My dilemma as an SLT

How best to support speech and language therapists who are working with children and adults who stutter so that they work as allies in the context of evidence which shows that stuttering therapy has an overall positive effect.  No one treatment approach for stuttering demonstrates significantly greater effects over another treatment approach. Herder, Howard, Nye, & Vanryckeghem (2006).

• Need to validate professional identities that support.
• Learning from people who stutter.
• Therapy which focuses on positive outcomes in terms of children and adults living the lives they want  to live and the development of therapy that focuses on education and resistance to normalising discourses.
• Resists focus on fluency and cure in therapy.
• Focus on confidence, fun and delight in finding and validating identities which fit with our dreams, hopes and ambitions.

Male gaze (Laura Mulvey)

Dr. Carol Marcus a Leading scientist, has doctorate in applied physics, specializing in advanced weaponry, who happens to take her clothes off halfway through a movie made in 2013 (Star Trek: Into Darkness).

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Medical/clinical gaze (Michel Foucault)

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White gaze (Toni Morrison)

The white gaze is the assumption that the default reader or observer is coming from a perspective of someone who identifies as white, or that people of color sometimes feel need to take into account the white reader or observer's reaction. Various authors of color describe it as a voice in their heads that reminds them that their writing, characters, and plot choices are going to be judged by white readers, and that the reader or viewer, by default, is white.

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Ideas of oppositional gazes have developed: the female gaze

Female gaze has been used to refer to the perspective a female filmmaker (screenwriter/director/producer) brings to a film that would be different from a male view of the subject. Having a female cinematographer allows women to be viewed as they really are and not the voyeuristic spectacle that the male gaze makes them out to be.

To stutter is often to feel the edges and the walls of lamguage, in the mouth, in the glottis, on the face, in the chest. It can be to experience those parts of language which do not signify but that force us to encounter the stuff that language is made of and the other buccal functions from which language is inseparable, such as eating, breathing, chocking, kissing, humming, hissing, coughing, drinking, sucking, vomiting, licking, swallowing, wheezing, and blowing. We often avoid paying attention to the stuff of language because it reminds us of the mechanical and involuntary crust upon the transparent flow of social and economic institutions and the rational expectations of social interactions.

I have two examples about what it might mean to experience the matter of language queered. The first I’ll call wood, and it comes from the Italian thinker Giorgio Agamben. Agamben writes in his essay “The Idea of Matter:”

“There where language ends is not where the unsayable begins, but rather the matter of language. He who has never reached, as in a dream, that woodlike substance of language that the ancients called silva remains, even when he is silent, a prisoner to representations.”  

— Agamben.

This is a very loaded assertion, but by “prisoner to representations” Agamben is referring to a use of language that is reduced to transparent meaning, pre signification, supple communication, and pure intelligibility that conceals the medium of that which you use to communicate. You’re a fly in a box who doesn’t see the glass walls. Silva, meaning wildwood, is also a term for a poetic form enjoyed by the ancient Romans, and it trades on its metaphorical meaning as material for construction. If language is woodlike, it has a texture, a grain, colour, rings. It is hard while it can be broken down, built up, pulped, and refigured. It is attached to non-wood things like leaves. Agamben’s reference to the dream gives it a more ethereal resonance. Without going too deeply into the dream theory, Freud noticed that words are often treated in dreams as though they were things. Jean-Francois Lyotard provides an example from a poster of what dreaming does to language. In Frédéric Rossif’s poster Révolution d'Octobre, the words are physically folded as if rippled on a 3D surface by the wind, and the letters become distorted. Conor Foran’s stuttering font is another example of the distortion of words by the pressures of desire upon language. Language can do a great deal outside of representation.

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• ‍The blurt. Stutterers pepper their language with so-called “fillers” that ostensibly sit outside of, and even detract from, the message. We sometimes grimace and groan in the act of speech. In addition, we sometimes find ourselves in the midst of speaking sounds, words, or phrases we didn’t fully intend.‍
• The misfire. The phenomenon of stuttering includes both prolongation and repetition. Stuttering can extend the opening sounds of a message (e.g. ---aaaaaaaagree or bo-bo-bo-book), which an ableist grammar recodes as misfires that communicative parties can tacitly agree to ignore.‍
• The stall. A repetition can be a redundant redundancy (one that serves no discernable purpose), like repeating most of a sentence multiple times to get a “running start” on the difficult finish that was long ago anticipated by our impatient interlocutor. Or, in a hard block, the voice suddenly and unexpectedly runs dry. A word stops in your throat, and you must wait for infra-bodily traffic to clear while the absence of meaning gapes wide and dangerous in the social world.‍
• Crossed wires. A regular experience for stutterers, crossed wires describes the state of “talking past each other” that might begin when one party “mishears” the other and then feedbacks error into the conversation.‍
• The swerve. Clinicians prefer the term “avoidance” to describe the strategy stutterers employ when we sense an oncoming phoneme over which we expect to trip. I might, for example, begin to say “I agree” but change course, swerving around a potential misfire to substitute on the fly: “I don’t know.”‍
• The cut-off. This accident is one of attempted repair, caused when interlocutors or bystanders rush to the scene of an accident, interrupt, and reimpose order by attempting to predict and finish the stalled (or otherwise damaged) message according to a dominant grammar.‍
• The gridlock. Stuttering ferociously at the front of a queue, for example, halts the flow of information, people, and capital; it stalls a lane of traffic and tempts impatient honks in the form of tapped toes and glances, as everyone waits for an undetermined time until information and thus bodies will once again flow free.

[the open secret is] a way of imparting knowledge such that it cannot be claimed and acted on.

— François (1999)

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Homophobia often insists on knowing rather than refusing to know about the sexuality of gay people.

— de Villier (2012)

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Linking the stutter and the unspeakable are logics of subterfuge, to be sure, but I find that Sedgwick’s construction of the “open secret” more closely relates to the kind of secrets that animate stuttering. The open secret is a form of coded disclosure that Sedgwick links to the closet, and it mobilizes language around the secret in order to disclose only to those in the know and hide from those on the outside. Anne-Lise Francois describes it as “a way of imparting knowledge such that it cannot be claimed and acted on.” The open secret is that which everyone knows but cannot discuss. I select this construction for the stutter because, while some stutterers can and do pass as fluent and come out of the closet by a discursive disclosure like “I stutter,” more often, the stuttered voice betrays her before any such disclosure can be made, and knowledge of the stutter is created without being acted upon or acknowledged. The stutter’s unspeakability is subtended by its audibility and uncontrollability. Sedgwick’s example of the open secret actually comes from a text featuring a stutterer, Herman Melville’s short story, Billy Budd. However, it is not the eponymous character’s stutter that reveals the structure of the open secret for Sedgwick but rather the possibility of mutiny onboard the ship on which Billy is impressed.

Like queerness, certain forms of discrimination against stutterers or unwanted social interactions often express themselves through a desire to know, and to know it as a symptom. Nicholas de Villier in The Opacity of the Closet argues that it is important to pay attention to the ways that “homophobia often insists on knowing rather than refusing to know about the sexuality of gay people.” Similarly, stutterers often encounter the diagnostic desires of others, the desire to know why and from whence. An example from my childhood: I was at summer camp and sitting in the camp nurse’s office for something mild. The nurse asked me questions about myself and I answered. Then we changed topics and I talked to her about my brother. She interrupted me and said, “did you know you only stuttered when you were talking about yourself, not your brother?” The nurse created her own interruption in my speech as if to master my stutter with her own impediment, and sought to psychologize the root of it as a symptom. This diagnostic desire is a practice of what Sedgwick calls, in a different work, paranoid reading, a kind of analytic reading that seeks to treat the text as a puzzle or stratagem to be untangled. Stuttering attracts this desire to know, in part, because it is an exemplary object of non-knowing. No one knows why people stutter. The stutter speaks to a great opacity within us, and that opacity might be productive of a different way of understanding the self and its relations to others.

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Society will not tolerate… that I should be… nothing, or, more precisely, that the something I am should be openly expressed as provisional, revocable, insignificant, inessential, in a word, irrelevant.    

— Barthes (1981)

Stuttering consists of involuntary disruptions to the rhythmic flow of speech, the speaker’s cognitive and emotional reactions to them, and the speaker’s perceptions of listener reactions.

In persistent stuttering, the speaker develops a sense of self-who-stutters resulting from attributing meaning to personal experiences through self-narrative. The construction of self-who-stutters is influenced by the speaker’s relationships with others. Current research indicates a neurodevelopmental basis for stuttering, with epigenetic influences. The narratives of people who stutter are key environmental factors contributing to the epigenetic process.

— O'Dwyer (2016)

• One of the hall-marks of affect is ‘In-between-ness’.

… the most fundamental insight of affect theory: that no embodied being is independent but rather is affected by and affects others bodies, profoundly and perpetually as a condition of being in the world.

— Ahern, A Feel for the Text. (2018)

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The challenge for researchers is that affect is not something, but rather is “in many ways synonymous with force or forces of encounter”; rather than housed in or controlled by the individual, it “arises in the midst of in-between-ness: in the capacities to act and be acted upon.

— Ahern, The Affect Reader. (2010)

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• ‘Affect’ as dynamic – emotions not static but in process – changing as they move between bodies.
• Robert Solomon recommended ‘thinking of emotions as acts’, as ‘something we do, not just have’.
• 'Affect’ captures maybe better than emotion that embodied aspect of experience (something felt before it’s understood).

We want to affirm, especially for the young people out there, that it is okay to stutter. We believe that not only is it okay to stutter, but people who stutter should be empowered to speak however is most comfortable for them – even if that speaking style contains pauses, repetitions, and blocks.

— NYC Stutters (2020)

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• Educators to integrate the diversity agenda into speech and language therapy training to enable future therapists to consider the philosophical underpinnings of their role and approach.
• Forums for therapists to examine their underlying values, role and scope of practice.
• Meaningful collaboration to rethink the scope, focus and role of future stammering therapy for CYP & adults.
• Open, public debate about social and ethical implications of research in the fields of neuroscience and genetics.
• Research into what matters for people who stammer.
• Balanced investment of funding.
• Accessible research findings & conferences.

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Still it appears to us that the answer will be forthcoming if we as a field are serious about engaging in a partnership between researchers and the population of people who stutter, for people who stutter can provide the most meaningful metric for determining whether a treatment is viable.

— Yaruss & Quesal (2004)

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It is critical for professionals to realise that people with lived experience are best situated to drive the effort for changing how our society thinks about stuttering. Professionals bring resources and credibility to the table which can be very important for public attitude change, and they can play a supportive role to improve social conditions. However, people who stammer themselves are best positioned to promote the agenda of their community in terms of actions and policies that effect their lives.

— Boyle (2019)

Committee for the Big Stutter Party

Self disclosure/stereotype threat:

• Children can develop a “growth mindset” through learning that success takes effort.
• mistakes are opportunities to learn and grow from.
• This mindset encourages children to seek out new challenges and fulfil their potential.

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Therapeutic practices must adapt to shifts in the conditions of people’s lives.

— Winslade (2013)

It is no longer enough to give people a relationship in which they are free from being judged. What they need is an opportunity to actively deconstruct the normalising judgements operating on them and to push back against the effects of these judgements.

— Winslade, p.8 (2013)

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