Alternatively the goal of therapy may be to get the clients to accept that they will always stutter so they should embrace it. These clients may work on avoidance reduction, stuttering on purpose, stuttering more easily, and advertising stuttering. Although there are many benefits in reducing avoidances and not hiding stuttering, when this is the essential goal, the client may feel very frustrated and guilty, because they are being taught that they should like their stuttering when in their hearts they still want to be able to speak with the ease and comfort that everyone else has. This can lead to emotional and even processing conflicts. In their own way, both of these approaches don’t consider an important factor: it is work to stutter. Therefore, we should not establish goals that add more work and more thought to an already heavily overloaded system. In real life, when either stuttering or fluency is on the speaker’s mind, and when the person is trying to either speak fluently or stutter in a different way, it is very hard to carry on a conversation.

Goals that are logical and that lead to automatic natural speech production can be transferred from the therapy room to real life are goals. They include doing all that we know that normally fluent speakers do to produce speech. In normal speech production we develop speech automatically in our brain as a progression of syllables. The execution of speech requires activating the vocal folds to produce phonation that expresses intonation. The voice is shaped into speech sounds by uncontrolled movements of the articulators.

In this case, fluency or stuttering is not the goal of therapy. The goal is to change the way the brain is functioning to create speech. A brain that is functioning in a normal way for speaking will, of course, result in normally fluent speech. The speech will sound normal and it will be produced with the same ease and comfort that normally fluent speakers experience. The good news is that according to the laws of neuroplasticity, the brain can change itself. New neural networks can be created at any age. Hebb’s Law states that neurons that fire together wire together. This means that the more the client uses the new way of processing speech, the more hard wired it becomes. Alternatively, if you don’t use it, you lose it. Therefore, as the new process is used, the strength of the old process is reduced. This means that repetitive use of the new process makes it easier, more dependable and possible to use even when under conditions of stress.

However, time put into practice is not the key to successfully rewiring brain function. Rewiring the brain requires focused awareness. We need to understand that the brain wants to function the way it has always functioned so keeping awareness is not so simple when the brain is wired to focus on the speech and the fluency. As a matter of fact, getting the clients to see what they need to focus on is not at all easy. The criterion for success is never non-stuttered speech. Maybe this is why I have found that it isn’t easy to get clients to achieve goals in therapy. When clients are not doing the process in the natural automatic way, the stuttering is there. The clients feel it and I may also hear it, although perceived stuttering is not required. Stuttering can be covert as well as perceived by the listener. I have seen that beyond doubt, there is a direct relationship between internal processes and the ease, comfort, and fluency of the speech produced.

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