The way our brains work is not right or wrong. So the main questions are: Is it actually helpful to stutter without struggle or is that a myth? Is 'stuttering easier' always helpful? What constitutes as controlled fluency?

The way our brains work is not right or wrong. So the main questions are: Is it actually helpful to stutter without struggle or is that a myth? Is 'stuttering easier' always helpful? What constitutes as controlled fluency? In my opinion: My aim here is not to argue but to make room for multiple, historically and currently held perspectives so that people who stutter and professionals can choose from the full spectrum of ideas. To be clear: to my knowledge there is no widely accepted intervention that reliably produces complete “stuttering remission.” In the absence of clear evidence for such an intervention, I agree that a stuttering-affirming approach is both valid and often very helpful - acceptance and growth can absolutely coexist. In clinical practice clients move through a process of acceptance and, alongside that, learn ways to speak with less effort: reduced muscle tension, fewer repetitions, and fewer signs of struggle. Those changes can be fully consistent with an acceptance-based approach and often improve quality of life without making fluency the primary goal. A related problem in the literature is inconsistent terminology. Different authors use terms like “subconscious fluency” and “controlled fluency” in different ways, which creates ambiguity. For clarity, I use “controlled fluency” to refer to strategies that rely on a client’s deliberate need to alter internal or external stimuli (for example, deliberately increasing or decreasing muscle tension - or fear of certain words/situations; or altering any other emotions, thoughts, or feedback evaluated by the brain) in order to execute the speech plan. When clients alter muscle tension to facilitate speech-plan execution, they are engaging an error-avoidance response: they are avoiding stimuli that the nervous system (or BLA-amygdala-basal ganglia loop) evaluates as problematic i.e., "an error to be avoided". That excessive error avoidance response, by its very nature, therefore constitutes controlled fluency. From this perspective, any conditioned need to do something in order to execute the speech plan should be classified as controlled fluency I argue. Surprisingly to many, most of these conditioned “needs” (that lead to excessive error-avoidance) are learned and operate deeply below conscious awareness; but they are not totally unconscious; therefore I recommend identifying and unlearning them when aiming for stuttering remission and subconscious fluency (over controlled fluency). By contrast, I use “subconscious fluency” to describe reduced reliance on those "conditioned" needs to execute the speech plan. Genetic and neurobiological factors underlie stuttering. And, therapy goals vary: clients often prioritize acceptance, desensitization, controlled fluency; whereas only a very few aim for subconscious fluency. Crucially, subconscious fluency does not equal spontaneous speech; after all - when clients use spontaneous speech, deeply subconsciously their brain is still relying on needs to excessively avoid a certain level of stimuli (until a certain threshold is achieved - on a word to word basis or millisecond timeframe) specifically to execute the speech plan. I think it helps when clients understand (1) what is unlikely for us to change (e.g., certain genetic/neurological predispositions), (2) what we can change i.e., we can attempt to extinguish conditioned stimuli where we address the excessive error-avoidance responses that lead us to excessively regulate speech-plan execution (which I consider the CR - conditioned response), and (3) how to tell the difference (between what we can and cannot change). Put simply: I recommend targeting the poorly fine-tuning of the release threshold (that decides when the brain should release -a segment of - the speech plan for execution); rather than simply attempting to speak without anticipatory fear. This distinction is extremely relevant! If a client wishes to pursue subconscious fluency (over controlled fluency), my recommendation is to address the conditioning that underpins excessive error-avoidance and the resultant over-regulation of speech-plan execution. The attached image (right side) lists the specific factors I suggest targeting. See the image (that I created). The image also explains that an error-avoidance mechanism is not good or bad; it's simply something we are born with (UR - unconditioned response). Which responds to a fear of social rejection (US - unconditioned stimulus). So. We do not want to eliminate this fear of rejection or error-avoidance response; it's healthy and adaptive. An approach-avoidance conflict by itself is not right or wrong. We simply want to fine-tune the execution threshold so that it works in our favor: so that we speak when it is adaptive to speak, and we don't speak when it is not adaptive to speak. https://preview.redd.it/weiexczazxuf1.jpg?width=1415&format=pjpg&auto=webp&s=1ac27e49a35fadd6c097c70f8fa4e7001db5ad15 Future research: (1) Future research should investigate non-conscious (unseen/subliminal) fear-processing or amygdala-activation when PWS stutter. (2) Future research should investigate these deeply subconscious 'needs' - that **PWS (people who stutter)** rely on - to execute a segment of the speech plan (3) Future research should analyze how these conditioned NEEDS to execute the speech plan - hinder spontaneous extinction (of the conditioned response) \~\~ Your thoughts?