Upon this basis of an involved visualization all the intricate phenomena of
stuttering may be explained. Let us take some of these up in detail.
THE START. Visualization processes are a matter of growth through exercise
and development and use from the sensory area mostly of the eye. If these
processes in their early start and evolution receive a setback through the
treatment of people in the environment, such as interruptions of their early
speech efforts, constant inattention of those to whom they speak, and
persistent refusal by older people to answer questions propounded or the
allowing of the little one to ask the same question without hopes of answer
for a great number of times, these visualization processes receive a
setback. This kind of treatment in the home is one of the chief causes of
the slump of visualization processes. Another cause is hearing other
stutterers interrupt their own visualization processes as they stutter; and
still other minor causes may be almost any psychic trauma; these traumata,
such as an operation, an accident or a severe illness, are sufficient to
bring to the surface or intensify a growing lack of visualization that has
been started by bad environment long before.
THE DEVELOPMENT OF STUTTERING. When the habit of visualization is lessened,
the action upon speech is the same as the withdrawal of an inhibiting or
regulating reflex arc.
It is thus that visualization processes act like reflex inhibition. When
visualization is present a higher inhibition arc is functioning and we have
a normal speech as a consequent reflex expression. When and in proportion as
visualization is absent this higher inhibition arc is not functioning; and
the speech thus uncontrolled flies away in spasms which we call stutter. It
should be called an exaggerated or uninhibited speech reflex.
The stutter, then, is merely the externalization of an exaggerated reflex of
motor speech, exaggerated through the loss of the inhibitory action of a
more or less weakened visualization process.
Not only does this explain the phenomena at large but seems to be a
satisfactory explanation for all its intricate, minute details. Some
examples may, perhaps, be welcome at this point. I say to two stutterers:
"Tell your first name." One of them stutters and the other one does not.
On furthering questioning, it is found that the one who did not stutter
visualized, and the one who did stutter did not visualize.
CONCRETE: These conditions are also seen when stutterers talk about
concrete and abstract matters or when they promulgate some important plea
that cannot be visualized. On concrete matters that can be easily visualized
the stuttering is gone; and on abstract matters where visualization is hard,
the stuttering again appears.
ANGER: In anger, when an intense visual picture is presented and occupies
the mind, there is then no stuttering, and also in other similar situations
there are periods when the individual is abandoned to some visual concept
which acts in the same manner.
SINGING: We all know that stutterers can sing without stuttering. The
process here is a similar one; only that there is held up over the speech
before utterance an auditory image of a melody in place of the visual image
as held in normal speech. This auditory image may be more easily applicable
as supplying the needed inhibition reflex arc than the visual because it is
nearer to the speech area.
PRAYER: For the same reason prayer is uttered without stuttering when there
is faith enough in a God to hold an image of Him during utterance. There may
also be other images held during prayer.
FAMILIAR SIGHTS: Familiar sights are less stuttered upon than the detailing
of situations that are less familiar and therefore can be less well
visualized. This is also true of sights that have been recently seen or
that have been repeatedly seen, or that in some other way have been made
intense as pictures in the visual field.
AS CURE PROCEEDS: In the process of recovery where visualization is seen to
increase as the stutter decreases, there is another illustration where this
visualization attitude explains the whole situation. I have taken a severe
stutterer and told him a story that could be well pictured, got him to work
up the pictures properly by several complicated processes (which we will not
consider now) and when he had them well in hand, I have seen him stand up
and relate the story from beginning to end with little or no stuttering If
at any point he would trip up, the inevitable confession would be that at
that point he dropped the picture, or, in other words, the visualization
could not be held over in its inhibitory action; and therefore the stutter
came. On further request to hold it over that point, the same passage would
be again expressed smoothly if he succeeded in holding the picture.
This constancy, this presence and absence of the picture, its presence to
make smooth talk and its absence to cause stuttering, is so constant at
every turn of the situation, that I would offer it as a new interpretation
of all these phenomena. I know of no other interpretation that can EXPLAIN
EVERYTHING UNDER ONE HEAD as does this absence, weakness or interruption of
visualization processes.
TERMINOLOGY. We have found in our orientation tests that in a vague way the
visualization was at fault. We have also found in normal individuals that a
marked visualization was an automatic process that preceded speech, and
lasted during utterance; and we have found in the long series of stutterers
that visualization is entirely absent in severe cases; that it is weak in
milder forms; that it is intermittent in most cases, and that on words that
are smooth it always appears, and in occasional stutter it is as
occasionally absent.
We have also found that the form of visualization common in normal speech is
the visualization of eye sensations; that in unusual situations we may have
visualizations from other sense areas, such as the ear, taste or smell, but
these are the RARE EXCEPTION.
From all this data it would naturally follow that some sort of term is
needed to designate this condition. Last year I probed to find such a term
without much success.
At present I see no reason why it should not be called an Asthenia; it is
surely the weakening of a mental process that is strong in normal
individuals. The evidence here presented shows that. I doubt whether there
is any marked pathological change, since the individual may be educated out
of it; but this does not necessarily follow as proven with my dog in
Berlin.[2] As a general designation, then, I should consider Asthenia as
apropos.
One objection to this is that the weakness is by this terminology lacking in
localization. Our data above has shown us that the location of the trouble
is visual; that is, it is situated about a centre of sensory registration
that deposits data from the eye; this must naturally then be located
somewhere in or near the cuneus. We could therefore add to the terminology
this idea of a minute localization and call it a Centre Asthenia.
Some may prefer to carry the matter one step farther and add the name of the
centre in which this weakness is located, but I fear if I take this step and
complete my terminology by the word "Visual Centre Asthenia," it will, as
such, not cover quite all the cases, for I find that sometimes the
visualization is absent in other areas as well, and also the holding of an
emotion of pleasure or pain and of other dominating mental attitudes that
are sometimes visualized would not, therefore, be included. I would
therefore retract the broader claim in order to place the term on a
conservative basis and call the essence of the lesion simply no more or less
than a Centre Asthenia. As well as visual Asthenia, the following terms
might be considered as applicable: collaborative centre asthenia;
imaginative centre asthenia; visual creative centre asthenia; picture
producing centre asthenia. We say neurasthenia when the trouble is not in
the nerves as such, so much as it is in the collaborative centres. More of
this later. Here in stuttering the trouble is also collaborative, and we
can be still more definite than that and say the trouble is with the
collaboration of visualization. So if I were forced, however, to choose one
term from all these, my choice would be "Visual Centre Asthenia." This
indicates a new and rational treatment. But of this later.
SUMMARY: Psychoanalysis reveals stuttering as some vague trouble in the
personality[1]. Psychological Analysis shows stuttering is an absent or weak
visualization at the time of speech. This new concept of stuttering as
faulty visualization may be called Visual Centre Asthenia. This lack or
weakness in visualization accounts for all the numerous phenomena of
stuttering in severe, medium, or mild cases. A new treatment is indicated.