Mindfulness and Stuttering
How can we start to incorporate mindfulness, breathing, and meditation into fluency therapy? Meditation and breath regulation might be methods used to help people who stutter.
There is a modicum of research connecting stuttering and mindfulness. However; speech therapists commonly teach diaphragmatic breathing to supplement stuttering therapy. We teach our clients to identify areas of the body where tension is held, and release the tension on upon exhalation. We teach stuttering modification strategies that require clients to be aware of their stutter prior to stuttering, during a stutter, and after a stutter. This all requires some level of mindfulness.
Mindfulness can be defined as, "the practice of maintaining a nonjudgmental state of heightened or complete awareness of one's thoughts, emotions, or experiences on a moment-to-moment basis (Merriam-Webser, 2022)."
Mindfulness can help:
Decrease feelings of anxiety and depression
Increase focus and clarity
Calm your sympathetic nervous system
People who stutter often experience emotions of fear, shame, and embarrassment around speaking. Often times, i've heard clients say "thinking about not stuttering is exactly what makes me stutter."
They feel that they aren't in control of their speech. The feeling of "loss of control" can lead to depression, frustration, feelings of helplessness, and anger. For a long time, speech therapists have tried to 'cure' stuttering, without realizing that it is chronic and cyclical. There are times when speech fluency improves and times when speech fluency becomes more difficult. Teaching someone who stutters not to stutter can have a negative impact on their self-image and confidence. I cringe a little inside when I see fluency goals to "decrease stuttering by __% when given __ prompts". It doesn't address emotional components, awareness of the speech mechanism, strategy usage, or self-advocacy; which, if addressed, can promote fluent speech.
Anyway... enough with my rant!
Mindfulness practice can potentially help a person who stutters:
Feel empowered and reshape how he or she views stuttering.
Help bring awareness to the environmental factors that make speaking more difficult.
Bring awareness to tension in the body before, during, and after stuttering.
Aid in breath control
Fabus & Gatzonis (2015) did a pilot study on 4 adults using a 6 week modified yoga breathing program. Each session started and ended with meditation. A pranayama technique called Bhramari, or "bee's breath" was used in the study. "During bee’s breath, an individual produces a vibrating sound with a constant pitch during exhalation while depressing the ear canals." Vialatte, Bakardjian, Prasad, and Cichoki (2008) found that Bhramari changed participants’ breathing rhythms and reduced their hypertension and anxiety. The participants were observed to have more regular breathing patterns following the Bhramari practice and reported an increased awareness of respiration.
The Stuttering Severity Instrument, 4th edition (SSI-4) was used to measure pre and post results of the program. There were significant reductions in percent of disfluencies in reading, spontaneous speech, duration of disfluencies, and physical concomitants in all participants! One participant's stutter was reduced from "moderate" stutter to a "mild" stutter. The Overall Experience of the Speaker’s Experience of Stuttering (OASES) was used to measure self-perception regarding stuttering. Surprisingly, there were no significant changes in self-perception, but a few participants reported more awareness of their breath.
The research by Fabus & Gatzonis (2015) is limited due to it's small sample size and no control groups. The treatment included Vinyasa yoga poses, breathing exercises, and mediation. I'm curious to know what the effects of meditation and breathing exercises alone would be for people who stutter. Even though this research has quite a few limitations, I believe it is paving the way for future research to be conducted in this area.
Sonia Hiller, MS, CCC-SLP
