The following is a transcript of a session with Sally (see Chapter Two) who was experiencing the feeling of great tightness around her throat when speaking to other people. This tightness was especially strong when she was in a social situation.
“So, Sally, when you are in a social situation, you really feel tightness around your throat?”
“Yes.”
“And what does the tightness mean to you?”
“Terror!”
“So, behind the tightness is terror?”
“Yes. Oh, yes. I am terrified of speaking to other people. Whenever I am in a social situation and even think of speaking, I become terrified.”
“Does speaking to other people have any other meanings to you?”
“I want to remain invisible. I don’t want anyone to see me.”
“What are you terrified of, Sally?”
“I am afraid I will stutter.”
“So when you speak to other people you become terrified that you will stutter and you want to be invisible? What is there about speaking to other people that causes you to choose to be terrified of stuttering and want to be invisible?”
“Everyone will be uncomfortable. They will not want to talk to me. They may not like me.”
“Oh, I see. So you are afraid that the other people will become uncomfortable with your stuttering and because of their being uncomfortable, they will not want to talk to you?”
“Yes, that is correct.”
“Tell me, how do you know that they may not like you?”
“Stuttering sounds bad. Everybody knows that. And people judge you by how you look and how you talk?”
“Oh, they do? Everyone judges you by how you look and how you talk?”
“Of course. Sure they do.”
“Have you asked them? How many people have told you that in the last few years?”
“Well, I haven’t asked everyone, but everybody knows you are judged by how you look and how you talk.” (Sally was adamant about holding onto that belief of other people judging her primarily by how she talked.)
“Sally, how come you want to be invisible? How long have you wanted to be invisible?”
“I have wanted to be invisible ever since I was a little girl.”
“What was that about? How come you wanted to be invisible as a little girl?”
“As a little girl, I was afraid to open my mouth or mother would get mad. She was always critical of me. She never complimented me. Mother was a witch. She looked like a witch. I can see her face now.”
“You were afraid to speak or your mother would get mad? She even looked like a witch?”
“Yes, I can see her face now.”
“What do you feel when you see your mother’s face?”
“I feel that tightening around my throat. It is like a rope choking me.”
“So you were afraid to speak up in your home and you wanted to be invisible?
“Yes, mom and dad fought all the time. I remember momma with a knife trying to kill dad. They were running around and dad begged her to put the knife away. I was afraid momma would kill me. I wanted to be invisible.”
“You have a movie in your mind of your mother trying to kill your dad and you were afraid she would kill you?”
“Yes, and it terrified me.”
“So, we sure know where much of that terror comes from. Where do you feel that terror in your body?”
“In my jaw.”
There is enough information there to know where Sally learned to be fearful of speaking. Growing up in that terribly dysfunctional family, Sally learned that to survive it was best for her to remain quiet and invisible. Not mentioned above were comments about her father. Her dad also was critical of her. She never could be good enough for him. From her mother and father, Sally learned to be fearful of the judgments of other people.
Importantly, Sally embodied the emotions from the childhood trauma in her throat and in her jaw. In other words, her blocking was an attempt to remain invisible and to avoid judgment. As a result of therapy – which took a number of sessions over several months to complete – Sally has let those fears go and now speaks with much greater fluency. During those sessions we used many of the techniques described in this book. As a result, Sally has become much more resourceful, and has a very healthy and strong sense of self-esteem which permits her to disregard the judgments of others. Blocking as avoidance
When relating to others, PWS often think: “I’ll avoid any situations around people or groups that will attract attention to me and expose this weakness.” “If I am around people I will try to cover up or block the stuttering so that I don’t look foolish.” This attitude demonstrates negatively stated (away from) outcomes (see Exercise 3.3). Negative outcomes or desires tend to create even more fear and start a spiral of negative thinking. Reframing breaks this vicious spiral. The art is to restate the intention in positive terms (Figure 6.1):
Original list from the case study: Alternative (positive, towards): I am not going to attract attention to myself.I want to focus attention on …I am not going to let others see my vulnerabilities.I am going to show people my strengths.I will not give others the chance to laugh at me.I can laugh at myself.I will not let them see me struggle.I want other people to treat me with respect.I will try to cover the stuttering up.Only by being open will I be able to change.
Figure 6.1: Positive reframes
If it appears the PWS is avoiding things, you could confront
