Stuttering Treatments in Europe: A Case Study of Henry Freund

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Stuttering Treatments in Europe: A Case Study of Henry Freund Dr. Sharon DiFino Assistant Professor of Speech and Language Pathology Jacksonville University sdifino@ju.edu Clinical Fellow Therapist Brooks Outpatient Rehabilitation Jacksonville

Dr. Henry Freund (1896-1982) Born 1896 in Germany to a Jewish family Highly educated: Medical (neurology) & Speech Pathology degrees Practice in psychology Published Scholar in Medical, Psychology and Speech Pathology Journals Presented with severe stuttering & underwent speech tx with the major therapists in Europe Emigrated to the US during WW II

What Is Stuttering? Stuttering is usually characterized by: Sound, syllable, or monosyllable word repetitions (e.g., [D-d-]do [you]you see?) Sound prolongations/blocks (e.g., [yyy]yes [www]we see?) Such disfluencies may: Be produced relatively often (i.e., > 3 per 100 syllables) Together, constitute over 50% of a child s disfluencies. Cluster together (e.g., [We]we [ha-]have to go.) Feature multiple iterations (e.g, [h-h-h-] he]) Be relatively lengthy (e.g., [G-g-g-]go [hhh]home) Sound irregular or rapid in tempo 4

What is stuttering? Speaker may demonstrate... maladaptive attempts to cope with fluency disruptions (Can you think of examples from your life experiences?) word, situational avoidance covering mouth with hands atypical physical tension, struggle, or bodily movements Negative feelings about self because of fluency skills. frustration, fear, anxiety, embarrassment, shame, self-esteem? Roughly 2% of the population, males more prone 4:1 and highly genetic 5

Profile of Dr. Freund s Stuttering History of Stuttering in the family (father, paternal uncle, & brother) Onset of Freund s stuttering: age 5 Underwent tx: throughout his life (young childhood, puberty, and adulthood) Patient of major therapists in Europe first three decades in the 20 th century

Leading Authorities in Stuttering Treatment in Central Europe Gutzmann family (Albert, Herman & Herman Gutzmann, Jr) Dr. Hugo Stern, famous Viennese phoneticist Emil Froeschels, Clinician at Vienna School of Logopedics Hoepfner Stuttering as Associative Aphasia

Gutzmann Approach to Treatment Stuttering viewed as coordination neurosis: organic Treatment targeted: Achieving normal coordination between respiration, vocalization & articulation Set of specific exercises: required pt to correctly & consciously-> utter sounds, then syllables & sentences; done on voluntary exhalation, vowels prolonged Stuttering was forbidden & harshly punished!

Dr.Hugo Stern s Approach Stern, a phoneticist and student of Gutzmann, focused on making Freund aware of difficult speech sounds Stern s therapy & harsh treatment of Freund resulted in total failure Freund s stuttering even more severe

Brief Return to Gutzmann Freund returns briefly to Gutzmann s prolongation approach at age 8 Applied to singing, which Freund enjoyed Resulted in remarkable improvement but only short lived

Emil Froeschels Clinical Treatment in Vienna Freund sought tx from Froeschels as a medical student & later as a doctor Stuttering viewed as more psychological Froeschels called stuttering a neurosis & believed it was caused by a logical error Emotional factors were consequences of stuttering not sources

Emil Froeschels Clinical Treatment in Vienna (Cont.) BUT Froeschels tx required knowledge & use of the phonetic alphabet (IPA) ʤ ɚ [kæt] Writing accompanying speaking the sounds proved unsuccessful for Freund Speaking is automatic! Therapy did not work for Freund

Hoepfner Stuttering as Associative Aphasia Misleading approach=> it did not refer to the organic syndrome (known as aphasia) but rather to momentary loss of auditory & kinesthetic imagery Freund described Hoepfner as serious, harsh, dictatorial, & explosive Hoepfner suffered TBI during WW I

Hoepfner (cont.) Expressed no interest in doing any individual psychotherapy, wouldn t accompany Freund in the streets to address people as part of tx Insisted that Freund go solo & accomplish these encounters on his own Hoepfner awakened a fighting spirit in Freund

Adolf Hitler s Political Influence on Hoepfner Hoepfner disdained the weak, sensitive & fearful Regarded Freund as embodying those traits due to his racial background Seven years later Freund decided to attempt self treatment Accompanied by his brother for moral support, Freund addressed strangers in the streets of Berlin

Fear of Stuttering Achieved Gained confidence with each attempt and failure approaching strangers Eventually overcame fear/stuttering 1931-1932 Freund devoted his time to studying all stuttering publications in Europe and noticed there was a gap in psychological theories of stuttering

Freund s Research & Private Practice Freund s productive time 1931-1932: published a series of articles on psychology of stuttering Left Berlin at went to Vienna to Froeschels clinic to study Speech Pathology Zagreb in 1933 private practice in ST From 1933 to 1938 did not stutter overtly

Broadening Fields of Specialization 1937-1940 Freund branched out into neurology and psychiatry When Hitler came to power: Freund forced to leave Europe, came to US Emotional stress and necessity to learn a new language caused Freund to relapse Relapse resulted in retreat from society

Freund s New Life Moved to Milwaukee & became chief of the VA Mental Hygiene Clinic Joined American Speech & Hearing Association Later became acquainted with colleagues specializing in stuttering

Other Notable Achievements 1971 published a collection of poetry about his stuttering experience O Meine Seele by the Europaeischer Verlag in Wien Became a close friend/mentor of Dr. Charles van Riper, a Father of Speech Pathology in America Inspired Van Riper s students to study stuttering in the aging (Freund developed Parkinson s in his later years after retirement)

Van Riper about Freund Here was a man who truly understood the psychology of stuttering as no other author I d ever read had known it. (...) Many people have been my teachers, colleagues, and clients alike, but of all of them, Henry Freund had the most impact in shaping my thinking. (Charles van Riper, 1984)