More on Mind/Body Connection

Disfluency is a combination of brain disfunction and mind involvement. The usual standard for judging stuttering severity is the number of disfluencies experienced over a given tIme period when reading, for example, a given amount of text. But the severity of stuttering gives no indication of the extent of brain involvement in the episode given that the mind and the context also come into play. In the ideal, we would like to rank the brain involvement on a scale from 1 to 10, where 1 is the least severe and 10 is the most severe. Similarly, the mind involvement can also be ranked on a 1 to 10 scale. So the most severe episode of stuttering would have a score of 20, while the least severe would be scored a 2. An individual may have intense brain involvement with a score of 10, yet not be very reactive and have a mind involvement score of 1, for a total of 11. Another person may have a mild brain involvement with a score of 1, yet be very reactive with a mind involvement score of 10, again for a total of 11. In both cases, the severity of stuttering may be the same, but the underlying causes would be different. And each of these cases may respond differently to treatment. For example, the person with greater mind involvement might respond better to psychologically based therapies while those with substantial brain involvement would show better improvement with drug therapies.

Unfortunately, it would be very difficult to disentangle the brain involvement from the mind involvement on a priori grounds. A clinician might be able to infer the relative amounts of involvement only after observing treatment results.