Friday, July 25, 2008

Something W-w-w-icked This Way Comes

This post ties in well with this one.

Because it's done at a university, a year of therapy for me consists of three different periods of time - Fall semester, Spring Semester, and June and July during the Summer session. During this past Spring Semester, for the first time, I started really playing a more direct role in making changes to my therapy. I've always had a say, and I've always been ok with what we were doing, but this time we (my clinician and I) worked and we changed things based on what I said.

We worked hard at the end of Spring semester and into the Summer because I felt I was moving towards the verge of somewhere good and I needed to get the details of what we were doing hammered out before the end of the Summer. When the Fall semester starts, I'll be getting a new clinician and I wanted a therapy plan in place that I felt good about and one that was explained thoroughly enough to be clear as to what we were doing and what my goals were.

We developed a plan to talk about certain topics, topics that are important to me and/or affect me emotionally. After having a conversation about such a topic I would then talk about how I thought my anxiety level was, how I thought the setting affected me, and how much I thought I struggled throughout the conversation. The idea was that talking about these things would help us to figure out if there were any correlations to the topic, my emotional state, outside influences, etc. On top of that, it was going to be a time where I could practice talking about those hardest of subjects, feel what's going on inside me at those times (fear), figure out where it's coming from (What am I afraid of and why?), and try to change it (get rid of the fear). In my head, this was going to be the new centerpiece of my therapy and this would carry into the Fall semester with my new clinician.

Then after working on this for a few weeks, we started trying something else in therapy, besides the conversations and discussions I just mentioned. I don't remember what exactly started it, maybe it was the Dairy Queen blog post that I linked to at the start of this post, but in any case... I knew I couldn't force myself to use natural repetitions in my speech because I would subconsciously use tremendous energy to avoid them. Well instead, I gave it a shot while reading aloud to my clinician. The theory was that this would be much easier for two reasons. First, because I don't stutter much while reading - so instead of adding repetitions as well as my normal struggling, I'm just dealing with adding repetitions. Second, because of the nature of reading, I can see exactly what's coming up and periodically choose to repeat a word.

The first few times reading aloud with repetitions were very uncomfortable and I felt really stupid doing it and I also felt an irrational feeling that what I was doing was wrong. Because I felt that way, I was shocked at how fast the uncomfortable feeling subsided. I remember that at one point during one of the first readings, after it started getting easier, I got a little smirk on my face. The smirk was actually me holding back laughter. If I hadn't kept it in, it would have been the kind of laughter that is raw and emotion filled. Like when you're waiting for something really bad to happen, it doesn't happen, and then you realize it's not going to. Happiness was certainly a main proponent of the emotion, but far from the only one. Relief, a major feeling of liberation, and maybe a smidge of "This is all it took? I could have done this years ago." were all present too.

After that, the repetitions in reading had gotten much easier and so we moved to bigger and better things, i.e. a more public place. We sat in a computer lab (although not a very busy one) with me reading a news article aloud to my clinician while other people were around (although not all that close). After a few sessions of that, we modified it a bit so that after reading a short article we would then talk about the article while I continued the repetitions, i.e. trying to make a transition from the repetitions in reading, which were now easy, to the repetitions in casual conversation which I had never been able to accomplish. It was very hard to make myself incorporate repetitions into that speech, but I was able to manage to get a few.

During this time I also read aloud a few times at home to my wife. The first time, this was very uncomfortable and I read for several minutes before I was able to bring myself to toss in a repetition. The next time we did it, it wasn't so bad and I ended up reading about the exploits of Scarlett and the gang for nearly a half an hour.

Back in therapy we decided to take it a little further and walk through campus and casually talk while I would use repetitions instead of struggle, i.e. when I felt like I was going to start to fight to get words out, I would instead (in theory!) just use repetitions in place of the struggle. The first session of doing this I still struggled quite a lot and didn't do a very good job at getting the repetitions in there. The second time was much more successful and was a large improvement in the number of repetitions I was able to use while being out-and-about.

So the therapy I explained near the start of this post, with the three categories, I said I had planned on it being the new centerpiece...well now I feel even stronger that this, these repetitions are the true centerpiece that everything else must be built upon. There are a number of things I've done in therapy so far that I've felt good about at some levels, but I could not fathom how they would ever translate into positive improvements in my everyday speech. Now I've realized that many, if not all, of these things (including the "three categories" idea discussed earlier) should be re-looked at and re-evaluated later in my therapy, at a time when I would be able to properly use them to help my everyday speech. It's not that any of these things were bad or worthless, I just wasn't ready for them yet.

So the wickedness coming this way are the repetitions that I feared 20+ years ago and have since built all of my struggling speech habits on top of.