BIO

Michael Sugarman has been an activist in the stuttering and disability communities since the 1970s. He was co-founder and former Executive Director of the National Stuttering Project and former chair of the International Stuttering Association. Michael wrote for academic journals and promoted people-first language and stuttering awareness in “It’s Ok to Stutter” (Journal of Fluency Disorders) and the Perniciousness of Labels (Transactional Analysis Journal). As a medical social worker, he recently updated his children’s book, The Adventures of Phil and Dotty. Michael currently co-facilitates a peer support group and is co-writing an article on peer and professional facilitation of support groups, emphasizing mindfulness communication, self-care skills, and resilience.

Listen to this episode on Apple Podcasts, Spotify, Google Podcasts or your favorite podcast platform. You can also watch the interview on YouTube.

EPISODE HIGHLIGHTS

• Michael digs into the integration of mindfulness and meditation into behavioral therapy practice. 

• He takes our viewers on a simple breathing exercise involving the ring of a bell that is used in dialectical behavior therapy. We can release avoidance, relieve stress, and open-up.  

• Michael sheds light on the misconceptions of psychotherapy.

• Michael brings personal experience and professional perspective - sharing ways forward in how we treat stuttering and help people open up to be more present and manifest effective communication.

• Michael invites us to consider new angles in how we treat stuttering and help people.  

• Michael opens windows for us to benefit from behavioral health approaches, including elements of ACT (Acceptance Commitment Therapy), CBT (Cognitive Behavior Therapy), DBT (Dialectical Behavior Therapy), and more.

• Michael expands on the relationship between emotions, communication, and comfortability.

• Michael talks about advocating for mental health, and self-care especially for those who stutter.

• Michael talks about ideas for the future: more awareness in the education system, diversity, and inclusion in the workforce.

• Michael brings up ways the stuttering/mental health community can change and better advocate for those who don’t have a voice.

  
  

RESOURCES LIST

Michael Sugarman: A Self-Help Stuttering Pioneer (Stuttertalk Podcast)

Overview and Brief History of the National Stuttering Association

Exploring Mindfulness Stuttering Language

Upcoming events

MORE QUOTES

“We're asking people more to do the journal writing and mindfulness practices and meditation. Cognitive reframing is basically moving a negative to a positive.” - Michael Sugarman

“We use the term disability or differences in the classroom, so there's more acceptance. And with diversability in the workplace with diversity and inclusion, more people are willing to take that effort.” - Michael Sugarman

TRANSCRIPTION:

Uri Schneider: So we're in for a big treat today. I want to lead in with a story that just happened two hours ago. And, and then the conversation will flow from there. I, I was talking to a young man and in New York city, they've just decided to go back fully virtual. So for a lot of families, that means things are going to be getting.

Challenging again, it was kind of nice in some ways, going back to having kids in school for those that were safe to do so. And, uh, and again, it's another transition. Another challenge to kind of find our way through, uh, for others, another person, I was just talking with the New Jersey. He's going back to school in person for the first time.

And he was talking about what he wants his teacher to do. So he's a young man who stutters and, uh, so his mom was going to write an email to the teacher. And I have, I see the situation all the time. Michael's familiar as well. You know, how do we want to put ourselves out there? How do we want to let people know what's up?

And at the same time, uh, advocate for whatever accommodation or understanding we rightfully deserve. And at the same time, in no way compromise the dignity and the humanity that is deserving because for a lot of people, they can mistaken. Difference as, uh, as less than, and we want to make sure that the language you use and the messages we use.

So this young man and his mom were sitting with me and we were crafting the email that he wished his mother to send the

Michael Sugarman: teacher.

Uri Schneider: And it was so important because had the mom gone ahead and written the email on her own. There may have been some phrases in there that may have left things unspoken. Like my son has an issue.

He stutters,

Michael Sugarman: what does

Uri Schneider: it mean? He has an issue and what does it mean? Stuttering? So, um, we went through three things which are part of this framework that we started developing. And I think it's going to run nice into what Michael's going to speak about, but. At the end of the day, these young man wrote down some bullet points and the three parts of his self-advocacy had to do with number one saying it like it is, you know, calling it by its name.

Sometimes I stutter. The second part is letting them know what to expect, what, what behaviors might come up. So you might notice that I repeat some sounds or you might see that I have a little, I know what I want to say, but there's a little delay there. Um, and then the third part is letting other people know what you want them to do.

And it was so interesting as always so surprising because some people don't want to have the responsibility to present in front of class or, or read aloud or present in teleconference calls. Other people are itching for the opportunity like this young man. It just want to a few extra seconds of response time and to have some allies.

And so what I was impressing upon them, and I want to share with everybody who may be going through these different shifts. In terms of school placements or jobs and distance and remote the importance to find your happy place, to think about what you really, how you can go ahead and go for the things that you want to go for while at the same time, acknowledging what is.

And calling it by whatever name works for you, and then letting the people in your life know how you want them to deal with it because the more it's, uh, revealed and less than an elephant, uh, the more we have a chance to connect and transcend and, and really be everything we want to be. And the more we leave it unspoken and we don't name it, it can become very scary with that introduction of practical, flexible advice.

I just want to say I got off the phone with my dad this morning. And I said, how exactly do you introduce Michael Sugarman for those that don't know, I will not even attempt, but I will say this much, Michael is a champion. He's been a champion and an ad activist, uh, always speaking up, uh, for his principles.

Um, and being there not only to advocate for himself as a person who stutters. But really being a leader in the global movement to create more understanding and more, uh, access, inclusion, and openness about stuttering for the community, people who start around the world. And he has been a champion for people who are marginalized in many different ways, and he has a career.

As a professional in mental health, he's had the privilege to work with some of the greatest pioneers in that space. And so he's going to bring a lot of wisdom from his personal story, from his, um, volunteer activism in the community of people who stutter and all kinds of efforts, both in his professional and personal intersections.

Uh, so it's with great honor to really. Bring this conversation and have Michael join us. And I'll let you introduce yourself, Mike, and thank you so much for taking the time.

Michael Sugarman: Thank you very much and very grateful to be here and share this. So what I'm going to be focusing on is, um, how in behavioral health, we integrate mindfulness and meditation into our therapy practice.

And then, uh, there's two folds things. Um, in behavioral health, we use act, uh, mindfully it's called, we use mindful based cognitive therapy as well as behavior therapy. Now we do both of those. We do group. In DBT in individual, then I'll do a mindful based cognitive therapy. So let's go with, uh, an exercise that I know is on a lot of people's minds is avoidance, but I will use the term that we use in dialectical behavior therapy.

So sit back. Take some breaths and I'm going to ring a bell. This is a common practice within dialectical behavior therapy. What we do in our groups, we began a group session with a mindful meditation and a focus. So we're going to ring the bell. I want you to just sit and breathe in through your nose and out through your.

Through your notes and help you remember

where you then,

and now on your left shoulder, there is somebody who loves you could be from. Your past or past teacher, your present, your father, mother grandparent, somebody that you feel love. Why

now on the other shoulder, there is, could be the same person, but who you feel comfortable in talking with sharing your experience? Talking about personal items

we're going to be focusing on now is avoidance. You have a chance to talk to the person that you feel most comfortable sharing. What you've been avoiding.

So there with that.

Now on the other side, I want you to share the opposite action from what you were avoiding to what you're going to be doing.

Talk to the person who loves you and share for a moment, what you're thinking, I'm going to ring the bell. I want you to breathe in and out. And when the bell ends, we can talk.

So that's how we begin our dialectical behavior therapy. Group session. And obviously how come I chose avoidance is since it's a such a big theme for Joe and for this community,

did something come up for you?

Like something that you've been trying to avoid, that you're going to do the opposite of action by any chance. I'll

Uri Schneider: be honest. I wasn't, I didn't hook into that, but I had a meaningful, meaningful, deep dive

Michael Sugarman: that's okay. So remember when you're a therapist, that's okay. You go into a deep dive. Then we come out of that and then we discuss like opposite action.

Like one big thing that I've done. Um, one short group, um, people who, who stuttered. Um, but I'm not a therapy. I mean, I'm no longer a licensed, so it was kind of like a teaching skills as well as two professionals. And some of the things that are coming up was, uh, to making a phone call. It may sound simple to some, but it was just, I'm going to just make that phone call.

So the opposite action was I'm going to actually make that phone call. And the reason why we do loving kindness is because we want to have the person feeling comfortable to share with you URI, either in an individual or in a group setting.

So the interesting thing for us, it comes out of a team CBT that's. Um, A lot of David Burns stuff. I got a chance when I was at Stanford. So, so he was one of the creators like back of CBT. So like back has moved into cognitive therapy, recovery and burns have moved into team CBT. So this is just and behavioral health being neuroscience, mental health.

And now we're going with, um, a social health as well, because we're dealing with homelessness and financial problems and this could come back. So, so then at the end of it, this session of the first, you know, when you're doing your individual session, I like of when you were talking the other day about, Oh, I start off with, so how are you?

You know, so what's going on with you? We think at the end of the session is to test what had just occurred during that session. Now, remember, you have to remember too, that CBT and DBT is a pretty structured format. So really what you're doing and what we're doing here is teaching skills in a therapeutic way.

Of course, when there's something heavier, You know, of course we'll go into more of a, a DBT trauma, you know, related, but

Uri Schneider: yeah. Can I ask you Michael, just to bring everybody up to speed? Uh, That evolution because a lot of people think of psychology is like going to be an endless journey of intense psychoanalysis and going into the past.

Can you just shut a little light into this whole wing or branch of psychotherapy and yeah, this doesn't approach it so different than what many people have assumed psychotherapy to be in mental health to be. I think it would be nice to shed some light.

Michael Sugarman: Yeah. Okay. So enlighten that. So what happened was during the eighties, um, David Burns and back seemed like there was more of a, kind of like how to get a point, a person point a to point B and point C with self care skills.

More of a teaching therapeutic way of dealing with, with things and items. So in neuroscience it's based. So that's the reason why you have the mindfulness comes in because how the brain, my rational brain wise mine in DVT terms, we move through those stages and, um, I'm sorry, I'm just going back and forth to my, uh, so what has happened in psychotherapy is that we've been influenced by Eastern philosophy, like for myself, um, like I was really fortunate to be in at Stanford med when, I mean, unfortunate and fortunate in both ways, um, with when the AIDS epidemic yet.

So it was kind of like mindfulness came into play in the early nineties and then the psychologist figure out that there's gotta be a format to the groups. You know, it's similar to what you've you put together, but it's more of a, kind of like a CBT and DBT model. So, what we're doing is that we're, we're, we're, we're being, we're bringing a skillset to people now back to Joseph Shyanne.

And so then in the nineties, um, there's a lot of us, you know. Okay, well, there's a mental health, uh, parody act. Yeah, we did demonstrate four and got passed. So we're paid for, that means a licensed marriage, family therapist, a LCSW, a psychologist, and Jerry, Jerry Maguire. Also during that time, what, what we moved into, like for some of us that we came from a self-help perspective.

So we saw. The integration of appear into our work rather than going outside, like a one-stop shop. Not saying that. Okay. So these peer groups are posts self-care after therapy. And, and so we could talk about that. So I'm not saying demolish, you know, you know, dismiss peer support groups. We're not at all what we're doing.

Yeah.

Uri Schneider: Wonderful. And there's a lot of feedback, Michael people, first of all, uh, calling you the goats, which is the acronym for the greatest of all time, Doug, from Doug and Texas. And Tom Sharfstein is liking the legend, a description and a singer DOR Frostburg. I believe Sweden, Iceland, Iceland. Uh, she is saying wonderful interview.

And again, I just don't want to make any assumptions. Michael, can you unpack, she's asking, can you explain the acronyms, you know, act CBT, if you want to weave that back in, but the last point, the last point you said, I just want to make sure I got it right, because I think it's a. It's an interesting insight.

It's an important conversation. A lot of evidence-based practice looks at the effect of different elements and whether they are valid and whether the, the rigor of the scientific method shows that they seem to have an impact. And that's important. What often gets missed is what you end up with is an array of different things that have some sort of evidence-based, uh, but what you were just describing those kinds of like, Maybe how things get lined up sequentially or in other words, the idea of peer support.

This is an interesting idea. You're talking about it happening in sequence, right after some kind of a therapeutic individual experience. I think, you know, that's a whole conversation, but I just want to highlight that. I think that's a subtle, but very novel point for people to consider that, uh, you know, an intervention of any sort.

First of all, it can't be one size fits all for everyone, but this idea of the timing, and this goes into, you know, Patricia's apprentice, he's worked with the stages of change and the lining up what people need at different stages. Uh, the thing that could be helpful in a later stage might be unhelpful or hurtful at an earlier stage and the importance of considering some of those things.

So I just want it to resonate with that point. And then when you get a chance to circle back to the acronyms, for those that, to know about that,

Michael Sugarman: The act is acceptance commitment therapy. DBT is dialectical behavior therapy and CBT is cognitive behavior therapy. But what arm, what, what, what I use is a mindful based, and that is what we were just showing at the start.

So, um, so let's go back to Joe Shan, for example. Now Joshi, um, avoidance was really popular at that particular time when he came and to psychology and presented this. Now, UCLA is one of the leaders in mindfulness based therapy. So if we assume that he lived today, that he would have done that introduction that I just did into avoidance.

Now we've come a long way in therapy, where I think in stuttering therapy, I think you may want to start looking at, you know, more things like self-compassion anxiety shame, and self-acceptance just

Uri Schneider: as a quick reference. My last conversation with Robin Croft, uh, down at UT Austin with Tammy, uh, with Courtney bird.

We talked exactly about that. Some of that, uh, self care and self compassion and the research on that. So I think that's definitely just another anchor. You could listen to Robin, talk more about it, but what Michael's talking about is what's amazing about Michael, just a quick parentheses is like some people, uh, get old and some people get young and, and Michael has a finger on the pulse and continues to evolve.

And that's, what's exciting is what Michael's talking about. Is a lifespan of his own journey and perspective and insight. But what he's talking about is so cutting edge, and he's helping you bring the black and white images of Joseph Xi. And for example, into a contemporary 2020 full color, which is a unique thing that you're going to get in this.

Conversation that you don't get from just reading a manuscript or from an event, you know, just throwing things in the sky. So,

Michael Sugarman: well, you know, if it makes sense that Courtney would be involved in that because Karen not NEF is from Austin, who is the big per a person in self-compassion. So. If you take a look at, you know, the Dhruv and I put together a six week format, it's just basically for you to take nuggets from that there's mindful base, um, cognitive therapy, tad techniques like cognitive reframing would be a thing.

The thing that we just went through with dialectical behavior therapy of, of the opposite action. So let's move to another thing and I'll get back to the peer thing. Um, and, and what I would like to address is apps. There are so many apps where somebody like URI has to inform his clients about calm insight timer.

Um, scanning breadth, scanning, um, you know, the exercise that we just went through was just a loving kindness that helps people to focus in a really good book. And I know that you guys are going to go, Oh God, it looks so young, but it's called a master of mindfulness. It was, it was helped by Kabat Zinn who is basically.

The mover and the shaker of the mindfulness-based stress reduction that became mindful based cognitive therapy. And the nice thing about this particular book, it goes through four different meditation exercises. So the body scan, for example, it, it doesn't really address the loving kindness because that's more of a clinical.

However, we've been seeing more PE people to use that

Uri Schneider: this is going to mention for those of you trying to jot everything down. Uh, Michael has shared with me and I I'll post afterwards on our blog page, this video conversation, as well as all the links to the different apps and resources that might come suggest.

Michael Sugarman: Yeah. And, and then you could do AR AR article because you as a therapist, just, you know, you know, the whole idea is for you guys to take the nuggets and integrated into your practice.

Uri Schneider: You know, Michael, that this is not a plug is not a plug, but I just want to share it. And again, you don't need me to do this, but just to amplify what Michael is saying, people often think, well, that's not going to work with this person.

Or this person is too young to the concepts and the approaches that Michael's talking about. Are the kinds of things we need to learn more about because they speak to the fact that a person is a person they're not just a pair of lips. And if we're just working on lips, we're missing the whole driver, the whole spirit of the person, the whole person, nothing to do with anything spiritual, but just the whole person.

So we've got to learn more. So just as a, a short anecdote we were doing, we have this group of teenagers going through this. Four part framework. We made this transcending stuttering framework and there's a whole unit, one of the forest self-acceptance and we introduced some nuggets, Michael from CBT and the therapist was facilitating these teenagers.

And I was wondering, would it fly over their heads? Would it fall flat? Would they enjoy the video pieces that we did? And these teenagers, when they heard about thoughts and feelings and behaviors as a cycle, the kid said to the group, So spot on. Yeah, it just all clicked. Now. I, now I understand like what's been going on for me the cycle and it was a game changer because it gave the person a chance to kind of like be their own observed themselves, have that Avenue on themselves and then be able to maybe choose some things differently.

So I just don't assume any of this is too high or too lofty or only for certain audiences. This is stuff that speaks to the humans. Well, your interest in helping humans should give it a shot.

Michael Sugarman: Well, well also, um, because you're doing with stuttering, um, um, we did a professional group too that joined our group and she used the body scan.

With a teen who stuttered and got connected to when they're stuttering. So, you know, I just want to, and, and the mindfulness practice is being used throughout the whole of therapy. So that's the reason why it's going to be really important for the clinician to decide with your client. If you're going to use calm insight timer.

Uh, breathe to relax. What kind of apps? Now, the next issue that I was going to talk about is not an issue, but you brought it up with, um, and so did Hilda in her, her article, and that is, we have an app that's called my strength. It's a digital format that has CBT and act. It's paid through, paid by Kaiser to have this app it's called my strength.

Now they have a success rate of 83% on the app and as well as in-person therapy, but, okay, so this is individual therapy. So they didn't talk. And Hilda's article Dan talk about what, what happens like in our work, if you combine individual and therapy groups doing these kinds of practices, but what, I don't know, because there hasn't been a study, but this is what we do in our wellness clinics.

We combine them too. So when you do apps, that's another app that you might want to look out. Uh, I don't know if you'd be able to get that app for people because you're not, uh, you know, uh, a mental health professional, but I don't know. I don't know. You know, I don't know the other app that is really popular.

It is a 74% they've been doing, Oh, this is another app it's called thrive. Global. It's put out by Stanford. Um, um, mad as, and the Huffington group is invested heavily. So you'll see this in your workplaces. It's called thrive global. Um, so you could see a lot of applications are being done in mental health.

Let me see if I could just get to it. Uh, I have thrive global, but, um, so let's see

first there yoga. There's a one called the neurosciences are saying that it works. It's called fit mine.

Uri Schneider: So Michael, when you say that, they say it works. Yeah, similar to the questions. We're always asking five

Michael Sugarman: to 80% effective

Uri Schneider: just to specify like Pfizer throughout their percentage, but their vaccine, it's hard to figure out what are we measuring?

So when you're saying they have that, that, uh, impact, can you describe what that's measuring success with? What success doing? Okay.

Michael Sugarman: I'll tell you in a sec. Okay. So. For you as a therapist and stuttery it's for a person to communicate more effectively.

Now, how do you base that on, is it life, life, experience, or quality of life improves? How would you for us? And, um, in the therapy world, we have two scales, anxiety scale. And a depression scale. So if a person co income comes in with a score of 22, which is near severe depression, the insurance company actually tells us, you know, six sessions with C with cognitive behavior therapy and two, six week sessions with dialectical behavior therapy.

So the hope is by the end of those sessions, that 22 scores goes down to eight or nine. So it's a mild depression. That's where we come in to like Doug and Tom and SIG with the self-help movement, which would be okay. So. The third thing is really important in your therapy work. That is gratitude journal writing.

So you, you want to, um, make sure that your clients, um, come away with that with writing notes to themselves about what just happened. Well, I just stuttered them, but how do I feel about it? How do I feel? What's the positive, what's the cognitive reframe to that? I made it through the speech. Okay. I got a C on it or something, or, but I made it through, I'm still alive.

I mean, it really depends on how you communicate with your client and for the person that started today. Yeah, that stutters. So why

Uri Schneider: do you, one of the things,

Michael Sugarman: well, one is, okay, so like you have three items that are working. You have apps to help you for when the client leaves your room to work with their apps, then maybe five minutes of meditation walking meditation.

It's your, your decision for us in the mental health field. And we'd like them to use the apps that I mentioned for mental health, um, to just help them, you know, to effectively, you know, kind of like work on their issue and gratitude journal, writing note would be on your iPhone just to chart chart down of what's going on for you.

So the whole issue is self care. Now comes the interesting thing about the integration.

Uri Schneider: So if I could just, if I could say one thing about this previous point to me, it's so that's what we do to a degree. And I think a lot of people are not yet doing enough of it, but if you buy into an app or you're able to access an app, or if you can't, I'll just share two quick thoughts, how you can do this today.

Uh, with every client that we work with, we create a Google doc. And that way across platforms, whether it's during our meetings, we can have some writing and written exercises, whether it's between our meetings. And then we have a running journal and they can have things they keep to themselves, or they could have things they share.

So that's one aspect. And in the group we have sometimes some shared doc clean from one another, their own personal reflections. Uh, we also use voice notes sometimes or bring together. Like mentors and young people in an asynchronous way. And they can, if typing isn't their thing or it's too cumbersome, but leaving a little voice note and saving it as a, as a collection of little anecdotes of reflecting, talking to yourself, giving yourself those messages, very powerful, and the apps that are freely available and make it so easy.

And the apps that Michael's talking about really formulate it and structure it. So if you can take advantage of those, go for it. But. Don't let that stop you if you can't get those. I think

Michael Sugarman: there was absolutely. I mean, because once they leave you and see like Tom's group or Doug's group or six in the self-help group, we'd like them to kind of like continue what you've taught them in the clinic situation.

So it's not like saying,

Uri Schneider: going from Deepak independence. Right. And whether the defendants. Or community getting to a point that you can hold yourself

Michael Sugarman: community building. Correct. Now, now, now, now what we've done. Um, and what we found now, SIG is perfect for this kind of a group exercise because she's in that age range, doing homework assignments, wanting to do it, you know, listening to you and doing it.

But what we found when. So I'm 67, but when we're older, we don't do the homework exercises and that's where it's Amy. It, it just happens that way. No, that's just how it is. So, um, so that's something that you could think about, um, you know, if you work with older clients, whether or not they're doing the homework assignments.

So these assignments are just basically what you're doing in your life to make it easier and make it positive. So, okay. So how we use. Pierce specialists. Of course we have them trained before they come into the clinic. And what they would do would be run like a DBT dialectical behavior therapy, just to understand the language because in dialectical behavior therapy, there's distress tolerance and emotional regulation.

But the focus again is on mindfulness. This is the beginning now. I mean, they're pretty, uh, like Tom and Doug and SIG would probably be perfect to work with the Schneider Institute as a peer therapist, peer

specialist.

Michael Sugarman: But, um, so in my setting, uh, that would be somebody to just do, you know, things like employment.

You know, the other day they were talking about, you know, for them to navigate, however, you, as the therapist would talk to the client about anxiety,

about going to the interview, the peer would help to navigate where to go and what would be the best job.

Uri Schneider: So again, just to reflect, I'm just trying to distill, because you're getting some really rich gems. So just for those that. Maybe this would be helpful. I think what I hear Michael saying is there's so much benefit from a, obviously a multifactorial perspective and a holistic look at life and challenges and what it is you're trying to achieve and where you're getting stuck.

But the role of a professional guide in one arena, the role of a peer, the role of an app that these things can be leveraged in different ways. That one is not mutually exclusive to the other. Is that fair?

Michael Sugarman: Yes. Um, and, um, however, you come equipped with these clinical skills that the peer does not. So when they leave your, your clinic, we like them to be self care and they would go to like Doug, Tom SIG in the self-help group, or, you know, the w the, uh, the w at SN and B.

Not knowledgeable enough, like you put together like six week session that could be adapted, maybe. I mean, it's something that, um, one of the fall points appears is their skill level and their training level. And so that's how, how, how, how come that it's so vital once they leave your clinic situation and they go see Tom, Doug and SIG that they already know the skills they reinforce the skills.

Uri Schneider: So what you're saying is the importance of the, uh, common language,

Michael Sugarman: um, which is really important.

Uri Schneider: And then the following experience of the peer group. If the peer group is speaking a different language. So let's say one uses the words and the stuttering of let's say advertising and when use self-disclosure and another one uses openness.

What, what, what happens then? Michael,

Michael Sugarman: it gets so confused. So like, so we use more of a dialectical behavior therapy peers because they know that language of emotional regulation, distress tolerance. Uh, so you're absolutely right. So somebody like, um, Tom or Doug, if they were in my clinic, that they would follow up and do a weekly cha uh check-in with people about.

You know, why is mine? Why speech listening skills and how they're doing as a check-in, but using the same language that they've learned in the therapy room. So that goes back to what we've always discussed. There is called standard of care. Which for, for your, for stuttering, it's gotta be, I mean, you guys have to decide your standard of care is going to be act CBT, probably not dialectical behavior therapy, but something about group that I know that you guys use arts, but, you know, um, to Vivian's work.

But, uh, it would be nice to do that as a 3.0, I mean, you know, it's like 20, 20 situation. So everybody's on the same wavelength and the scope of care is you would be clinical skills, an individual and group. And then somebody like Tom, what he's doing would be post clinic. And with Doug's doing with SIG in the self-help is post Glen.

So you're all on the same wave,

Uri Schneider: I think in a utopian, an idyllic sense. It would be amazing if all the shareholders would be able to find a common language and a common approach. I think inherent in the challenge is that we have so many different people and many doing different work. That's having a wonderful contract distribution.

What's your thought, Michael, about the fact

Michael Sugarman: that

Uri Schneider: you share about that? Because different let's say even DBT and CBT and act, and then you've got, you know, other approaches here and other approaches there. Each one comes with its own vernacular, which is somewhat exclusive to another. What are your thoughts about how do we practically bring in, like you said, a, a more consistent thread of language and terminology so that we're not adding more confusion, but more clarity.

Michael Sugarman: More clarity is if you all get together, we do like the zoom meetings, like 20 of you. And I mean, it's a similar thing of what's happening with the Biden campaign, basically, you know, uh, they do these zoom meetings, get people together, send in their policy makers and come out with some kind of. Of con congruent thing.

And then you you'll have some of the stakeholders, somebody like Tom Doug or Sigi involved so they could hear what, so, so there is the standard of care that's

Uri Schneider: in developing, you know, in developing what we did with that. Transcending stuttering framework, which is this video course and the companion principle guide I actually worked on, on getting a lot of people's input.

One person I need a Blom was, was deeply involved and contributed a lot. And one of the things that I heard from a lot of people, and I'd love your input on this, because on the one hand, the dilemma is there's a lot of professional lingo that's out there. And a lot of it has developed over time or has lingered over time.

It needs to be developed the idea, for example, of common words like stuttering modification or pseudo monitoring or fluency shaping, you know, these are terms that were coined quite some time ago. We deliberately have, we're not against any one term or another person. But find it less helpful because one person's understanding of that and other person's understanding is totally different and it may also bring up feelings and, uh, you know, different connotations or experiences.

What are your thoughts about moving towards a language that's more common, more phenomenological, uh, and actually not, not jumping into any one or another where it becomes kind of exclusively CBT terminology or exclusively this terminal. What do you think of that mindful

Michael Sugarman: communication and then under that becomes effective communication.

I mean, you know, the, the funny thing about mindfulness is, you know, we started to use the hat back in the eighties, but it wasn't isn't as popular until Brock Obama or to use mindful speech. And then all of a sudden it's Brock Obama was the one who brought mindfulness into our culture. Um, emotional regulations become a cultural thing that people is that's a dialectical behavior term that we use during the nineties.

So I do think if you broaden your scope to communication or effective communication and you know, or mindful communication, that would be helpful. There's. There's also terms that are being used with fluency, uh, uh, call it emotional fluency by Ben Abraham, emotional fluency. That is being able to talk about your emotions.

Uri Schneider: Yeah. There's always been one that's out there reading fluency.

Michael Sugarman: Yeah.

Uri Schneider: So word fluency becomes kind of co-opted by all kinds of different intentions.

Michael Sugarman: And your intention is your group is to making it communication.

Uri Schneider: One of the things that we do in, in the group, either individual groups, meaning clinician and person, or the clinician and family, or a small group facilitation, we have everybody kind of find their own language, how they want to describe, uh, that experience of a word, getting stuck, the physical feeling of it, the name of it.

If they like the word stammer stutter, it's so interesting. Well, all of this is so interesting because words start to carry meaning and they also start to carry feelings and they can attract, they can repel, or they can be more descriptive and not judgmental, or they can be more judgmental. The impact of that you want to just language

Michael Sugarman: really matters, language matters.

And that's the reason why we're asking people more, doing the journal writing and mindfulness practices and meditation. Um, you know, cognitive reframing is basically moving a negative to a positive.

Yeah. What we want, you know, people like you, or like, like myself to do, or Tom Doug's SIG, you know, is, is how do we make communication effective? And how does people feel more comfortable in going out in the world, world being effective? Now I know it's really important for, for clinical, for you to do clinical or for clinicians to figure out ways.

There's a lot of good stuff that's available. And I noticed you were field is more going to our standard care of act. Mindfully will be, but I don't know. I mean, that's what I read in and in her paper that the focus, however she was doing individual therapy say, you know, he'll double us Hilda,

Uri Schneider: meaning that she's talking about act, but as a mental health practitioner, you're thinking.

Act in that

Michael Sugarman: context? Well, I'm thinking of, okay, well, if you're going to that, you have to combine it with a group therapy, right. If you're wanting to group therapy and these are some of the things that we laid out a 3.0 for Vivian to do, and for, you know, Shan would definitely do something like that. Um, I mean, I can't imagine him not to.

So he's, you know, one of the leading schools in the country.

Uri Schneider: Um, I think, I think what's interesting to me is that point, you just made that the research and the literature has really been moving in a, in a really positive direction, looking much more broadly than just that the physical behavior of stuttering for sure.

Looking at a, uh, evidence-base for these types of approaches, but I think it's striking that you find, as you said, the discussion of act, but then you look at how it was delivered and it wasn't delivered in the classical act sense. There's still a need for the interpretation and the application got to just share a little bit about that, about how we practically bring some of this knowledge and wisdom to life

Michael Sugarman: and will, because I think eventually somebody, either Krista, you know, Kamala does a lot of practical skills with mindfulness.

So I. I think, you know, there's an act mindfully is now being talked about in your field. Um, I, in every time when act is brought up, I said, well, are you doing mindfully? Are you doing both practices? Are you doing clinical group as well as the individual group? So if we know that acceptance commitment therapy.

And cognitive behavior therapy is 83% effective. That's individually on the base. Can we look at if we add group and maybe people, but like Tom dug into the mix, you know, to, um, to make it maybe 90%.

Uri Schneider: Well, we have lots more to explore because the, the, what we rolled out, it was intended and being thought through way before COVID.

But in these times of distancing, it becomes all the more helpful to have the apps you're talking about or different ways that people can move themselves forward between times where they have the access to an individual or to an individual professional or peer group. Um, What, what are your thoughts about where we're at with that?

And the value of that? The question I hear a lot is like, during these times of social distancing, how can I possibly do anything for my young child or my adult child or myself, all the doors are closed. Uh, and it feels like technology is so artificial. You want to share anything about that?

Michael Sugarman: Uh, practicing self-care skills.

I mean, here's some dude, I mean, you know, simple things like. Spending five minutes to yourself reading a book meditating. Um, I know one of the big things in my field, because I worked with depression was making your bed every morning

Uri Schneider: habits. I thought that in your six week, it's one of the exercises in getting these small rituals and habits.

They create little micro, you know, I read something a while ago. You're from the Bay area, right?

Michael Sugarman: So we have a lot of like this mindfulness practices, like recants and, and. Can I just give a plug,

Uri Schneider: please go.

Michael Sugarman: So in my strength, um, platform at digital, what came out of some of our interns that's Stamford, which makes sense, right there they're clinical social workers move into the tech world.

Of course, that were kind of like upset that they didn't say in our world, but you know, they're your age group or, you know,

Uri Schneider: better than me, but that's a, I take the compliment.

Michael Sugarman: Okay. So two more things I want to just really quickly. And then I'm going to show you one exercise that would be really fun to do, but,

Uri Schneider: but fundamentally I think, but I just wanted to get your insight on as, uh, as who you are.

Would you agree that no one should think that this time we're living in, uh, should be a time where people should kind of hang in and wait until. The old ways come back and we're too distanced to do anything on the contrary. Would you suggest on the more, all the more so there's a need for learning skills and self care and moving yourself forward?

Michael Sugarman: Oh, absolutely. Like, um, especially right. Uh, right now we're on zoom. So person that stutters has to see themselves as the actually. Before, we didn't have to do that. Now we have to. Now we could have some time before we come into a situation of talking with a group and say doing some meditation exercise, just, uh, a calming, you know, uh, calming meditation.

What am I going to say? So that gums into, um, Salesforce. So last week I went over to Salesforce and, or two weeks ago with the NSA and they've developed a group called ability force people that Snyder, but for all cross disabilities and the guy that hosted that was saying that his boss says to him, go ahead and tell everybody that you stutter.

And when he was interviewed, uh, they actually gave them time. They said, just take your time. So I'm wondering if we're doing a cultural shift, like, um, of what's happening, like between my age group to Tom and Doug's age group to yours. And then

Uri Schneider: I think Rubin Rubin talked about that and I think it's a real.

It should be a Testament. A source of novice for is like pride, um, that, you know, some movements are generational and they take time. Uh, he shared that in the name of Barry yeoman. I'll be talking to in a few weeks, but the idea that some of the seeds that you planted, Michael, and you deserve credit for that, you know, the seeds didn't sprout in the first season or the second season.

But what you're seeing now with that kind of experience at Salesforce and major corporate atmosphere, That's something that probably was not something you could imagine when you started off on this journey of activism,

Michael Sugarman: right? Oh, absolutely. And also you go with Microsoft, which is asking people to do confidential self IDs identification, and now they're encouraging disability pride.

Now that's always a big issue within the stuttering community. Well, I'm not disabled. Am I just shy? Like tell him that I have a disability, but that could be another time

Uri Schneider: kind of to get some things and I'm not going anywhere till we get through the things that you'd like to share, because these are really precious.

And I just want to invite anyone that's watching, uh, your comments, your questions. Certainly you can contact me or Michael. We will have this on replay. We will put all the links and the resources that Michael is sharing together, both on Facebook and also on the blog page. Uh, Schneider speech.com/our blog.

And if you share this share Michael's, uh, wisdom, that would be the most amazing thing. Well,

Michael Sugarman: and like we're all working together. It's not like we're all working together. That's a really important thing about like, uh, Tom's group is going to do with you, Doug and the NSA and all, all these groups around the world.

They're using video now to talk. I mean, that is incredible. So, so I just want to end with something, um, that, that I wanted to share. So the stuttering and speech therapy of Arizona. Okay. Um, she put out this thing called try laughing yoga classes. Okay. So. I, I, I don't know if you guys want us to, but, but we've been doing this for a while and behavioral health.

I mean, I've been retired, so this is one of the exercises is people. If you want to stand up or sit down, it's fine. I'll show you what it is. Okay. You wrap your hands around here, like this. And you laughed three times. You go,

you clap two times. You go. Very good. Good. Yay.

So on that note, We're integrating in Tom and Doug and SIG. Those are really good, fun exercises for groups. It kind of like, it's a meditative exercise, but it's used as a part of yoga.

Uri Schneider: Let me ask you a question that kind of underlies everything you shared and also everything you shared with me. I have a complete file. I actually need an external hard drive for all the things you shared with me prior to this conversation. So many resources that I am, I am looking up right now to share on the screen.

So many wonderful things, that image of the DVT and the wise mind. I'd love to share that if I don't find it, I'll share it afterwards. But Michael, here's the question. And I, I did weave this into our framework and this is everything you're talking about, but I think it's an unspoken and I just want to make it explicit.

The function of yoga and wellness way beyond the traditional confines and boundaries and scope of speech therapy for people who stutter, what relevance is there to exercising, to having a good state in your mind, to dealing with mental wellness. If that's something that's, you know, significant dealing with diet, dealing with fitness, what relevance, what

Michael Sugarman: bearing does that have?

Michael. So much is it's it's mental wellness, it's wellness. I mean like Tom just quotes and it said something, there's something there's more than just stuttering. There's your life. And. I mean, just to share with you, like in our depression group that we did, we had a yoga person to come in. We had a nutritionist to come in and this is for depression.

So, um, yes, I feel like, you know, we're so focused on our, our mouth and cognitively our head. We don't think of our whole body. And that's what this whole issue is about is bringing our whole body. And since we're stuttering and it is a whole body thing,

Uri Schneider: Just kind of

Michael Sugarman: like, to me, it, it, it's a perfect way to understand what's your process that you're going on and it's a part of that self care.

So then you're identifying, you're stuttering. You go, Oh God, I'm stuttering. Now. Now it's a, whether or not it's going to affect you for the whole day for 24 hours or less than that. Or if you're able to talk to somebody, it could be you, it could be, Tom could be Doug, it'd be sick. It could be somebody. But in a clinical sense that you'd be focusing more maybe on the anxiety of it.

Uri Schneider: This has been and continues to be. And I'm going to ask you, I'll give you the question and then I'll do my little wrap and then I'll finish with one other thought. So my question to you is what do you want to see in the next five to 10 years? What's your vision, your hope, your dream. And I'll let you think for a moment on that.

I just want to say that this has been. The richest bounds. Like we haven't had a chance to really talk one-to-one we just kind of jumped on here and I will be listening to this more than once. I feel an amazing kinship. Also a lot of wisdom that I feel much smarter and more stimulated than I did coming in.

And at the same time, more grounded than I did coming in. And I just, uh, I just want to encourage other people to do the same. There's a lot. Packed in here. And as, as Michael said together, we can do things that he could never do alone. And so I look forward to more conversations, you know, offline and maybe a follow up to this, but I just thank you and give you a chance to just give a thought of where you see.

We could go with the world in five to 10 years, and then I'll share one story about how I manage my wellness, which I think might be enlightening to some people.

Michael Sugarman: Well, We're moving in that direction. Uh we're we're definitely the educational system, um, is moving towards more to be aware. I mean, we are, we use the term disability or differences in the classroom, so there's more acceptance.

And that in the educational, obviously with diversability in the workplace with diversity and inclusion, more people are willing to take that effort. There are people, um, we have to think, um, uh, the notorious RBG for that, because in 99, she led the Supreme court with the Olmsted at that actually gave.

Disability services, the meet to the ADA

Uri Schneider: for the non-Americans out there. Notorious RBG is not the notorious VIG, Ruth Bader Ginsburg, who was a w a woman, a force to be reckoned with a Supreme court justice and a real pioneer, uh, and she passed away within the past year. So she has the name, notorious RBG, great documentary too.

Michael Sugarman: Yes. Uh, so, so with that kind of stuff, that's happened in our world here in the United States, which is transported. It's going to be transported around the world with these conferences that you're doing. Stuttering will be viewed as this is something I do, but it's not all of them.

Uri Schneider: This is something I do, but it's not all of me that is.

That's where we need to be.

Michael Sugarman: Yeah. You started off with that kid saying I stutter. I mean, that's right. I need these holes situations or the environment is making it easier to quote unquote disclose, which you guys use it in the old days that we use the term coming out, but people, but you know, it was these terms and language.

Right,

Uri Schneider: right. Well, I attempted to share another story, which I'm going to hold for another time, but again, I just want to thank you. And I just want to share, I had a call yesterday with a colleague mine. Uh, don't say who it is, but we meet on a regular basis and we have real hearts of hearts and kind of support one another.

So I think it's important also just to share that practitioners, you know, in speech pathology don't have the concept of supervision. And it's an important element for any practitioner to have someone that they check in with and cannot air things out and get guidance. It's a real sore missing piece. We hope to be offering that for people that are looking for it, but people should seek it out for themselves wherever they feel fit.

But for myself, I don't stutter. Some people have thought that I stuttered. Why would I be so invested? Why would I be doing all this? And it's a great honor. That someone would think that because it shows a level of empathy and connection and understanding I don't stutter, but I still have to do all the things that Michael talked about.

So a couple of years ago, my rabbi told me you got to start running. I said, why? He says, you've got to manage your stress. And since then I became a runner. And for me running two to three times a week, And then in between those days that I run some basic calisthenics, I use the seven minute workout.

There's no, no machinery involved, no gym required. You can do it at home. And just a few minutes and different variations of it. Also scientifically based great outcomes you do that you can really add years to your life, but also add life to your years. And, uh, the other piece that Michael talked about, the importance we schedule ourselves back to back.

I talk about these micro vacations. It's a concept I stole from Jack Dorsey who runs Twitter and square. And, uh, now he does it differently with two hours a day of meditation, but he used to do this thing called a micro vacation where he would just in his mind drift into that pleasant place. And even if it was a matter of 30 seconds, We're five minutes between meetings being deliberate about taking care of ourselves and not just responding to the needs of our inbox or pings and dings is so important.

And I think when you hear Michael talk about apps, you might scratch your head. I'd say more apps. I'm trying to get away. I'm trying to disconnect the importance of integration, healthy technology, since we're so hooked up anyway, is I think critical as part of a healthy way of living. If you're going to have technology, you're going to be on the grid.

You need to integrate the kind of good stuff that's going to be the same way. You have healthy food in the pantry, and you have your snack food in the pantry, in your technology, bacon things that are taking care of you and not just taking you for a ride. Um,

Michael Sugarman: let's just add one thing. What you're saying is the fact that, um, mindfulness now is throughout the whole tech world.

Uri Schneider: That's fine.

Michael Sugarman: Like Salesforce said that on every floor, there's a mindfulness room and technology and they talk about it constantly. So I think it's, it can

Uri Schneider: penetrate in that space. It can, it can be integrated into our personal lives and so important. So again, thank you, Michael. Thank you everyone. Please share comment, Michael, where can people reach you or learn more

Michael Sugarman: now amSherman1@sbcglobal.net or, you know, okay, well,

Uri Schneider: I'll post everything again.

You can see the playback and all the notes that Michael will share and resources and apps and everything that was discussed today will be up in a few days. Oh, the gratitude

Michael Sugarman: journal writing too. And no.

Uri Schneider: So check out Schneider speech.com/our blog. And you'll see all the conversations, including this one, with Michael and links and resources, everyone have a wonderful day.

Stay safe, stay healthy, keep breathing and keep talking.