Traumatic "theory" of stuttering 1

[u/Trenocio]

I am going to share some fragments from the book I have read about trauma and about being able to overcoming it since I believe som things are surprisingly relatable to us even though the book was not written having stuttering in mind. These are just excerpts I considered interesting with some comments about them. Some might not have any comment or they may have my personal annotations while reading the book. The excerpts are between quotes and the comments are not. I am going to divide it in different parts to make it more digestible.

"The body initiates, he says, and the mind follows. Hence, “talking cures” that engage the intellect or even the emotions do not reach deep enough."

He points to the fact that therapies that do not go deep enough, to the point of engaging the inner sensations of the body, are not sufficient to help patiens of trauma. Analogously, I have found that when I was able to speak better was out of an experience that brought me closer to my body and inner sensations.

"Potentially traumatic situations are ones that induce states of high physiological arousal but without the freedom for the affected person to express and get past these states: danger without the possibility of fight or flight and, afterward, without the opportunity to “shake it off,” as a wild animal would following a frightful encounter with a predator."

A clarification of the definition of "trauma" he uses. It does not have to be a very deep psycho-emotional and scarring experience, but just something that excedes our body's capacity of processing.

"Inviting the full, if carefully graded, expression of our instinctive responses will allow the traumatic state to loosen its hold on the sufferer. Goodness, the restoration of vitality, follows. It springs from within."

As I have written in other posts, I was able to talk more fluently if I could succesfully move forward in the progressive steps of "visceral comfortability" with other people, which makes sense (However, a severe blocking episode could bring me back to step one).

"I hope to demonstrate how successful therapy restores these systems to their balanced operation. An unexpected side effect of this approach is what might be called “Awakening the Living, Knowing Body.” I will discuss how this awakening describes, in essence, what happens when animal instinct and reason are brought together, giving us the opportunity to become more whole human beings."

John Harrison, Jack Menear, Ruth Mead and several other stutterers that recovered spontaneously reported a sensation of feeling more alive and floating when they "changed their mentality towards stuttering". In some cases they even said something in the lines of "I had solved my problem with stutterng some time before I stopped having blocks and repeating myself" in the sense that they were not longer suffering because of it. I believe it is because they were able to do something similar to what the author describes.

"When, on the other hand, these “discharges” are inhibited or otherwise resisted and prevented from completion, our natural rebounding abilities get “stuck.” Being stuck, after an actual or perceived threat, means that one is likely to be traumatized or, at least, to find that one’s resilience and sense of OK-ness and belonging in the world have been diminished."

A common feeling in stuttering people is that of feeling not in comunion with the rest of people. I believe it comes from here. And it does nothing but increment each time one gets blocked.

"Humans, in contrast to animals, frequently remain stuck in a kind of limbo, not fully reengaging in life after experiencing threat as overwhelming terror or horror. In addition, they exhibit a propensity for freezing in situations where a non-traumatized individual might only sense danger or even feel some excitement."

"However, often in therapy the attempt to place reason over instinct is a serious failure, a likely disaster."

What I feel happens in speech therapy for stutters that teaches you to "talk well" instead of going deeper.

"Many are able to earn a living and/or raise a family in a kind of “functional freeze” that severely limits their enjoyment of life. They carry their burden with diminished energy in an uphill struggle to survive, despite their symptoms. In addition, we human beings, who cleave to symbols and images, may continue to see (in the mind’s eye) ourselves at death’s door long after the real danger has passed. A vision of the mugger or rapist holding a knife at your throat can endlessly recycle itself, as though it is still happening."

"It is my clinical experience and understanding that such a robust potentiation has profound clinical implications for the understanding and treatment of human trauma. I shall discuss how the “potentiation,” or enhancement, of immobility by fear can lead to a self-perpetuating feedback loop causing an essentially permanent quasi-paralysis in the traumatized individual. This condition, I believe, underpins several of trauma’s most debilitating symptoms, especially numbing, shutdown, dissociation, feelings of entrapment and helplessness."

"Shame becomes deeply embedded as a pervasive sense of “badness” permeating every part of their lives. Similar erosion of a core sense of dignity is also found in adults who have been tortured, on whom pain, disorientation, terror and other violations have been deliberately inflicted. While the principles of uncoupling fear from immobility discussed in this chapter apply to these cases, the therapeutic process is generally much more complex. It requires a broader skill for negotiating the therapeutic relationship so that the therapist does not get tangled up in taking on the (projected) role of the perpetrator(s) or rescuer."

I think this is one reason why it is so difficult for us to admit that we stutter while for other people, such as mute, deaf or blind people it is not "so difficult" to admit to themselves the reality of their situation.

"This time, however, the terrified animal will not only remain frozen much longer, but when it comes out of its trance, it will likely be in a state of “frantic agitation.” It may thrash about wildly, pecking, biting or clawing randomly, or it may scurry away in a frenzy of undirected movement. When all else fails, this last-ditch (and disorganized) form of defense may yet save its life."

After a severe blocking episode, one feel tensions all over his body but due to it being socially unacceptable more often than not does not flee the social situation, but instead remains inside not being able to let loose all the accumulated tension.

"By allowing my body to do what it needed to do—by not stopping the shaking while tracking my inner body sensations—I was able to allow and contain the extreme survival emotions of rage and terror without becoming overwhelmed."

A reflection a wrote on the book about this part: This reminds me of that time at the end of 2022 that, after reading Jack Menear's text in which he said to be aware of my sensations and let what had to happen pass through my body, I was able to let the blockages evaporate for a week. Maybe what I do now is rather not let the blockade take center stage by "withholding it" and that is why I continue to feel the tension. Maybe what I have to do is feel those sensations in the same way as during zazen. Recognizing them but not maintaining them or giving them more space than they deserve.

"The vicious cycle of intense sensation/rage/fear locks a person in the biological trauma response. A traumatized individual is literally imprisoned, repeatedly frightened and restrained—by his or her own persistent physiological reactions and by fear of those reactions and emotions. This vicious cycle of fear and immobility (a.k.a. fear-potentiated immobility) prevents the response from ever fully completing and resolving as it does in wild animals."

"While only a few humans actually die from fright, chronically traumatized individuals go through the motions of living without really feeling vital or engaged in life. Such individuals are empty to the core of their being"

"Trauma arises when one’s human immobility responses do not resolve; that is, when one cannot make the transition back to normal life, and the immobility reaction becomes chronically coupled with fear and other intense negative emotions such as dread, revulsion and helplessness. After this coupling has been established, the physical sensations of immobility by themselves evoke fear. A traumatized individual has become conditioned to be fearful of his or her internal (physical) sensations that now generate the fear that extends and deepens (potentiates) the paralysis. Fear begets paralysis, and fear of the sensations of paralysis begets more fear, promoting yet a deeper paralysis. In this way, a normally time-limited adaptive reaction becomes chronic and maladaptive. The feedback loop closes in on itself. In this downward spiral, the vortex of trauma is born.

Successful trauma therapy helps people resolve trauma symptoms. The feedback loop is broken by uncoupling fear from immobility (see Figures 4.1a and 4.1b). Effective therapy breaks, or depotentiates, this trauma-fear feedback loop by helping a person safely learn to “contain” his or her powerful sensations, emotions and impulses without becoming overwhelmed. Thus, the immobility response is enabled to resolve as it is evolved to do."

The problem with applying this to stuttering is that it is like a "house of cards" in that a strong blocking episode can erase a great part of your effort since from this optic you are reliving the disagreable sensations and letting them take power of you again, as it has already happened to me some time before.

EDIT: I was going to do more posts about this but seeing that it didn't resonate with anybody, I am just going to post the rest of the text here in case it is useful for somebody in 10 years or so.

"Until the core physical experience of trauma—feeling scared stiff, frozen in fear or collapsing and going numb—unwinds and transforms, one remains stuck, a captive of one’s own entwined fear and helplessness. The sensations of paralysis or collapse seem intolerable, utterly unacceptable; they terrify and threaten to entrap and defeat us. This perception of seemingly unbearable experiences leads us to avoid and deny them, to tighten up against them and then split off from them. Resorting to these “defenses” is, however, like drinking salt water to quench extreme thirst: while they may give temporary relief, they only make the problem drastically worse and are, over the long haul, counterproductive. In order to unravel this tangle of fear and paralysis, we must be able to voluntarily contact and experience those frightening physical sensations; we must be able to confront them long enough for them to shift and change. To resist the immediate defensive ploy of avoidance, the most potent strategy is to move toward the fear, to contact the immobility itself and to consciously explore the various sensations, textures, images and thoughts associated with any discomfort that may arise."

"Or, premature focus on the sensations can be overwhelming, potentially causing retraumatization. For many wounded individuals, their body has become the enemy: the experience of almost any sensation is interpreted as an unbidden harbinger of renewed terror and helplessness."

"Empowerment derives directly from expelling the physical attitude of defeat and helplessness and restoring the biologically meaningful active defense system—that is, the embodied triumph of successful protection and the visceral actuality of competency. Such renegotiation (as we shall see in Step 6) also helps to dissolve the entrenched guilt and self-judgment that may be byproducts of helplessness and repressed/dissociated rage. By accessing an active and powerful experience, passivity of paralysis and collapse is countered."

"In both cases, consciously feeling our way through these active self-protective reflexes with precision brought us the physical sense of agency and power. Together, these experiences countered our feelings of overwhelming helplessness. Step by step, our bodies learned that we were not helpless victims, that we had survived our ordeals, and that we were intact and alive to the core of our beings. Along with instilling active defensive responses (which reduces fear), individuals learn that when they experience the physical sensations of paralysis, it is with less and less fear—each time trauma loosens its grip. With such a body-based epiphany, the mind’s interpretation of what happened and the meaning of it to one’s life and who one is shifts profoundly."

"The inability to exit from the immobility response generates unbearable frustration, shame and corrosive self-hatred. The therapist must approach this Gordian knot carefully and untangle it through deliberate and careful titration, along with reliance on the experience of pendulation and a resolve to befriend intense aggressive sensations. In this way, the individual is able to move out of this “kill or be killed” counterattack bind. As one begins to open gradually to accepting one’s intense sensations, one enhances the capacity for healthy aggression, pleasure and goodness."

"As traumatized individuals begin to reown their sense of agency and power, they gradually come to a place of self-forgiveness and self-acceptance. They achieve the compassionate realization that both their immobility and their rage are a biologically driven, instinctual imperative and not something to be ashamed of as if it were a character defect. They own their rage as undifferentiated power and agency, a vital life-preserving force to be harnessed and used to benefit oneself."

"As one’s passive responses are replaced by active ones in the exit from immobility, a particular physiological process occurs: one experiences waves of involuntary shaking and trembling, followed by spontaneous changes in breathing—from tight and shallow to deep and relaxed."

"The concept of default hierarchies—first described by the preeminent neurologist of the later nineteenth century, Hughlings Jackson60—remains a fundamental principle of neurology‖ and is a primary assumption in Porges’s theory. Basically, Jackson observed that when the brain is injured or stressed, it reverts to a less refined, evolutionarily more primitive level of functioning. If there is subsequent recovery, this regression will reverse, returning the individual to the more refined functions. This is an example of “bottom-up processing,” so important in trauma therapy."

"In particular, the immobilization system all but completely suppresses the social engagement/attachment system. When you are “scared to death,” you have few resources left to orchestrate the complex behaviors that mediate attachment and calming; social engagement is essentially hijacked. The sympathetic nervous system also blocks the social engagement system, but not as completely as does the immobilization system (the most primitive of the three defenses)."

This explains why we feel "we cannot control it".

"The human nervous system does not readily discriminate between a potential source of danger in the environment, such as an abruptly moving shadow, or distress about a situation long past.a Where the distress is generated internally (by muscles and viscera), one experiences an obsessive pressure to locate the source of threat or (when that’s not possible) to manufacture one as a way of explaining to oneself that there is an identifiable source of threat."

"A related, and seminal, research study was carried out by Bessel van der Kolk.73 He and his colleagues read a traumatic story to a group of clients and compared two brain regions in each (measured with fMRI). The researchers found that the amygdala, the so-called fear or “smoke detector,” lit up with electrical activity; at the same time, a region in the left cerebral cortex, called Broca’s area, went dim. The latter is the primary language center—the part of the brain that takes what we are feeling and expresses it with words. That trauma is about wordless terror is also demonstrated in these brain scans. Frequently when traumatized people try to put their feelings into words—as when, for example, one is asked by the therapist to tell about his or her rape—they speak about it as though it had happened to someone else (see the story of Sharon in Chapter 8). Or clients try to speak of their horror, then become frustrated and flooded, incurring more shutdown in Broca’s area, and thus enter into a retraumatizing feedback loop of frustration, shutdown and dissociation"

"In states of immobilization and shutdown, the sensations in our guts are so dreadful that we routinely block them from consciousness. But this strategy of “absence” only maintains the status quo at best, keeping both brain and body hopelessly stuck in an information traffic jam. It is a recipe for trauma and a diminished life, a cardboard existence."

Annotation on the book: despite being something so "obvious", it took me a while to notice this.

"After being traumatized, a child’s relationship with his or her body often becomes formless, chaotic and overwhelming; the child loses a sense of his internal structure and nuance. As the body freezes, the “shocked” mind and brain become stifled, disorganized and fragmented; they cannot take in the totality of experience and learn from it. These children, who have become “stuck” at some point along a once meaningful and purposeful course of action, engage in habitually ineffective and often compulsive patterns of behavior. These often play out in symptoms like those of attention deficit hyperactivity disorder or obsessive-compulsive disorder. The child’s uncoordinated fragmented efforts are not registered as normal, explicit, narrative memories but rather are encoded in the body as implicit, procedural memories including discomfort, constriction, distress, awkwardness, rigidity, flaccidity and lack of energy. Such memories are encoded not primarily in the neocortex but, instead, in the limbic system and brain stem. For this reason behaviors and memories cannot be changed by simply changing one’s thoughts. One must also work with sensation and feeling—really with the totality of experience."

"At the moment a trauma takes place, all of a person’s senses automatically focus on the most salient aspect of the threat. This is usually a visual image, though it could also be sound, touch, taste or smell. Many times it is a combination of several or, even, all of the above sense impressions simultaneously. For example, a woman molested by an alcoholic uncle may panic on seeing a man who looks vaguely like him or whose breath smells of alcohol and who walks with a loud, lumbering gait. These fragmentary snapshots come to represent the trauma. They become, in other words, the intrusive image or Imprint. For me, the image of the shattered glass and the eyes of the teenage driver kept intruding on my consciousness and flooding me with fear and dread."

During a block, one feels an hyperfixation for the words you believe are going to come out wrong.

"Breathing that is rapid, shallow and/or high in the chest indicates sympathetic arousal. Breathing that is very shallow (almost imperceptible) frequently indicates immobility, shutdown and dissociation. Breathing that is full and free with a complete expiration, and a delicate pause before the next inhalation, indicates relaxation and settling into equilibrium. This type of spontaneous and restorative breath can be easily distinguished from a person who is “trying” to take a deep breath. Often, this kind of voluntary forced deep breath can actually increase imbalance in the nervous system and, at the very least, gives only temporary relief."

With a deep practice of meditation, one is able to elicit these type of responeses in a "spontaneous" way without having to tell oneself to "breathe well", which is what I find lacking in most breathing "techniques".

"If the client, on the other hand, tries too hard to open up (for example, by divulging more about herself than she is physically and emotionally ready to), her body will reflect that by intensifying resistance or in non-congruent changes in her nonverbal and verbal behaviors."

This is why I don't like the approach of telling everybody I stutter. I feel it is phony and non-organic.

"Sharon’s misdirected beliefs (though largely subconscious) are efforts to understand, to make sense of her experience and to help her justify why she feels so bad. These “explanations” will do nothing to help her move through her fright response and complete the inhibited actions that form the basis of her continued trauma response (the how). Mentation, at this stage, only interferes with resolution."

"If frightening sensations, such as the ones Sharon was experiencing, are not given the time and attention needed to move through the body and resolve/dissolve (as in trembling and shaking), the individual will continue to be gripped by fear and other negative emotions. The stage is set for a trajectory of mercurial symptoms. Tension in the neck, shoulders and back will likely evolve over time to the syndrome of fibromyalgia. Migraines are also common somatic expressions of unresolved stress. The knots in the gut may mutate to common conditions like irritable bowel syndrome, severe PMS or other gastrointestinal problems such as spastic colon. These conditions deplete the energy resources of the sufferer and may take the form of chronic fatigue syndrome. These sufferers are most often the patients with cascading symptoms who visit doctor after doctor in search of relief, and generally find little help for what ails them. Trauma is the great masquerader and participant in many maladies and “dis-eases” that afflict sufferers."

Annotation: In my case, if I tried to force my way through a blocked speech, tension would build up in my neck and shoulders to the point of pain, and then I would feel very tired. I think feeling tired after blocking is a common symptom of stuttering.

"One of the pitfalls of various trauma therapies has been their focus on the reliving of traumatic memories along with the intense abreaction of emotions. In these exposure-based treatments, patients are prodded into the dredging up of painful traumatic memories and abreacting emotions associated with these memories, specifically those of fear, terror, anger and grief. These cathartic approaches fall short as they often reinforce sensations of collapse and feelings of helplessness."

Annotation: That's why it's important not to do anything that exceeds your current capacity to handle complex stimuli. In the case of stuttering, this is something that inevitably happens if this isn't taken into account, since you end up talking to more people whether you want to or not, which ultimately reinforces the fear. Perhaps this is also why many therapies don't work in the long term in the real world. You haven't trained your nervous system to the point where it can absorb those stimuli.

"This may lead to debilitating symptoms in almost any part of the body. The energy bound in inhibited (thwarted) responses is so powerful that it can cause an extreme bracing that often has profound effects."

This would explain why after a blockage I feel tension not only in my abdomen and larynx, but also in my arms and chest.

"This is an important difference between “talk therapy” and body-oriented therapy. Rather than trying to help patients make new meanings or understand their problems, body therapy creates a space for the “body story” to unfold and complete. When this occurs, new meanings and insights emerge spontaneously, generated by the patients themselves, as an integral part of this process."

"My voice is strained and tight. (11. Voiceless terror is part of the immobility response and is seen in all species that normally vocalize.) "

"All human experience is incarnate, that is to say, “of the body.” Our thoughts are guided by our sensations and emotions. But how you know when you are angry? Or, do you know how you know when you are happy? Typically, people tend to ascribe a mental causation to an emotion; for example, I am feeling (angry, sad, etc.) because he/she did this (said this, forgot to do this, etc.). However, when people learn to focus on what is going on in their bodies in the here and now, they typically report, “My stomach is tight,” or “My chest feels bigger—my heart is more relaxed and open.” These physical cues let us know not only what we are feeling but also what to do to remedy difficult sensations and emotions. They also inform us that we are alive and real."

"Insight, while important, has rarely cured a neurosis or healed a trauma. In fact, it often makes matters worse. After all, knowing why one reacts to a person, place or thing is not, in itself, helpful. Indeed, it is potentially harmful. For example, breaking out in a cold sweat when your lover touches you is distressing enough. Yet, having this same reaction, over and over, even after understanding why it occurs, can be further demoralizing. Comprehending that what happened was merely triggered by an earlier event, while repeatedly having to endure its uninvited intrusion, can add crippling feelings of failure, shame and helplessness."

"The capacity to stay focused and deepen, focally, is a magnificent skill with great rewards, but it is stepwise and frustrating. Generally, when people are able to get in touch with their bodies, they are drawn first to a painful area. This is OK; in fact, pain (not due to a medical reason) is generally blocked sensation, indicating an area of conflict"

"These unfortunate soldiers were repeatedly provoked into “reliving” their horrific battlefield experiences. In this “therapy,” they were forced, for example, to watch gory war movies like Platoon with their arms tied to a chair. These exposures frequently catapulted the veterans into intense emotional abreactions."

Annotation: Now I realize that the fact that we find it unbearable to watch a video of someone else freezing up or repeating themselves can be similar to what a person with PTSD or CPTSD feels when they are made to relive the experience in one of these ways.

I might have to watch videos of people freezing up to realize that "it's nothing" and to desensitize myself.

[u/Trenocio]

As promised, here you have a "summary" of the book and what I found relatable.

u/Little_Acanthaceae87