What is stigma, and why is it so important in stuttering therapy?
Public stigma is what society believes about and how they act toward a particular group of people. This includes stereotypes, prejudice, and discrimination. Self-stigma occurs when the individual applies the stigma generally to others with the condition and personally to himself or herself.1
In a previous article, we looked at why it’s important to address the aspects of stuttering hidden beneath the iceberg. You might recall that physical stuttering behaviors are only the tip of the iceberg; hidden beneath the surface are the thoughts, feelings, and life impact caused by stuttering—and all of these are affected by stigma.
This is important because increased self-stigma of stuttering is associated with reduced physical health and healthcare satisfaction along with higher levels of stress.2 Concealment of stuttering is also very common. In a recent study, 48.2 percent of participants reported that they felt the need to hide the fact that they stutter, and 37 percent reported that in many areas of their life, no one knew that they stuttered.3
Self-disclosing stuttering may help reduce self-stigma. There is a positive association between disclosure and well-being. Additionally, people who stutter who are involved in a support group are more likely to disclose their stuttering.4
The Role of Anticipation in Stuttering
Anticipation is the cognitive sense that a moment of overt stuttering is imminent. A 2015 study found that adults who stutter report that they anticipate “often.” In this same study, all the participants (all of whom were people who stutter) reported employing some kind of strategy to change their speech production in response to anticipation. These strategies included both self-management strategies (such as reducing the speech rate, breathing, prolonging, using easy onsets, and so forth) and avoidance strategies (which are associated with anxiety or uncertainty, reduced confidence, and feeling a loss of control).
Why Are Self-Help Groups So Important?
Recent research confirms that people who are involved in the National Stuttering Association, a support group for people who stutter, are less likely to avoid speaking situations and are more likely to talk about stuttering and have successful speech therapy. They also report that their stuttering has less impact on work and school.6
Attending a self-help conference for people who stutter can also help minimize the negative impact stuttering can have on daily functioning. Self-help conferences are perceived as a safer or “stutter-friendly” environment and promote social interaction along with relationship and community building.
The big takeaway here is that research is addressing the role of anticipation and stigma in stuttering. These can both be addressed by teaching self-disclosure of stuttering, engaging in desensitization and avoidance-reduction activities, and referring clients to self-help organizations like the National Stuttering Association, SAY: The Stuttering Association for the Young, and FRIENDS: The National Association for Young People Who Stutter.
- Boyle, M. P. & Blood, G. W. (2015). “Stigma and stuttering: conceptualizations, applications, and coping.” In K. O. St. Louis (Ed.), Stuttering Meets Stereotype, Stigma, and Discrimination (pp. 43-70). Morgantown, WV: West Virginia University Press.
- Boyle, M. P. & Fearon, A. N. (2018). Self-stigma and its associations with stress, physical health, and health care satisfaction in adults who stutter. Journal of Fluency Disorders, 56: 112-121.
- McGill, M., Siegal, J., Nguyen, D., & Rodriguez, S. (2018). Self-report of disclosure statements for stuttering. Journal of Fluency Disorders, 58: 22-34.
- Boyle, M. P., Milewski, K. M., & Beita-Ell, C. (2018). Disclosure of stuttering and quality of life in people who stutter. Journal of Fluency Disorders, 58: 1-10.
- Jackson, E. S., Yaruss, J. S., Quesal, R. W., Terranova, V., & Whalen, D. H. (2015). Responses of adults who stutter to the anticipation of stuttering. Journal of Fluency Disorders, 45: 38-51.
- Trichon, M. & Tetnowski, J. (2011). Self-help conferences for people who stutter: a qualitative investigation. Journal of Fluency Disorders, 36(4): 290-295.