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Breakthrough Techniques for Stuttering and Spasmodic Dysphonia

MORE THAN 70 million people worldwide stutter. That’s about 1 percent of the entire population. In the United States alone, more than 3 million people cope with stuttering every day. Those of us without the condition can only imagine how frustrating it must be to know what you want to say but not be able to get the words out of your mouth—to be engaged in conversation, moving from word to word, vowel to consonant, not knowing which sound might get stuck.

Current research attributes stuttering to a mixture of causes—genetics, child development problems, disruptions in the way the brain processes speech and language, and even the pressure of a family’s high expectations.

But although speech therapy has helped countless people to some extent, there’s no cure. Over the years, a lot of people have sought me out, looking for an alternative therapy or cure, and I’ve been happy to help. My techniques have had a high success rate with many of my clients, and I love seeing the transformation they can bring to someone’s life. One story in particular stays forever in my mind.

My kids have attended a wonderful nearby school in an unpretentious, charming community filled with great kids and with parents who are actively involved in supporting the students from the elementary grades through high school.

One day, the mother of one of the high school students called my office. Her son, Jeremy, had been stuttering since he began to speak. (About 5 percent of small children do, but three quarters of them stop by late childhood.) I could hear the pain in the woman’s voice as she told me about the challenges Jeremy was having in school and in social situations. He’d been struggling for a long time with self-esteem issues, she said, and she blamed the stuttering for much of that.

She’d tried speech therapy with little success and didn’t know where else to turn. She just wanted to help her son. So did I.

This is what I told her:

I’m not a doctor, merely a vocal coach who works intuitively with sounds, physiology, and mind-set. The theories and strategies I share to help people who stutter or have other voice-related problems stem from my experiences with clients. They’re the results of experiments that we’ve done to see what variables bring relief.

As a voice coach, I have spent my life working on two key skill sets:

1. How to get the vocal cords to move in specific ways, and

2. How to control the way air comes through the cords.

If you can control the air and the movement of the vocal cords, you can sing or speak much better.

When I began working with clients who stutter, I used a lot of my standard vocal exercises to see what might work. I remembered that when I was little, my family used to watch a TV variety show where a country singer named Mel Tillis would come on as a guest. Before he sang, he would always tell a funny story and stutter his way through it, making fun of himself in a sweet, vulnerable way, and the audience would laugh with him and not at him.

The striking thing was that when Mel started to sing, he sounded completely normal. He never stuttered for a second. I stored that memory in my brain for many years, and I decided to focus on it when I started looking for a way to help people recover from stuttering. After a lot of experimentation and thought, I began to see stuttering as an airflow problem. When everything runs smoothly, the words are supposed to ride out of the mouth on a solid stream of air. If the air comes out of the mouth in small, disconnected bursts, the sound will follow that pattern and be broken up and disjointed. You can try this for yourself.

Hold up your hand about an inch from your mouth, palm facing toward you and fingers pressed together with no space between them. Remembering the diaphragmatic breathing you learned in chapter 3, take a nice breath in through your nose. Pretend you have a balloon in your stomach, fill up that balloon with air, letting your belly expand, and then exhale while you say and hold out the word “MEEEEEEEEEEEE.”

You should feel a solid amount of air hitting your fingers, a stream that doesn’t stop until the word stops. Now read the following sentence aloud, pausing each time you come to the dots: “Roger says… when I stop a lot… before I… get to a… comma or a period… it… sounds like this… and I don’t feel a solid stream… of air… hitting my fingers. This is… what I mean by NOT having a… solid stream of air.” (Listen to audio 46 to hear this pattern.)

When a person stutters, the basic instinct seems to be to look at what’s happening in the individual’s mouth, thinking that the tongue or the lips or the teeth are somehow getting in the way of the sound production. I thought that was a possibility as well.

But the more I played around with it, the more I realized that if the right amount of air were coming through the vocal cords and out of the mouth, the placement of the tongue, lips, or teeth would not be enough to make a person stutter. Instead, the right airflow would open up the back part of the throat and guide the words out regardless of what was happening in the mouth.

So today I always start by teaching clients who stutter how to do diaphragmatic breathing, the same way I’ve explained it in chapter 3. You inhale deeply, pretending to fill up a balloon in your abdomen, and then exhale and allow the belly to fall back to its normal position. With these clients, I emphasize focusing on the exhale, and learning to send air more evenly out of the mouth as they speak.

When you can breathe out in long, flowing lines, you can connect long, flowing lines of words.

We start with the sounds of the vocal exercises, then make the transition from singing “nonwords” to actual words. When they’re comfortable with exercises, I ask people to sing phrases like “I CAN if I want,” instead of gugs and googs and mums and nos. (Listen to my example on audio 47.) Other phrases that work well:

I MAKE my own way.

My TIME is at hand.

I GO where I want.

My NEIGHBOR is nice.

Next, say the following: If-I-connect-all-the-words-together-like-this,… and-only-stop-when-I-get-to-a-comma-or-a-period.… a-solid-amount-of-air-will-come-out,… keeping-the-words-attached.

When you sing a song, the words actually do connect to one another the way I just demonstrated. A song is not a random combination of unlinked words and notes. So when you sing, and when anyone who stutters sings, it’s quite easy to connect the words and the air and have the words leave the mouth on a solid stream of air that doesn’t stop until you get to a comma or a period.

Be Prepared for Success—a Cautionary Tale

I taught all these techniques to Jeremy, and after a one-hour session with me he was speaking like a professional orator. If you hadn’t heard him before, you never would have guessed that he had a problem with stuttering. His mother cried when she heard the difference, and I felt like I had saved the world, or at least his part of it.

Before they left I asked Jeremy’s mom to call me in a week and let me know how things were going. I was excited and anxious about Jeremy going back to school the next day and unveiling his new voice. I know how hard kids can be on other kids, and how some people react to change.

Many times over the years I have seen clients back down from using their new voices, just because someone else made them feel self-conscious or reacted in surprise to the new sounds coming out. The people who know you are used to your sounding a certain way, and if you make a change, no matter how positive, it can catch them off guard and they might say something that could make you retreat to old habits.

A week went by and I didn’t hear from Jeremy’s mom. At the end of the second week I called her, and once more she was in tears, not happy ones this time. Jeremy sounded great when we left your studio, she said, but the next day, one of the kids said to him, “Who are you trying to be? Who do you think you are now?” And almost instantly, Jeremy went back to the way he used to sound. His so-called friends didn’t want Jeremy to be better, they just wanted him to be the same guy as the day before. And faced with that, Jeremy was afraid to change.

His mother was devastated, but there was nothing she could say or do to persuade her son to try again. I will never forget this story, and I wanted to share it with you because I want you to learn from it and not fall into the same trap.

Jeremy didn’t do anything wrong—he was perfect. But he wasn’t prepared to be challenged.

I want you to be prepared. In the quest to have speaking and singing voices that are healthy and life-changing, you will need to have the courage to stand behind your decision to be the best. You must focus on the prize and realize how precious it is. You will also need to explain to the people closest to you what you’re doing. I now tell all of my students to let their friends and family know that they went to see a voice coach, that they may be making sounds that are a little different, and that they are asking for patience and acceptance as they try to make themselves better. Building this kind of support system works out a lot better than surprising people.

What I most want you to know is that you can succeed, just as Jeremy did before he was derailed—and that you need to prepare for success, then keep practicing what I teach you. You are not destined to stutter forever. You can change the way air moves in and out of your body, and the words will ride out the way they should.

Help for Spasmodic Dysphonia

Once I saw that this simple airflow technique worked, and that it seemed to be helping people more than conventional methods of treatment for stuttering, I was thrilled and happy to help people recover. My clients were very vocal within the social media community, posting their progress online and telling people about my effective stuttering therapy methods.

As a result, people began contacting me with other serious vocal issues for which they couldn’t find solutions. One of those maladies is called spasmodic dysphonia, or SD. I’m sure many of you have never even heard that term. I’m a vocal coach and had never heard of it myself until relatively late in life. According to the National Spasmodic Dysphonia Association, www.dysphonia.org, SD is a vocal disorder—that’s what dysphonia means—that results when the muscles of the larynx spasm, causing the voice to “break up, or sound strained, tight, strangled, breathy, or whispery. The spasms often interrupt the sound, squeezing the voice to nothing in the middle of a sentence, or dropping it to a whisper. However, during other activities, such as breathing and swallowing, the larynx functions normally.”

The condition affects about 50,000 people in North America, the SD association says. It’s more common in women than in men, it generally occurs in middle age, and there is no cure. The disease may go into remission, but remissions are rare and brief.

I am always up for a challenge, but honestly, when people started coming to me with SD, it was hard not to feel overwhelmed. They were understandably sad, frustrated, and confused. Can you imagine speaking normally your whole life, suddenly hitting middle age, and then having your words become strangled for no apparent reason?

There was some evidence to suggest that SD was brought on by an emotional crisis, like losing someone you love, but the statistics, and my own discussions with clients over the years, made me and others skeptical about that. Plenty of people had no specific emotional trauma and still had a sudden onset of SD.

One thing was clear: No matter what the cause, once you got SD, you could no longer trust your voice to be there for you. My career has been centered on helping people find their voices and communicate with the world around them, and when I became aware of this mysterious condition that was making so many people silent, I was passionate about trying to help.

In the beginning, I tried to use the same airflow techniques that had worked with stuttering patients, and had some success. Teaching someone how to get air in, and to effectively control how it comes back out of the mouth, carrying the words with it, is always helpful. But that wasn’t enough to fix the SD problem.

I began to experiment with the pitch of SD patients’ voices, how high or low in the range they were speaking. Many clients had lowered their voices, as if they were a piano with just the very bottom keys working. With those low notes, most were making the squeaky hinge sound I taught you about in chapter 2.

Others were adding a ton of air to their voices and sounding like Marilyn Monroe. They were simply trying to find any sound that could get the words out, and going to extremes in the process—eliminating the air, which creates the squeaky hinge, or exaggerating the air with the Marilyn voice. But neither was working.

In my trials, I started asking everyone to try to move closer to head voice, way above where they were normally speaking. That did help them get more sound out. The combination of speaking in head voice and speaking only while the stomach was coming back in from a diaphragmatic breath made things even better.

Then I asked people to connect their words as though they were singing, as I was doing for the stuttering patients, and that also seemed to help. The problem was, it would work for a short period, and then the person would spasm and the sound would disappear.

It was difficult to keep the air and the vocal cords working normally for any length of time, so I kept looking for what was missing.

I noticed that whenever the sound got strangled, I could see and feel clients creating pressure in two specific regions of their bodies. One was the upper part of the stomach area, and the second was the back of both sides of the neck. The fear of not being able to speak would make anyone tense. But the amount of tension I was noting in both of these spots was far greater than any I could attribute to nervousness, stage fright, or the fear of speaking poorly. The neck was filled with pressure and tightness.

In order to relieve the tension, I took the clients’ heads in my hands and asked them to lend me control of the movement as they let their heads become free and heavy and allowed me to support the weight. Then I would gently roll the head in a small circular motion from front to back. It was hard for people to let me do this at first; they were tightening the muscles and trying to pull the head away from my hands. But I kept playing with it until they relaxed the neck enough for me to have some control.

You can play with this yourself by doing some small neck rolls in a circular motion, clockwise and then counterclockwise. Don’t try to take your chin too close to your chest or too close to your back. Just make smaller circles, trying to release the excess tension in the back part of the neck. Once the client relaxed the neck, I was able to get more sound out, so that was very helpful.

My goal was to have clients use all the helpful elements we’d discovered at the same time:

1. Only speak while the stomach is coming in.

2. Speak much higher in the range, toward the head voice.

3. Relax the tension in the neck.

4. Connect all the words.

Those factors, used simultaneously, made the voice sound a lot less strangled.

I worked on the tension in the top part of the stomach by asking people to allow their stomachs to come back in without using the muscles to make that happen. Singers often tighten their stomachs on the exhale to “help” push the breath out, so I was familiar with the problem.

I used this analogy to help my SD clients understand why exhaling doesn’t require any added effort from the muscles: When air goes into a balloon, the balloon gets bigger as the inside fills and the sides stretch out. When you want to release air from the balloon, all you have to do is open the top a little and the air happily rushes out of the hole. You certainly do not need to squeeze the balloon to get the air out. The same idea applies to the lungs. Air comes into the lungs and they expand, like the sides of the balloon. The lungs don’t like that expanded feeling, so they want the air to come out. You don’t need to pull your stomach in, any more than you need to push the sides of the balloon in. You need simply to relax your stomach as you exhale and let it gently fall back to its normal smaller position as air leaves your nose and mouth. (Review the discussion of breathing in chapter 3 for more details that might help you.)

Taking away tension in both the neck and the upper stomach area was a good step toward helping someone with SD relax and speak more easily. But it didn’t solve my problem with consistency. Remember how the students would sound better for a few minutes or so and then go back to not being able to get the words out? Well, let me tell you what I’ve learned.

During my sessions with students, I continued to do all of the things I’ve mentioned to help eliminate the SD speaking problems, but I just couldn’t crack the consistency issue. People would move in and out of making normal sounds, and I would do my best during the time I was teaching them, then send them away to work on the techniques I’d demonstrated. I also asked them to practice a daily warm-up set of vocal exercises, similar to the ones I use for all of my speaking and singing students. The results were spotty, but here is the amazing part of the story: The SD clients who kept trying the warm-ups anyway would contact me and report huge breakthroughs.

Some of these changes took only months, and some took as long as two years, but those who stayed with the program achieved striking improvements, even to the point of getting past SD altogether.

I came to understand that stutterers can see huge results quickly, but SD clients need a longer time to retrain the muscles and voice.

Though I love a quick fix, I am still very satisfied with any course of action that leads people to getting better, some faster than others.

If you are coping with SD or stuttering, remember: You can make things better. Just be patient and enjoy the process and improvements along the way, never stopping until you truly set your voice free.