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Heilpern, E. (1941). A Case of Stuttering. Psychoanal Q., 10:95-115.

(1941). Psychoanalytic Quarterly, 10:95-115

A Case of Stuttering

Else Heilpern

Stuttering has been thought of in many ways, especially as a disease on the organic neurophysiological level. It has been envisaged as a manifestation of a relative reduction in cortical control resulting in the absence of an excitation in the central nervous system of sufficient potency and complexity to integrate the complete mechanism of speech. The management of stutterers has been attempted by physical and mental hygiene, by the unification of motor leads, by writing and speaking exercises. Not until the dominant importance of the functional disturbance of the speech function was recognized was it possible either to discover an adequate explanation or a successful treatment of stuttering.

The understanding of stuttering has been developed particularly through psychoanalytic investigation. From insight into the stutterer's previously hidden unconscious mechanisms, a specific therapy has been evolved.

The investigation of stuttering ranges from vague and general statements to the most precise and detailed insight. Flügel in a note on the phallic significance of the tongue, rests content to say: 'Although the psychical mechanisms connected with stammering have not yet fully been revealed, it is clear that they are closely connected with feelings of inferiority, and perhaps also with ideas of castration'. Stekel (Nervöse Angstzustände) gives correct diagnoses, but does not go far enough in analysis. Appelt (The Real Cause of Stammering) believes a physiological predisposition, weak nerves of speech, to be determinent of stammering as one form of expression of a repressed complex.

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