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Practical Thoughts Blog

How do I work on secondary characteristics in therapy?

How do I work on secondary characteristics in therapy?

Clinicians often ask us how they should work on secondary characteristics, like eye blinks, physical tension or struggle behaviors, or arm movements. We've addressed the topic in a couple of our previous blog posts (addressing secondary characteristics and even more thoughts about secondary characteristics). But, we still have more to say!

It is understandable that we might want to work on these aspects of stuttering, because they stand out and draw attention to themselves, and they reflect the overall severity of the stuttering (as least as perceived by the listener).

More often than not, however, the secondary characteristics shouldn’t be a primary focus of our therapy. The reason is that the secondary characteristics really are secondary! They aren’t a primary part of stutteringthey’re a reaction to something. Specifically, they are a reaction to the speakers’ sensation of feeling stuck or of not being able to say what they want to say.

Typically, secondary characteristics develop because they seem to help speaker get words out. Those behaviors rapidly become part of the stuttering behavior itself. They arise due to a discomfort with stuttering, or an attempt to prevent or hide or avoid stuttering.

Rather than trying to eliminate secondaries, then, it is more helpful to reduce the underlying desire to avoid stuttering. That is, rather than focusing on the surface behaviors themselves, focus on the reasons for the surface behaviors—the underlying fear of stuttering.

(Moreover, if you focus on the secondaries, it is likely that you will diminish them only to find that another secondary behavior takes its place because the underlying discomfort with stuttering remains.)

SO, consider goals related to education, understanding, awareness of stuttering, and especially desensitization and acceptance, so the speaker can learn to stutter more easily--without tricks that are designed to hide stuttering.

Being able to stutter openly is probably the most important step any person who stutters can take in their path to reducing the burden of stuttering. That is the best way to help people reduce their secondary behaviors.