Perspectives on the effects of stuttering on the formation and maintenance of intimate relationships

Journal of Rehabilitation, July-Sept, 1998 by Gerard W. Linn, Anthony J. Caruso

Consumers who stutter can experience difficulty communicating and one major functional impact of the disability is in the area of social interaction. Stuttering affects a person in many ways, but one of the most critical social activities an adult individual undertakes is that of finding a partner and maintaining an intimate relationship. Rehabilitation professionals are often reluctant to focus on such personal issues, but for the person who stutters, developing and maintaining intimate (and supportive) relationships is critical to functioning up to potential as well as quality of life issues. Shears and Jensema (1969) reported that people who stutter severely were rated as acceptable marriage partners by only 7% of the participants. A review of the literature reveals that little is written specifically on this topic, although a variety of sources have examined issues relating to disability, stuttering, and intimacy.

The present writers will use these sources to both provide a review of what is researched and to interpret previously published findings using a coping and succumbing framework. In addition, specific suggestions are provided to aid rehabilitation professionals in counseling consumers who stutter. These suggestions are designed to facilitate the consumers' ability to improve social interactions and develop intimate relations, thus enhancing the quality of life.

Stuttering is a particular type of disfluency(1) that is often characterized by repeated or prolonged sounds/syllables within a word. This disorder affects 1% of American adults, with its incidence reported to be three or four times greater in males than females (Bloodstein, 1995). Onset of stuttering begins for most individuals between their second to fourth year of life (Conture, 1990). Treatment programs with young children who stutter are quite effective if initiated close to the onset of the problem. However, if stuttering is not successfully treated by adolescence, the individual is at high risk for maintaining stuttering throughout adulthood (Van Riper, 1973). [When an adult has experienced lifelong stuttering, it often influences the person's attitude toward speaking in general. His/her abilities to communicate and his/her self-identification as a "stutterer," rather than as a "speaker" often influences the individual's attitude about speaking in general, his/her abilities to communicate, and his/her self-identification as a "stutterer" rather that as a "speaker".] It has frequently been reported that adults who stutter view the act of speaking as negative, stressful, and even threatening. Moreover, given a long history of stuttering, it is likely that many adults have or will develop negative ideas (Conture, 1990). For example, it is not uncommon, based upon our clinical observations, that adults who stutter develop the belief that speech is hard work, I'm not good at speech, and speech is something I should avoid. Speaking/communication plays a major role in the development of interpersonal relationships and adults who stutter may experience greater difficulty in such relationships as compared to their fluent counterparts.

Wright (1983) constructed a conceptual framework at the macrosystem level from which to analyze the positive and negative behaviors, attitudes, and structures that shape how a disability affects a person's life. In a coping framework, the emphasis is on what an individual with a disability can do. Value is placed on the specific assets and functions which the individual with a disability is able to do, and not on comparing the individual with a disability to a functional level of individuals without disabilities. Conversely, the succumbing framework emphasizes what an individual cannot do. Similarly, the individual with a disability (and the family) can approach the concept of a person having a disability using either comparative values or asset values (Dembo, Leviton, Wright, 1956). Murphy (1987), an anthropologist, states in The Body Silent that "Shame and guilt are one in that both lower self-esteem and undercut the facade of dignity we present to the world. Moreover, in our culture they tend to stimulate each other" (p. 93). Shame and guilt, especially when they are connected to disability, are examples of the succumbing framework at the cultural level and of using comparative values at the personal level. The differences involved in the coping versus succumbing frameworks are useful in analyzing the psychosocial impact of stuttering on intimate relationships from the macrosystem level of analysis. Studying an individual's and/or families values from the perspective of comparative values or asset values allows the writers to discuss negative and positive views of how stuttering affects the formation and maintenance of an intimate relationship.

Macrosystem

Intimate relationships happen within a cultural and societal context, which may foster a framework of a coping or a succumbing response or set of responses. The individual who stutters and his/her partner or potential partner operate within a cultural and social context. Doody, Kalinowski, Armson, and Stuart (1993) examined the stereotyping of people who stutter in three rural towns in Newfoundland, Canada. The researchers asked respondents to identify the traits associated with a fluent male speaker and a male speaker who stutters. Despite the cohesiveness of these three communities and the high percentage of respondents reporting that they either knew someone who stuttered or had a family member who stuttered, their perceptions of the male stutterer were significantly more negative than the adult male nonstutterer. These perceptions of apparent normative values of speech and resultant spread within the family and community setting support succumbing framework. Spread "refers to the power of single characteristics to evoke inferences about a person" (Dembo et al., 1956). Comparing the disfluent speech of people who stutter to the fluent speech of nonstuttering2 individuals fosters an environment in which people who stutter are devalued. Within this succumbing framework, people who stutter are socialized to view themselves or other people who stutter as less valued than fluent speakers (Kalinowski, Lerman and Watt, 1987).