Psychotherapy is an umbrella term that covers talking to a mental health professional about one's challenges, fears, insecurities, thoughts, and ideas. Psychotherapy may be in the form of psychoanalysis, cognitive therapy, behavior therapy, or humanistic therapy.
During psychotherapy for stuttering, a person gets to learn more about their own feelings, emotions, moods, and stuttering behaviors.
Just like stuttering treatments, psychological counselors and therapists use a combination of multiple techniques for psychotherapy. Cognitive-behavioral therapy (CBT) is one of the most common and effective approaches used to address stuttering in children and adults.
Do People Who Stutter Need Psychotherapy or Psychological Counseling?
People who stutter (PWS) may feel apprehensive about speaking in public. This may happen due to the negative emotions associated with memories of stuttering in public.
Similar situations may evoke unpleasant memories and trigger anxiety, fear, and, even, shame.
“People will laugh at me”, “people will think less of me”, “they’ll think I’m stupid”…thoughts like these can cross your mind quite often if you stutter.
Stuttering results in more emotional tumult and physical tension in the speaker, which makes them more likely to stutter.
Alternatively, they might compensate by acting introverted, trying not to speak, or avoiding social gatherings.
PWS often find themselves in a vicious cycle of negative self-talk, unhelpful coping methods, and emotional turmoil that reinforces one's anxiety of speaking rather than diminishing it. Psychotherapy or psychological counseling can help help a person who stutters deal with such challenges.
How Can CBT Help Someone Who Stutters?
In therapy, the professional helps the client explore the possible link(s) between their actions, thoughts, feelings, behavioral responses, and physiological reactions. The clients may find it easier to identify which coping mechanisms are unhealthy and develop new skills to manage their stuttering behaviors.
Therapists may also encourage the client to “experiment” with their assumptions and predictions to see how accurate they are. For example, the therapist may suggest ways of advertising stuttering to the client and give them ways to note their listeners’ reactions.
A good therapist will never decide for the client or judge them. They will only provide empathetic listening and emotional validation, so that the client can form their own conclusions.
Cognitive-behavioral therapy aims to work coordinately and collaboratively with the client. The idea is to avoid arguments, debates, and instructions. Instead, a mental health professional encourages the client to ask questions like –
- What are the pieces of evidence that support my assumption and prediction?
- Can there be another way of looking at the incident?
- Is there a reason for my prediction to be inaccurate?
- Are my listeners truly trying to belittle me, or are they simply feeling awkward or insecure due to my stuttering?
How Can CBT Help Break Unhelpful Thoughts & Beliefs About Stuttering?
Throughout our lives, we find ourselves in multiple "thinking traps." These are unhelpful patterns that we have developed to find meaning in our struggle.
For example, you may believe that stuttering is completely in your control, and you stutter when you are afraid or anxious.
These unhelpful thoughts and beliefs about stuttering not only arise from the anticipatory fear of stuttering but also feed the social anxiety that makes stuttering worse.
Cognitive-behavioral therapy may help you break free from this unhelpful pattern of thoughts. With every session, you may be able to identify, check and, eventually, stop the thinking trap from taking over your confidence.
Here are some of the unhelpful patterns of thinking that adolescent and adults who stutter have recognized during therapy –
It is quite common for PWS to assume that they know that other people are thinking. We are quick to believe that people will think less of us if we stutter while speaking.
In truth, it is impossible for us to read someone's mind. You may be able to read their expressions and gestures. However, your judgment of a person may be clouded by your emotions related to similar circumstances in the past.
CBT can help you distinguish between the presumed reactions and the real reactions of your listeners.
There are times when you feel that the world is coming to an end or the worst is going to happen if you stutter.
It happens when other possibilities seem too far-fetched. It may also be possible that you catastrophize because you believe that you no longer deserve good things in life.
Psychotherapy can help you explore various other positive fantasies and possibilities that you may not be able to see on your own right now.
You tend to dwell on the words you repeated or blocked on, but you forget about the others you said smoothly. It is easier to remember the negatives and magnify them, but focusing on the positives at all times isn't as easy.
A good psychological counselor or therapist will help you build your resilience and explore the positive qualities you already have inside. With a little help, you should be able to focus on the positive aspects of your speech, regain confidence and reinforce the fluency shaping skills you are learning at speech therapy.
You may make sweeping conclusions based on one event. For example, when looking at a situation, you may perceive it to be an “utter failure” because you stuttered twice.
However, that is far from the truth. You may have been fluent for 90% of the conversation and stuttered on only 8 to 12 words. Your disfluency doesn’t determine the success or failure of a conversation.
Maybe you are unable to perceive that right here, right now. Nonetheless, with regular therapy, your counselor may be able to help you gain a new perspective on similar situations in the future.
What Does Psychotherapy (CBT) Not Do?
Therapists using the CBT approach don’t “teach” their clients to think more positively or be rational. It is not the therapist’s responsibility to judge their client’s behaviors or thoughts.
Therapists are not here to provide their clients with ready solutions to their problems. They are here to enhance the client’s problem-solving skills and resilience towards life’s hurdles.
Therapists do not make the decisions for their clients. Psychotherapy focuses on helping the client cope with daily struggles. Continuing CBT may help a client assume a new point of view so that conflicts appear as challenges.
CBT is concerned with helping the clients lead a more productive and happy life. Counselors may provide empathetic listening, unconditional support, and emotional validation to help their clients make their own decisions.
Psychological counselors, therapists, or psychotherapists do not teach fluency skills, exercises and stuttering modification techniques to clients. Clients may undergo psychotherapy alongside their speech therapy sessions to gain a better understanding of the secondary behaviors of stuttering.