander effect” in social psychology? There’s been a lot of research into this phenomenon over decades and my understanding of it is that the more people who are witness to someone else’s distress, the less likely it is that anyone will respond or help. The effect was earlier termed “bystander apathy” but it seems that such bystanders are not apathetic at all. Instead, they feel stressed, trapped between a desire to help the person in distress, the fear of negative evaluation by others or of making an error if they do something different from the herd and a diffusion of responsibility that results from being one of many. The result is inhibition of action, as the bystanders feel psychologically frozen. If this was a factor on that terrible day, it doesn’t excuse the (lack of) action of those bystanders, but it might explain to some extent why you were left to cope with the after-effects of such a terrible experience alone and unsupported. As a podcast enthusiast, you might enjoy this episode of Freakonomics where they discuss bystander inhibition: http://freakonomics.com/podcast/misused-psychology-terms/ . I particularly like a comment by the main contributor to this episode, Scott Lillienfield, who is a psychology professor at Emory University. Describing the experience of the bystander’s viewpoint, he says, “Deep inside of us is the hero; also deep inside of us is the chicken”.

        To come back to your original point when you initiated this thread – why is covert stuttering so hard to understand – I feel this all ties in to long-running debates within the stuttering community regarding to what extent it is the responsibility of people who stutter to educate others about stuttering (both covert and overt features), and to what extent it is society’s responsibility to be compassionate, knowledgeable and understanding about individual differences, without expecting people who stutter to take on a role as ambassadors for the community. Complex, indeed.

  4. Hi Pamela-
    Thank you so much for sharing your story and your experiences! I am sorry that you had to go through this!

    I think your experiences with being covert are very important reminders that each person who stutters walks a different journey. Sure, there may be some similarities and there are also differences. Each person’s journey is their journey – no one else’s. As a clinician who works with people who stutter – I can say that I believe the client-clinician relationship to be the most important part of the entire therapeutic process. If I don’t understand my client’s thoughts, values, experiences, and goals – how can I walk with them on this journey?

    Many students and even clinicians have limited experiences working with people who stutter and may view progress in therapy as a decreased amount of stuttering. However, with those individuals who identify themselves as covert – an increase in amount of stuttering may suggest huge amounts of progress as the person may be stuttering more openly and/or talking more. I think that is a really important idea for all of us to consider – progress is as individualized as each person who stutters! As clinicians, allies to people who stutter, and people who stutter – the most important thing we can do is listen to a person’s story and experiences and meet them where they are with compassion, kindness, and empathy!

    Thanks again for sharing! And, best wishes with your talk at ASHA! It sounds like you will definitely be able to share some very thought-provoking thoughts and experiences with both students and SLPs!
    ~Jaime Michise

  5. Hello, Pam,

    I’m glad you posted your comments/questions about covert stuttering. As Paul’s example of his own experience during his training in the field illustrates, your experience is far too common. I frequently am asked by SLPs how they can work on stuttering when they don’t see it. And, I’ve had clients who are covert who report that friends and family members simply will not believe that they stutter when they are so succesful at being fluent on the surface. I guess that many find it hard to get past the idea that “seeing is believing”. Making matters worse, not enough SLPs are trained to understand avoidance as a factor in stuttering, particularly in the case of covert stuttering, and further, do not know how to support clients in identifying and addressing avoidance behaviors.

    I appreciate that you are willing to speak out about your own experience, especially since you have had negative responses from others who stutter who do not understand covert stuttering. Certainly, education is key, so that more people become aware of the issues related to covert stuttering in the stuttering community. The same is true in training SLPs. Paul gave a good summary of the diagnostic and clinical issues that are relevant in working with people who stutter covertly. Vivian Sisskin’s work on avoidance reduction therapy, while so helpful for anyone who stutters, is quite helpful in addressing covert stuttering.

    Of course, all of this doesn’t help much when you are confronted with someone who challenges you in such a way as you noted. I appreciate your willingness to continue to speak out. I will not be at ASHA this year, so I send my best wishes for you as you and Charley present.

    Regards,

    Lynne Shields

    • Hi Lynne,

      Thanks for the comments and encouragement. I hope my sharing really does help others understand that everyone’s experiences are valid and need to be heard so that we all have a deeper understanding of stuttering in general but especially covert stuttering.

      If you haven’t yet, check out my video contribution under “Papers Presented By.” There’s some really interesting thoughts percolating there too.

      Pam

      • Pam,

        Thanks for encouraging me to watch your video and read through the comments/discussion. Really great paper–thanks for bringing up these so very important ideas regarding the importance of listening and understanding other people’s experiences of stuttering as they experience it. I particularly appreciated the comments regarding acceptance, as I do think this is a loaded term. People tend to interpret another person’s experiences through their own lens and, hence, those who do not accept their stuttering are alienated when they feel pressure to accept their stuttering. I work hard not to use that term, as it can mean so many things (Rob pointed this out quite well). In particular, someone who is experiencing so much pain relative to their stuttering may take the idea of acceptance as a statement that they are wrong if they do not “accept” their stuttering. So, I think your points about the need to talk more about the issues you bring up (and especially listen more) is so important for anyone connected to the stuttering community.

        I would like to see everyone who is involved in moderating conversations about stuttering face-to-face or online taking care to ensure that all voices are heard and all experiences are honored.

        Thanks,

        Lynne

  6. Thank you for sharing, and I’m so sorry this happened. As a professor who consults in a university clinic, I find we have to constantly and consistently reiterate with students that just because you don’t see it, doesn’t mean it’s not there and treatable. I find this to be the case with both stuttering and cluttering (I don’t think he’s cluttering…I didn’t see it in the session” even though client has given clear examples). I recently had a student write the “supposed cluttering” in a plan for evaluation after chatting with a client by phone. I am constantly advocating that you need to take the client’s story at face value. I do find more understanding when I help guide them through the process of how they can treat something they can’t see. Unfortunately I find it’s sometimes easy for students and professionals (and I guess others) to dismiss what they don’t understand. I am so happy you are presenting at ASHA, as this is an important step in better understanding.

    • Hi Kathy,

      Thanks for commenting. I do hope this thread and my co-presentation at ASHA helps further understanding of stuttering in general and especially covert stuttering. Yep, just because you don’t see it, doesn’t mean it’s not there.

      It’s important we all get that.

      Pam

  7. Dear Pamela

    Introduction

    Let me rephrase what I heard you say. You made yourself vulnerable by opening up about your experience with covert stuttering. One of the listeners dismissed your experience out of hand. You felt pain and probably deep frustration. If I am right, the situation arose because of the different experiences you and your listener had. Each of you probably had different severity of stuttering which resulted in him not being able to hide his stuttering, but you, on the other hand, being able to live in the painful land of avoidances and the unhealthy negative feelings associated with covert stuttering.

    Let me summarize what I have learned while working with people with covert stuttering.

    1. Covert Stuttering arises from the desire, nay demand, to conceal. It is rational to desire and try to find a way to not stutter, if and only if, it does not cause unnecessary mental anguish. Where we get into trouble is when we demand and search for a guarantee to be able to hide stuttering.
    2. The person with covert stuttering (PWCS) has developed a collection of intricate avoidance strategies to conceal his or her stuttering.
    3. In most of the people with covert stuttering, the disfluencies may be infrequent and the severity of stuttering can be mild, but the psychological cost on the PWCS is severe.
    4. The PWCS define stuttering as “awful” and “unbearable”. Consequently, thinking about speaking evokes intense unhealthy negative feelings of fear, shame, guilt, inadequacy, etc.
    5. There is an expectancy of “doom” if others find out that the PWCS stutters. For example, a person might feel that if someone finds out that they stutter, it would prove that the PWCS is worthless, a child of a lesser god…
    6. As a person who recovered from stuttering, and from extensive experience with my many clients, I can say without hesitation that all of us have tried to hide our stuttering. However, as the listener who out of hand dismissed the covert stuttering experience, most of us were unable to hide our stuttering for any length of time. Because we could not hide it, we may have escaped the intensity and severity of unhealthy negative emotions.
    7. Some theorists regard covert and overt stuttering as two separate problems I believe, on the other hand, that we (PWS and PWCS) all are on a continuum of covert/overt stuttering.
    8. In my experience, covert stuttering is more prevalent among people who have a less severe stutter and who feel a great urgency to be “normal” to be socially accepted.
    9. The need or demand to be fluent that leads to covert stuttering (if the degree of severity of stuttering allows it) is a learned behavior often accelerated by overt or covert punishment for stuttering, such as bullying or even a presumably kind phrases by our caretakers (parents, et al) of “Johnny, please slow down.”
    10. The pyramid of covert stuttering consists of a) the stuttering itself,-the inability to say a word when one knows exactly what one wants to say; b) the fear of stuttering based on past experience of negative consequences; culminating in c) the demand to hide one’s stuttering so as to avoid these negative consequences
    11. The fear of anticipatory punishment is compounded by feelings of inadequacy, shame, guilt, etc. These feelings can be very intense and painful.
    12. Who are the PWCS? There are two categories of covert stutterers: a) those whose symptoms have always been mild and b) those who are experiencing a period of remission from severe stuttering (frequently associated with stuttering therapy such as fluency shaping and stuttering modification).
    13. In my practice, I have found out that I really have to make sure that I teach the PWS to unconditionally accept milder or infrequent forms of disfluencies and to understand that there is nothing inherently “awful” about having some disfluencies. Otherwise, what I am producing is a horde of people with covert stuttering.
    14. I remember somewhere Dr. Sheehan talking about suppression versus recovery. Suppression, I assume, is the elimination of stuttering-like disfluencies without the elimination of the unhealthy emotions and unhelpful attitudes of his famous iceberg theory. He noted that the more successful the suppression, the smaller the probability of true recovery.

    Description of recovery

    In point 14, I warned against suppression of stuttering as contrasted to recovery. That begs for a description of recovery. As you proceed reading this remember that true recovery deals with what is below the waterline in Dr. Sheehan’s iceberg theory.
    Recovery is contrasted to cure. Cure implies that once therapy is completed all genetic traces or conditioned responses are permanently eliminated. Recovery, on the other hand, means that the client is no longer negatively impacted by stuttering, as described below. In recovery the client:
    1. No longer feels significant shame, fear, anticipatory anxiety, anger, and other unhealthy emotions over stuttering. It means that he/she can joke about stuttering. He/she enjoys talking.
    2. No longer feels a need to avoid sounds, words, and situations.
    3. May well have some Stuttering Like Disfluencies (SLDs), but these SLDs are reduced in frequency and severity. If there are SLDs they are effortless and forward moving. It means that infrequent disfluencies do not concern him/her, and are considered to be part of his/her speech. Frequently they are indistinguishable from normal disfluencies.
    4. The outcome is operational fluency. That is natural sounding speech achieved without constant monitoring. Easy bounces are welcome because there is no struggle in them and they approximate how the PWS/PWCS talked before he started to stutter.
    5. There is no demand to become perfect speakers. Chasing the witch goddess of fluency may lead to relapse.
    6. The client no longer constantly thinks about stuttering. It is no longer the central theme in his/her existence.
    7. When a non-expert hears the client talk he or she will not single the client out as a PWS.
    8. The client no longer defines himself as a PWS. He/she understands that he/she is a complex person with many character traits. He/she understands that no single characteristic—such as stuttering–defines him/her. Therefore he/she avoids labeling himself or herself.
    9. The client is able, willing, and committed to acknowledging to all people that on occasion he/she has and may have an easy repetition or a stutter. This is done in a dignified manner from a position of strength that starts with unconditional self-acceptance of himself/herself whether or not he/she stutters.
    10. The client is willing and able to live life to the fullest by pursuing any career and seeks out romantic and social relationships without stuttering interfering with his/her choices.

    What to do when you encounter a person who dismisses your experience out of hand?

    It may sound silly, but it is a great opportunity for your individual growth and education of the stuttering community and general populace. You will learn how different we who had or have developmental stuttering are.
    The following composite interchange has been constructed from the experiences the PWCS and I have constructed. The view of covert stuttering is presented by the PWCS after self-disclosure with the PWS starting from a skeptical stance:
    The PWCS has presented her experience with covert stuttering. She is vulnerable at the moment because she has been utterly honest and has expected some support. “I don’t want to be alone. NSA has advocated for the stance “We are not alone.” She has experienced long stretches on being able to hide the visible aspects of stuttering.
    The PWS experience, on the other hand, has had no real success with hiding his stuttering.
    PWS: B***S***
    PWCS (gathering her strengths and understanding this may be a challenging experience): Joe, I see that you do not agree with some of the things that I have self-disclosed. Could you, please, tell me if your disagreement is with 1) my ability to hide my stuttering or 2) with the pain I have undergone while hiding my stuttering? Or maybe both? How about if we start with 1) and end with 2)?
    PWCS: Do you believe that I could by the use of various strategies of avoidances hide my stuttering? Have you ever been able to do that?
    PWS: (depending on the severity of PWCS) might come up with a lot of answers which the PWCS handles the best she can.
    The discussion may well end up with an honest difference of opinion.

    PWCS: Do you believe me that I have suffered due to trying to be covert?
    PWS & PWCS get in a respectful but vehement discussion which may or may not end in an agreement.

    The discussion ends when time runs out and a facilitator or one of the participants summarizes the discussion akin to the following.
    We saw how different PWS and PWCS have experienced the world and come up with different stances. It would be counter-indicated to try to argue with either person’s experience and resulting conclusions. Although we are not alone, neither our experiences or beliefs are the same. If we want to we can examine our beliefs further by asking:
    1. Is there evidence to support my belief?
    2. Does my belief sound logical?
    3. Does my belief help me?

    Good luck with your presentation
    Gunars

    • Thank you Gunars for such a thorough and detailed response. Yes, you summarized my experience accurately.

      I agree that my experience has the unique potential to help me and the greater stuttering community. That’s why I posted it here. 🙂 I’ve had some time to reflect now on what happened and why I may have been so hurt over it. It’s human to feel hurt over feeling dismissed and I’m OK with that. I started feeling a little guilty about “over sharing” here and then realized I shouldn’t feel bad about that. My experience hopefully WILL help others understand the complexity of stuttering more. All of us.

      And if we don’t share stuff like this, then how do we promote greater understanding and invite deeper dialogue about harder conversations? I think I’ve done that (I hope so at least) and I don’t feel any shame or guilt about sharing here. This is where we’re supposed to share stuff like this, so we can help the whole of the stuttering community better figure things out and move forward.

      Again, thanks for such a detailed and helpful response.

      -Pam

  8. Hi Pam!

    I’m so glad you shared your story. You ask a great question: “Why is the ‘covert experience’ so hard to wrap one’s brain around? Even SLPs and SLP students seem very uncomfortable with it and don’t always seem equipped to help.”

    Since you have received a number of excellent responses to your question already, I’ll briefly share a few ideas and describe how I address covert stuttering with teachers and my school-based SLP colleagues to try to better equip them to help.

    In your example, I imagine the person who was rude to you never had the opportunity or incentive to “go covert.” Perhaps his stuttering pattern never made it feasible or tempting to try to hide it. When hiding stuttering is an option, though, there are powerful incentives to conceal it: Avoiding physically and emotionally unpleasant moments of stuttering and the feeling of losing control; avoiding the unpleasant experience of panic (fight/flight/freeze) that may accompany stuttering and anticipated stuttering; avoiding the social penalty and stigma of “being different” and having a disability; and so on. Understanding covert stuttering involves appreciating the powerful incentives to avoid the moment, and risk, of stuttering openly. There was a time in my life when I would have gone to almost any lengths to avoid stuttering, or letting people know I stuttered (even though they ended up knowing anyway). My avoidance behaviors tugged on me like the pull of the moon on the tide.

    I make a point to teach educators about the patterns of avoidance that students who stutter may exhibit. They may be surprised to learn that a student is not simply “quiet” or “shy,” but avoiding talking to avoid stuttering; that a student is not simply “anxious” but hypervigilant, perpetually scanning the environment for dangers that may trigger stuttering; that a student is not “language impaired,” but has trouble expressing thoughts and saying complete sentences due to word changes and revisions meant to avoid stuttering; or that a student does not have an “attention problem,” per se, but is preoccupied with figuring out how to respond in class without stuttering.

    In my consultations with SLP colleagues, I often share my favorite definition of stuttering, which goes beyond the usual perceptual characteristics of stuttering. It comes from the essay “What is Stuttering: Revisited,” by Jackson, Quesal, and Yaruss, 2012:

    “Stuttering is a neurobiological lack of integration of the underlying processes of planning and producing language and speech that, upon verbal execution, can lead to interruptions in the acoustic speech signal (e.g., blocks, part-word repetitions, disfluencies) and physical struggle (e.g., tension). THESE SURFACE BEHAVIORS MAY NOT BE PRESENT, HOWEVER, WHEN THE SPEAKER EXHIBITS COMMUNICATIVE AVOIDANCE (E.G., CIRCUMLOCUTIONS, FILLERS) [emphasis mine]. The underlying features may lead to surface behaviors, as well as emotional and cognitive reactions. Depending on the individual, these may result in significant difficulties in communication and an adverse impact on the speaker’s quality of life. The physical symptoms, emotional and cognitive reactions, and impact on the speaker’s life all comprise the disorder of stuttering.”

    Even clinicians who understand that “there is more to stuttering than stuttering” may be surprised to learn that in the absence of overt stuttering, people can still stutter – covertly. I hope this is helpful! Warmest regards,

    Rob Dellinger

  9. Thank you, Pamela -both for sharing your personal story and for bringing to light the topic of covert or interiorized stuttering. I recognize the thorough responses above, and will therefore add just a few more comments or reflections.

    Firstly; I prefer the word interiorized much more than covert in relation to stuttering because I find the word more objective or neutral. In many ways, aspects related to covering, hiding or/and avoiding are often concepts which might be linked to stuttering -even if we define the stuttering as predominantly covert or overt.

    Stuttering is what the person who stutter define it to be, and based on my experience, the level of focus and competence towards the interiorized stuttering has increased among SLP students and SLPs. Anyhow, I agree With you that there might be less confidence among SLP students and SLPs regarding what to do. People who approach me in clinic express so many different ways of handling their Stuttering. My impression is that the persons With interiorized Stuttering is having very good Language skills. Their goals for treatment are expressed within the principles of coping in real world settings too. I think it is important to regard the covering elements the person might bring out in clinic as ordinary coping strategies, and which probably each of us would be using if we were in a similar context. I believe this aspect is important to highlight. I assume the balance between benefit and cost is relevant in this sense, and that we do have to respect the peoples’ diffeent ways of coping. Hopefully we can support even better the persons in such a way that they can talk freely and without fear -and that there is no ‘need’ anymore to avoid words.

    I am grateful that we have access to more material and measurements taking into account both visible and invisible stuttering variables. Then we are more able to see what the cost might be for a person who is passing as only fluent and explore the benefits together with the person in a respectful and collaborative process.

    Interiorized Stuttering is still so unknown in the general population. Therefore it should be more people who would be willing to talk about this phenomenon in public/media. Within-perspectives are very important perspectives to share, and thanks to you and your important work, the awareness and knowledge will increase among PWS, SLP students/SLPS, and hopefully among people in the general population.

    All the best wishes, and good luck with your presentation in Boston!

    Hilda Sønsterud