Traditionally, in the West, therapy for stammering has been considered to belong to the domain of “speech therapy” and has been carried out be speech therapists—who have tended primarily to teach their clients techniques and ways of speaking that increase the ease with which they can get their words out. It has, however, long been known that stammering has a strong cognitive component and that both the severity of stammerers’ symptoms and also the degree to which stammering affects and interferes with their lives are strongly influenced by their beliefs and understandings about the condition—and about themselves. So for example, if a person believes that his stammering is a sign of a weak or inadequate personality, or if he believes his stammering is his fault, then each time he stammers, he is likely to experience feelings of inadequacy, shame and guilt. In contrast, if a person believes that his stammering is caused by an inherited neurological abnormality or by a neurological injury, he may feel angry at his stammer or frustrated by it, but is less likely to feel guilt and shame. On the other hand, if a person believes that stammering has some positive advantages, and that for example, it enhances his ability to communicate with other people, then he will probably feel quite good when he stammers and will not be afraid of it.

In recent years, perhaps spurred on by increasing body of evidence that in older children and adults, speech therapy alone does not generally provide lasting relief from stammering, there has been a general trend for therapists to look for ways of helping their stammering clients’ break free of their unhelpful beliefs about their stammering.

In this module, we explain the basics of two stammering therapy approaches that should help us arrive at more realistic and more helpful understandings and beliefs about our stammering: Mindfulness practice and Cognitive Therapy.

Mindfulness practices can help us gain more control over our focus of attention and can help us to learn how to focus our attention in ways that are more helpful to us.

Cognitive Therapy teaches us how to identify the beliefs that we currently hold and how to test them—to see if they are accurate and beneficial, and how to discard them if they are not. If you stammer, then learning about the nature of stammering is itself a form of cognitive therapy—inasmuch as it can help you arrive at new understandings and beliefs that are more accurate and more helpful than those which you previously held. Thus, working through the contents of our “Understanding Stammering” module itself constitutes a form of cognitive therapy.

Although all people who stammer can benefit greatly from cognitive therapy and from developing a deeper understanding of their stammering, these approaches are absolutely essential for therapy for people whose stammering is covert and for people whose stammering has become associated with negative emotions—and in particular with feelings of shame and guilt.

Similarly, although mindfulness practice is of benefit to everyone who stammers, it is an essential component of therapy for people whose stammering is associated with extreme emotional response and also for people whose stammering is associated with trauma and traumatic stress.

Further reading

Cognitive approaches to therapy for stammering