Case study - stuttering begins at age 15

I began to stutter when I was 15, and a senior in high school. As part of a process that was heavily psychogenic, I began to progressively stutter when reading out loud in school, from mild repetitions to the point where I graduated to complete blocks. It was a terrifying feeling. The speech production system that had performed flawlessly for me up to that point, had gradually transformed into a bucking broncho that I felt powerless to control. It felt as though that stable, solid fluency "core" had shifted. It was as though a primary motor carrier signal, a sort of conveyor belt that carries the words out of your mouth, had became desynchronized, destabilized, scrambled and herky-jerky. There was a definite sense of loss and depression, as well as terrible anxiety.

A younger sibling, my brother, stuttered, although he grew out of it. I have a somewhat compulsive personality, with a mild tendency to overcheck, to hoard, etc. There were no drugs or medications related even remotely to the onset of my stuttering. Aside from some flu or mild virus that could have affected my brain, the only theory I can come up with to explain the "nuts, bolts, and wires" neurological component of my stuttering is that there was possibly a dormant miswired center in my brain that was activated by the flood of sex hormones and changes in the blend of neurotransmitters at puberty.

Having had a later onset of stuttering--I consider it to be acquired, rather than developmental--I have a different perspective on identity than most people who have stuttered since an earlier age. I've had a considerably long initial period of inherent, primary fluency. I tend to think of myself as a fluent person who just happens to stutter at times. It is not something that I am proud of or happy about. Given the chance to take a magic pill that would eradicate dysfluency, I would take it in a heartbeat and never look back. I do not consider this to be "chasing the fluency god," but merely attempting to restore my speech production system to its inherently normal, healthy, functioning state.

I would not say that I am a better person because I stutter. I do not look at this "condition" with rose-colored glasses, or in the context of trying to make lemonade out of lemons with the usual--I'm more compassionate, I've met so many nice people--rationale. I am more keenly aware of my stunted and truncated development as a person, both professionally and socially, due to my speech difficulties over the years. On the other hand, I am not cynical or bitter, but rather the eternal optimist, and I "accept" my stuttering in the Jungian sense of embracing the shadow part of myself. It is like being in a labyrinth that I will eventually work my way out of.

I do take the Zen, "no mind" or mindless approach to stuttering. I feel I have become more fluent by not trying to overcontrol my speech. The last thing I would ever do is "practice" speaking fluently, or using targets, etc. I subscribe to the John Harrison school of thinking that I don't want to overcontrol something that is already overcontrolled in a pathological way. For me, speech is an automatic servomechanism that should require minimal effort.

I have been taking a beta-blocker, propranolol (Inderal), for five years, as a migraine or migraine-equivalent prophylactic, however I find that it has had a beneficial effect on my fluency. Beta-blockers reduce the effect of adrenaline on the body, and they help to lower blood pressure. They are also prescribed for people who suffer from performance anxiety, such as musicians. I have found that propranolol significantly reduces the sense of speed stress and anticipatory anxiety in me. It attenuates the tendency to race ahead and pre-map what I'm going to say. I find that I simply speak more in the moment, and any blocks and repetitions that I do have seem less severe, less frequent, and don't bother me as much.

Along with the propranolol, I have been taking low doses of Xanax (alprazolam)-- an anti-anxiety agent. The alprazolam reduces the general anxiety I feel, and both medications have worked rather well together to give me a better sense of control over my moods and my life. I am aware of an article on the Internet which implicates alprazolam with inducing stuttering in a patient, but I haven't had any problems with it. I don't like feeling that I'm being "controlled" by medications, but I don't get that feeling with these two.

For almost 13 years, the National Stuttering Association has been one of the key resources that has helped me along my journey.

added with permission, September 16, 1999