I stuttered and worried about what the listener would think of me as a person who stuttered.  I struggled to push words out and felt helpless, anxious, afraid, shamed and guilty.  (p.78)

There are so many times and so many situations when I feel like I could help…, but I don’t because of my stuttering…That is so hard to deal with because I end up feeling really guilty, very worthless. (p.32)

I felt I had let myself down.  My self-esteem dropped and I felt that I couldn‘t accomplish the goals that meant the most to me… (p.101)

These honest, courageous stories from adults who stutter (St. Louis’ Living with Stuttering, 2001) reflect the negative impact communication struggles may have on one’ s confidence and self-worth.  While it is clear that not every person who stutters has low self-esteem (e.g., Blood, Blood, Tellis, & Gabel, 2003; Yovetcih, Leschied, & Flicht, 2000) and experiences feelings such as self-doubt, shame, fear, and guilt, these feelings do seem to be significant in the lives of many.  Over the past twenty plus years, I have had the privilege of knowing many remarkable adults who stutter and who shine, communicate impressively, inspire others, and fully embrace their lives. How can loss of speech control in one person lead to fears, avoidances, shame, guilt, and negative life choices, yet similar speech control loss is perceived by someone else as simply an annoyance – a blip on his computer screen, rather than a crash of his hard drive?  I have come to believe that the joyful and hopeful approach to life observed in some is intricately and inescapably related to the person’s self-esteem.  Further, through confidence and self-respect, stuttering for these persons does not become a debilitating and paralyzing problem that prevents one from living life to its fullest.  These individuals seem well equipped to deal with the problems and challenges associated with speech breakdown.  They appear to have “steel rods” of core positive beliefs that run from their heads to their feet that allow them to know and appreciate themselves (see Shub, 1999).  These rods serve individuals well as they bolster the person throughout daily activities and challenges and resist bending during times of crises.  Can such rods be developed in a person?  I believe so – as do many others who have written on the subject.   The following discussion presents some of my thoughts about enhancing these rods, i.e., developing healthy self-esteem.  Although much self-esteem research has been completed in the field of psychology and some has been completed examining people who stutter (e.g., Blood et al., 2003; Fielder & Wepman, 1951; Kalinowski, Lerman & Watt, 1987; Yovetich et al., 2000), more empirical work is needed.  Without such investigations, the thoughts presented here should be viewed as ideas rather than as truths.  It is hoped that this discussion will stimulate further study and prompt individuals to initiate their own journeys to enhance their self-esteem.  The following will be explored:  

•  Self-esteem impacts the quality of one’s life.

     •  Self-esteem is dynamic and multifaceted.

         •  We have choices.

         •  Enhancing one’s self-esteem requires commitment and focus.

     •  I am worth the effort!

Of all the judgments we pass in our lives, none is as important as the one we pass on ourselves (Branden, 1995).  The importance of self-esteem and its impact on the quality of our lives is evident as one considers the link between traits and behaviors and high and low self-esteem.  These characteristics, some of which are presented in Table 1, often are addressed in stuttering treatment (e.g., Bloom & Cooperman, 1999; Manning, 2001; Starkweather & Givens-Ackerman, 1997).  Many clinicians and people who stutter recognize the value of problem solving, persistence, risk-taking, flexibility, and resilience.  Moreover, they understand the importance of these traits in the change process and maintenance of change, including behavioral changes.  As these traits develop in a person, so does one’s self-esteem.  And vice versa, enhancement of self-esteem leads to growth in these traits and behaviors.  In addition, a person’s self-predictions and images of the future may be better predictors of the future than a person’s past performances (Torrance, 1983). If this is the case, developing positive images through enhanced self-esteem may be an investment in future positive outcomes in behavioral and other domains.  Further, positive, healthy self-esteem impacts not only you and your behaviors, but also influences the responses of others around you.  By respecting and valuing yourself, you send signals to others that require appropriate responses to you.  Hence, high self-esteem supports us in our daily activities, motivates us to take risks and face challenges, and permits us to feel good about ourselves and to have successful relationships. 

Table 1.  Traits and behaviors correlated with high and low self-esteem (adapted from Branden, 1995; White, 1992).

We need to know what something is before we can change it. The self-esteem “definitional maze” (Mruk, 1995) includes both constructs for empirical study as well as concepts for addressing the change process.  For our discussion, we will consider self-esteem as both living and dynamic, where one experiences oneself as competent to cope with basic life challenges and as worthy of happiness.  Self-esteem involves both self-efficacy, or confidence in the success of our efforts, and self-respect, a conviction of our own value (Branden, 1995).  It is both stable, yet open to change (Mruk, 1995) and contains both cognitive and affective information related to self.  Moreover, it serves as a major feedback function in guiding behavior (Wells, 1992).  Hence, behaviors, thoughts and feelings all affect and are affected by one’s self-esteem.   Self-esteem changes over one’s life time (see Lipka and Brinthaupt, 1992).  In addition, there is evidence that self-esteem fluctuates in daily life, rising and falling within different contexts and with different people (e.g., Wells, 1992). Thus, self-esteem is both dynamic and multidimensional. 

We often discuss the choices a person has regarding speech modifications (e.g., fluency enhancers, stuttering easier).  Choice also is important when considering our self-perceptions.  Although early feedback and environments impact who we are, there is clear evidence that self-esteem changes with age and that self-perception can be actively modified (Carlock, 1999).  Each day we have thousands of choices to make and through these choices we define who we are (Branden, 1995).  Should I speak up or remain silent?  Should I approach a new person and initiate a conversation or avoid him?  Should I confront a colleague or let the conflict go?  Should I answer the phone or let the machine pick up the call?  Should I ask for that raise that I deserve or accept my current compensation? Should I risk getting a negative reaction from an unfamiliar person while asking for directions or stay lost?  Should I share my ideas that may save the company money or just hope they discover the solutions themselves?  What we choose to do in these situations impacts what we think and feel about ourselves.  Also, how we think and feel about ourselves impacts what we do in these situations.  We must recognize that we have choices and that through these choices we shape who we are.

There are numerous helpful resources available to guide and support the self-esteem change process.  (See the list of some these resources at the end of this discussion).  Whatever journey you choose, each requires commitment and focus.  Here are some ideas to help jumpstart the process.

Seek self-awareness.  Whether you keep a journal, complete self-assessment activities, or visit with others, seek to monitor your feelings, thoughts, sensations, wants, and needs.  By using our “inner barometers” (Carlock, 1999), we learn what is special or unique about ourselves and can develop specific, accurate, and believable descriptions of who we are.  As a result, we learn that we although we have weaknesses, we also have strengths and assets – a fact we often minimize or tend to ignore.  According to Branden (1995), living consciously and increasing self-awareness involve many directives, including the following:

·      A mind that is active rather than passive.

·      Being “in the moment,” without losing the wider context.

·      Being concerned to distinguish among facts, interpretations, and emotions.

·      Persevering in the attempt to understand in spite of difficulties.

·      Being receptive to new knowledge and willing to reexamine old assumptions.

·      A concern to know not only external reality but also internal reality, the reality of my needs, feelings, aspirations, and motives, so that I am not a stranger or a mystery to myself (p.72).

Self examination should help lift the fog in which we conduct our daily lives.  We then are better able to accept ourselves and develop plans for responsible change. 

Seek self-acceptance.  While self-esteem is something we experience, self-acceptance is something we do (Branden, 1995).  Through self-acceptance we say, “I am for myself and on my side,”  “I accept my thoughts, feelings, behaviors as a part of me,”‘ and “I am a compassionate friend to myself.”  These statements allow you to self-affirm and to experience rather than disown feelings.  Self-acceptance does not necessarily mean you like all that you accept and you cannot wish for changes.  It serves, however, as a precursor for change.  If you deny feelings, thoughts, beliefs, you are stuck in them and cannot move on.  Consider completing the following stems (i.e., incomplete statements that, when completed, allow you to identify feelings, beliefs, behaviors, and related patterns; Branden, 1995):

§      If I am more accepting of my speech fears, I….

§      If I am more accepting that I stutter, I…

§      If I am on my side and my own friend, I…

§      If I am more accepting of who I am, I …

Seek healthy voices.  At a recent event (Kern, 2003), we were asked, “What would you do if you had $525,600?” All of our answers involved some sort of investment for growth in the future – investing in real estate, contributing to a child’s college education, etc.  Each year we have exactly 525, 600 minutes that can be invested in a manner that leads to growth or not.  Negative thoughts and listening to critical voices do not lead to growth over time.  How are you investing your 525,600 minutes – in the bank of negative returns or positive returns?  Consider completing the following suggested by White (1992):

1)   Hear the critical voices that talk to you.  These voices are often present to protect you from the fear of failure or rejection. These voices may have good intentions for you but they also have limited resources.

2)   Call upon your healthy voices.  These voices may act as an accepting friend, healthy coach, compassionate mentor, etc.  In other words, you may need different healthy voices to counteract different critical voices.

3)   Paraphrase and verbalize the healthy voice (e.g., “That’s right…”). This action reinforces your thinking and serves to decrease the impact of the negative critical voice.

Seek challenges.  Wells (1988) suggests that self-esteem is highest when challenges and skills are nearly equal and when both of these are above a person’s average challenge and skill level.  On the other hand, self-esteem is lowest when challenges and skills are nearly equal but both are below the individual’s average level. So, when are you feeling most confident and worthy?  That is, when do you experience your highest levels of self-esteem?  According to this study, the answer is when you are being stretched and you have the skills to meet the challenges.  So, when are you stretched?  Are you seeking out challenging opportunities and using skills to meet these challenges?   We may need to go beyond our comfort zones to achieve higher levels of self-esteem.  Consider identifying and acting on one personal “stretch” each day.  Identify the skills needed to meet the challenges in that stretch and develop a plan for acquiring those skills if they are not already in your repertoire.

Practice self-assertiveness.  When we honor our wants, needs and values, we are practicing self-assertiveness (Branden, 1995).  To not stand up for ourselves, is a slap to our self-esteem.  We need to embrace the attitudes and actions articulated in the Bill of Rights and Responsibilities for People Who Stutter (St. Louis, 2001).  Asserting your rights and accepting the responsibilities described in this bill (which was recently presented in a beautiful poster by Michael Sugarman) are important steps towards increasing your assertiveness and, ultimately, your self-esteem.

In facing our challenges, we commonly look for that quick fix – the person who has all of the answers, the device that cures stuttering, the drug that provides the solution, the diet that really  works. The reality is, the answers for change are within us, not around us.  Brandon (1995) reminds us that “No one is coming.”  That is, no one is coming to make it right, to solve our problems, or turn everything around.  He stresses that if we don’t do something, nothing is going to get better.  Commit to the change process – either individually or with others.  It may be helpful to seek out “bridge people” (Carlock, 1999) who provide support, encourage you, and celebrate with you as you bridge from one place to another.   Do not lose hope – all things are possible with hope and commitment. After all, you are worth it.

References and Resources

Blood, G. , Blood, I., Tellis, G., & Gabel, R. (2003).  A preliminary study of self-esteem, stigma, and disclosure in adolescents who stutter.  Journal of fluency disorders.  28,  143-159.

Bloom C. & Cooperman, D. (1999). Synergistic stuttering therapy:  A holistic approach. Boston:  Butterworth-Heinemann.

Branden, N. (1983).  Honoring the self. New York:  Bantam.

Branden, N. (1987).  How to raise your self-esteem. New York:  Bantam.

Branden, N. (1998). Self-esteem at work:  How confident people make powerful companies.  San Francisco:  Jossey-Bass Publishers.  

Branden, N. (1995).  The six pillars of self-esteem. New York:  Bantam.

Carlock, C.J. (1999).  Enhancing self-esteem. Philadelphia, PA:  Taylor & Francis Group.

Fielder, F. & Wepman , J. (1951).  An exploratory investigation of the self-concept of stutterers.  Journal of speech disorders, 16, 110-114.

Kalinowski, L., Lerman, J. & Watt, J. (1987).  A preliminary examination of self and others in stutterers and nonstutterers.  Journal of fluency disorders, 12, 317-331.

Kern, D. (September, 2003).  Kick-off event for Healthy Women, Healthy Lives.  Sponsored by KERA, Harris Methodist Hospitals, and TCU, Fort Worth, TX.

Lipka, R.P. & Brinthaupt, T.M. (1992). Self-perspectives across the life span.   Albany, NY:  State University of New York Press.

Manning, W. H. (2001).  Clinical decision making in fluency disorders.  San Diego:  Singular – Thomson Learning.

MCKay, M. & Fanning, P. (2000).  Self-Esteem.  Oakland, CA:  New Harbinger Publications.  

Mruk, C. J. (1995).  Self-esteem:  Research, theory, and practice.  New York, NY:  Springer Publishing Company, Inc.

Shub, N. (1999).  Developing high self-esteem.  In C.J. Carlock’s (Ed.) Enhancing self-esteem. Philadelphia, PA:  Taylor & Francis Group, pp. 39-86.

Starkweather, C. W. & Givens-Ackerman, J. (1997).  Stuttering.  Austin, TX:  Pro-Ed.

St. Louis, K. O. (2001).  Living with stuttering.  Morgantown, West Virginia, Populore.

Torrance, E.P. (1983).  The creative child and adult quarterly. VIII.

Wells, A.J. (1988).  Self-esteem and optimal experience.  In M. Csikszentmihalyi and I. Csikszentmihalyi (Eds.),  Optimal experience:  Psychological studies of flow in consciousness.  New York:  Cambridge University Press, 327-341,

Wells, A. J. (1992).  Variations in self-esteem in daily life:  Metholodogical and .developmental issues.  In R. P. Lipka & T.M. Brinthaupt (Eds.) Self-perspectives across the life span. pp. 151-185.   Albany, NY:  State University of New York Press.

White, J.  (1992).  The psychology of self-esteem.  Boulder, CO:  CareerTrack.

Yovetich, W., Leschied, A.,  & Flicht, J. (2000).  Self-esteem of school-age children who stutter.  Journal of fluency disorders. 25, 143-153.

-Discussion-

September 26, 2003