Illuminating Stuttering: Attention’s Role – Treatment Implications

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Written by Matthew O’Malley


Synopsis: The conscious mind and the unconscious mind are not separate entities but work in unison.  The unconscious mind directs most conscious activity.  While some control over the human attention is under the direction of the conscious will, it is often unconscious processes that control and direct the attention.  As humans are an evolved animal whose valued goals are survival and procreation, the attention is a product of this evolution and is utilized with these goals in mind.  Unconscious processes direct the attention to what is deemed most important in the current environment to maximize information gathering in regards to it.  What is most important is often a threat of some sort to its goals (survival/procreation).  In a person who stutters, the looming threat in speaking situations is stuttering and social rejection.  As a result, unconscious processes hyper-focus the attention on speech and stuttering to “monitor the threat.”  This interferes with the development of the automaticity of speech.  Automaticity simply refers to movement skills that have been mastered to the point that conscious attention and manipulation are no longer required.  An example of an “automated skill” is riding a bike.  Another example is speaking in a fluent speaker.  One of the final stages in a skill becoming automated is the removal of the conscious attention from it.  However, due to consistent penalties based on social speech acts in the person who stutters, the attention continues to hyper-monitor speech in these situations as there is a threat based on its performance.  This hinders the person-who-stutter’s speaking skill from becoming fully automated.  This placement of the attention on speech, as stated, is mostly controlled by unconscious processes outside of the realm of the human will.  However, while the unconscious mind has significant power over the conscious mind, the conscious mind can also impact the unconscious mind.  This is where there is hope for effective stuttering intervention.  The unconscious mind assumes that if something is not being consciously monitored by the attention, that it is not a threat.  If it were a threat the attention would be on it, is its assumption.  So, when a person who stutters begins placing their attention completely off of speech and stuttering, the unconscious mind interprets this to mean that speaking is safe and therefore allows automation (fluency).  Blocks and stutters are based in an unconscious “belief” that speech acts will result in punishing outcomes.  However, when the conscious attention is removed from monitoring speech, the unconscious mind interprets this to mean that speaking is not a threat and therefore allows automation, block free.  Based on this, a significant part of stuttering intervention should be attention training off of speech.  This is a brief synopsis and is explained in more detail below.

Full Version

When a person who stutters enters a speaking situation, their attention often goes directly to speech.  There is a possibility of stuttering and the attention hyper-focuses on this to monitor whether stuttering happens or speech flows.


Sidenote: Human life and existence are deep subjects.  I personally see deep purpose in the human journey and am not devaluing this purpose (or lack thereof for those who have different beliefs) by discussing human beings from an evolutionary vantage point below.

So, why does the attention focus so strongly on speech?

To answer this question we need to look at the human organism in its totality.  A human being is the result of billions of years of evolution. The valued goals of every species including humans are survival and procreation.  The human organism has evolved to value these things at its deepest levels.

As a highly evolved being, the human has both an unconscious mind and a conscious mind.  To give a brief definition of each, the unconscious mind is composed of all operations of the human outside of one’s conscious awareness and/or one’s conscious control.  The conscious mind is both what we consciously experience as well as what we consciously control.

The Unconscious Mind Largely Controls the Conscious Mind

Many often separate the conscious mind from the unconscious mind.  However, they mostly work in unison and as a team.  For the most part, unconscious processes largely direct even the conscious mind.  As conscious beings, we passively experience much of our conscious reality as opposed to direct it with our will. We are far more observing passengers of our experiences than we think; as opposed to conscious operators.

As stated above, we are a species that has evolved over billions of years to survive.  Self-preservation/staying-alive is what the entirety of our organism has been designed to do.

The attention has resulted from evolution and is not an exception to the above rule.  Its purpose lies in survival. One of the attention’s key roles is to aid in the human organism’s gathering of information to increase its chances of survival.  The attention will often be forced to focus on what has been deemed the most important factor in one’s environment for one’s survival. It becomes focused on this factor to allow for maximum information gathering about it.  The sensory organs will often be more directed to it (the eyes will look at it etc.) and one’s conscious focus is also on it.

In demonstrating this in a non-stuttering related way, let’s look at a situation in the wild.  A human is trudging the forest when in the distance this human detects a mountain lion in full sprint towards him/her.  This human’s attention will immediately become focused on this threat to allow it to gather as much information as possible and formulate the best strategy for survival.  This is not an act of the will. Whether this human wants to focus on this mountain lion or not, the attention is going to focus on it. This is evidence that often unconscious processes outside of the human’s conscious control is what is directing the conscious attention.

In demonstrating this relative to stuttering, let’s look at how the attention operates in a person who stutters.  For people who stutter, when they enter into a speaking situation, the attention is almost always hyper-focused on speech.  Is this something that was consciously directed by one’s will? No, it isn’t. This is demonstrated by the fact that the person who stutters finds it nearly impossible to take the focus off of speech in a speaking situation.

Sidenote: I have asserted in previous posts that attention is one of three elements we have “some” control over.  However, in that post I acknowledged this control is limited.

So, in the above example, the person who stutters is nearly powerless over the fact that their attention goes onto their speech.  This demonstrates that it is not the conscious mind nor the conscious will that is directing where the attention goes. It is unconscious processes that have controlled the attention.  The unconscious mind (processes outside of our control) has placed the conscious attention where it deems it should be and it deems the attention should be on speech.

Automatic Abilities & Speech

I have written extensively on automaticity.  Automaticity simply means that we are able to do something without much conscious focus or effort.  Riding a bike is an example. When you ride a bike, you just hop on it and start riding. You don’t think about contracting each leg muscle and coordinating the movements.  You “just do it”. That is an automatic ability.

Well, speaking is also an automatic ability for a fluent speaker.  They simply say what they want to say without focus or attention on the speech mechanism.  They “just talk” like anyone “just rides a bike”. The attention and conscious control have been removed from the processes required to perform these automatic abilities.  The person “just knows” how to do it and “just does it”.

When we are first learning any of these skills, there is direct focus and conscious manipulation of our bodies.  However, after we have performed these movements enough times without penalty, our “muscle memory” kicks in and the conscious mind and attention are no longer needed.  The unconscious mind knows how to perform these processes and trusts they will be performed without penalty. As a result the unconscious begins to direct the attention elsewhere.

In people who stutter however, because there have been numerous experiences where the speech process has broken down and there was significant penalty for it (social rejection), the unconscious continues to direct the attention to speech in all speaking situations.  Because there have been penalties (social punishments) for speech acts, the unconscious mind never removes the attention from this process as it continues to correctly believe its performance is a threat and must be monitored.

As the human is an evolved social animal, social acceptance is perceived as a survival need.  Speech breaking down in front of another person and receiving a disapproving reaction as a result is perceived as a significant threat.  This explains why people often fear public speaking as much as death. I have written extensively on this here.

In continuing, as a result of these continuous penalties for speech acts (social rejection) and breakdowns in speech performance, speaking in the person who stutters never moves up the hierarchy of automatic abilities and the attention remains hyper focused on it.

Despite this, each person who stutters has the ability to speak automatically.  It is impossible to say any two word utterance at an adult level of speech through direct conscious control.  If a person who stutters has ever strung together two words, then their ability to automate speech can function properly.

Speaking is a very complex and muscularly coordinated act.  To string two words together at an adult speaking level (sounding like an adult) requires automation.  There is far too much coordinated muscular contraction involved for the conscious mind to do it. Therefore, people who stutter’s ability to automate skills (including speech) is intact and has the ability to function.

The Unconsious Mind Is Affected By What The Conscious Mind is Doing

To demonstrate the above section’s title, let’s look at an example.  If a person is in the comfort of their own home, a way to demonstrate this is by consciously focusing on some different things.  If I focus for a few minutes on a bright future and/or a happy past memory, my mood likely lightens. If I spend this same time worrying about a potential future problem or ruminating over a past sad memory, my mood likely gets worse.

In neither of those scenarios did the person directly affect their mood.  They did not consciously change their mood. They consciously focused on two different things and this produced different outcomes in mood.

This is an example of how what the conscious mind is doing (focusing on something positive or negative) can affect the unconscious mind (produced different mood states depending on where the focus was).

Well the above was just an example to demonstrate the point that what the conscious mind is doing can affect unconscious processes.

There is a more important example that directly applies to stuttering.

I discussed some around the subject of automatic ability.  When a skill has been mastered at a high level, the attention no longer monitors it.  This is due to the fact that “muscle memory” has kicked in and any penalty for performing this automated ability is few and far between.

However, if as a movement skill is being mastered (walking, talking, riding a bike) there are continuous penalties (social rejection, etc.) that are consistently delivered upon the performance of this skill, the attention will continue to monitor this skill.  This skill will not “graduate” to one of the final stages of automaticity where the attention no longer focuses on it.  The attention will continue to monitor this skill as its performance is deemed a threat based on repeated and continuous past experiences that resulted in negative outcomes.

However, the unconscious can be “tricked”.  It can be “tricked” into thinking the performance of a skill it usually deems a threat is not one.

If the attention is placed completely off of speech in a person who stutters, the unconscious interprets this to mean that there is no threat in performing the automatic ability of speaking and therefore automates it without interruption (blocks).

To the unconscious mind, a lack of focus on something means it is not a threat.

In applying this directly to stuttering:  If a person who stutters can train themselves to focus on something other than speech and stuttering during the speaking process, the unconscious mind will interpret this lack of focus on speech to mean that there is no threat to performing speech and will therefore allow automation without blocks.

This happens to many who stutter occasionally.  It has happened to me for very brief occasions.  I have had brief moments where I forgot I stuttered for one sentence here and there and therefore did not focus on my speech.  As a result speech flowed (it was automatic).

I would assert that the reason devices like the Speech Easy (a device that looks like a like a hearing aid but replays what a person says in an altered and delayed voice) often work only temporarily is because when the person puts the device in their ear and begins getting auditory feedback, their attention is placed on this auditory feedback and not on the speech itself.  There is new sensory stimulus that grabs the person’s attention.  As a result, the unconscious allows block-free automation of speech as the person is not focusing on speech directly.  However, as this new stimulus (auditory playback from the Speech Easy) becomes normal, the person who stutters goes back to their normal direct focus of attention on speech and the device “stops working”.

The unconscious mind assumes that if something is not being focused on it is not a threat.  When a person who stutters is hyper-focused on their speech, which they usually are, the unconscious treats the performance of speaking as a threat and does not allow automation (fluent speech flow) of it.

However, if the person who stutters focuses on something other than speech and stuttering itself, the unconscious will interpret this to mean that speaking is not a threat and therefore can be automated (fluent speech flow).  As a result, it is automated (fluent).

A significant portion of stuttering treatment with the goal of increasing fluency should be attention training off of speech itself.  Consistent exercise and training can begin to empower the person who stutters to have more control over their attention which will better enable them to focus it off of speech.

12 thoughts on “Illuminating Stuttering: Attention’s Role – Treatment Implications

  1. Is it possible, Matthew, that the Unconscious and Conscious have different values. It is the goal of my Unconscious to make sense of the universe, or so it seems to me. Understanding in a deeper broader way seems to be my general goal. But it is the value of my consciousness to survive. If my consciousness insists on its value of survival, it often outshouts the quiet values of awareness, understanding and insight. For me, the sense and reason of consciousness is so vastly inferior to the brilliant technology we call the Unconscious that I can hardly use the two words in the same sentence. To be conscious and to be aware is like the diff between knowledge and wisdom. And as all good hippies “whatever happened to wisdom when we were getting all that knowledge?”

    Sent from my iPhone


    Liked by 1 person

    1. Hi there. Sure its possible. However, the unconscious has also been shaped by its evolutionary animal past. I believe in a soul and spirit that is virtuous, however, much of the unconscious mind is very limited in its beliefs. Much of the unconscious mind is very much “animal”. So putting all things unconscious on a pedestal as virtuous and genius is a mistake. Most limiting beliefs reside in the unconscious. Our animal desires for procreation, status, and survival lie in our unconscious. Romanticizing everything about the unconscious just isn’t accurate.


  2. Thanks Matthew for choosing such a great topic.
    Indeed, In my case the most irritating and subtle thing is my attention on speech especially on my feared words/sounds.
    I’m trying my best to off attention from speech and many times i succeeded but when my feared words/sound appeared then the attention pop up and i blocked, then i took time to get it out from that block or substitute the word.
    what would you suggest me on it??

    Abdul Haseeb

    Liked by 1 person

    1. Hi Abdul,

      Thanks for a great comment.

      Getting the attention off of speech and stuttering is a task. I have an idea to open a 60-90 day stuttering treatment center where one aspect of this intensive and long term treatment center would be to train attention. So, ideally the approach would be a long term and intensive one. However, you can consistently practice meditation in gaining control of the attention. You can focus on things other than speech itself such as a positive thought or the fact that the person you are speaking to is a fellow person who wants to connect. However, as I assert in the post, attention is largely controlled unconsciously so getting the attention off speech would be a long term process.


    1. Richard,

      I meant to reply to this earlier. My apologies. Yes this is an updated version with some minor changes. I would love to see your French translation as always as they are brilliant.

      Keep up your great work.



  3. Excellent article with deep insights. I am still implimenting your treatment guide which does mention this as part of the treatment. Your links of stuttering with various other stutter-like behaviour and your lovely articles on the influence and role of the unconscious mind are the final big pieces in this puzzle. Great work and will always be appreciated. All thats left is implimenting your guide as intensively as possible which is the difficult and frustrating part. But I am noticing very slow improvements. Speaking should be effortless and the idea (not the words) the focus. It is very difficult though trying to change how your mind works when we speak. Old habits die hard. But normal fluency can be achieved. Much thanks Matthew.

    Liked by 1 person

  4. Hi Mathew,
    2 queries please.
    1. what does the current research say as to why the automatic speech pattern in “fluent” vis a vis “PWS” do not behave smilarly which results in stutters in PWS —-why does it err ?
    2. why did stutter core events occurred in the first place —-a direct corollary can be —is the speech automaticity in PWS inherently defective compared to “fluent” person speech automaticity ? if yes , what is the solution to rectify it ?


    Liked by 1 person

    1. Hi Anu,

      Thanks for a great question. It is my understanding that the current literature does not have a clear understanding as to why automaticity in the speech of PWS does not function like fluent speakers in all situations. Many researchers I do not even believe are framing the question in this way. They are not looking at stuttering necessarily as a problem with “automaticity”. SO, much of the research is not even attempting to answer that question.

      I think it is important to note that automatic speech does function properly in most people who stutter in numerous situations. FOr example, many PWS have automatic speech when alone or in other various situations. This is indicative that there is not necessarily something inherently defective with a PWS’s ability to speak automatically. So this points away from a built in defect.

      My most through explanations come in my posts regarding stuttering as a movement disorder which interacts with reward projections. You can check that post out to get the full view. Also, inner speech is an area of interest. I cover that in “Stuttering: A New Theory That Could Shed Light”.

      I also have a treatment guide that can be aimed to help curb some of the effects of stuttering based on my understanding of its nature.

      Liked by 1 person

      1. Dear Matthew,

        How could have I missed that ! Super impressed by your analytical and logical answer.
        Finally I find someone who has the guts to “Think outside the box” !
        Trust me buddy, it really IS wonderful to read in black and white what I have always “felt ” and analysed myself too. I’m a big fan of logical reasoning and sincerely appreciate the same trait thriving in you too. The best “SLP Therapy” which helped/s “overcome” my stutter is what I found through trial an error and sheer gut instincts. Pretty much Im in the same boat as you 🙂 the same age bracket and the same wave length I guess.
        Funny thing is that during my Medical School Training and then Ophthalmic Surgery training I was really thirsty to find some “written ” train of thoughts which resonated with what I and Im sure many other PWS could “feel” ! Your writing was long due 🙂
        I have devoured every single word you have written till date and looking forward to read and hear from you more. Keep up the good work and Godspeed.
        May I humbly let you know , if there is any way I could be of any help in your wonderful endeavor just shoot a mail 🙂

        Warm regards,

        Liked by 1 person

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