Where does the real problem of stammering lie?
How does society communicate its values and norms about fluency and how does this affect people who stammer?
How does the SLT tread the delicate path between helping their client manage their stammering more effectively (and increase ease of communication) without reinforcing unhelpful ideas about stammering (and fluency)?
These are just some of the questions Katy Bailey, Sam Simpson and I posed in a joint presentation to the Oxford Dysfluency Conference on 19 July 2014.
At the presentation’s heart was a conviction we all share that the social model of disability has much to tell us – people who stammer, speech and language therapists, and wider society – about stammering, and how by working together we can challenge and overcome some of the stigma out there and self-oppression in here which can make life so difficult for those of us who stammer.
Katy began by tracing the origins and development of the social model in the disabled people’s movement which disputed the traditional medical conception of disability as the individual’s problem requiring impairment expertise, cure, therapy and care. Instead, the social model locates the ‘problem’ of disability in society: in the physical barriers, but also in the negative stereotypes and prejudices which can push disabled people to the margins of society, whilst upholding powerful notions of ‘normality’. The physical barrier of a voicemail which does not let me finish saying my name may be familiar to people who stammer, but far more insidious and interesting for me is the stigma around stammering which operates along psychological and emotional pathways, and is there, Katy argues, in the struggle of stammering itself.
Sam then recounted her own development as a speech and language therapist and the disturbing realisation that she was training within a tradition firmly underpinned by the medical model in which she, the ‘impairment expert’ was expected to ‘fix’ and restore the client to normality (fluency), without any awareness of the social norms and stigma the therapy was reinforcing. Times have moved on since then – Sam’s book which she co-edited with Carolyn Cheasman and Rachel Everard, Stammering Therapy from the Inside is evidence enough – but there is still plenty of stammering therapy for which fluency is the overriding preoccupation, and which fails to take the client’s voice into account, and to grasp the broader factors of self-identity, society and social stigma.
Finally, I assessed some of the cultural pressures we face: the performance-driven and perfectionist zeitgeist in which we live and the haunting and destructive appeal of the ‘fluency god’ which I am happy to say more and more people who stammer are starting to renounce. That certainly seems to be the impression I get from a range of blogs, podcasts and websites: StutterTalk, Stuttering is Cool, British Stammering Association, Free Speech, Diary of a Stutterer and the latest, Did I Stutter? project. If you haven’t done so already, check them out! The internet and social media has been a wonderful way of bringing people who stammer together, to share our stories, insights and experiences, and to provide some collective resistance to the powerful social norms which tell us either to keep quiet and get it fixed, or at least to keep up the façade of fluency. This is the good news. And the other piece of good news is that speech and language therapists also have an important part to play in helping people who stammer overcome these barriers. Approaches such as mindfulness and cognitive behaviour therapy enable us to look at our thoughts around stammering differently, and foster healthier and more self-accepting thoughts and behaviours. There is much good work to build on, and more opportunity to continue this conversation between therapists, clients and self-help groups on how we can all work together to help people who stammer on our ongoing journey from oppression to liberation.
St John Harris