62 Chapter 3
lunch period or to participate in study groups. And like most boys, he needed great courage and
resolve to ask a girl out for a date and to deal with real or imagined rejection. Chad strug gled dur-
ing high school in dealing with girls, and his stutter was a serious complication. For example, dur-
ing school dances, Chad found the courage to take the “long walk” to the opposite side of the dance
f loor, politely ask a classmate to dance, and, like most boys, anticipate the possibility of rejection.
But unlike many boys, Chad, because of his stutter, wore his anxiety on his sleeve. Frequently, he
suffered the inevitable smirks, jokes, and mean comments of those nearby. Chad weathered the
rejection of high school and eventually entered college.
Because of Chad’s stuttering, college was not much dif fer ent from high school. He still had
prob lems dealing with the opposite sex. It wasn’t that college women were rude; he simply couldn’t
find the courage to walk up to them and start a conversation. He tried many ways, including hav-
ing his roommate approach them first and explain that Chad would be asking for a date. He tried
blind dates and a computer dating ser vice offered by student government. Meeting women in bars
and at parties was a disaster. He even tried first confessing that he stuttered and then attempting
to start a conversation. But apparently, nothing could overcome the stuttering obstacle to meeting
women. After 3 years of college, Chad preferred to be lonely than to suffer rejection. At least for
3 hours a week, he could talk to Linda about his life, fears, anxiety, and stuttering. He cherished
the weekly sessions and talking to a thoughtful, caring person. Sometimes he wondered what he
would do without stuttering therapy.
Linda and her clinical supervisor discussed ways to make Chad less dependent on stuttering
therapy and to remove the potential for secondary gains. First, they agreed to encourage Chad to
go to the counseling center. A counselor, with an understanding of stuttering, could help Chad
deal with his social interaction prob lems and ego restriction. The clinical supervisor explained to
Linda that ego restriction, a concept developed by Anna Freud, occurs when a person unneces-
sarily limits his or her life rather than suffer potential rejection. Ego restriction is an aspect of an
inferiority complex. Second, they agreed that Linda would continue to act professionally toward
Chad and not allow the relationship to develop beyond the therapy sessions. On several occasions,
Chad had asked her to have coffee with him after the session, and once he asked her to a movie.
Third, they agreed that Chad had to take a greater role in planning and directing his therapy. He
needed to identify his objectives, how to achieve them, and what criteria would be used to decide
when they had been met. Fi nally, a date for termination of therapy would be set if pro gress could
not be demonstrated. Although Chad would resist, Linda and her supervisor agreed that it was the
only ethical course to take.
Linda and her supervisor met with Chad and discussed the long- term objectives of his therapy.
At first, Chad disagreed with their assessment and the need to discontinue therapy if no pro gress
could be demonstrated. He also questioned whether he was gaining secondarily from the sessions.
Eventually, he agreed to the changes in the long- term objectives and actively participated in the
design and procedures of his stuttering program. He met regularly with a counselor from the
counseling and testing center. The following semester, Chad suggested that his stuttering therapy