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Stuttering is an odd affliction. A few years back, I wrote an Op-Ed column in the Daily Princetonian, my college newspaper, exploring my (mostly successful) efforts to vanquish stuttering’s verbal demons. Soon after, the Progressive Review, a lefty campus rag whose editorials ordinarily would have smited the slightest anti-disability-rights claptrap, cited my column as part of the year’s “worst trend,” a “discomfortingly intimate personal disclosure” akin to conquering “soggy diapers that leak.” “If you don’t have anything to say,” the editorialist said without irony, “then don’t say anything at all.”

Not saying anything at all is, needless to say, the crux of stuttering, though hardly in the way my adversary meant it. Thankfully, the personal disclosures and broad social history of stuttering explored in Benson Bobrick’s Knotted Tongues: Stuttering in History and the Quest for a Cure can only help to break this silence. Bobrick writes of the affliction with an eloquence that only a recovering stutterer could muster.

I emphasize “recovering stutterer” in the same sense that people in AA remind themselves that they are always recovering alcoholics: Contrary to the prayers for sudden deliverance echoed by Knotted Tongues‘ historical case studies, the lucky ones never really consider themselves “cured.” They’ve just learned to manage a bit more eloquently—whether through physical therapy, a feeling of psychological security, or, most likely, both.

After cataloging a millennium’s worth of treatments ranging from the silly (psychoanalysis focusing on genital envy) to the horrible (unanesthetized tongue surgery), Bobrick explains that scientists now suspect that stuttering is a genetically based neurological disorder, perhaps due to the faulty conduction of the voice through the skull. Somehow, they say, the condition jars the body’s delicately balanced speech mechanisms. One percent of the world’s population is affected; male stutterers outnumber women by a 4-1 ratio.

But the updated medical explanation is only part of the story. While the physical tics that make stuttering so embarrassing come in endless variations—as do the sounds that trigger a speech block, and the methods of avoiding them—there’s one common thread that makes serious speech disorders unique: They cut to the core of one’s personal dignity. Unlike those with a chronic illness such as multiple sclerosis, stutterers often wonder whether they’re at fault for their condition—if they haven’t been told so by physicians or family members.

Simply speaking one’s own name, Bobrick pointedly notes, is among a stutterer’s most dreaded tasks. A name not only signifies identity, but is the single inescapable word that any person must say. To hesitate to speak one’s name—to appear even for an instant not to know it—is to risk being branded an imbecile. This makes stuttering more likely than many disorders to breed the kind of insecurity that encourages relentless, existential self-diagnosis.

It complicates life in other ways too: Because of my own difficulty with initial vowels, I personally fear falling in love with an “Amy” or an “Ellen.” Bobrick notes that the poet Philip Larkin, afflicted since age 4, expressed a typical stutterer’s fear in his somber “Next, Please.” “Although obviously about disappointed hopes and the inevitability of death and extinction,” Bobrick notes, “the poem’s title phrase was one [Larkin] had dreaded hearing as a child, for it signaled his imminent obligation to speak once he reached the head of the line.”

Although public embarrassment is a concern, the bulk of stuttering’s psychic weight usually comes not from the effect of verbal stumblings on others, but from the elaborate avoidance mechanisms that take over a stutterer’s life. Stutterers lard sentences with easy-to-say words, even at risk of mangling their intended meaning; they arrange the details of their lives in an effort to outwit the diabolical wizard who controls their vocal cords. Few aside from the afflicted ever become aware of, much less experience, the breathless, otherworldly terror that precedes such ordinary tasks as answering a professor’s question or making a telephone call. To outsiders, this struggle is invisible; it’s a testament to Bobrick’s skill that his first-person testimony communicates it so accurately.

That Bobrick became a writer is unsurprising; many other stutterers have been seduced by the freedom provided by the written language. Indeed, his intriguing, if somewhat overlong and Anglocentric series of thumbnail biographies indicates how many people have been able to express their talents despite the mental stress of stuttering. (A handful of actors, among them James Earl Jones, do not stammer when following a script.) In a perverse way, stuttering can be a character-builder.

That is, if it doesn’t become a character-destroyer first. For Bobrick, the psychological strain was almost too much to bear. After completing his Columbia University Ph.D. in English but realizing that his moderate-to-severe stutter precluded a professorial career, he punched the clock as a leather craftsman, file clerk, bookbinder, and book production assistant—anything to avoid speaking. Later, drinking eased his stutter but helped wreck his marriage. Eventually, though, he overcame his fear-inspired inertia and found salvation through a modern treatment regimen that included 120 hours of speaking practice, some of it with gadgets that gauged his vocal vibrations. Knotted Tongues is the learned, empathetic, and witty result of Bobrick’s hardship.