Winston Churchill was a closet stutterer and his vast vocabulary was in large measure due to the fact that he was continually word substituting. Closet stutterers are walking thesauruses; they do crossword puzzles in ink. And since they don't stutter, they function well in society.

I recall evaluating a closet stutterer and then later communicating with him by mail. His wife called to say that she had received the letter and wondered what it was all about since her husband of nineteen years had never stuttered. I told her he was a closet stutterer and that he avoided certain words, sounds and speaking situations. There was a long pause and then a torrent of questions. "Do you think that's why he has me make the phone calls, and why I always wind up ordering in restaurants, and why he never speaks up at PTA meetings?" As she asked these questions, questions which were in a sense rhetorical, I could hear by the change in the pitch of her voice that she was beginning to understand something about her husband, something she had never known. I suggested she speak with him about it since I felt if he were to undergo successful treatment, her assistance would be invaluable.

Closet stutterers report they are exhausted at the end of the day. There is no such thing as an idle conversation, they are always on, hunting, substituting, avoiding. In a sense, they are more stressed than the overt stutterer, because for the latter, everyone knows, "it all hangs out." But if no one knows, then one must maintain a constant vigilance, and this is always fatiguing.

Closet stutterers report that in an effort to hide their stuttering, they frequently say things that are inappropriate, foolish or nonsensical. They also often leave sentences hanging in the hope that the listener will fill in the missing (difficult) words.

I recall treating a hair dresser whose name was Pierre and who spoke with a thick French accent. As part of my evaluation, I asked him where he was born and he responded, Brooklyn. Thinking that he had been raised in France, I asked him where he gone to school. And again he responded Brooklyn. "So your accent is phony?", I queried. "Yup", he answered without a trace of an accent. He then recounted his discovery that if he spoke in this manner, he tended not to stutter, and people would forgive him for the fractured English that his word substitution required. Also, if he couldn't say a particular word such as comb, he could easily point to it and say, "How you say in English?". This strategy had worked well until his brother-in-law suggested that he join him in his Insurance Agency. He wanted the job and so now sought treatment.

Closet stutterers will go to inordinate extents to hide their difficulty. I evaluated a man who was a judge in a state Supreme Court in New England. He had been a closet stutterer for over thirty years, and although his word substitution habits had sometimes resulted in rather unusual language, he was so good at it that, in a sense, it added to his speaking charisma.

He controlled his stress by taking a moderate dose of Valium each day, and this he had done for over fifteen years. While on a cruise with his wife in the Caribbean, he decided to forgo the Valium and within a day began to have seizures - the sign of Valium dependency. He immediately went back on the drug.

He was a respected member of his community and much admired for his legal expertise. It was no surprise when he was asked to take a Federal District Judgeship. But he refused the offer and no one knew why. He gave some excuse of liking the kind of work he was doing when everyone knew the Federal position was a real prize.

He came to see me for two reasons. First, he wanted to be able to gradually reduce his Valium intake, and this he felt could only be accomplished if he eliminated the stresses associated with being a closet stutterer. Second, and by far the real reason for visiting me, turned out to be the explanation for his refusal to take the Federal District Judgeship: on the State Court he was allowed to paraphrase the charge to the Jury, on the Federal Court he had to read it word-for-word, couldn't substitute, and thus obviously couldn't take the position.

He was now confiding this for the first time, and the apparent release of tension associated with this confession reduced his Base Level Stress considerably. I did not see him immediately; he was initially unwilling to substitute my technique for his well-established avoidance behaviors. But a year later, when he was again offered a position he wanted, he presented himself for treatment and was successful.

While any consideration of stuttering reveals approximately five times as many men have this problem as women, the statistics for closet stuttering are reversed. In the study reported in the appendix of this book, 87 of the patients were closet stutterers. The group was comprised of 62 females and 25 males - a ratio of two and a half to one favoring females. It would appear that women elect to hide stuttering more often than men.

One female patient I treated reported that she had stuttered openly until the age of twelve at which point she had learned to word substitute and situation avoid. When I asked her why she had elected to do this, her response was quite revealing: she said "It's just too darn unfeminine to fight." And I think there is some truth to that. Some male stutterers may feel it is, in a sense, alright to show their struggles while more females may find physical behavior of this sort totally unacceptable. Of course no one knows if this is in fact the reason, but the evidence is clear, two and a half times as many women as men are closet stutterers.

Closet stutterers make more rapid progress than overt ones because they have less to accomplish - they already function well in society and are not viewed by themselves or their peers as handicapped. Their self esteem and socialization skills tend to be good. And when they stop word substituting it constitutes virtually a seamless transition into their everyday activities.

The overt stutterer, on the other hand, has a direct and negative effect upon his environment and suffers as a result of it. His socialization skills tend to be poor and when he no longer stutters he must begin to acquire new skills for interacting with his peers. As one patient said to me, "Dr. Schwartz, now that I don't stutter, what do I say to people, what do I talk about?"

I often tell the closet stutterer: "If you stutter openly and you stop, it is a gift to the world because the world is no longer required to see and hear you stutter - and a gift to yourself because you know you are free of the affliction. But when you are a closet stutterer, it is a gift just to yourself, you can't expect society to know or care or be interested in your hidden problem. The gift, of course, is this incredible sense of freedom to be able to say whatever you want to say, wherever you want to say it, whenever you want to say it - without fear."

I once treated a closet stutterer who, after learning the technique successfully, and practicing it for several months, called to tell me that one of his colleagues at the office had said to him, "John, for some reason you now make a lot more sense when you talk".