The Value of Self-Disclosure in an Increasingly Virtual World – Loryn McGill and Trisha Thapar

About the Authors:

Loryn McGill, M.S., CCC-SLP is the owner of OC Fluency Center in Costa Mesa, CA providing therapy exclusively for people who stutter and at Chapman University she is an Adjunct Professor and teaches the graduate course in Fluency Disorders. She is the co-developer of the Childhood Stuttering Screening for Pediatricians (CSS-P) and has conducted international research examining the benefits of early identification of stuttering and its benefits as well as researched the use of medication in the treatment of stuttering. As West Coast Coordinator for Camp SAY she runs overnight and day camps for children who stutter and is actively involved with FRIENDS, The Stuttering Foundation, and the NSA. 

Trisha Thapar, M.S., CCC-SLP is a licensed and board certified speech-language pathologist. She is the owner of Adventures in Communication, a private practice based in Lakewood, CA. She is passionate about working with the stuttering community and has collaborated on international research examining the benefits of early identification of stuttering and its benefits. She obtained her Masters of Sciences in Communication Sciences and Disorders from Chapman University. She also helps coordinate Camp SAY LA, a fun camp for young children who stutter through Stuttering Association for the Young. 

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  Clients who had pushed themselves so hard to take risks now had most of their communication opportunities withdrawn.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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Comments

The Value of Self-Disclosure in an Increasingly Virtual World – Loryn McGill and Trisha Thapar — 26 Comments

  1. “Instead of continuing old intervention techniques over new platforms, we need to acknowledge the trauma that has been experienced and use that to inform to the new direction of therapeutic goals and objectives.” This a powerful statement, it is no surprise that virtual learning and interaction changes the dynamics of communications. For a PWS, they must learn to adapt to a new way of communicating. Moreover, online communication makes it difficult to read the listener’s reactions and preconceived notions of stuttering. Clinicians need to recognize that virtual communication comes with a whole set of challenges and they must work with their clients to ensure they are confident in adapting to a new way of life. Above all, I believe that self-disclosure is a powerful tool for PWS to have a sense of control and ownership of their stutter. It demonstrates that they are free to be their authentic selves. Lastly, I found the idea of decreased social interaction for PWS which can lower their anxiety. However, it can also inhibit them from taking the chance and facing their stutter in a real word context. Thank you for shedding light to this topic, very important things to be mindful about!

    • I couldn’t agree more with you Zevin on how for PWS and CLINICIANS need to adapt to embracing new therapeutic techniques! I also agree on how extremely challenging virtual communication is for EVERYONE with the varying platforms one must keep into account that the typical expectations we place on individuals need to be modified and thus, our techniques when we clinicians do therapy. I really couldn’t agree more about how important “disclosure” is important and with covid, its been rather difficult. I couldn’t agree more on how we need to “encourage and educate about the reasons why stuttering freely is the right option without excuses or apology.” I am dating someone who stutters, i can totally can see how PWS feel less anxious about socializing, because they don’t need to go out, BUT i have seen the anxiety rise when doing conversations over the phone in my personal experience with sorta living with my boyfriend.

  2. Hello Loryn and Trisha,

    Congratulations on a terrific paper. I want to be certain that I am correctly understanding your use of the term “disclosure.” I view “disclosure” as telling people that I stutter, whereas “advertising” is using voluntary disfluency to let people know that I stutter. (Sometimes, these two practices seem to go together like peas and carrots.) Is this the meaning of “disclosure” that you had in mind? If so, I would be curious to know what role, if any, advertising plays in your work with your clients. Best,

    Rob Dellinger

  3. Hi Rob,
    Thank you for taking the time to read the paper and ask this question. The act of disclosure and advertising go together quite often as you stated as advertising is a great way of disclosing and can also be a step towards directly saying, ” I stutter.” I am finding that it is more pressing now to disclose sooner in order to reducing stuttering being confused with connectivity issues which may lead to frustration and increased anticipation of being asked to repeat ones’ self. Advertising is so important to desensitize the experience of stuttering and continues to have a strong place in the therapeutic process. Thank you, Loryn

  4. I enjoyed reading your thoughts on this topic. COVID has made the already difficult task of self-disclosure even more challenging. I’m curious, do you have any suggestions that might make it easier for clients to self-disclose in our post-pandemic world? What can they do in the face of the challenges you mentioned? You made an excellent point in emphasizing that the pandemic has given clinicians the opportunity to re-examine previous intervention techniques and use what we have learned to guide therapy moving forward. This is a reminder that we must continuously reevaluate the treatment process and how the environment might play a role in that process. Thank you!
    Lauren

    • Hi Lauren,
      What we are finding is disclosing sooner is what seems to be helping the most in getting ahead of what others might think is happening in the virtual medium. Appreciate your feedback and comments, Loryn

  5. Hello Loryn and Trisha,

    Your paper addressed some points about our virtual shift that I had not previously concerned with regards to stuttering, specifically the idea that stuttering over a Zoom meeting or Facetime can be brushed off as an internet or connectivity issue (which we are all experiencing far too often these days). It may be easy for some people to casually dismiss these disfluencies over the internet, but this brushing off can be extremely damaging for a person who stutters. As someone who does not stutter, I do not know what it is like to avoid certain situations and casual conversation because of my speech. I do not understand the first-hand anxiety that comes with pushing yourself so far out of your comfort zone just to interact with someone. COVID has likely changed the way we interact with others for quite some time; thus, we need to approach situations differently than we did pre-pandemic. I would love to hear a perspective from a person who stutters about how they have changed their self-disclosure strategies as of late.

    Best,
    Alexa Abadee

    • Hi Alexa,
      We learn best from those who experience it and PWS’s experiences were definitely the inspiration for writing this paper. We can always learn and gain perspective and forums like this are such a great opportunity. Thank you for your comments, Loryn

  6. Hello Loryn and Trisha!

    The nature of everyday communication, since social distancing has become the norm, has rapidly formed into something that I perceive as foreign and oddly more taxing than in-person interaction. Your point that we have lost essentially all opportunities for casual communication made me realize that I was mourning the loss of that continuous exposure to communication opportunities. Using virtual communication platforms is indeed highly ‘intentional’ communication. I find that it requires one to purposefully shift their attention to being social from being alone and socially distanced, where there is no expectation for external communication. This is quite a jarring contrast from when we could be out in the world where there was a constant low-level expectation of casual interactions.

    I can only imagine that for a person who stutters (PWS), this new duality of being fully alone and then having to intentionally seek out an explicit communication act could be very anxiety-producing. I am deeply sympathetic to the notion that self-disclosure for PWS now requires a bit of production in scheduling a time to purposefully communicate, as opposed to pre-pandemic times when it could be more casually mentioned in an off-hand conversation between colleagues or friends.

    The pandemic has been extraordinarily difficult for everyone. As clinicians, it is important that we remain sensitive to the unique struggles of our clients, and work to support them as they tread in previously unimagined circumstances.

    Thank you for sharing your insights!
    -Catherine Usery

    • Hi Catherine,
      Thank you for sharing such well written comments. I am glad that we can all come together as a community and support each other during this time. Best wishes,
      Loryn

  7. With such a major shift in the world, communication is almost always virtual nowadays. As mentioned in the paper, “we lost our casual communication opportunities”. Although we are able to communicate virtually, we are no longer able to take in the listeners body language and reactions (especially if their camera is off or they have connectivity issues). Self-disclosure is imperative for PWS to take charge of their stuttering. The moment of self disclosure is vital and what happens next can have a positive or negative effect on them. With this new way of communicating, I agree that there should be “new rules and considerations” for treatment.
    People tend to feel more confident and relaxed when they’re around people that they’re familiar with (such as family members or close friends). Has there been any instances where one of your clients has actually felt more comfortable speaking virtually, since they’re at home, around family?

    • Hi,
      I have clients where the planned aspect of communication has worked to their benefit as the unknown factors of not knowing who they might see and what might be spoken about was significantly anxiety provoking. That being said, it also identifies opportunities for growth when new communication opportunities present themselves in the future. Thank you for your comments,
      Loryn

  8. Hi Loryn and Trisha,

    This was very eye-opening for me to see how the pandemic has affected PWS and how much social isolation has impacted them. I have now learned what self-disclosure is, and I can’t imagine how difficult it must be for those working on that strategy to now have to seek their own communication opportunities. Connecting virtually is challenging at times, but I was aghast at PWS’ stuttering was being brushed off as a connectivity issue or delay. This really shows the courage and adaptability PWS demonstrate when utilizing this medium that requires such vulnerability. I agree that we need to change with this ever-changing world and align it with our therapeutic goals and objectives, rather than taking the easy way of using old techniques that we are comfortable with on new platforms. I appreciate the empowerment in this paper, that we do have the power to keep going with our new ways of life. Thank you for sharing your thoughts!

    • Hi Laura,
      I am thrilled that you had a sense of empowerment after reading. Trisha and I hope that through all this, we can support each other as we navigate these ever changing waters.
      Best,
      Loryn

  9. As a society the pandemic that catapulted our social lives into this technological world, we can acknowledge the hardships and frustration that virtuality brings (e.g., connectivity issues, coordinating schedules, technology demands). As future clinicians, current clinicians, and professionals, we can acknowledge how the increasing demands and stress that virtuality brings to our clients on top of their diagnosis. I am lucky enough to work with a fluency adolescent group online and can attest to the influx of core and secondary behaviors that I have observed. What I am ashamed to admit with the lack of consideration on my part, is that some of these students are potentially experiencing an even greater sense of social isolation than those of their fluent peers. You bring up resilience and adaptability and it is easy to think of kids being resilient in nature. And while I check-in with my students who stutter about their beliefs/attitudes each week – I haven’t asked how those feelings have changed from before social distancing restrictions were put in place versus now. I started working with them after COVID-19 had gone into full effect. I think it is important to note how the shift onto virtual platforms have influenced them so I can provide the most effective treatment. Outside of therapists, clinicians, and family they typically communicate with – how many opportunities are they getting or initiating in communicating with unfamiliar partners or less familiar people. Since the start of Professor McGill’s class, I have found an inclination towards working with fluency disorders and wonder if there are any platforms (existing or in progress) that provide a place for PWS to talk with the freedom to take those risks you mention. I would be interested in knowing what places/opportunities that I can maybe direct my clients towards where they can. A place where as you mentioned above, they can stutter freely and not withdraw when others talk at the same time because virtually, following conversational rules like turn-taking is difficult. Somewhere they don’t feel like they have to apologize every time I or someone else asks for them to repeat something, not because of their disfluency, but because the connection on my end is terrible.

    • Hi Tori,
      How great that you are thinking so much about the clients that you are working with. This is a new situation for everyone and we are all learning so much as we go along. You have such awareness to be thinking to offer such support. FRIENDS offers online meetings as well as NSA and Stutter Social.
      Best, Loryn

  10. “While we had multiple means to remain connected, the decision to communicate became more intentional than ever before.” This statement really stuck out to me. Although I am not a PWS, I myself have experienced extreme difficulty creating opportunities to communicate and keep in touch with others. I can only imagine how much more difficult it has become for a PWS. Opportunities which were once disposable to us are now more effortful than ever. The feeling of setback is unreal. There is so much nonverbal information we gain from in person communication. Having to adjust how you interpret others’ communication and express your own is a challenge we are all facing. During these trying times, I am comforted in that you two, Loryn and Trisha, have been pillars of strength for your clients. One of my current practicum placements is at a middle school. I have one PWS on my caseload and he has only showed up to our sessions once. It has been extremely difficult getting his buy in but I can’t imagine all of the other difficulties he is facing. I imagine going to school was an escape for him and now home life and school are synonymous. Any advice for how I can get through to this student?

    • Hi Linda,
      How wonderful to see your commitment to supporting this student. When you are able to connect, I would encourage you to start at a place of joint interest and finding out what some of the challenges have been. Letting you client know that you are a safe place to listen and not judge can go a long way in establish the foundation of a trusting therapeutic relationship.
      Thank you for advocating for your student,
      Loryn

  11. With the current state of the world, I had not thought about the fact that communication is now almost entirely intentional. With all interactions being set behind a login, people who stutter are likely met with more anxiety about each communication opportunity. These interactions are more formal, and situations in which someone may casually say something to start a short conversation are gone. This has been frustrating for most people, but I am sure it leads to even more increased stress for people who stutter. The idea that a person who stutters trying to disclose their stutter without saying “I stutter” may have that moment dismissed as a glitch is also something I had not thought of. It could lead to that person feeling defeated and anxious that they may be forced into a more overt way of disclosing their stutter before they have fully mentally prepared. I currently work with one student who stutters, and it has been difficult to get him to log on for our sessions. I can only imagine his frustration with the loss of informal conversations with friends and of non-verbal communication strategies. The additional loss of leaving the house for school and activities to these struggles makes his difficulties with classwork and coming to our sessions understandable.

  12. Hi Loryn and Trisha,
    I love the statement “what shone in the next phase was our undeniable sense of adaptability”. I think the way in which covid has forced our entire nation, and our world, to adapt to an unprecedented situation has been inspiring. While teletherapy is undoubtedly different than in person therapy, it allows for a new sense of normalcy and human connection. This is not to say, however, that teletherapy is not without its challenges. The idea of how to promote self-disclosure of one’s stutter in the virtual terrain is interesting, and complicated. I also had not considered the potential for a stutter to be written off as technological difficulty, and how hurtful that must be for the individual attempting to self-disclose. Sadly, I do not see our world reversing back to ‘normal’ anytime soon, so I will be curious to research the way in which self-disclosure is being approached through virtual therapy in the months to come.

    • Hello,
      It is definitely new terrain and I myself am learning so much about this process and have still so much to learn from this experience. Thank you for reading,
      Loryn

  13. Professor McGill and Ms. Thapar, thank you for sharing your views on how self-disclosure has been affected by COVID-19. I had not realized how difficult it may be for a person who stutters to self- disclose over a zoom conference call. The idea that their stutter would be mistaken for an internet connection issue or bad audio had not crossed my mind. I like that your article focused on how the need to adapt has become more critical than ever, because as you mentioned, we are all separated right now, so casual conversation is limited, but we still need to try to reach out. Reaching out and continuing to communicate with others is important for a person who stutters because honestly, right now, having the option to keep the camera and microphone off, probably feels safer. However, in the long term, it would be best for a PWS to continue to push outside their comfort zone, practice speaking in all situations, and continue to self-disclose in order to prevent isolation in these already isolating times. Thank you for your enlightening article and your perspective!

  14. Hi Loryn and Trisha,
    The transition to this new virtual lifestyle has definitely posed issues for everyone, but it never crossed my mind just how much it could affect PWS and the professionals who work with them. I’m currently in undergrad for speech-language pathology and am just now learning about self-disclosure, and I could not imagine the way this could affect someone’s progress or interactions. Living life without our small daily interactions has had much bigger affects than anyone would have initially thought. Another aspect that I haven’t considered is the risk of someone’s stutter being brushed off as a connection issue or delay! It really can be the smallest things that have the big impacts. What are some other ways, as SLPs, that you have had to adjust to patients during recent times?

  15. Hi!
    I know for myself that I have realized how much I rely on cues from body language and the virtual platforms make it much more challenging. Also during assessments and therapy I am depending more on feedback/ report from my clients about the secondary behaviors that I cannot see such as tapping, leg movements etc. Thank you for reading,
    Loryn