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What Causes Stammering In An Adult?
Question: Dr. XXXXXXX H. Sheppe, as per your suggestion, I am starting this new discussion:
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How it affected your life in 2 yrs:
As I explained, this I noticed while on a call. While talking to the customer, suddenly I felt that my mouth /tongue has gone dry, unable to pronounce words properly. Later I drank a lot of water, took rest for sometime & then logged in to desk again.
I then started carrying chocolates in my pockets to the workstation (Like candy, chewing gums etc) to keep my mouth normal (To avoid drying of mouth /tongue).
Even though I was talking normally (As I felt that stammering /mis pronunciation of words words would be due to excitement /hurry to finish the call), I noticed these same problems while speaking over the phone.
I really didn't take it so serious as I felt it would be only due to the drying of mouth.
Let me explain what happens exactly. I will be fluently speaking (With correct pronunciation of words & also talking fast).Suddenly I feel that my tongue is being pressed down (Lightly) to a corner of my mouth,& I wont be able to talk with that fluency. It sometimes takes few minutes to be normal & some times it takes hours, where I start speaking normally (With fluency & perfect pronunciation).
When it started happening again & again, I started feeling bad as I thought people would have noticed the way I talk, unable to pronounce words properly, though I am very XXXXXXX in the company, other employees might think that being a XXXXXXX I still don't know how to talk etc..
(1) When the floor (Our workstation) is full, where all the employees have logged in taking calls & when it sounds just like a bus stand (U might be knowing how a call center floor will be when all r taking calls):
I will be very very comfortable to take calls & talk to customers. Its because floor is already busy no body (other employees /managers) are listening to my talking style. Only me & my customer. I will be so comfortable in these kinda situation.
(2) During evening shift, when most of the employees have logged out from their desk & only few are taking calls (Where the floor will be calm, not busy like morning shifts, other employees /managers can listen to me when I am taking calls:
I wont be comfortable at al. Even if its a very simple inquiry by a customer, where it needs only 1-2 minutes to complete the call, I wont be able to greet the customer properly, I wont be able to pronounce customer's name clearly, I wish I shouldn't be getting more calls.
People have not made fun of this till now (They might have not noticed this or they would have thought that's the way I speak).. So I haven't got any negative reactions from anyone but only I know how fluent & confident I was before & now I am not the same. This makes me feel bad & due to which I wont take part in most of the activities in office. Also, I wont be confident enough to apply for the internal promotions (Thinking that my talking style, confidence wont match the position).
Time of events regarding the speech:
There is no particular situation for this where I loose confidence, start speaking like this, stammer. Even if am calm, taking calls (I would have taken 3-4 calls with great energy level, with good pronunciation. The 5th call would be different to me. Whichever scenario the call is about, I would stammer, mis pronounce words on that call).
If I stammer on one particular call, for next call I prepare myself saying this to myself "Come on.. forget that call which was not okay according to u where u stammered, now pick this call with confidence. I know u will help the customer & cust. will be happy with the assistance. Come on..".. When I take the call, I may stammer /mis pronounce the words or I may be confident. There is no fixed situation /result.
About your reactions & emotions to these difficulties:
Basically I will be surprised like what the hell is going on, why am I not able to speak with confidence. I am not a teenager any more, I am grownup, having a kid.. how can I be so shy where I cant even speak with confidence when people are around me!!!?
How much ever I mentor myself, control myself, motivate myself, I am unable to come out of this situations doctor.
-----------------------------------------------------------------------------------------
How it affected your life in 2 yrs:
As I explained, this I noticed while on a call. While talking to the customer, suddenly I felt that my mouth /tongue has gone dry, unable to pronounce words properly. Later I drank a lot of water, took rest for sometime & then logged in to desk again.
I then started carrying chocolates in my pockets to the workstation (Like candy, chewing gums etc) to keep my mouth normal (To avoid drying of mouth /tongue).
Even though I was talking normally (As I felt that stammering /mis pronunciation of words words would be due to excitement /hurry to finish the call), I noticed these same problems while speaking over the phone.
I really didn't take it so serious as I felt it would be only due to the drying of mouth.
Let me explain what happens exactly. I will be fluently speaking (With correct pronunciation of words & also talking fast).Suddenly I feel that my tongue is being pressed down (Lightly) to a corner of my mouth,& I wont be able to talk with that fluency. It sometimes takes few minutes to be normal & some times it takes hours, where I start speaking normally (With fluency & perfect pronunciation).
When it started happening again & again, I started feeling bad as I thought people would have noticed the way I talk, unable to pronounce words properly, though I am very XXXXXXX in the company, other employees might think that being a XXXXXXX I still don't know how to talk etc..
(1) When the floor (Our workstation) is full, where all the employees have logged in taking calls & when it sounds just like a bus stand (U might be knowing how a call center floor will be when all r taking calls):
I will be very very comfortable to take calls & talk to customers. Its because floor is already busy no body (other employees /managers) are listening to my talking style. Only me & my customer. I will be so comfortable in these kinda situation.
(2) During evening shift, when most of the employees have logged out from their desk & only few are taking calls (Where the floor will be calm, not busy like morning shifts, other employees /managers can listen to me when I am taking calls:
I wont be comfortable at al. Even if its a very simple inquiry by a customer, where it needs only 1-2 minutes to complete the call, I wont be able to greet the customer properly, I wont be able to pronounce customer's name clearly, I wish I shouldn't be getting more calls.
People have not made fun of this till now (They might have not noticed this or they would have thought that's the way I speak).. So I haven't got any negative reactions from anyone but only I know how fluent & confident I was before & now I am not the same. This makes me feel bad & due to which I wont take part in most of the activities in office. Also, I wont be confident enough to apply for the internal promotions (Thinking that my talking style, confidence wont match the position).
Time of events regarding the speech:
There is no particular situation for this where I loose confidence, start speaking like this, stammer. Even if am calm, taking calls (I would have taken 3-4 calls with great energy level, with good pronunciation. The 5th call would be different to me. Whichever scenario the call is about, I would stammer, mis pronounce words on that call).
If I stammer on one particular call, for next call I prepare myself saying this to myself "Come on.. forget that call which was not okay according to u where u stammered, now pick this call with confidence. I know u will help the customer & cust. will be happy with the assistance. Come on..".. When I take the call, I may stammer /mis pronounce the words or I may be confident. There is no fixed situation /result.
About your reactions & emotions to these difficulties:
Basically I will be surprised like what the hell is going on, why am I not able to speak with confidence. I am not a teenager any more, I am grownup, having a kid.. how can I be so shy where I cant even speak with confidence when people are around me!!!?
How much ever I mentor myself, control myself, motivate myself, I am unable to come out of this situations doctor.
Brief Answer:
Private Consultation
Detailed Answer:
Hello again XXXXXXX
Thank you very much for this additional history and information. I am forming a very clear picture of my mind how this is happening, and how difficult it must be for you.
First let me speak about the potential cause of this, and then we will address your reaction to it (which in my view is the most modifiable thing we can work on changing right now).
Given your description of these speech events, it remains unclear to me whether the cause is neurologic or psychiatric. This would require a physical exam and very likely an MRI of the brain to rule out a neurologic cause. Once that is done, your description is consistent with anxiety, and we can continue treating it as such.
For now, and indeed even if the cause of this is neurologic, we need to continue to work on your emotional reaction to these events. Let me tell you what I mean.
Your reaction to this happening to you is, understandably, one of embarrassment. You are a XXXXXXX official at your company, and you pride yourself on your ability to speak quickly and pronounce things well. When you are unable to perform to your high standards, you become highly embarrassed, you doubt your abilities, you worry other people are judging you, you feel like a weak teenager, and you become unhappy.
I think in your mind you exaggerate the problem because you are used to performing so well. You are MUCH HARDER ON YOURSELF than anyone around you would be or is. As you say, no one has mentioned this to you, which probably means no one has noticed. And even if they did notice, of which we have no evidence, they very likely don't care. As I sometimes tell my patients, people care more about what they are having for lunch than about your problems. Your mind is your own worst enemy here.
I'd like you to consider the possibility you're exaggerating the severity this speech problem is having on your image, and further consider the possibility you have constructed an image of yourself that is too hard to attain at all times and be perfect. This may be related to your strict upbringing.
Once you realize other people aren't watching you and really don't care about this problem, it may help you relax.
What are you thoughts about these ideas and suggestions?
Dr. Sheppe
Private Consultation
Detailed Answer:
Hello again XXXXXXX
Thank you very much for this additional history and information. I am forming a very clear picture of my mind how this is happening, and how difficult it must be for you.
First let me speak about the potential cause of this, and then we will address your reaction to it (which in my view is the most modifiable thing we can work on changing right now).
Given your description of these speech events, it remains unclear to me whether the cause is neurologic or psychiatric. This would require a physical exam and very likely an MRI of the brain to rule out a neurologic cause. Once that is done, your description is consistent with anxiety, and we can continue treating it as such.
For now, and indeed even if the cause of this is neurologic, we need to continue to work on your emotional reaction to these events. Let me tell you what I mean.
Your reaction to this happening to you is, understandably, one of embarrassment. You are a XXXXXXX official at your company, and you pride yourself on your ability to speak quickly and pronounce things well. When you are unable to perform to your high standards, you become highly embarrassed, you doubt your abilities, you worry other people are judging you, you feel like a weak teenager, and you become unhappy.
I think in your mind you exaggerate the problem because you are used to performing so well. You are MUCH HARDER ON YOURSELF than anyone around you would be or is. As you say, no one has mentioned this to you, which probably means no one has noticed. And even if they did notice, of which we have no evidence, they very likely don't care. As I sometimes tell my patients, people care more about what they are having for lunch than about your problems. Your mind is your own worst enemy here.
I'd like you to consider the possibility you're exaggerating the severity this speech problem is having on your image, and further consider the possibility you have constructed an image of yourself that is too hard to attain at all times and be perfect. This may be related to your strict upbringing.
Once you realize other people aren't watching you and really don't care about this problem, it may help you relax.
What are you thoughts about these ideas and suggestions?
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Yogesh D
Namaste doctor..
I am absolutely having the same question on my mind that this problem is Neurological or Psychiatric.
I would also like to comment on the Strict Upbringing. Doc, I used the term 'Strict' just explaining that my father wasn't soft like my mom. That's it. He was not literally like a Army General.
He was a little introvert (Not showing his love so openly like a mother till I became a responsible person). That's all. In XXXXXXX parents will be strict to their children. Most of the fathers (Almost 95%) wil be strict. This is just to keep the child alert that there is someone in the family who is always not sweet like a mother). Any one in the family (Either a mother or a father) wil be strict to their children till they are adolescent/till they become a responsible person.
I don't know whether parents will be strict in the US/ Western world.. but In XXXXXXX father wil be a little strict. Sorry if started giving you a lecture :-) :-) .. I just tried to explain my case.
Doc, before going to a neurologist (I Wil surely visit to get the MRI done) but before that I have the confidence that my problem can be resolved by your experience in Psychiatry..
I just want to walk on the streets like a Soldier without any shyness or without worrying thinking about what others think.. I want to smile openly while talking to anyone without having the shyness, Maintaining eye contact while talking to someone. As u know, my mind wil always be filled with 'What others may think /What they might be thinking'..
It's of course good to think if the other person is feeling comfortable etc.. but that thought shouldn't ruin my every show.. U know what I mean..
I would like to be confident like the way I used to be.. Pls advice.
Thank you..
Namaste.
I am absolutely having the same question on my mind that this problem is Neurological or Psychiatric.
I would also like to comment on the Strict Upbringing. Doc, I used the term 'Strict' just explaining that my father wasn't soft like my mom. That's it. He was not literally like a Army General.
He was a little introvert (Not showing his love so openly like a mother till I became a responsible person). That's all. In XXXXXXX parents will be strict to their children. Most of the fathers (Almost 95%) wil be strict. This is just to keep the child alert that there is someone in the family who is always not sweet like a mother). Any one in the family (Either a mother or a father) wil be strict to their children till they are adolescent/till they become a responsible person.
I don't know whether parents will be strict in the US/ Western world.. but In XXXXXXX father wil be a little strict. Sorry if started giving you a lecture :-) :-) .. I just tried to explain my case.
Doc, before going to a neurologist (I Wil surely visit to get the MRI done) but before that I have the confidence that my problem can be resolved by your experience in Psychiatry..
I just want to walk on the streets like a Soldier without any shyness or without worrying thinking about what others think.. I want to smile openly while talking to anyone without having the shyness, Maintaining eye contact while talking to someone. As u know, my mind wil always be filled with 'What others may think /What they might be thinking'..
It's of course good to think if the other person is feeling comfortable etc.. but that thought shouldn't ruin my every show.. U know what I mean..
I would like to be confident like the way I used to be.. Pls advice.
Thank you..
Namaste.
Brief Answer:
Private Followup
Detailed Answer:
Namaste XXXXXXX
Let me explain a little bit more what I'm getting at when I talk about your upbringing and your father. I definitely recognize that there are cultural differences between XXXXXXX and the United States especially in terms of upbringing -- I imagine that a "strict" parent is very different in each country. But more important that my use of the term "strict" is the idea that your father, regardless of culture, may have instilled in you a habit of "alertness," to use a word you used. In other words, it may be that you have the tendency to care very much about what others are thinking about you, and have the drive to appear strong, confident, and successful to others.
You can see how this drive would be a contributing problem to this situation, where you are experiencing a speech problem that you are afraid others will notice and judge you for. You express a strong desire to appear strong not shy, strong like a soldier. People admire soldiers. You want to be admired. I think we need to look carefully at where that want comes from. In my experience this comes from childhood, when we learn these habits of interacting with people.
I think once you learn more about yourself, you will see that this drive to be admired is not necessary. You are already admired. You have a wife, a child, and an excellent job. A temporary speech problem will not change those successes. Indeed, we have no evidence that anyone had judged you about this problem except for one person -- you.
What are your thoughts about these comments?
Dr. Sheppe
Private Followup
Detailed Answer:
Namaste XXXXXXX
Let me explain a little bit more what I'm getting at when I talk about your upbringing and your father. I definitely recognize that there are cultural differences between XXXXXXX and the United States especially in terms of upbringing -- I imagine that a "strict" parent is very different in each country. But more important that my use of the term "strict" is the idea that your father, regardless of culture, may have instilled in you a habit of "alertness," to use a word you used. In other words, it may be that you have the tendency to care very much about what others are thinking about you, and have the drive to appear strong, confident, and successful to others.
You can see how this drive would be a contributing problem to this situation, where you are experiencing a speech problem that you are afraid others will notice and judge you for. You express a strong desire to appear strong not shy, strong like a soldier. People admire soldiers. You want to be admired. I think we need to look carefully at where that want comes from. In my experience this comes from childhood, when we learn these habits of interacting with people.
I think once you learn more about yourself, you will see that this drive to be admired is not necessary. You are already admired. You have a wife, a child, and an excellent job. A temporary speech problem will not change those successes. Indeed, we have no evidence that anyone had judged you about this problem except for one person -- you.
What are your thoughts about these comments?
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
That's right sir,
My desire to excel in whatever I do is creating problems to me I guess. Even the president of a country might do some small mistakes & even God too. I mean to say, nobody is perfect in this world & nobody can be perfect in everything.
I hv this knowledge theoretically. but when it comes to live action, I end up myself pushing thorough the perfection & the whole game Wil be spoiled due to my desire to get things done perfectly. I become very very conscious & end up thinking what people think, y am I not confident etc..
for example when I go to the cash counter in a mall to pay the XXXXXXX I expect myself to walk like a model & talk to that person with a perfect tone & perfect English!!!!! I don't know if it's normal. if it's not normal, pls explain why & what should I be doing in those situations
My desire to excel in whatever I do is creating problems to me I guess. Even the president of a country might do some small mistakes & even God too. I mean to say, nobody is perfect in this world & nobody can be perfect in everything.
I hv this knowledge theoretically. but when it comes to live action, I end up myself pushing thorough the perfection & the whole game Wil be spoiled due to my desire to get things done perfectly. I become very very conscious & end up thinking what people think, y am I not confident etc..
for example when I go to the cash counter in a mall to pay the XXXXXXX I expect myself to walk like a model & talk to that person with a perfect tone & perfect English!!!!! I don't know if it's normal. if it's not normal, pls explain why & what should I be doing in those situations
Brief Answer:
Private Followup
Detailed Answer:
I have certainly encountered many people who have these desires to excel, appear like a model, speak perfectly clearly, and be admired by people around them.
It is not a question of whether or not it is normal, but rather a question of how much it affects your life. It is clearly affecting you to be confronted with these thoughts and feelings at work, at home, and performing tasks such as paying a XXXXXXX
We need to do two things. First, we need to understand how these thoughts and behaviors developed, from childhood though adolescence until now. Second, we need to examine very carefully what is happening in your mind during an anxious moment about one of these episodes, and restructure those thoughts into positive ways of thinking.
The first thing is called psychodynamic therapy, and the second is called cognitive behavioral therapy. Both are very important.
For your next response, let's focus on one moment when you were having a speech problem recently. Pick one moment. Describe what you were thinking and feeling during that episode. Be as specific as you can. I will examine it, and in the next thread we open up we will break down how to restructure your thinking.
Dr. Sheppe
Private Followup
Detailed Answer:
I have certainly encountered many people who have these desires to excel, appear like a model, speak perfectly clearly, and be admired by people around them.
It is not a question of whether or not it is normal, but rather a question of how much it affects your life. It is clearly affecting you to be confronted with these thoughts and feelings at work, at home, and performing tasks such as paying a XXXXXXX
We need to do two things. First, we need to understand how these thoughts and behaviors developed, from childhood though adolescence until now. Second, we need to examine very carefully what is happening in your mind during an anxious moment about one of these episodes, and restructure those thoughts into positive ways of thinking.
The first thing is called psychodynamic therapy, and the second is called cognitive behavioral therapy. Both are very important.
For your next response, let's focus on one moment when you were having a speech problem recently. Pick one moment. Describe what you were thinking and feeling during that episode. Be as specific as you can. I will examine it, and in the next thread we open up we will break down how to restructure your thinking.
Dr. Sheppe
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Well I was a very confident kid in my childhood (School days & College days). I was taking part in stage shows /dramas, XXXXXXX day march past etc. Actually during my teenage (I may be around 19-20), when I started getting pimples on my face, I had become a little thin too (As a teenage boy, I was a little thin). Like any other teenager, I was also little down for some time (I was not much comfortable to talk to girls as I was thinking that my pimples would look ugly, I am not looking good etc.)..
I discussed the same with my father. He actually educated me that this is all common during teenage, I will again look good after one or two years. However he also took me to a psychiatrist for counseling (He wanted me to talk to a counselor freely & just to bring back my confidence).. I spoke to the psychiatrist, shared all my views. He gave me good tips & also gave a few medicines. I continued medicines for 1 to 2 months I think. Later I was back with the confidence. Though it took couple of years to get rid of the pimples, I had got back my confidence within 1-2 months of meeting the doctor. I was very pleased with that doctor visit, as it helped me kick off all the worries /inferior feelings which I had about myself.
I was the same till now but these days I am again feeling low confidence /no confidence as I discussed with you with lots of examples.
As you also know, my problem wouldn't be exactly related to Neurology. It may be due to lack of confidence. Doctor, I would like to inform you that more than the speech problem (As I explained, sometimes I end up with slurry speech, Stammering sometimes), I would like to overcome other simple day to day problems related to self confidence & I should be able to * Walk with head up, looking strait, * smiling freely while talking to people, * maintaining eye contact.
Once I overcome these problems, I am sure I can control myself, mentor myself whenever I stammer.. What I am trying to tell u is, this stammering /slurry speech would be because of low confidence itself. Once it is fixed, it gives me the next level energy to fix speech problem & of course I will visit a Neurologist too.
What do u say?
I discussed the same with my father. He actually educated me that this is all common during teenage, I will again look good after one or two years. However he also took me to a psychiatrist for counseling (He wanted me to talk to a counselor freely & just to bring back my confidence).. I spoke to the psychiatrist, shared all my views. He gave me good tips & also gave a few medicines. I continued medicines for 1 to 2 months I think. Later I was back with the confidence. Though it took couple of years to get rid of the pimples, I had got back my confidence within 1-2 months of meeting the doctor. I was very pleased with that doctor visit, as it helped me kick off all the worries /inferior feelings which I had about myself.
I was the same till now but these days I am again feeling low confidence /no confidence as I discussed with you with lots of examples.
As you also know, my problem wouldn't be exactly related to Neurology. It may be due to lack of confidence. Doctor, I would like to inform you that more than the speech problem (As I explained, sometimes I end up with slurry speech, Stammering sometimes), I would like to overcome other simple day to day problems related to self confidence & I should be able to * Walk with head up, looking strait, * smiling freely while talking to people, * maintaining eye contact.
Once I overcome these problems, I am sure I can control myself, mentor myself whenever I stammer.. What I am trying to tell u is, this stammering /slurry speech would be because of low confidence itself. Once it is fixed, it gives me the next level energy to fix speech problem & of course I will visit a Neurologist too.
What do u say?
Brief Answer:
Private Followup
Detailed Answer:
Let me begin my saying I completely agree with you. I think this speech problem is caused by low self-confidence. I would see a neurologist as you mention, but I think the most likely thing is that low self-confidence is what is causing the problem here.
Thank you for telling me more about your life growing up. Could you tell me a bit more about your visit with the psychiatrist at that time? What tips did he give you? What helped you feel better? Can you remember the medications you were taking? I think you probably don't need medication now, but it would be good to know what you were taking in the past. It sounds like simply talking to the psychiatrist helped you.
I want to help you regain your self-confidence. Now that I know a little bit more about you, we can begin to talk about cognitive ways to re-evaluate your situation when you are feeling low, embarrassed, or self-conscious.
We have reached the end of this question thread. Open up a new one, and answer the questions I've just asked you. We can then move on to talk more about techniques that will help you overcome low self-confidence.
Dr. Sheppe
XXXX
OR
https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684
Private Followup
Detailed Answer:
Let me begin my saying I completely agree with you. I think this speech problem is caused by low self-confidence. I would see a neurologist as you mention, but I think the most likely thing is that low self-confidence is what is causing the problem here.
Thank you for telling me more about your life growing up. Could you tell me a bit more about your visit with the psychiatrist at that time? What tips did he give you? What helped you feel better? Can you remember the medications you were taking? I think you probably don't need medication now, but it would be good to know what you were taking in the past. It sounds like simply talking to the psychiatrist helped you.
I want to help you regain your self-confidence. Now that I know a little bit more about you, we can begin to talk about cognitive ways to re-evaluate your situation when you are feeling low, embarrassed, or self-conscious.
We have reached the end of this question thread. Open up a new one, and answer the questions I've just asked you. We can then move on to talk more about techniques that will help you overcome low self-confidence.
Dr. Sheppe
XXXX
OR
https://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=70684
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Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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