CHENNAI: Avoiding certain situations and events started in a very unassuming way at a very early stage in my life. For instance, when I was in middle school, I would take the day off pretending to have a stomach ache to get out of a scheduled oral test,” shares Keshav Kumar, a 30-year-old software engineer.
For almost two decades now, Keshav has been living with a stutter (stammer), a speech disorder that affects the frequency and flow of speech. In India, over 11 million people are estimated to have the condition.
However, despite its widespread presence, not many are mindful and empathetic to the struggles of those who stammer, say people who have been fighting their way through stigma, mental health battles and denied opportunities associated with the condition, one syllable at a time.
Stigma and suffering
“Growing up, I’ve always wanted to keep myself aware and in a sense, predict when I would have to speak. This constant sense of awaiting used to make me perpetually anxious. I used to take extreme measures including injuring myself to escape speaking in public!” he opens up. At the age of 15, when Keshav’s stumbling over syllables became the theme for wisecracks in the classroom, his grades began dropping, he painfully recalls. “I enjoyed studying. The time I spent with my books academic and otherwise, was cathartic.
However, the constant bullying and jokes about my stutter punctured my confidence. Looking back, I realise how this lack of confidence dented several opportunities and kept me away from doing things I wanted. Until I started working, I didn’t even dare to go up and speak to the girl I liked. Though I knew the answers to all the questions, I never used to raise my hands in the classroom to answer them,” he shares. Several questions including, ‘What if it took me a while to speak and I was laughed at? Or worse, if the opportunity was, because of lack of patience, passed on?’ used to plague the engineer’s mind. “It took several years, dedicated speech therapy and psychological counselling to help me overcome the fear. I still stutter and haven’t been ‘cured’ of it.
But I am not afraid to speak anymore,” he says, hoping to start his Podcast soon. “I even have a name for it I and ‘Um’ (an interjecting word often added during a speech by people who stutter). I want to talk about my experiences and share others experiences too,” he notes. For Maheshwari, an architect and consultant with the condition, attending a job interview after graduation, was one of the most harrowing experiences. “Though I struggled with speech, an encouraging family, supportive and understanding friends, and early intervention through therapy helped me have a ‘normal’ life. For the most of my life, I knew to navigate any type of speechrelated awkwardness,” she shares.
This was until she had to sit in for her first job interview in 2019. “A few days ahead of the interview, I found myself fidgeting. It was just that nervousness. On the day of the interview, when I was asked to talk about my strengths, it became hard for me to get the words out. Within a few minutes, I was teary-eyed. More than the hitch, it was the interviewer’s attitude towards me that bogged me. While one sniggered, the other rolled his eyes. But I held my ground, took a few long breaths and called them out for their insensitivity and walked out. Now, I work in a firm that gives importance to my abilities than the lag in my speech,” she smiles. Though she continues to occasionally stutter, Maheshwari says that she consciously tries to not let it affect her daily life.
“Be it during presentations or group meetings, I always go extra prepared. If I do stutter, I ask the team/audience if they need me to repeat myself. So far everything’s been good. For anyone who stammers, don’t give up. Show up every day and don’t stop speaking,” she shares. While most people tend to use interjecting words like ‘uh’ and ‘um’ in their speech, in people who stutter, the disfluencies are higher in number. “Sometimes, there are repetitions of words or part of it. Then there is Prolongation, wherein a syllable or sound is stretched out and there are blocks, where people with the condition have a hard time getting a word out.
They are primary behaviours,” explains Ramya Sudersonam, audiologist and speech-language pathologist, Gleneagles Global Health City, Chennai. Secondary behaviours include hand moments, tensing of facial muscles, leg movements and rapid blinking of the eye during speech. “One can mostly notice these behaviours when the person is having a hard time saying a word. In some cases the disfluencies can worsen when there is excessive tension, stress, or a change in a social situation,” she points. During times when it gets hard yet becomes a necessity to communicate in the real world, people with stuttering, especially adults, subscribe to coping methods and strategies, she tells.
“There are times a person could exhibit avoidance behaviour. But in times of necessity, they cope with the disfluencies by trying to cough, covering their face or mouth while speaking. However, the best way is to modify the stutter instead of hiding it,” she emphasises. These, will not only break the stigma that clouds the condition but also reduce stress and other mental health conditions — major factors in causing stuttering. “It is a vicious cycle which needs to be mindfully and willfully controlled,” adds Maheshwari.
Let’s talk therapy
With several myths like ‘keep a pebble under your tongue to get rid of stuttering’ doing the rounds, Ramya suggests that it is important to get professional help when a person notices such disfluencies. “In therapy, we firstly provide counselling to improve one’s mental health and confidence, break myths and give out facts that are necessary for one to understand the condition. This education is important in treating it. Many are also under the impression that stuttering is a mental illness.
But, this is a fluency disorder that requires therapy and counselling. While direct strategies are used to treat it in adults and children with awareness about the condition, indirect strategies are administered in other cases,” shares the therapist. Therapy techniques including f luency shaping, stuttering modification (where avoidance behaviours, fear, anxiety and tension are eased to reduce severity in stammering), positive reinforcements and MIDVAS (motivation, identification, desensitization , variation , approximation, stabilization) a fluency technique created by Van Riper to address stuttering modification in stages are also administered.
“If a person cannot afford or access therapy, there are a few things one can try themselves. Practising relaxation techniques, breathing exercises and practising communication in different social situations, continuing it despite stutters, aiming to improve social skills can reduce anxiety and in turn, ease stuttering,” she offers.