There is ample reason to accept a psychological explanation of the cause of stuttering. Stutterers acknowledge that their problem becomes worse under conditions of stress and report, for example, that when they were alone and under no stress, they have no difficulty.

Stutterers for years have gone to psychologists or psychiatrists to have their problem treated. The published results have not been encouraging. The stuttering rarely, if ever, improved. And the usual explanation offered by the psychotherapist was that the problem was so deep-seated, having most often begun between the ages of two and six, that it would require years of intensive therapy to get to its roots and handle it effectively. And this, in spite of the fact that repeated psychological tests have shown stutterers to be totally representative of the normal population.

One stutterer I saw had undergone seventeen years of psychotherapy at a total cost of approximately $85,000. I remember noting on my evaluation form that this young man was probably the most well-adjusted stutterer I had ever seen.

To this very day, the mythology persists that stuttering is a "psychological problem." Each year so-called experts write books that proclaim this fact aloud, and articles appear frequently in both newspapers and magazines that reinforce the belief. Psychiatrists continue to attempt to treat thousands of stutterers each year using techniques that have long since been proven inadequate.

Freud knew they were inadequate. In one of his early books he wrote, "Whatever the source of stuttering is, it is not amenable to the treatments I have developed. I therefore refuse to attempt to deal with it further."

But it was never-the-less clear to me that stress was affecting the tension at the vocal cords. I discussed the problem with a physiatrist friend who specialized in physical medicine and rehabilitation, and he told me about a study that had been published in 1953. It appears that a laboratory had been established in Germany to study the physiology of movement of world-class athletes, with the goal being able to enhance athletic ability. As part of this research, the investigators had considered the effects of stress.

The research found that the athletes tensed their muscles when stressed, but most interestingly, that they focused tension in certain areas of the body - the most common ones being the muscles of the shoulder girdle, abdominal wall, lower back, face and hands. These foci were later termed targets and found to be congenital and frequently, but not always, inherited.

There were also less common targets, and one of them, affecting about two percent of the world's people, are the muscles of the vocal cords. Subsequent research revealed that all stutterers come from this 2% population. Stutterers are born with the tendency to tense their cords when under stress.

In these studies the entire body was mapped for men and women, and sex differences in targets were found. For example, while fully five times as many males focused tension at their vocal cords when stressed, almost three times as many women focused tension in the abdominal wall muscles when under identical stress.

I showed this research to the Speech Pathologist and he postulated that the five-to-one sex ratio for the vocal cords shown for males might explain the precisely identical sex ratio for stutterers reported in the research literature. 

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