**Stutter example:**  **Neutral stimulus**: A specific word used without issue in casual speech. **Transformation**: Repeated difficulty with this word during moments of high stress creates a mental association with failure. **Conditioned stimulus**: Encountering the word or sound prompts anticipatory mental conflict and speech blocks. **Extinction**: If the anticipation is not paired with a negative outcome, the conditioned response (i.e., stuttering) goes into extinction/remission. **Extinction failure**: If we keep holding on to significant associations connected to the conditioned stimulus (anticipation), extinction might fail.  **Examples of significant associations**: Having intrusive thoughts “Nothing I do will help anyway” (distorted view: catastrophization) or “There is no way I can put it into extinction” (i.e., no confidence) >The smell of food in a restaurant >When you enter a restaurant and smell the aroma of freshly prepared food, you may not initially experience any specific response to that smell. The smell of food in this context acts as a neutral stimulus. However, if you associate that smell with the feeling of hunger and the satisfaction that eating gives you, it is possible that over time you will begin to salivate or feel more anxious to eat when you perceive that smell, becoming a conditioned stimulus. **Stutter example:**  **Neutral stimulus**: Making eye contact during a conversation. **Transformation**: After negative listener reactions (e.g., impatience or confusion), eye contact becomes associated with pressure. **Conditioned stimulus**: Direct eye contact triggers blocks. **Extinction**: Pairing eye contact without perceiving ‘impatience or confusion’ from the listener **Failure to extinct**: If we don’t let go of significant associations, such as the intrusive thought: “I gradually start believing that even without perceiving impatience or confusion - that it won’t put into extinction” >The sight of a work uniform >Suppose that every time you see your work uniform, it does not generate any type of emotion or reaction in particular. In this case, the sight of the uniform is a neutral stimulus. However, if you begin to associate seeing your uniform with stress or the anticipation of having to go to work, over time you may experience anxiety or discomfort when seeing it, turning it into a conditioned stimulus. **Stutter example**:  **Neutral stimulus**: Background noise during speech (e.g., traffic or music). **Transformation**: Associating background noise with an inability to focus or articulate properly or manage speech during stressful conversations. **Conditioned stimulus**: Noise triggers increased self-monitoring and doubt. **Extinction**: If background noise is paired without the perception of one’s inability to focus or manage their speech/fluency (that is, an intrusive thought) **Failing to extinct**: If we replace above intrusive thoughts with other negative associations together with background noise