Tuesday, September 06, 2011

Parry's Valsalva theory and treatment

A reader has asked me about my opinion about the Valsalva theory and treatment created by William Parry. Check out Parry's website. As two year ago, I have not made up my mind.

At best, his theory is a partial theory of stuttering and only focuses on the stuttering and blocking events. For Parry, the mis-use of the natural Valsava mechanism greatly blows up the symptoms of our inefficient speech system. Relaxation of the muscles involved in a Valsava mechanism helps reducing the tension and severity of symptoms. It seems to me that his method is similar to muscle relaxation techniques.

I have added a diagram that I found on his page that illustrates his theory. Have a look at it! Let me know of your opinion.



17 comments:

Anonymous said...

Absolutely True!

Its a learned habit. If u fail the first time, u feel u'll fail the second time.

In my 28 yrs, i think i have failed thousands of times so its natural for the brain to accept failure at this point.

But if i pratice for 2-3 yrs i may increase my fluency around 80-90%.

So my age * 0.10 = 2.8 years

Most of us practice for 1-2 weeks and give up seeing little improvement. we are looking for that magic thing to help us cure in under a week or so.

Its all in ur brain.
Well i guess this chart also applies for the non-stutterers. The difference being..

"Speaking is so easy" instead of "Speech is so tough"

Anonymous said...

Backwards, backwards, backwards. While the vast majority of research in motoric and neurological disorders continues to evolve in productive and valuable ways, stuttering research continues to harbor these backwater channels of crackpot theorists, snake-oil salesmen, and self-loathing pseudo-scientists. I know plenty of colleagues who are more actively challenging these types of pseudo-science, but clearly there are plenty of academic departments and individuals who aren't doing enough.

Is anyone proposing these days that if people with schizophrenia stop "fearing" their disorder it will disappear? How about people with aphasia? How about people with Tourette's Syndrome, or cerebral palsy, or epilepsy? So why, then, do these zombie theories continue to plague stuttering research?

Fear. Doesn't. Cause. Stuttering. It doesn't cause epilepsy. It doesn't cause Tourette's Syndrome. It doesn't cause structural or functional neurogenic disorders.

Period.

Tom Weidig said...

@LastAnonym: I don't think that Parry says that fear causes stuttering. But that most stuttering symptoms are the result of much milder stuttering events and that most of the handicap arises from the reaction to stuttering.

Many disorders have learned components and dealing with those will reduce the symptoms and handicap of the disorder.

@FirstAnonym: I don't agree with you. Stuttering is not a learned behaviour, but the original stuttering is blown up due to learned behaviour in such a way as to significantly increase the handicap experienced by stuttering. Working on those learned behaviours will significantly reduce the frequency and severity of your stuttering.

lolocopter1231 said...

Has anybody been on one of his courses? results?

Jon said...

"For every problem there is a solution which is simple, clean and wrong."

H.L. Mencken


And see Anonymous above.

Anonymous said...

@FirstAnonym: I don't agree with you. Stuttering is not a learned behaviour, but the original stuttering is blown up due to learned behaviour in such a way as to significantly increase the handicap experienced by stuttering. Working on those learned behaviours will significantly reduce the frequency and severity of your stuttering.


Yeah that is what i meant. Initially its our brain wiring which is wrong since stuttering runs in my family to some extent.
But fear and telling someone not to speak automatically tells a child that something is wrong with their speech and that blows up as u said and the result is a full blown stuttering

While i was a teen maybe it was a software problem but now i also feel my jaw automatically blocks up automatically and becomes stiff when i speak even though i have control over my speech. So i guess now its an hardware problem.

I think this is evolution taking place. Software -> Hardware..
Well bad luck :( but im optimistic.
Lets see.

That is why i guess children outgrow their stuttering at early intervention. With adults, the problem grows at a physical level so that makes it difficult to break even though we feel we have control over speech.

Wht do u guys think?

Tom Weidig said...

@LastAnonym:

You seem to be saying that the brain was neurobiologically unstable in childhood and that causes stuttering due to learned behaviours.

But I say that we STILL have this abnormal speech system, which makes it so hard for us to unlearn bad learned behaviours.

So, yes you can unlearn with hard practise but a core issue due to neurobiology will always stay. But you can speak nearly normally.

I don't think children outgrow stuttering due to early intervention. They might learn better behaviours to control their deficient speech system.

Anonymous said...

I agree that we stil have an abnormal speech system which makes it hard to overcome bad habits. But I do think that children can outgrow stuttering due to early intervention. But with outgrow... I mean that they can start with a therapy form early on, and therefore learn at a younger age to cope with their stutter problem and how to get rid of the anxiety of speaking. Because adults have a much harder time unlearning bad habits because of the fear and social stigma which has been build up for many years. I do believe that stuttering is a neurological problem and that it is genetically transferable, but I do believe that we can learn to speak more fluently and to get rid of the pesky fear and insecurity that shows its ugly head when stuttering. And the earlier you intervene (when you notice your child stuttering) the easier it will be get rid of all the negativity surrounding stuttering and the more fluent the child will become. But its still hard work, child or adult.

I just wrote a post about my stuttering, and my journey to fluency...which still isn't over! If you want to read it...be my guest: http://www.lovingmyhappylife.com/2011/09/happy-nr-23_06.html

Anonymous said...

"But that most stuttering symptoms are the result of much milder stuttering events and that most of the handicap arises from the reaction to stuttering."

Conjecture without evidence. There are no peer-reviewed studies supporting the claim that *most* of the handicap arises from the *reaction* to stuttering. How are you quantifying this? How are you de-coupling secondary "reactions" to stuttering from "actual" stuttering?

It's these types of sloppy thinking approaches and careless assumptions that continue to hamper real research in stuttering. Focusing on secondary "reactions" to stuttering is exactly the kind of dead-end research activity that has irresponsibly misled the stuttering community for decades.

Anonymous said...

"but the original stuttering is blown up due to learned behaviour in such a way as to significantly increase the handicap experienced by stuttering. Working on those learned behaviours will significantly reduce the frequency and severity of your stuttering."

Another false assumption--one presuming all stutterers have negative learned behaviors. I am a mild-moderate stutterer who never blocks--all my disfluencies are repetitions. And because my stuttering is rather mild, therapy techniques (e.g., light onsets, prolonged speech) result in less fluent-sounding speech than my *clean and natural* stuttering. In my case, then, there are no techniques that result in reduced frequency and severity of stuttering.

For that matter, it's a highly dubious claim to insist that working on learned behaviors will "reduce the frequency and severity of [one's] stuttering." I've yet to find any studies in peer-reviewed journals that support this assertion, and yet it's taken as axiomatic in much of the field.

ari(israel) said...

Anonymous-i don't know how you stutter,but it could be that your "clean stuttering" is not your real stuttering,but kind of avoiding your real stuttering.
In my stuttering i didn't find till now, what is my real stuttering,all the stuttering i do is attempting to avoid stuttering.

Gustaf said...

I've been following Parry's work for a number of years now. I think his book is excellent. I have rarely felt so understood when reading about stuttering.

He definitely has a scientific outlook, and I think he must be admired for giving up his work as a lawyer to pursue a career as an SLP, at an age when most people stop working!

About his theory, I believe Tom is spot on saying it's partial. It helps explain the kinds of stuttering blocks in which the air-flow is hindered (in the chest, throat or mouth) and it does that quite convincingly. But it says much less about the stuttering blocks that occur before we attempt to speak.

Anonymous said...

All stuttering originates in the brain--it makes no sense to differentiate between stuttering blocks "in the chest" vs. blocks before we attempt to speak. There are different physiological realizations of stuttering, in the same way that motor tics are realized in different ways depending on the action an individual is performing (and other factors, random and non-random).

Gustaf said...

I agree all stuttering originates in the brain. But Parry's contribution is connecting the Valsalva maneuver to stuttering. That's a physical reaction, requiring effort. Therefore, my understanding is that the Valsalva hypothesis excludes those "blocks" in which no effort has taken place. The air-flow is not hindered, the diaphragm is not frozen in position, lips are not sealed. It's just a strong feeling of "there's no way I can say this word right now". It's as if something has to sync before we're able to utter the word. That's separate from any stuttering in which the Valsalva maneuver may be involved.

Einar said...

To me this diagram illustrates well this vicious cirle of fear that stutterers experience. The only way to break that circle is to accept stuttering and to free yourself of pressure and negative feelings towards speaking.

Jon said...

I had forgotten something I just remembered and should add here. If you look up Parry's book on Amazon.com, you'll find glowing 5-star reviews. Knowing Amazon like I do, I took the trouble to investigate the reviewers who were giving the book such glowing recommendations. They came from around the English-speaking world, and most of them shared one trait - they came from people with no other Amazon reviews on their record. Which is a red flag for fake reviews. Which, of course, Amazon is full of. Be warned. When you see glowing reviews on Amazon, ALWAYS look for a history on the site, and not a single five-star sales pitch.

Anonymous said...

@Gustaf: It's still just a different manifestation of the same underlying event. All stuttering events are neurologically-based, whether they surface as blocks, repetitions, etc. Focus on the "Valsalva manuever" is a red herring: it tells us as much about potential causes of stuttering as do, say, lip EMGs.

This "hypothesis" is just another example of the psychologizing of stuttering: that "negative beliefs" about speaking somehow cause the brain to "neurologically prepare" the valsalva mechanism to exert effort, etc. With no evidence, as usual.

Why do these zombie theories keep coming back? There are at least two reasons I continually come across. One is the attractiveness of psycho-babble theories to therapists and some researchers, who can then 1) avoid attempting to understand complicated motoric and neurological underpinnings of stuttering, and 2) conveniently shift the locus of treatment to the stutterer's feelings and atttitudes. If you still block, then it is because you still fear! Please pay for another sixteen sessions and we will work on a deeper level of fear confrontation!

The second reason, I suspect, is that it is a comforting thought to stutterers that fear is the cause of stuttering, or at least the only contributing factor we should be primarily interested in. Of course on some level this is understandable, and working through speaking-related fears is certainly a meaningful goal. But it is both intellectually dishonest and ethically reprehensible to propogate sloppy science and bad therapy. There is too much at stake.