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Stuttering Hexagon

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thumb|The Stuttering Hexagon

The Stuttering Hexagon is a comprehensive model of stuttering originated by John C. Harrison in order to adequately characterize the chronic blocks of adult stuttering.[1] Harrison, Associate Director for National Stuttering Assn. for 16 years, was convinced that traditional paradigms being offered were not inclusive enough to fully describe the dynamics that drive the problem of stuttering. Harrison’s paradigm suggested that the speech block is the product of an interactive system comprising a person’s physiological responses, behaviors, emotions, perceptions, beliefs and intentions. This system is not static; rather it is a system that ebbs and flows, depending on the circumstances. Harrison believed that if stuttering was simply a problem with the mechanics of speech, we’d stutter all the time, even when we are alone. Rather, it seemed to him to be an interactive system involving the six above-mentioned components, only one of which was physical. It is the way these components interact, he believed, that create a self-reinforcing system.[2][3]

Harrison’s Stuttering Hexagon stands in sharp contrast to the paradigms offered by those who regard stuttering as merely a speech problem, those who regard stuttering as a unitary problem with a single cause, those who believe that stuttering is an emotional problem, or a timing problem, and still others who believe stuttering is caused by some genetic glitch in the brain or a cerebral anomaly. [4]

Every point of the Stuttering Hexagon is connected to every other point. This means that each element is influenced, either positively or negatively, by what is happening at the other locations on the Stuttering Hexagon. Harrison also contended that to make stuttering disappear you can't focus on solving it. You must focus on dissolving it. In other words, to remove the problem of stuttering, you must destroy its structure.[5]

ModelEdit

This system was visualized by Harrison as a six-sided figure—in effect, a Stuttering Hexagon—with each point of the Hexagon connected to and affecting all the other points. It is the moment-by-moment dynamic interaction of these six components that maintains the system’s homeostatic balance. The six essential components: behaviors, emotions, perceptions, beliefs, intentions and physiological responses are shown in Harrison’s following diagram: [6]


Further elaborationEdit

All the system components of the Stuttering Hexagon are in a dynamic relationship. If most of these elements are negative, they will create more negativity. Thus, even if one part of the system has become positive, such as speech that has improved after therapy, it will be under pressure by the rest of the system to drift back to its previous negative state to support the integrity of a negative system. On the other hand, if the points of the Hexagon are mostly positive, they’ll create a positive system that will support any positive changes such as more expressive and fluent speech.[7]

During good speech periods, the Hexagon will be positively biased and support a state of physical and emotional well-being. Conversely, a failed enterprise, broken relationship or other unfortunate happenstance can cause negative changes all around the Hexagon, and those changes will be reflected in more dysfluent speech. Each individual word is capable of having its own Hexagon, depending on what we associate with it and the context in which it is being used. If a person is uncomfortable with the negative feelings associated with a particular word, he may hold them back, blocking on the word to insulate himself from having to experience the associated feelings. As we speak, the mind operates like forward-looking radar. It searches ahead for threatening words and situations, processes this information in milliseconds on a word-by-word basis, and takes "corrective" action in the form of a speech block. On a pre-conscious level, the speech block is perceived as necessary to protect the individual from harm whether it be emotional, physical, or social level.[8][9]

Certain situations may always seem to be biased one way or the other. For example, to understand why someone may regularly have difficulty saying his name, we must look at his perceptions, beliefs, emotions and intentions as they relate to his name. One effective way to block feelings is to block the primary vehicle through which emotion is expressed, and that is speech. Holding one's breath and/or tightening speech-related muscles is an efficient way to bring about a speech block. The more points you change around the Hexagon, the greater chance you have to build a positive, self-sustaining system that leads to greater expressiveness and fluency. Making positive life changes will affect one's life Hexagon in a positive way. These changes will often be reflected in easier, more expressive speech. This means that each element of the Hexagon is influenced, either positively or negatively by what is happening at the other locations on the Stuttering Hexagon. In other words your emotions will influence your behaviors, perceptions, beliefs, unconscious programs and physiological responses. The Stuttering Hexagon is a useful concept because it resolves the question of whether a speech block is emotional or physical or genetic or environmental. As you can see by this paradigm, the blocking behavior is not an either/or issue, but rather, a system that involves the constant interaction of all these factors. Each point can exert either a negative or positive force on the other points. Thus, in a system where most of the points are negatively biased, there is little likelihood that gains in fluency or ease of self-expression will be lasting, while if the person has made gains all around the Hexagon, then it will be supportive of greater fluency. Unfortunately, many therapy programs adopt a strategy in which the focus is almost entirely on changing the person's speech and not much else. It is precisely because of the self-perpetuating nature of the system that it is so difficult to bring about permanent change at only one point. What usually happens is that after therapy most people who stutter slide back. This is because many therapy programs simply adopt a strategy of control in which only speech issues are addressed. Nothing is done to transform the system that supports the dysfluent speech. A strategy of disappearance, on the other hand, calls for breaking down the stuttering system into its separate components and making changes concurrently at other points around the Stuttering Hexagon, specifically addressing the individual's emotions, perceptions, beliefs and programming. Pursuing this global strategy can lead to a self-maintaining fluency system because not only are the speech blocks addressed but also those contributing factors which lead the person to block. It can also lead to a different perception of what stuttering is all about.[10][11]

OriginEdit

In preparing a presentation for the National Stuttering Association’s first annual conference, held in San Francisco in 1984, John Harrison came up with a new model, or paradigm, for stuttering that was inclusive enough to answer all his own questions. He called this model the Stuttering Hexagon. His book (REDEFINING STUTTERING, What the Struggle to Speak is REALLY All About), a distillation of Harrison’s discoveries, is not only a classic in its field, but is a highly popular “read” in the stuttering community. Harrison is a recovered stutterer who lived with the problem for roughly 30 years. He's also a lifetime member of the National Stuttering Association in America and one of the first people to join the organisation. He was Editor of National Stuttering Association’s monthly newsletter “Letting Go” for 9 years. Through participation in a variety of personal growth programs throughout the 60s, Harrison discovered that stuttering was not what he thought it was. It was not just a speech problem, but a problem that involved many different sides of himself. The deeper he delved into himself during those years of exploration, the more he was struck by how his various problems were not only interrelated, but dynamically present in his speech each time he blocked. It was as if each speech block, like a corner of a hologram, contained a complete view of his total self. It was during this period of self-discovery that his stuttering "disappeared"; not the behaviors, of course, which took longer to tail off, but his perception of what was really going on. Then in 1977 John joined the National Stuttering Association, and for over three decades he became involved in every aspect of NSA activities. He ran chapter meetings. He helped develop programs. He ran workshops for the NSA in cities all over the U.S. as well as in Australia, Ireland, England, Denmark, Sweden, and Norway. He served as Associate Director and also served on the board for almost two decades. He also talked with people who recovered. All this gave him an unusually good vantage point from which to explore the stuttering phenomenon.[12]

ApplicationEdit

Does the Stuttering Hexagon apply to all forms of stuttering dysfluencies? We need to define the dysfluencies to which the Stuttering Hexagon applies. Harrison observed that the easy dysfluencies that many people experience in emotional situations are manifestly different from the struggled behavior characteristic of a full-fledged stuttering block. The Stuttering Hexagon applies to dysfluencies such as blocking and stalling but in a letter to the editor in the "Journal of Fluency Disorders", Harrison stressed that the word "stuttering" promotes confusion by being too vague and unspecific, observing that the easy dysfluencies that many people experience in emotional situations are manifestly different from the struggled behavior characteristic of a full-fledged stuttering block. One is a reflex triggered by emotions and probably influenced by genetic factors. The other is a learned strategy, a set of behaviors designed to break through or wait out a speech block. They are, in short, not simply points on a continuum but entirely different phenomena. By using a common name, we imply relationships and similarities that may not in fact exist, and it only creates endless confusion to call them by the same name-- 'stuttering'--even if we distinguish one as 'primary' and the other as 'secondary.' Harrison differentiates each of five different behaviors by assigning each its own separate and unique terminology. Those to which the Stuttering Hexagon apply are the two main forms of stuttering: Blocking and Stalling: First, Blocking is the struggled, choked speech block that comes about when someone obstructs his air flow and constricts his muscles because the person is blocking something from his awareness (such uncomfortable emotions or self-perceptions) or blocking something from happening that may have negative repercussions. This is the chronic dysfluency that most people think of when they speak of "stuttering" behavior that extends into adulthood and is understood by Harrison to be a strategy designed to protect the speaker from unpleasant consequences. Secondly, the Stuttering Hexagon applies to what Harrison refers to as “Stalling”, a dysfluency related to blocking that occurs when the person continues to repeat a word or syllable because he has a fear of blocking on the following word or syllable. Since he is just buying time until he feels ready to say the feared word, we'll call this kind of dysfluency: stalling. The other 3 types of dysfluency (to which the Hexagon does not specifically apply) are Pathological Dysfluencies (dysfluencies related to primary pathology such as cerebral insult or intellectual deficit) as well as Developmental Dysfluencies (surfacing, then disappearing as the child matures). The third dysfluency to which the Stuttering Hexagon does not apply (and for which there was no unique distinctive terminology at the time) was described by Harrison as “Bobulating” a word Harrison coined in order to specifically describe the temporary upset in which the speakers’ words are discombobulated.[13]

AnalogyEdit

The Stuttering Hexagon can be seen as a constellation of problems in a dynamic relationship, comparable to a Lego car. If you go into Toys R Us and look for this car, you will not find this car. What you will find is a box of parts. It’s up to you to put the parts together in the right way to create the car. That is also true with the nature of speech. It’s not just any one element by itself that creates the blocking behaviour. It’s how these elements go together. It’s about how they relate to one another. This is why researchers looking for the cause of stuttering haven’t been able to find the answer. There’s nothing exotic about the parts of the system. What’s exotic is in how the parts come together. Focusing on chronic stuttering (which, unfortunately, many therapy programs do) only serves to entrench it within the individual’s psyche, whereas disassembling it into a six-sided system not only destroys its form but automatically gives you six issues to address instead of one.[14][15][16]

EXAMPLE: Harrison constructed a graph to show how the Stuttering Hexagon worked in his own life:

John, age 15 John, age 35
Beliefs
  • I have no worth (low self-esteem)
  • I must be nice at all costs.
  • What I have to say is unimportant.
  • I have to please everybody.
  • People are focused on me.
  • The world wants me to be good.
  • Expressing feelings is bad.
  • The world has to meet my mother’s standard.
  • My needs always come second.
Beliefs
  • I am worthy (good self-esteem)
  • I must be genuinely me.
  • What I have to say is important.
  • I have to please myself.
  • People are focused on themselves.
  • The world wants me to be me.
  • Expressing feelings is desirable.
  • The world is perfect the way it is.
  • I can decide when my needs have priority.
Perceptions
  • People are judging me.
  • I’m not measuring up.
  • I’m being aggressive.
  • The other person is speaking the “truth.”
Perceptions
  • I’m the one who’s judging me.
  • I’m doing the best I can.
  • I’m being assertive.
  • The other person may be speaking the truth (and maybe not.)
Intentions
  • My intentions to speak and not speak are fighting each other.
Intentions
  • My intentions are in alignment. I’m clear when I want to speak, and it’s okay to speak.
Physiological responses
  • I am sensitive and quick to react.
Physiological responses
  • I am sensitive and quick to react.
Physical behaviours
  • I tighten my lips and vocal chords and hold my breath when I’m worried about speaking.
Physical behaviours
  • I keep everything lose and supple.
Emotions
  • I hold back.
Emotions
  • I let go.
[17]

Other Relevant material on the Stuttering HexagonEdit

  • Harrison, John C., Overcoming Performance Fears
  • Harrison, John C., Anatomy of a Block
  • Harrison, John C., Understanding the Block

See also Edit

ReferencesEdit

  1. "Keynote presentation by John C. Harrison delivered at the 2004 World Congress for People Who Stutter, held in Freemantle, Western Australia on February 15 – 20, 2004.". http://www.mnsu.edu/comdis/kuster/Infostuttering/Harrison/harrisonperth2005.htm. Retrieved 25 July 2014. 
  2. Harrison, John C.. "DEVELOPING A NEW PARADIGM FOR STUTTERING". The National Stuttering Association. https://www.mnsu.edu/comdis/kuster/Infostuttering/Harrison/hexagonarticle.html. Retrieved 3 July 2014. 
  3. "From Stuttering to Stability: A Case Study". http://www.neurosemantics.com/meta-states/from-stuttering-to-stability-a-case-study. Retrieved 3 July 2014. 
  4. "6th World Conference of People who Stutter, Ghent Belgium, Stefan Bagdanov speech on stuttering hexagon.". http://www.mnsu.edu/comdis/isad4/papers/bogdanov.html. Retrieved 22 July 2014. 
  5. HARRISON, JOHN C.. "National Stuttering Association, John C. Harrison, REDEFINING STUTTERING, 2011 Edition, Words that Work, San Francisco.". http://www.mnsu.edu/comdis/kuster/Infostuttering/Harrison/redefining-stuttering.pdf. Retrieved 3 July 2014. 
  6. "ISAD, International Stuttering Awareness Day, presentation by Alan Badmington". http://www.mnsu.edu/comdis/isad8/papers/badmington8.html. Retrieved 22 July 2014. 
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  10. Margolina, Anna. "The Science of Fluency". http://www.masteringstuttering.com/articles/the-science-of-fluency/. Retrieved 3 July 2014. 
  11. "Mastering Blocking and Stuttering Workshop". http://www.masteringstuttering.com/Workshops/Workshop.htm. Retrieved 22 July 2014. 
  12. HARRISON, JOHN C.. "THE HAWTHORNE EFFECT AND IT'S RELATIONSHIP TO STUTTERING". http://www.mnsu.edu/comdis/kuster/Infostuttering/Harrison/hawthorne.html. Retrieved 3 July 2014. 
  13. Template:Cite book
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  15. "International Stuttering Association, Mark Irwin, past Chairman of International Stuttering Association". http://stutteredspeechsyndrome.com/category/updates/. Retrieved 22 July 2014. 
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