Avoidance-reduction therapy for stuttering.

Abstract

Historically, stuttering has been treated with a multitude of approaches, including wine, burning, surgery, rhythmic tapping, psychoanalysis, and family counseling. Behavioral methods gained prominence in the 1960's with a re-emphasis on breathing and by using modern technology, e.g., delayed auditory feedback and Brady's metronome. Psychotropic medications have demonstrated practical limitations in abetting stuttering due to their disabling side effects. Avoidance-reduction therapy for stuttering emphasizes the interpersonal and intrapsychic conflicts of the stutterer. Attempts at hiding the primary symptoms of stuttering by avoidance techniques result paradoxically in the perpetuation of stuttering. By attacking the avoidance behaviors and pathological interactional dynamics, the stutterer is freed to speak more naturally. The therapeutic strategy is towards increasing open acknowledgement of the stutterer's identity through nonverbal and verbal cues. Practical action-oriented assignments are encouraged. At the same time, the stutterer's defense mechanisms of denial and projection are delineated and reduced leading to greater self-confidence, and a freedom to live and speak without fear.