The pandemic of 2020 hit like no other. In a matter of days, school was out, and we were isolated from our family and friends. The daily routine of hellos and goodbyes abruptly disappeared. There was extreme isolation and our primary contact with others was now over devices.
As speech-language pathologists who specialize in treating stuttering, watching the impact that sudden social isolation had on our clients was distressing. Over the course of the next few weeks, we watched anxiety increase and previously dormant avoidance behaviors start to resurface. Clients who had pushed themselves so hard to take risks now had most of their communication opportunities withdrawn. Some were relieved by this and began to thrive; others were distraught. With the lack of opportunity to venture out, these individuals were not only unable to take risks with their communication, but were also asked to be extra cautious with their physical health and well being. The first few weeks of the pandemic were therefore naturally about self-preservation.
As time began to pass and we started to get used to our new schedules and ways of life, one of the first things we realized as a nation was that we do in fact have the ability to keep our lives going. We saw clinicians rise up to their new role as tele-therapists, parents and teachers come together to figure out distance learning, and professionals everywhere figure out how to make remote work more effective than we had ever imagined possible. What shone in this next phase was our undeniable sense of adaptability.
We were able to adapt many of our daily needs effectively within the boundaries of a socially distant world. Communicating in person however, was not one of them. Video chats and virtual happy hours were certainly an option, but we lost our casual communication opportunities. No longer were we saying hello to a neighbor in passing, chatting with a co-worker in the elevator, or thanking someone for holding the door open. While we had multiple means to remain connected, the decision to communicate became more intentional than ever before.
As speech-language pathologists, we saw this lack of communication opportunities affect our clients who stutter, particularly those working on self-disclosure. Self-disclosure, a widely-used, evidence-based strategy that works on reducing the fear and anxiety associated with the anticipation of stuttering, relies heavily on social interaction. In a pre-pandemic world, a school-age client may have disclosed their stutter with a casual mention at the lunch table or during a brief chat with teachers between class periods. However, these subtle, casual interactions were no longer an option. Self-disclosure, an already intentional and personal act, now also required clients to actively seek out communication opportunities. In addition, clients now had to adapt to the inherent complications of socializing over devices. These complications ranged from connectivity issues to difficulty reading and responding to their listeners’ body language.
There is significant stress that comes from not being able to read the subtle nuances of a listener’s reaction and know what their preconceived notions of stuttering are. An individual choosing to stutter openly over a virtual interaction was now not only finding it difficult to gauge their peers’ reactions to their stuttering, but they were also risking the possibility of their stutter being brushed off as a connectivity issue or delay. To add to it all, we had been told for months to avoid risks and play it safe. The idea of disclosing one’s stutter flies directly in the face of that. It requires a person taking what makes them feel most vulnerable and exposing it for all to see.
While the method for self-disclosure is being updated to suit our increasingly virtual world, the need for it remains as great if not greater and more urgent now than before. At a time when social interaction has lost some of its nuances in delayed connections and physical distance from others, we are all coping with a loss of control. For individuals who stutter, that coupled with the lower locus of control that inherently comes with a moment of stuttering, can be highly distressing.
Disclosing one’s stutter, however, allows a person to enter an interaction with increased control. It can be liberating and can allow a person to present their authentic selves to others. The power that comes from self-disclosure may therefore help individuals who stutter approach their interactions with a higher locus of control and may ultimately increase their comfort behind the screen.
Self-disclosure continues to be an important part of stuttering treatment, but it now comes with a new set of rules and considerations. As clinicians, it is our responsibility to recognize what our clients are going through and help them navigate this new terrain. We must choose to look at this ever-changing world as an opportunity to learn and not allow physical boundaries of space to become limitations in our creativity. Instead of continuing old intervention techniques over new platforms, we need to acknowledge the trauma that has been experienced and use that to inform the new direction of therapeutic goals and objectives.
Resilience refers to our ability to rebound after challenging circumstances. As a community we have shown great resilience in figuring out how to keep our lives going despite the pandemic. As clinicians, let us help our clients realize their own resilience by encouraging them to actively create opportunities for communication, and not let physical distance from society stand in the way of them being their authentic selves. At a time when being silent behind a screen may initially feel like the safer option, let us encourage and educate about the reasons why stuttering freely is the right option without excuses or apology.
As we look ahead, there is a strong likelihood that the pandemic has made virtual interaction commonplace for healthcare, education, and work. Let us be mindful of this as we consider what the future of self-disclosure within stuttering treatment looks like. It is crucial that we continue to evaluate how these changes affect our clients’ needs so that we may continue to help them communicate effectively and authentically. In this unprecedented time, let us reassure our clients who stutter that we will adapt together, no matter what changes may come our way.
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