The Road to Resilience – Heather Najman

About the Author:

Heather Najman, MS, MA, LMFT, SEP, has been a part of the stuttering community for more than 30 years serving in roles such as NSA/ISA workshop presenter, NSA Chapter Co-Leader, and as part of the co-hosting team on “Stutter Social.” As a psychotherapist, she consults and works with individuals, and families with a focus on resilience, stress, shame, anxiety, and trauma, including dealing with the emotional effects of stuttering. She is excited to finally cross over and share her thoughts and approach with her stuttering community.

This year’s ISAD theme of “Resilience” is one of my favorite topics, and one that I have been personally and professionally exploring for over a decade. I was originally introduced to it when I began my journey a decade ago in studying Somatic Experiencing© (SE), developed by Dr. Peter Levine, which is a modality of working with short-term or “Shock” Trauma, such as with car accidents, falls, natural disasters, PTSD, and so forth. Resilience is commonly thought of as how can we “bounce back” from when difficult things happen. 

Much of the study and literature on resilience has been influenced by the work of Dr. Stephen Porges, whose Polyvagal theory has had an important impact on those working with trauma. The sympathetic branch of the autonomic nervous system revs us up and prepares us to get ready for activity (action, threat, or exercise), while the parasympathetic helps to slow our systems back down. These two branches, sympathetic and parasympathetic, act as the gas and brake in our nervous system (Graham, 2018). Something happens: a twig snaps, a growl from the woods, a phone rings, and our hearts beat faster, we breathe quicker, and threat is upon us. Ideally, once the threat is gone, the parasympathetic comes on board, and our heart slows down, we can see/hear more clearly again, our hearts begin to slow, and we can “rest and digest”. 

These two systems help regulate our physiology, and support behavior.  Porges’ Polyvagal theory (Van Der Kolk, 2014) proposes that there are two sub-branches of the 10th cranial or Vagus nerve, Ventral and Dorsal, within the parasympathetic (slower) branch of the autonomic nervous system, that travels through our body, from our brain all the way to our gut (gut instinct, anyone?).  In a nutshell, when there is perceived threat, the Dorsal branch affects our energy conservation, it shuts things down when the engine/stress runs too high, and can be sometimes interpreted as a shutdown or freeze state. The Ventral branch, or vagal brake, will try to lower the sense of threat by social engagement, such as making a friendly connection, eye contact, soothing behaviors, laughter, pleasing/submitting, or negotiation. Think of a parent soothing a little one: eye contact, making facial expressions, higher pitched baby talk, and slowing down to connect. If this does not work, or social engagement is not possible, we then will likely engage our stress/threat responses, our fight or flight behaviors, or go to freeze. 

The psychiatrist, Dr. Daniel Siegel, has written extensively on his concept of staying within our nervous systems’ “Window of Tolerance” (Siegel, 2010).  When something gets our attention, our attention and our physiology go on alert to assess what we need to do. That sound in the bushes…is that a twig snapping from a hyena or a hippo? Will I become dinner or will I get dinner? Once I can ascertain the danger is passed, then my system returns to its’ normal state. However, when we live in chronic stress, our bodies may struggle to find its’ way to come back down to “rest and digest.” 

We need to feel some sense of safety in order to feel connected with others. When we feel stressed, our body responds in one of several ways: Fight, Flight, Freeze, Please. We usually have a default or preferred mode, though we are hardwired to fight/flight/freeze. When we feel our activation rise, if we don’t feel safe…one threat response is a sense of Fight. I wonder if the “Fight” response comes out as pushing through blocks/sounds? If we can’t stay and fight a threat, we look for the door, we look for a way out of the stressful encounter. Is Flight in stuttering an avoidance? Word substitutions? And then there’s Freeze. If we can’t Fight, and we can’t Flight/Flee, we can Freeze. Think of possums. Antelopes. They may appear dead, until the threat leaves, then they usually get up, shake and tremble, then escape.  We become silent, and perhaps even stop thinking of things to say…the stress is too constant. The tricky thing is that humans have these big three part brains: the Prefrontal cortex, that is our thinking, logic, reasoning part; our Limbic brain where our emotions, fear, memory, our “fire alarm” resides, and our Reptilian or lizard brain, which controls our heart rate, breath, digestion, just to name a few—all those biological processes that we don’t have to consciously think about to do. 

Dr. Peter Levine has described trauma as things that feel “too much, too fast, and too soon” as in a sense that our nervous system has been overwhelmed. (Eves, 2020).  Trauma is seen not just as a “Big T” Trauma event—an earthquake, hurricane, attack, accident, a birth…”  but can be a series of “Small t” traumas that accumulate over time, and impede our ability to feel resilient. 

Some experience stuttering as a result of Trauma, whether head injury, or accident, as an example.  I wonder though, how many persons who stutter experience the effects of Trauma as a result of their stuttering, of the repeated assaults on their nervous systems, and frustrations day after day, minute after minute,  of feeling the repeated uncertainties of “Will I be able to say this word or sound today?”, the feeling of loss of control, the struggles of trying to use tools and techniques, and so forth. Over time, it takes a toll, there’s a “high cost of doing business” to our bodies. 

What do you do when the remedy, (the Ventral vagal part of the parasympathetic nervous system,) which uses social engagement and connection, which may be the source of more threat distress, for those who stutter? As infants, we look into the eyes and faces of our caregivers for reassurance (Levine, 2010).  Have you ever seen a baby look away when they become too tired, fussy or overstimulated? Breaking eye contact can be a way of regulating our emotions and activation levels.  How does this connect to the tendency that many Persons Who Stutter (PWS) have to break eye contact during a block? Is it an attempt to manage our own dysregulation? Can therapy, whether speech therapy, or self-therapy, find a softer, titrated way to help PWS’s regain eye contact? (I remember one grade school therapist that pulled the back of my hair to make me raise my head. I was too frozen, (and scared and mad) to tell her “Stop!”)  Do we *have to maintain eye contact at all costs? Fluent people don’t. Can Speech Language Pathologists (SLPs) and therapists allow our eyes to settle, to find something grounding or soothing to look at, then back at our faces?  What helps you feel a sense of safety or calm, even a little bit? 

When I went back to school and began studying Cognitive-Behavioral Therapy (CBT) as a part of my studies to become a psychotherapist, I chuckled…for the descriptions reminded me of what I had learned as a young adult in speech therapy. Hierarchies. Desensitization. Challenging automatic negative thoughts.   And it was helpful. It started to change my perspectives, as a person growing up with negative messages.    But CBT did not address my insides, my engine that felt like it was either continually revved up or stuck in a low gear.  It was not until I started exploring somatic (body oriented) approaches that I found change and felt my resilience begin to grow.  I could not think my way out of stress, but had to “tend and befriend” my body, and explore the signals, triggers, and what eased the stress. I began to learn to listen to the language of the lizard part of my brain, the language of sensations.  I began developing an awareness of my internal sensations, slowly, carefully, with support, and tuning into when I felt even the smallest bit of safety, which was a challenge at first, for speaking situations were likely to start revving my engine in microseconds. It is not all about deep breathing and meditating, for some people can actually feel more anxious and dysregulated, once the vagal brake is lifted and all the horsepower underneath comes rising up.  It can be helpful for SLP’s and PWS’s to work with somatic psychotherapists with training and experience in working with Trauma and dysregulation, to help our bodies develop new neuropathways and develop emotional and physiological regulation. 

It is when I met and began studying with authors Kathy Kain and Dr. Stephen Terrell, that my understanding of resilience grew and I felt the parallels with the stuttering community. In their book, “Nurturing Resilience” they remark on how the field of resilience is growing rapidly, and how it is not only about individual characteristics or traits, but many factors—such as family, community, “and larger cultural contexts—that influence how resilience is developed or restored.” They define resilience as “the ability to achieve positive outcomes—mentally, emotionally, socially, spiritually, –despite adversity” (Kain & Terrell, 2018).  I knew this to be true, for I believe that it is in these larger contexts, including self-help, support group, stuttering communities and speech therapy (for those who wish to), that our sense of resilience can be increased.  

It is in relationship that resilience is nurtured, grown, and birthed. Kain & Terrell (2018) cite protective factors that support resilience in children, (even those having undergone significant adversity):   Having supportive adult-child relationships; developing adaptive skills and building capacity for self-regulation; and having some sources of faith, hope and cultural traditions. “ They add that,  “Some people seem to be born with a fortunate predisposition toward resilience, but that is not the most potent influence on its’ development. Harvard’s Center on the Developing Child (2017) suggests that “the single most common factor for children who develop resilience is at least one stable and committed relationship with a supportive parent, caregiver, or other adult.” 

I was fortunate to have supportive parents when I was young. However, back in their day, they were told not to mention stuttering, so as not to draw attention to it. They meant well, but that silence only increased my sense of shame around my stuttering, rather than lessened it. There were others that became supportive in my struggles with speaking. I remember Mr. Lampert, a friend of my parents, who would walk along the beach with me at camp, engaging me in conversation, and listening to me. Mrs. Lazzo. Mrs. Doerr.  John Lowe–the first speech therapist to ever actually ask how I felt about my stuttering. These friends, teachers and professionals took an interest in me and listened to what I thought and what I had to say. Later, when I was in college, I finally met other PWS’s when I came across a conference of the National Council on Stuttering and my life changed. I remember meeting people like Mel Hoffman, Bill Murphy, and learning about the National Stuttering Project, (which is now the National Stuttering Association) but it was three women—Lisa Gibson, Kay Shipton, and Sandra Wagner, that I remember most that first year. Someone like me…women that stuttered. Women and men, with careers, relationships, productive and interesting lives, who happened to stutter. I knew I was not alone anymore.  Connections. My resilience began to grow.  Just as the most common factor for children developing resilience is a stable relationship with a parent, adult or caregiver, the same can be said for adults too. Meeting other PWS’s can feel like our “Safe Haven”. To meet others who will help us co-regulate and not look away, who will not interrupt us, who will not ask us if we have forgotten our name or fill in our words, but who wait patiently and know the effort it takes, can encourage the feeling of home. As the National Stuttering Association’s motto is, “You Are Not Alone.” Through the years, I have heard many PWS’s go to a chapter meeting, a conference, or a Stutter Social hangout, and, perhaps after initially feeling the fright of “What have I gotten myself into?” come back and say that it has changed their worldview, their perspectives, and themselves.  Resilience can be nurtured and grown, by developing awareness, developing emotional and physiological regulation skills, and connecting with others. As one of my teachers said, “If connecting with others is too scary, “try a tree.” (Nature can be a wonderful resource.) Find someone that can help you find your resources, and take one step at a time. It takes time to build new neuropathway roads of resilience, when we’ve spent a lifetime driving fast, bumpy speedways, full of fear and communication crashes. Take all the time that you need. 

References:

Graham, Linda (2018). Resilience. New World Books, p. 30. 

Van Der Kolk, Bessel (2014). The Body Keeps the Score: Brain, Mind and Body in the Healing of Trauma, Viking Books, p. 78. 

Ives E (2020) Peter Levine and Somatic Experiencing. J Psychiatry Ment Illn 3(1): 101 and Somatic Experiencing Training handouts, 2009. 

Levine, Peter. (2010). In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness, pp. 98-99, 106. 

Siegel, Daniel J. (2010). Mindsight: The new science of personal transformation. Bantam Books.

Kain, Kathy L. & Terrell, Stephen J. (2018).  Nurturing Resilience: Helping Clients Move Forward from Developmental Trauma. North Atlantic. p. 3.

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Comments

The Road to Resilience – Heather Najman — 27 Comments

  1. Very thoughtful and insightful piece. Something kept crossing my mind as I read it, but I’m not exactly sure why. I’ve heard several people say—and I’ve been guilty of this myself—that following an instance of stuttering, they just keep talking, almost like they’re using the fluent words to try to erase the disfluent moment. Assuming low acceptance of stuttering in this example, could that be a Fight response followed by a self-remedy? It’s not exactly calming, but provides more a feeling of regaining some control.

    • Thanks, Dale. I agree that it can be an attempt to regain a feeling of control, or to reduce a potential negative perception. Interesting to consider it as a Fight response…initially your question felt like a Flight response or an avoidance… (to quote the Teletubbies…”Run awayyyyy!” lol ) but I could see how it could also be a Fight response, by harnessing the energy to wrestle on the conversation. Thanks for the thought!

  2. Hi Heather,

    Thank you for this wonderful paper, and for the help you have given me over the years on understanding and managing trauma.

    I have no doubt that “persons who stutter experience the effects of Trauma as a result of their stuttering, of the repeated assaults on their nervous systems, and frustrations day after day, minute after minute”. This is certainly true for me, and I have yet to find my way to work through those traumas and their multi-layered effects. Your writing certainly helps me along my journey with that.

    Regarding the connections between some secondary behaviours of stuttering and the Fight/Flight/Freeze/Please responses: very intersting ideas. For me, looking away or closing my eyes feels like a flight response, as I try to escape the situation. Being quiet, not responding, feels to me like a Freeze response. Avoidance behaviours certainly feel like Fight responses. Very interesting to think about the experiences of stuttering in this way, and very helpful, too, as it frames my reaction is biological responses that make sense in the context of the difficulty of the situation. I think that merging those concepts with Mindfulness attitudes can be very helpful. Acceptance can help me remain in that moment, accept (or even embrace) the uncomfortable feelings. There, with non-judgemental awareness in the present moment, is perhaps where we can change.

    My question, then, is: If we can remain in the moment of stuttering, how does that help develop or change the (the Ventral vagal part of the parasympathetic nervous system? Perhaps I am using the wrong terminology. Can learning Acceptance and Staying in the Moment of Stuttering help our nervous system to help us manage the trauma?

    Thank you

    • Hanan,
      I appreciate hearing your experiences of your secondaries in the Fight/Flight/Freeze responses. I look forward to exploring these more with the community.
      Practicing staying in the moment, whether through mindfulness tools, or cognitive tools, or other means, can help us downshift and regulate to where the Ventral part of the Vagus nerve comes on board. As we learned in school, “Safety First.” I see Acceptance as an organic process, that comes onboard once there is more capacity on board, and a broader “window of tolerance” where we are not activated so quickly, or for so long, or shut down less time. Acceptance and being able to use mindful tools will be easier to notice and cultivate when we have more regulation skills and a greater capacity in our nervous systems. Both are key concepts and skills, but they need safety and regulation to really take hold. HTH.

  3. This was fascinating and informative. I am very intrigued by the connections of fight/flight/freeze and an individual’s response to their stutter. I am in graduate school studying to be an SLP. I have had a professor mention the complexities of addressing eye contact. As you said, fluent people don’t maintain eye contact 100% of the time. The nuances are subtle. I liked your idea of allowing someone’s eyes to “settle” and find something “grounding” before looking back. So much of what I have learned about being a speech therapist is how different every individual’s needs are and how adaptive we need to be in response. I am grateful to be made aware that somatic approaches to stress and trauma exist. Thank you.

    Christa

    • Thank you for reading and for your feedback. Somatic approaches in dealing with trauma are becoming more and more known in the psychotherapy community, and are beginning to be looked at in the SLP community as well. It is though, more than “let’s take deep breaths” and relax. You raise an excellent point. Every individual is different, and as clinicians, being adaptive, creative, and flexible are key. Learn as much as you can from as many places, people and modalities as you can…And please consider referring out for adjunctive support for your clients. SLP’s have so much to study and learn and don’t have to “do it all.” Good luck on your journey.

  4. I love that you brought up trauma and eye contact as an emotional factors to consider. I think overall, we tend to lack consideration when it comes to trauma because it’s something we don’t understand very well. On top of that, it’s so difficult to quantify how the experiences of bullying or shame may affect one child versus another. I feel we approach eye contact similarly- we have a very narrow and finite idea of what it should be, or what’s “expected” – but consequently, we fail to consider how it may be related not only to each individuals’ social behavior, but also to their coping skills as well. I’m so glad I had the chance to read about your opinion and experiences firsthand. It’s something that, as a future SLP, has made me reconsider the ways in which we approach behavior and stuttering as a cohesive unit.

    Best,
    Kennedy

    • Thank you, Kennedy. There are many reasons for varied eye contact. It is not all trauma-based. Sometimes lack of eye contact was an effective secondary coping mechanism, until it wasn’t. Sometimes cultural factors are in play. Sometimes, it is triggered by Shame. And sometimes, it may have been any of those, and now has become a defensive accommodation. My point was to question the common technique of forcing eye contact, (which can increase a sense of dissociation for many people) rather than slowly, carefully, organically, allowing the eyes to make contact. A radical idea perhaps, but one that I’m playing with. Shame also has postures and reactions, a sense of Somatic Shame, if you will.

  5. Ms. Najman, your insight on the topic of resiliency is so interesting. Often, when we talk about emotions, we talk about our different feelings, but I liked that you provided an explanation of where these emotions and responses occur in our brain. Your breakdown of the “three big parts of the brain” made so much sense and really outlined the process of “flight, fright, freeze, or please”. Another part of your article that I thought was most interesting was how you talked about our responses to trauma, and how trauma doesn’t have to be earth shaking, but can be small everyday occurrences that build up over time. This concept is exactly what we are taught in school when we learn about disfluency. We learn that PWS develop these negative feelings toward themselves and their stutter because of the negative experiences they deal with over time. I like that you shared your own experience with your audience and reiterated that we can all learn resiliency and we can all “bounce back”. I think this is a great skill to work towards with PWS, and one that I, as a future clinician will try to incorporate in my sessions. Thanks!

    • Thank you, Christi. I suggest you check out the work of Linda Graham, LMFT, who has several good books on Resilience. “Small t” traumas definitely build up over a lifetime, whether you stutter, have lived in a challenging environment growing up, had to survive in the midst of systemic challenges and discrimination, had to move schools/make new friends, and on and on. You may find literature on Kaiser’s ACES study to be interesting and informing as well. Good luck in your journey!

  6. Heather, thank you for the thoughtful insight into resilience and trauma. I liked the depiction of the two types of traumas as ‘Big T’ and ‘little t’. I feel like when discussing traumatic events that result in a need to bounce back, most people think of a ‘Big T’ instead of a series of ‘small t’ events when these events can just as likely take a toll on a person’s body and mind. I also appreciate the connection to the development of resilience. It is so interesting to learn about the multiple factors that contribute to the ability to positively overcome adversity. I was surprised to find that the most important influence of the development of resilience is the presence of stable, committed relationships. While this was new information to me, it makes so much sense. That support system serves as a ‘cushion’ to assist in the bounce-back that is associated with resilience. I love the emphasis that this comfort can come from other means, like a relationship with nature. I think it is so important to take into consideration people’s differences and your paper did so wonderfully! I appreciate your thoughtfulness!

    • And I appreciate your feedback! It is always helpful to read what “speaks” to readers. Was there a parent, a teacher, a family friend, a troop leader, a friend, a sibling who “made the difference” for you? Even if we did not feel that in a strong way in our lives, we can “earn” that sense of security with others even in our adult relationships. This may come through a partner or significant other, a therapist, a teacher, a dear friend…perhaps even a support group. Just some ideas to ponder. Thanks for stopping by!

  7. Hi Heather,

    I really enjoyed reading your paper. It was fascinating. I was not surprised to read that most of the literature on resilience is in relation to trauma. As an SLP graduate student, I’ve learned that PWS can experience their own kind of trauma, whether their stuttering is a result from trauma or they experience trauma as a result of their stuttering. Whether it’s from bullying, a fear of speaking, or a negative image of themselves as a speaker, I agree the series of these “small t” traumas over time can impede a person who stutter’s ability to feel resilient. I thought it was very interesting to compare the physiological fight, flight, and freeze responses with blocks, avoidance behaviors, and not speaking altogether, respectively. The concept of considering physiological regulation is something I never would have considered with a person who stutters. This is something I will definitely consider as a future SLP, because we don’t want to fight against what the body is naturally designed to do. You also mentioned that breaking eye contact is a form of regulation. If many PWS break eye contact during a block, it now seems inappropriate to force them to maintain that eye contact if it is just a form of physiological regulation to reset. Considering that fluent people don’t always maintain eye contact either, it is important to think about why we would make a PWS do it. I also wanted to address your comment that, “it is in relationship that resilience is nurtured, grown, and birthed.” In another paper I read, I learned that relationships and models from supportive adults are crucial to developing resilience. In addition to support from adults, you mentioned that meeting other PWS can also grow resilience. Would you agree that PWS receive a different type of support from other PWS than from people who don’t stutter? Is it possible to still grow in resilience through support from someone who doesn’t stutter, like close friends or family?

    Thank you so much for sharing.
    Best, Nicole

    • Thank you for your feedback, Nicole. See my response to Kennedy above for some thoughts on eye contact.

      I do feel that there is a unique resonance, a different type of support and empathy that emerges when PWS get together. There is a depth of understanding that can go beyond words, when someone shares a story, a painful one or a funny one, without having to explain it, and you know people “get it.” Whether it’s a national association chapter or conference, a Stutter Social hangout, or two people meeting, it is different. The same could be said for people who connect to others through a 12 step or other type of support group. That being said, I do think growth in resilience is possible from close friends or family, when we feel acknowledged, seen and heard, which is a need we all have, regardless of if we stutter or are seen as fluent, or wrestle with something else.

      Healing and resilience can and does grow. It can be challenging with family, who are likely to be managing their own traumas, and family members tend to trigger each other, (such as seen at many holiday tables 🙂 ). As I mentioned above, a sense of security can be “earned” later in life, through close relationships. We plant seeds, but we never really know how these seeds grow as time goes by. We keep on planting…

  8. Hi Heather,
    Great to see you have a paper again this year. I know you are constantly under time constraints and always so busy, so I know it must have felt important to write and contribute.

    What has been the biggest challenge for you this year, in terms of resilience? Besides the obvious of this isolation being so hard for so many people.

    I’m also happy to learn you are able to pursue your passion and do this work that will help many, I am sure.

    Pam

  9. Thank you, Pam.
    Resilience is a major part of my personal and professional journey, so I was thrilled to see it as this year’s topic. I am grateful to you and all those on the ISAD 2020 Online conference committee who read through all the entries, suggested edits, and herded cats (or crickets, depending on your climate). 🙂

    I think you hit on an important note, that I tried to touch on in my piece. Isolation challenges our sense of resilience, as we are hardwired to connect, and not having friends or family close can be so challenging. I think virtual meetings have helped, but it is not the same. It takes more work for our nervous systems to connect online, thus the “Zoom fatigue”. I have found rest to be so important, (“rest and digest”) and develop new forms of “play” and ways to connect with people, nature, myself, and “something bigger.”

    I do love it, (talk therapy has left out the body for a long time) and am honored and humbled to continually learn, listen, and respect those that I have the privilege of getting to know.

    • “If it’s easier for you, just make it tens and twenties…” 🙂 (You should catch the reference, lol).

  10. I’ve heard bits and pieces of all of this from different sources throughout my life but I do not think that I’ve ever brought it all together like this or seen anyone else put it all together like this. I really appreciated that you pointed out how trauma be caused by a series of events rather than always having to be one big event like an accident or hurricane. What you say makes sense. I am a graduate student studying to become an SLP. Thank you so much for taking the time to share this. It really helped me to pull all this information together that had seemed separate and unrelated.

    • Thank you for your feedback. To paraphrase Peter Levine, the founder of Somatic Experiencing, trauma is not the event, but the overwhelmed response to the perceived threat to the nervous system. It’s not just the accident or hurricane, but can be that third-grade teacher, or bullies. Also, there are different types of trauma, such as shock trauma, and developmental trauma.

  11. Hi Heather!
    What a wonderful paper! Truly so insightful for a graduate student like myself who is practicing to become the absolute best future SLP I can be!! I enjoyed and really understood your perspective on how stuttering and trauma are parallel, and how our body processes the two the same. If a person who stutters is constantly experiencing negative feelings too often, too fast, and they have no control over it, there is no arguing that trauma and stuttering are two in the same. I appreciate how you shared your own experience and how the support of a community allowed you to find your resilience and how important it is to have a strong home base. Your paper has given me so much insight on how to be a supportive and nurturing figure in the life of a person who stutters.
    Thank you for sharing!

    • Thank you for your comment. There are many ways to build resilience…community and connection are important for us humans. I also am grateful for doing a lot of my own inner work, and I hope with the expansion of tele-health, that more people will be able to find a good somatic-based therapist. I have yet to meet anyone who hasn’t experienced trauma (or Trauma) of some kind.

  12. Hi Heather,

    Thank you for sharing your article. I enjoyed reading it very much. Your viewpoint of looking at somatic approaches was extremely fascinating. I always thought it was all about the mindset in terms of stress, but you cannot simply think your way out of stress. I definitely agree with you about how it is not all about the deep breathing and meditation and that people can actually feel more anxious doing so. That has never worked for me, so I never believed that. It would be a very beneficial collaboration if SLPs and somatic psychotherapists can work together in working with trauma and dysregulation. I wonder if this is happening nowadays, but more awareness should be brought to this idea. It is encouraging that resilience is not something a person is born with but is actually something that can be developed and nurtured. I hope to bring more awareness to other people on what to do when someone who stutters so we can create a safe space in society. It is important to teach people to wait, not interrupt, not look away, and just understand how much effort the PWS makes.

    • Thank you, Laura. Yes, resilience can be nurtured and developed. Some people describe meditation as a change in consciousness or attention. I know many who find that state of flow while walking, swimming, listening to music, and so forth. The collaboration is just being talked about, and I hope will begin to grow.

  13. I know it’s past ISAD, but I couldn’t leave without a reply. You’re spot on as usual. Safety is the key to confidence, growth and resilience. That’s why the relationship between a PWS and a clinician is crucial for success. And that’s why support groups are such a fantastic addition to therapy. Many thanks for your insightful paper.

    Stay safe and keep them talking

    Anita

  14. Heather, I really enjoyed reading your writing. Several things stuck out to me in this piece. First, was the “please” portion of the Fight/Flight/Freeze response. Although I have not heard of this addition, I feel like I have seen it often in others and even in myself. It completely makes sense. Furthermore, I do completely agree in having learned the difference between Trauma and trauma that stuttering surely could cause Trauma. I would love to share this paper with my graduate SLP students that take my graduate stuttering course to read. Very well done and informative and really makes one think outside of the box.

    • Some clinicians call it Fight/Flight/Freeze/Submit, but I like things that rhyme, and Please fit better. People pleasing as a coping response…