Remission and Relapse

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Published on December 15, 2017

Author: makk63

Source: authorstream.com

Remission and Relapse: Remission and Relapse Paul Brocklehurst PhD The Stammering Self-Empowerment Programme C.I.C . December 2017 www.stammeringresearch.org All educational and teaching materials developed by The Stammering Self-Empowerment Programme C.I.C are licensed under a Creative Commons Attribution- NonCommercial - ShareAlike 4.0 International License . Permissions beyond the scope of this license may be obtained on request. For details, see www.stammeringresearch.org/copyright.htm Remission and relapse - An intrinsic characteristic of stammering: Remission and relapse - An intrinsic characteristic of stammering Periods of remission can last anything from hours to years. People often think the stammer has completely gone away. But the fears and avoidances may remain – or even grow cycle of remission and relapse 1: cycle of remission and relapse 1 remission relapse 3 rise in vigilance of monitoring for speech errors rise in hopes and expectations fear of relapse increased sensitivity to speech errors & disfluencies rise in the release-threshold fall in vigilance of monitoring for speech errors lowering of hopes and expectations depression and disillusionment feeling of nothing left to lose Lowering of the release-threshold decreased sensitivity to speech errors & disfluencies cycle of remission and relapse 2: cycle of remission and relapse 2 remission relapse 4 rise in vigilance of monitoring for speech errors rise in hopes and expectations fear of relapse increased sensitivity to speech errors & disfluencies rise in the release-threshold fall in vigilance of monitoring for speech errors lowering of hopes and expectations feeling of panic and depression Disillusionment - feeling of nothing left to lose Lowering of the release-threshold decreased sensitivity to speech errors & disfluencies Remission and Relapse following therapy: Remission and Relapse following therapy 5 “Regression to the mean”? A consequence of being impressed by the therapist? A placebo effect Placebo vs. Genuine effect how can we tell the difference? Remission and what lies beneath the surface Sheehan’s Iceberg: Remission and what lies beneath the surface Sheehan’s Iceberg ‘Covert’ stammering: ‘Covert’ stammering Covert symptoms may begin during later stages of ‘remission’ Hypervigilant monitoring for speech errors and disfluencies Avoidance of words, people, or situations that are perceived as likely to trigger blocks. Making remission last: Making remission last To minimise the impact of relapse we need... A reliable method of dealing with blocks should they ever arise. A robust sense of self-esteem. An understanding of remission and relapse as intrinsic to stammering Acceptance Reducing the impact of relapse: Reducing the impact of relapse Accept that some degree of relapse is going to happen Don’t tell people you’re cured Be mindful of any tendency towards fear-induced avoidance and perfectionism Appendix: Factors that may cause transient increases in the frequency of blocks: Appendix: Factors that may cause transient increases in the frequency of blocks Physical factors Tiredness , H angover, Colds and sore throats, Blocked sinuses Poor overall health , Cognitive, mental and emotional factors C ognitive dissonance (thinking one thing and saying something else). The perception of the need to speak more accurately in a specific speaking situation. Any strong emotions which produce unwanted changes to your tone of voice. Environmental factors... Anything that makes it difficult for people to hear/understand you People not listening to you.

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