About the presenter: Dr. Heather Grossman has worked with children and adults who stutter for over twenty years and was among the initial cadre of Board Recognized Specialists and Mentors in fluency disorders treatment. She is a member of the stuttering self-help community and presents regularly for Friends: Association of Young People who Stutter and the NSA, and has presented at national and international conferences including at ASHA and the IFA (International Fluency Association). Her research explores stuttering modifications including voluntary stuttering. She is currently the Clinic Director at the American Institute for Stuttering in New York City, a not-for-profit organization dedicated to stuttering treatment and clinical training.


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Extreme Desensitization

by Heather Grossman
from New York, USA

When we describe someone as "sensitive" to something, we are saying that this person reacts to that stimulus more strongly than would be expected. Once we "habituate" to a stimulus (for example, get habituated to a certain sound in the environment such as a train), while we still sense that stimuli around us, we no longer react strongly to it. We become "used to" stimuli through repeated exposure. As a society we have become desensitized to violence, for example, through repeated exposure in the media.

Desensitization to stuttering involves diminishing the negative emotional responses that individuals have to instances of stuttering or even to the very anticipation of possibly stuttering. Unless a client is able to fully experience his or her stuttering, he or she will be unable to come to modify it, just as one must overcome the fear of water and must be able to get in the pool in order to learn to swim. If one is to be successful using pull-outs for example, he or she must first be able to achieve the ability to stutter without avoidance or struggling to attempt to escape from that moment.

Various procedures are helpful in the desensitization process.

These include

"Extreme" desensitization activities involve completing stuttering challenges that have clients dramatically confront their stuttering in ways that help them reframe their expectations and fears. In addition, these activities also provide an opportunity for clients to actually have fun while experiencing moments of stuttering, and many report this feature as critical in coming to reduce the negative association they have involving their stuttering.

Some of these activities include:

    1. Making a phone call with the intent of stuttering so much, that the other person hangs up the phone. Many PWS fear being hung-up on or having someone walk away while they are speaking. When one's intention is to MAKE this happen, achieving this outcome and realizing that it is tolerable becomes extremely empowering.
    2. Completing outlandish challenges using voluntary stuttering. We encourage clients to create funny challenges for themselves and each other where they plan what forms of stuttering will be used. These may include asking store clerks or others some extremely funny questions. One teenage boy recently was challenged to ask which Kate Spade pocketbook would match his t-shirt and another adult female chose to use voluntary stuttering while asking whether a wok or a frying pan would make a better weapon!
    3. Disclosing one's stuttering "Loud and Proud!" It is so helpful to be able to talk about stuttering objectively without excessive negative emotion. Those who stutter often spend much time and energy trying to hide stuttering, further driving negative feelings, thoughts, and behaviors. This negative cycle can be alleviated by having clients conduct numerous surveys about stuttering. We usually have them first survey friends and family, and work up to surveying random individuals and groups. Clients come to see that listeners are typically non- reactive to stuttering in these contexts and also come to realize that when people walk away, it is usually because of a reason that has nothing to do with stuttering.
    4. Toward the end of the desensitization process, we model and encourage clients to complete the "subway challenge." Here, they loudly announce on a crowded subway that they are people who stutter working on their speech, and would be happy to answer any questions about stuttering. Many report this to be the ultimate step in being able to achieve openness about stuttering and to be able to think and talk about stuttering in a way that is less emotionally charged.


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SUBMITTED: August 30, 2012


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