Stuttering And Anxiety

Written by: Roselyn Mathew / Fluency & Stuttering / June 07, 2023 / 8 minutes read

Stuttering can be defined as “a disruption in the fluency of verbal expression characterized by involuntary, audible or silent, repetitions or prolongations of sounds or syllables. These are not readily controllable and may be accompanied by other movements and by emotions of negative nature such as fear, embarrassment, or irritation.” (Wingate 1964). 

According to the American Psychological Association” Anxiety is an emotion characterized by feelings of tension, worried thoughts, and physical changes like increased blood pressure. People with anxiety disorders usually have recurring intrusive thoughts or concerns. They may avoid certain situations out of worry. They may also have physical symptoms such as sweating, trembling, dizziness, or a rapid heartbeat.”

Relationship between anxiety and stuttering

It has been observed that most people with stuttering seem to be anxious about their speech. They generally try to avoid speaking or speaking situations as such. This anxiety is mostly due to the fear of stuttering in front of someone and the fear of being judged by that person. The more the listener is a stranger the more the speaker gets anxious. Certain people with stuttering also feel anxious even if the listener is well known to them which could be due to previous instances where they got corrected or got a criticism for their speech by the listener or from someone in a similar position or situation. 

Disfluencies increase or tend to increase when a person is anxious. Along with other physical symptoms of anxiety, the speaker may stumble in their words or might prolong or repeat speech sounds, repeat words or even phrases. 

The speech of a person with stuttering gets much more affected when they are anxious. They might prolong or repeat sounds multiple times with long pauses. There can also be excessive tension on their tongue, lips, jaw or other areas in their face and throat which can cause speech to get excessively disrupted or ‘locked’. They might also display certain actions or speech known as secondary behaviours like repeating a sound or a word many times, jerking or tapping hands or feet, having a tremor on their jaws, lips, tongue, hands or feet, blinking or closing eyes, clenching teeth or jaw, head shaking etc. There might be a single or a few secondary behaviours during an episode of stuttering. These can happen during a stuttering episode or might also happen whenever the speaker is speaking with anxiety or tension. 

Persons with stuttering are quite often caught in a vicious cycle, the stuttering and secondary behaviours cause anxiety of being judged and criticized by listeners and this anxiety in turn leads to an increase in stuttering, tension and other secondary behaviours. There should be a break in this cycle to reduce stuttering and have a confident speech. 

Disfluencies increase or tend to increase when a person is anxious. Along with other physical symptoms of anxiety, the speaker may stumble in their words or might prolong or repeat speech sounds, repeat words or even phrases. 

How does anxiety result in speech disruption for people who do not stutter?

We have understood the relation between stuttering and anxiety in people who stutter. As mentioned before, people who do not stutter can also have speech disruptions or disfluencies due to anxiety. Extreme anxiety can result in a speech that is very similar to stuttering. Along with a major speech disruption, the person might also experience other things like excessive sweating, fast rate of heartbeat, excessive tension of muscles in face or body, feeling of nausea, shortness of breath, shaking or trembling of hands, dry mouth etc. These might be high or low depending on each person and on the level of anxiety that they are experiencing. 

Speech disruption and stuttering like behaviour can occur without stuttering due to one or a combination of the following reasons:

• When a person is anxious, they find it extremely difficult to think clearly. Their train of thoughts get disrupted. The ability to think about a topic, get clear ideas, think of points and form sentences would all get affected when a person has stress or anxiety. Due to this difficulty to form sentences in a timely manner, speech gets disrupted and the person might stumble or might repeat sounds, words or phrases to get more time to think. Due to anxiety, the person feels uncomfortable to be silent and think as they find silence to increase anxiety because of others watching them. 

• When someone is anxious, they tend to speak with a much faster speaking rate. In order to form sentences, a person should initially get an idea regarding what they need to speak. After that they need to focus on how to convey these ideas by focusing on the word choice and the sentence length. When a person has an average speaking rate, the brain is able to think of these and send signals to the muscles involved in speech regarding the sound and word enunciation and due to this, speaking would be smooth and fluent. But if a person has a fast rate of speech, the words are uttered at a faster pace and the brain does not get enough time to perform thought processing, sentence formation and send signals for proper execution. This causes a person to stumble in their speech, use filler sounds and words and repeat sounds, words or phrases.

• As mentioned previously, a person with anxiety tends to have increased muscle tension. This muscle tension might on the body or face or both. If a muscle gets excessively tensed, the movement of the muscle gets restricted or might stop moving till the muscle gets relaxed. So, if a person is anxious and if the muscles of their tongue, lips or jaw get tensed, they wouldn’t be able to move them freely and as a result might have frequent pauses and repetitions.

How to reduce speech disruptions and stuttering and improve fluency?

For a person with stuttering, it is important to undergo fluency therapy to reduce stuttering and other secondary behaviours. For a person with anxiety without stuttering, a speech therapy focusing on relaxation, confident speech and positive thinking would be beneficial.

Conclusion

A speech with disruptions and/ or stuttering can be highly correlated to anxiety. It is important to reduce anxiety to ensure a fluent and confident speech.

To speak with one of the speech-language pathologists at Well Said: Toronto Speech Therapy, schedule an initial consultation by clicking the link below or calling (647) 795-5277.