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'Mastering blocking and stuttering: a cognitive approach to achieving fluency', 2004, by Bob G Bodenhamer

Rosemarie Hayhow, Debbie Mason, Mark Smith | 01.02.2005

Book reviews

Review by Rosemarie Hayhow and Debbie Mason, SLTs

Book cover: 'Mastering blocking and stuttering' by Bob G. BodenhamerFrom 'Signal', 2005

This book is based on the assumptions that: stuttering is a learned behaviour; blocking is primarily cognitive rather than physiological; and it is maintained by the meanings that individuals attribute to their stuttering. The thoughts and feelings that maintain stuttering are well described in the book. However, the range of variation that exists among people who stutter isn't always acknowledged, for example, the differences among people in their particular balance between the cognitive and physiological elements of their stuttering, and how this might influence their responsiveness to NLP. This may arise from Bodenhamer's experience of working with adults who stutter rather than children. In chapter 1 his discussion of the causes of stuttering does not refer to the extensive literature on early stuttering and so parents seem to shoulder an unjustified degree of responsibility. However, we would urge you not to give up on the book at this stage as the following chapters provide clear and interesting descriptions of NLP exercises or patterns that the author has used with people who stutter (PWS). These are illustrated with reference to individual clients and so the reader gets a good idea of how these patterns would work in practice. The reader is recommended to try these patterns on themselves before using with clients, essential if the reader has little or no NLP training.

Some patterns seem relatively straightforward, for example, 'creating a new self narrative', an exercise reminiscent of Kelly's 'fixed role therapy' (Personal Construct Therapy, 1955). However, a major difference is that Kelly would recommend more extensive elaboration of the implications of the changes so that the client isn't rushed into changing the very things that provide a sense of predictability. Bodenhamer does acknowledge the importance of elaborating what you've experienced when he refers to the client thinking of 'counter-examples', that is, exceptions to their usual story. These counter-examples are much like the 'exceptions' to the rule that are a starting point for change with clients in 'brief therapy' (George et al 1999). Therapists who are trained in other cognitive therapies may feel at ease with this pattern. Some patterns invite people to look at painful, difficult emotions and so have the potential to cause distress. The 'dropping down through' in chapter 6 is an example of this. In this pattern the client identifies a behaviour or experience with an emotion and then step by step finds what lies beneath the emotion, and the next emotion, and so on until they reach some sort of 'emptiness'. Then they move into positive frames. This pattern has been the most effective of all in Bodenhamer's experience with people who stammer. However, it would seem crucial that the therapist really knows what they are doing so that they are sure to move the person to their resourceful frames and not leave them floundering in their negative ones. The examples in the book demonstrate this movement from the negative and troubled to the positive and so the over all well-being of the client is given due attention. Therapists will have to work out for themselves where their own competence lies and whether they should seek NLP training or supervision if they wish to use this and other more demanding patterns with people who stammer.

This book is easy to read, well organised and with interesting examples. The lack of reference to the stuttering literature is not surprising considering that the author's expertise is with NLP rather than stuttering. The evidence that Bodenhamer cites to support his claims is anecdotal. In the current climate, which favours evidence based practice, expert opinion is no longer enough to guide therapists in choice of treatment. Maybe some therapists who are inspired by this book will feel motivated to carefully document their applications of 'Mastering Stuttering' and provide us all with the much needed evidence.

References
Kelly, G.A. (1955) The Psychology of Personal Constructs. Norton Press, New York.
George, E., Iveson, C. & Ratner, H. (1999) Problem to Solution: Brief Therapy with individuals and Families. Brief Therapy Press, London.

©2005 Rosemarie Hayhow and Debbie Mason. Reproduced with permission from Signal (2005), the magazine of the Fluency SIG (www.fluencysig.org.uk).

Rosemarie Hayhow is a speech and language therapist specialising in stammering. Debbie Mason is a speech and language therapist and NLP Master Practitioner.

Review by Mark Smith

Winter 2004 issue of 'Speaking Out'

I am 45 and have tried various speech therapy techniques over the past 40 years with varying degrees of success. I have been incredibly lucky in that time to have met and had therapy from some of the leading speech therapists in the country. These gifted individuals have given me techniques, which I still use to this day, such as prolonged speech and to a lesser extent block modification. But, and there is always a but, these techniques do not offer for me the full solution. They help prevent some of the overt symptoms of stammering but do not tackle the underlying cause, that is, what triggers my stammering?

Bob Bodenhamer's book, Mastering Blocking and Stuttering, describes the application of Neuro-Linguistic Programming (NLP) to stammering and attempts to provide an answer to what triggers stammering. The basic concept put forward in the book is that everybody has periods or 'states' of fluency and if only an individual can identify the composite elements of these fluent 'resource states' they can then be applied in situations where dysfluency normally occurs. This will hopefully lead to a natural diminution of the stammer and help the person to focus on elements in life other than their pattern of speaking and people's perception of them.

The first chapter concentrates on the origins of stammering and puts forward the theory that the majority of stammering is derived from some childhood trauma or particular circumstance which leads to an internalisation of emotions such as frustration and anger. This manifests itself in a reluctance to speak and hence stammering or blocking occurs.

Then as we develop and mature into adulthood our experiences and responses to stammering encode our mind-body system to such an extent that the cues or triggers for stammering have become so embedded that we are not conscious of them happening. These experiences and responses then form layers of emotions which dictate the person's view of the world which is often negative and thus a misperception.

The second chapter leads on from this idea that a stammerer's perception of themselves and the outside world has been determined by many years of stammering and that in order to become fluent they have to think differently. In effect, by gradually peeling away the ingrained responses you can get to the essential triggers of stammering.

Bob also feels that the person has to admit that they are in control of their stammer and emotions and therefore by dispensing with continual negative thinking they can achieve a state where the stammer has no reason to exist and fluency can almost occur naturally.

The rest of the book goes on to provide practical NLP techniques and case studies to help reframe the stammerer's perceptions. These are primarily designed to be used by an experienced NLP practitioner as the psychological techniques are quite complex and will inevitably uncover fairly deep rooted and difficult emotions within the person. That's why I believe that the NLP approach would only succeed if applied by an experienced NLP practitioner.

However, I found the book to be tremendously useful to identify a methodology to analyse the psychological aspects of stammering. Even applying some of the basic principles for a few weeks, for example, to stop having a negative framework and perception of oneself and the world, I have found to be enormously uplifting and empowering. I have become more relaxed about my stammer and in some situations I am beginning to see a lessening of the fear and anxiety. I shall now seek out an NLP practitioner to continue the therapy.

Reviewed by Mark Smith in the Winter 2004 issue of 'Speaking Out'