On Stuttering

December 24, 2020

At the beginning of this year I was visiting a research group at another university to present my PhD thesis project. I already knew a couple members of the group, because they had already visited us here in Copenhagen. I went to their university, I met with them and we went to a meeting room to introduce me to the rest of the group.

They introduced me, and things went on normally. After some time, someone new came into the room and introduced himself. I also introduced myself and, as is usual, I stuttered with the “g"s in my name (Mig-g-guel G-go-gonzález). Another member of the group asked in good spirit “Did you just hesitate to say your own name?” To which I answered “No, I just stutter.”

I stutter, and I’ve been stuttering since I was 4 years old. But what is stuttering? Let’s start with that:

Stuttering (or disfluency) consists of a language impediment in which the fluency of speech gets interrupted by either blocks or repetitions. These names are the technical ones and they mean exactly what you’d expect: in a block, the word or phoneme just doesn’t come out. And in a repetition, the stutterer keeps repeating a phoneme and the rest of the word is put on pause.

I would like to believe that we all know at least one person who stutters, but the chances are somewhat slim. More or less 0.7% of the world population stutters. Stuttering usually starts when kids are 4 or 5 years old, and it affects all sexes about equally. It usually dissipates when they grow up. In some cases, like mine, stuttering persists in adulthood. It’s more common for adult men to stutter (with a ratio of 4 stuttering men per every stuttering woman).

Let me try to walk you through how it feels to stutter. When I want to introduce myself and I’m about to open my mouth to say “Miguel”, I already know that I’ll stutter and where. This is called anticipation, and it’s fairly common in stutterers: we know we’re about to stutter, and we can’t do anything about it. Let’s say I start the word, I get to a repetition at “g” and I decide to start all over again. When I try to say my name again, I would get stuck at the same place (and this is called consistency). I guess every stutterer is their own world. King George VI had difficulties with the letter “k” (and that must’ve sucked since king starts with a k). The letters “d”, “p”, “g” and “f” are especially hard for me. It’s not that bad though, and if I try to read the same text over and over again, I stutter less with each repetition. This is known as adaptation.

It’s not that bad. Almost no one notices my stutter after a first interaction, especially when someone else introduces me. It happened that a friend I met here in Copenhagen only realized that I stuttered months after we met (and I even gave a 1-hour presentation with her in the room).

Sometimes it gets uncomfortable, though. During my masters, I stopped ordering a type of coffee at the local coffee shop, because I just couldn’t say the word without stuttering (and without the barista laughing at me). I went from ordering “d-d-de l-lo-lolitas” to ordering slightly more expensive “americanos” (so maybe the laughs were only economically incentivized). It also happened that, at one of the main restaurants of the university, a person behind the counter usually recognized me for my stutter, and mocked me while I ordered lunch. That hasn’t happened in Denmark yet, and I keep ordering “chai l-la-latte"s at Analog Café. Maybe if the students mocked me I’d be encouraged to drop the sugar.

My experience with stuttering is nothing compared to what others go through. First, because my stutter is subtle, almost imperceptible. Secondly, because I grew up with tons of privileges, with a supporting family that didn’t make a big deal out of it. I also had tons of support from friends, colleagues, and mentors. I always was (and I still am) the type of person that would raise his hand to talk in public settings, that’d stand up and go to the blackboard in class. I always say what I think. Stuttering didn’t shut me up.

Once, I had a rough week during my bachelor’s (I was stuttering way more than usual). I mustered the courage to ask my thesis supervisor a question that had crossed my mind sometimes: if I have a stutter, should I still pursue a career in academia?, would I still be able to give lectures or supervise students? He comforted me by saying that, in our meetings, my stutter was never in the way of me getting my point across. And that’s true: my stutter is much worse in daily situations (ordering a coffee, introducing myself, asking for something at the supermarket…), but my stutter is almost non-existent when giving presentations, when talking about math or my research, or when I give a lecture to a full auditorium.¹

But other people tell a different story. Stuttering, for them, becomes a catalyst for depression, for anxiety, for suicidal ideation. What brought me to writing this blogpost was a podcast I listened to, in which a woman shares her experiences with stuttering. I really recommend it. Many of her stories strike a chord with me, but I can’t empathize with all of them. For example, her high-school guidance counselor advised against applying to UCLA (her dream uni) because “she wasn’t exactly college material”.

And I feel there’s a cultural taboo with regards to stuttering (but it is maybe stronger inside Colombia). I think they think we’re stupid, that we don’t have much to say, and that we don’t know how to talk. A friend of mine was telling me that, a couple of generations prior, it wouldn’t be rare to take a stutterer out of school because, you know, it’s not like they’ll learn a lot. If they don’t know how to speak, which is so easy, how’ll they learn more difficult stuff, like the multiplication table for 7 or Newton’s second law. The most sincere interaction I’ve had regarding my stutter was with the son of a neighbor when he was 7 years old (or even younger). He asked me “Why do you talk like that, Migue?”, to which I answered “No clue, Migue” (he’s also called Miguel) “I just speak like this, I can’t really help it”.

As I was saying before, male adult stutterers are more common than their female counterparts. The reason might lie in how stuttering is manifested at a physiological level. In these next paragraphs, I talk a little bit about the neuroscience component of stuttering and what we understand about stutterers’ brains. Disclaimer: I’m not a neuroscientist, but the papers and books I found were interesting and I’d like to share them. If you’re not interested in brain stuff, feel free to skip to the end.

There’s² a two-factor model for stuttering: First, there’s a structural abnormality in the brain, and second, this anomaly gets reinforced through avoidance and compensation. No one knows what generates this anomaly, but it seems that some genetic factors are involved (and that checks out, since my paternal grandfather stutters too).

Using fMRIs (functional Magnetic Resonance Imaging), some researchers came to the conclusion³ that there seems to be a correlation between disfluency and anomalies in the basal ganglia, a cerebral structure that is heavily involved in controlling movement (getting implicated in e.g. Parkinson’s disease). And yeah, stuttering usually comes together with involuntary movements, with facial ticks.

This area (the basal ganglia) is related to certain dopaminergic ways, arriving at the hypothesis that there’s some sort of dysfunction regarding dopamine. There’s even more evidence for this since the fluency of a stutterer improves when taking dopamine antagonists and vice versa. That is, there seems to be a hyper-dopaminergic state in the basal ganglia of stutterers.

The brains of people who stutter seem to compensate for this anomaly by using the right hemisphere. But language is lateralized in the brain, and it occurs mostly in the left hemisphere. This seems to be the reason why there’s such an imbalanced ratio of male to female adult stutterers: in women, this language lateralization isn’t as pronounced.²

There are plenty of situations in which I don’t stutter (or in which I stutter less): when I’m talking to myself, when I sing, when I talk to my pets or to infants, when I’m writing at the same time (and this is the best trick to introduce myself in lectures: I introduce myself while writing my name on the blackboard), if I’m repeating what someone else is saying…⁴ Some of these activities have this in common: there’s an external signal, a rhythmic one. This external signal is telling me when to say the next word. These types of external signals have been proven useful to Parkinson’s patients as well, giving more weight to the hypothesis that stutterers have an anomaly of some sort in the basal ganglia.³

People usually ask me if there’s a correlation between my psychological state of mind and how much I stutter (e.g. if I stutter more while stressed or sad). I can’t really tell. For me, it’s mostly about having good or bad weeks. There are days in which I just can’t get a word out, and there are other days in which I’m almost completely fluent. I don’t see a strong correlation. This is anecdotal, but it seems that some stutterers get cured precisely because they submerge themselves in stressful situations. Allegedly, Bruce Willis fixed his stutter while acting.⁵ Maybe the same thing is happening to me with lectures and presentations.

Stuttering happens. Aristotle, the bible’s Moses, Wittgenstein, Alan Turing, Marylin Monroe, James Rodríguez, and Emily Blunt all stutter(ed). If I could give you some advice when it comes to listening to a person who stutters, I’d say: be patient. It’s fairly common that, in the discomfort of the moment, fluent people see us struggling and decide to finish a word for us. Please don’t, give us two or three seconds and we’ll get it out. Focus on what we are saying, instead of how we say it. The second piece of advice would be: don’t judge. We do know how to speak, but we stutter just because we can’t help it.

My final piece of advice is feel free to ask. I didn’t write this post to cancel anyone who mocks stutterers. Nor did I write it to paint me as a victim, as someone with a disability. I wrote this post to start a conversation, to let everyone who knows me know that they can ask as much as they want. There’s no problem, no taboo.