|About the presenter: In addition to owning a full-time private practice dedicated to fluency disorders, Tim Mackesey has taught the graduate-level Fluency Disorders course at Georgia State University. An SLP since 1992, he travels internationally presenting workshops on early intervention, stuttering treatment, and cognitive therapy. Tim is published and has been interviewed on a number of television and radio programs related to stuttering. He has been selected as a Board Recognized Specialist in Fluency Disorders and Specialist Mentor by ASHA. As a certified master practitioner of Neuro Linguistic Programming, Tim integrates numerous unique strategies into therapy and teaching.|
Eye contact aversion, or intentional breaking of eye contact during moments of stuttering, is more than meets the eye. It is far more than just a behavior. Cognitive and affective patterns are at the root of eye contact aversion. To fully understand eye aversion it is important to first focus on four key points. These include: 1) defining appropriate eye contact, 2) the positive intention behind eye contact aversion, 3) the cognitive and affective aspects of eye aversion, 4) the listener’s perception of eye aversion.
Defining appropriate eye contact is the first step. In language there is a system called pragmatics. Pragmatics is the language system that governs socially appropriate nonverbal and verbal language. This includes, but is not limited to, body posture, turn taking, ‘politeness,’ and eye contact. Appropriate eye contact does not mean staring like a deer in headlights into your listener’s eyes. In fact, that is impossible because humans follow a distinct pattern of eye accessing cues as they retrieve and/or formulate information. For example, most right handed people will look up and left when accessing pictures, look up and to the right when creating pictures, look down when accessing emotions, and look left and right respectively when accessing or creating dialogue (words)*. So, there is natural and necessary eye movement when conversing. If you stutter, or provide services to those who do, you know how to recognize eye aversion.
The person who stutters (pws) will avert eye contact immediately before and during the stutter. Most pws will have an internal threshold for averting eye contact. When the pws reaches a boiling point of anticipation they will avert eye contact. Loose, effortless stutters often do not result in aversion.
There is a relatively consistent positive intention behind eye aversion. Stuttering therapy pioneer, Dean Williams, wrote about positive intentions behind many stuttering behaviors.** No one was born eye averting. Eye aversion is not a neurological tic (involuntary body movement). Eye aversion is a voluntary action programmed and conditioned subconsciously. Eye aversion is provoked by a combination of cognitions (limiting thoughts) and limiting beliefs about listener reaction. People who stutter may be attempting to protect themselves from seeing a listener reaction. If so, they are mind reading, or presuming to know the reaction of the listener. It is often associated with guilt and shame over one’s stuttering.
Stern correction by adults, teasing, bullying, and other negative experiences when young may help explain the foundation for the habit of eye aversion. The term “foundation” is used to imply these experiences are the references for the cognitions and emotions; the beliefs that stuttering is “bad,” “unacceptable,” “not tolerated,” and so on. It is when a child attaches a stigma to the behavior of stuttering that cognitions and limiting beliefs take root. I have seen eye aversion in children 3 years old to adults in their 70’s (older cases surely exist). The young children I have treated in my practice have discontinued the behavior after resolving stuttering. The eye contact aversion was not mentioned to them, nor was any teaching or demands of eye contact done. Adolescents through adults have to take ownership over the behavior in order to integrate new patterns of communication and fluency.
There is a mind and body connection in stuttering. For instance a person may anticipate a stutter on the word “stutter,” look away from his listener, tense his tongue against his front teeth and utter “st-st-stutter.” Often that just isn’t enough. He may then replay the moment of stuttering, feel guilty, mind read, and question his ability to say the word “stutter” next time.
I recently interviewed a 41 year-old attorney who stutters. The dialogue was as follows:
TM: “…I notice that you look away each time you stutter. Is that something you have been doing for some time?
BB: “Yes, come to think of it I do it all the time.”
TM: “How do you know when to look away?”
BB “I get embarrassed”
TM “How do you manage to get embarrassed when you stutter?”
BB: “I wonder what they are thinking about me?” (mindreading)
TM: “Please fill in the blank for me. If people see or hear me stutter they think (blank)?”
BB “I am inadequate” (limiting belief)
TM: mirroring comment “You think you’re inadequate”
BB shrug “Yes… I guess I have been thinking that.”
TM “Has that served you well?”
BB: “Definitely not!”
It is here that I modeled two ways of stuttering on my name. I asked him to watch both examples and tell me which way made him feel more comfortable. First, I looked directly into his eyes and said: “My name is T-T-T-T-T-T-im” with visible tension in my mouth. Second, I kept eye contact for “My name is” and then averted eye contact for “T-T-T-Tim.” (The actual stutter in the mouth was made as identical as possible.) When asked which made him more comfortable he was adamant that the example with eye contact made him more comfortable. He went on the say it made him more comfortable when I stuttered with eye contact. When asked what he thought of me as I looked away, he answered “afraid.” Afraid, uncomfortable, and scared are the typical answers I hear in this exercise. That experiential exercise helps people who stutter decide that they want to keep eye contact. It is one thing to intellectually understand the importance of eye contact. It is entirely different to emotionally commit to it.
Well-meaning speech pathologists, parents, and teachers have been known to demand a pws maintain eye contact. Some have resorted to tactics such as using a sweeping gesture with their finger in an attempt to direct the pws eyes to their own. The problem with wanting it for someone else is just that- they want it for the pws. The one demanding the eye contact can break rapport quickly. The pws must make a decision that eye contact aversion does not serve them well, and then commit to stop doing it. In many cases, the aversion has been running on an unconscious program for some time. Constant nagging to maintain eye contact is as ineffective as telling a nail-biter “don’t bite your nails.” The reduction in stuttering severity and reduction in stuttering frequency is profound when the pws commits to maintaining eye contact.
Eye aversion can have a profound impact on a relationship. For example, I recently facilitated a family counseling session involving an 18-year old male with a severe stutter and his parents. When asked the positive intention of looking away while
stuttering, the 18-year old replied: “I think I’m bothering them when I block…it takes so long for me to get the word out….sometimes I just say ‘forget it’ and walk away.” His parents reported that they also always looked away. When asked their positive intention for looking away, they replied: “We thought it would be easier on him…less pressure…we just wanted to help.” Can you see the communicative wall that was built between child and parents? It happened that the young man had his most severe and chronic stuttering around his parents. They all committed to keeping eye contact during moments of stuttering modification. The parents kept a relaxed, supportive expression. They noticed an improvement in fluency and a much more healthy relationship in a couple days. Eye aversion makes the listener less comfortable and makes the stuttering appear like more of an impediment. It is a lose-lose habit.
Eye aversion’s cognitive and affective phenomenon can be examined in another way. A pragmatically correct and comfortable conversation would involve appropriate eye contact. When a person uses eye aversion they are intermittently disassociated from the conversation. Specifically, as they look away they mind read, physically tense, and stutter- they intensify the stuttering state. The stuttering state is a combination of physical tension, affect, cognitions, changes in breathing, and many other symptoms.
Charles Van Riper once said: “Stuttering is everything you do trying not to stutter.” Eye aversion is an avoidance strategy- trying not to stutter and not be identified as a “stutterer.” Stuttering severity, anxiety, and physical tension (the stuttering state) all increase during eye aversion. People who stutter initially think it helps to avert eye contact- that is until they experience the contrast of direct eye contact. Staying relaxed and confident is a prerequisite to utilizing any fluency shaping or fluency modification strategies. One must intentionally keep eye contact during the anticipation or realization of stuttering. That way the speaker is associated, present, and in the “here and now.” One must build his mental acuity to identify the urge to avert the eyes, and then make a commitment to make eye contact and go forward into the word. This commitment would, of course, disallow any use of interjections (i.e., “uh,” “um”) or any filler words before the feared word. If you want to swim, you must get into the water.
Eye contact aversion can break rapport between speaker and listener. Maintaining rapport is verbal and nonverbal. Webster’s Dictionary defines rapport as: “a close or sympathetic relationship; agreement; harmony.” When the pws is averting eye contact during stutters, it sends a non-verbal message of self-consciousness to the listener. Since the average listener is misinformed about stuttering, they may become unsure of how to react properly to support the pws.
Communication is like a waltz. If the speaker is disassociated and averting eye contact, he may step on toes and get his toes stepped on. The pws may benefit in “selecting the music for the dance” by acknowledging the stutter and keeping eye contact.
Telephoning is another situation where eye aversion can be evaluated. Using a mirror, people who stutter can face themselves during a phone call. If they avert eye contact with themselves during stuttering, similar cognitions and limiting beliefs exist. The positive intention of eye aversion is to protect oneself from confronting the reality that he is stuttering. Fear of stuttering and shame are at work in that moment. Purposeful eye contact in the mirror during stuttering modification can rapidly desensitize people who stutter to the behavior of stuttering. Voluntary stuttering while making eye contact, in face-to-face conversation or making phone calls, can be helpful in expediting desensitization.
Regardless of the variety of speech therapy strategies employed or favored by the individual who stutters, success is dependent on being associated with the listener. This requires a commitment to purposeful eye contact when stuttering is anticipated or experienced.
In summary, pws are to recognize that it is vital to maintain eye contact at the moment of stuttering anticipation or realization. There was a positive intention behind eye aversion when the person who stutters was younger (to protect oneself from possible listener reaction), and that to move on one must have a new positive intention- to be associated, confront fear, and gain freedom speaking. One must experience that eye contact is a prerequisite to the ability to elicit a state of confidence and relaxation. Therefore, success with fluency strategies is positively contingent on keeping eye contact. Beliefs and cognitions to replace the old, limiting ones could include: self-acceptance, feeling safe and secure using purposeful eye contact, feeling worthy as a speaker, believing that listeners will approve of eye contact during stuttering and/or stuttering modification, and that disfluency of speech is tolerated by others. Realizing that eye aversion is a rapport breaker and that purposeful eye contact is a win-win habit- it makes speaker and listener more comfortable.
* Brooks, Michael. Instant Rapport (Warner Books, 1989)
** Williams, D.E. (1957). A Point of View About Stuttering. JSHD, 22, 3, 390-397