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Peter Wolson

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Is Stuttering Biological or Psychological?

Posted: 10/16/11 11:48 AM ET

The Stuttering Foundation of America has proclaimed on its website (www.stutteringhelp.org), "There is no reason to believe that emotional trauma causes stuttering." Similarly, the National Stuttering Association (www.nsastutter.org) has stated: "We do know that stuttering is not caused by emotional problems and is not a 'nervous' disorder. We also know that stuttering is not the fault of the family or the person who stutters."

These organizations suggest that stuttering is primarily an inherited disorder unrelated to environmental upbringing. Based on case studies I, a psychoanalyst, am convinced that the exclusive emphasis on biological causes is misguided, insofar as it rules out psychoanalytic psychotherapy for those stutterers whose speech disorder derives from internal conflicts due to family influences, as was strikingly evident in last year's Academy Award-winning film, "The King's Speech." This film was based on historical fact.

From its viewpoint, Bertie, who became King George VI, was portrayed as intimidated and frightened by his oppressive father, the King of England, during childhood. The film implied that this caused him to become fearful of expressing himself verbally, especially his anger. From a psychoanalytic perspective, the expression of his own speech apparently represented transgressing against his father. Bertie's symptom of stuttering served the defensive function of blocking any provocative speech while making him look inadequate, thereby diminishing the fear of his aggression and its anxiety-inducing consequences.

Although his Australian speech therapist, Lionel Logue, treated him with various speech exercises, what appeared to help most was when he provoked Bertie's anger, first by having him say the F word, over and over again, and then by acting like a dominating authority figure while sitting on the king's royal throne. Enraged, Bertie screamed at Logue and was amazed when Logue pointed out that he wasn't stuttering. In effect, the stuttering diminished when he was able to express his anger. The speech therapist's friendship and support of Bertie's right to express his own independent feelings and thoughts, especially his anger, and especially when the therapist represented a dominating father figure, ultimately made Bertie feel safe enough to speak freely. This is what happens in psychoanalysis when the patient might experience the therapist in the transference, for example, as an oppressive parental figure. The therapist then helps the patient work through his fear of aggression toward dominating authority figures in the transference relationship.

In various interviews, the writer-producer of "The King's Speech," David Seidler, a stutterer himself, speculated that in real life, Bertie benefited most from his speech therapist's "talking cure" based on Freudian psychoanalysis, not from the mechanical speech exercises portrayed in the film. In fact, Seidler said that most of the speech therapists he consulted agreed that speech exercises didn't eliminate stuttering. He concluded that Logue must have used Freud's "talking cure" on Bertie based on the fact that Seidler's uncle, who was also a stutterer, had coincidentally been treated by Lionel Logue for years. His uncle said that Logue got him to talk about his parents and childhood, and although his uncle considered all of that rubbish, by the time his treatment ended, he no longer stuttered (www.dailymail.co.uk).

Seidler noted that he wished he had someone like Logue to listen to him attentively and help him understand his life better. Bertie, in "The King's Speech," clearly didn't grow up with a father or brother who were lovingly attuned and supportive of him. But Lionel Logue, his speech therapist, helped him to repair these experiential deficits and to resolve his internal psychological conflict over his aggression.

Similarly, Jack Welch, former CEO of General Electric, on June 11, 2011 confided to TV guest show host Piers Morgan that he was a stutterer. He said that what helped him most was his mother's belief in the value of what he had to say and her encouragement to speak his mind. He felt listened to and understood by her, and she supplied the reassuring explanation that his intelligent mind worked more rapidly than his capacity to speak his ideas. In effect, she validated his right to say what he wanted and to be his authentic self.

There is abundant research evidence for a biological predisposition for stuttering; however, environmental stressors, such as family relations, can produce internal psychological conflicts that cause stuttering, possibly in combination with this predisposition, as in the case history cited above and in the psychodynamics of George VI depicted in the film, "The King's Speech." That is why I urge stutterers and organizations devoted to the treatment of stuttering to consider psychoanalytic therapy as an often essential part of the treatment for this debilitating, humiliating psychological symptom. Proclaiming that stuttering is unrelated to emotional issues and family relationships is a misguided, potentially damaging omission for individuals whose stuttering is largely caused by psychological conflicts in childhood.