Conventional speech therapy never really helped me. When I started trying to figure out the problem and find solutions for myself, I looked inward for possible causes for my stammer. Delving deep, I realised it all started after a series of traumatic events around age 7. I had been suppressing emotions for many years, didn't really know myself, and was thoroughly depressed and anxious, with a severe stammer. I began working on my psychological issues. It wasn't just about speech anymore, but about building mental health, processing trauma, and resolving inner conflicts. Every time I worked through some trauma, some dissonant aspect of my mind, my speech improved by itself. Thus, a clear link between mental health and speech (for me - I'm not saying this will be true for everyone). The more I learned about myself, understood my authentic self and what I truly wanted to express, and resolved the inner conflicts that prevented that expression, the more fluent my speech became. I didn't need speech therapy - I needed psychotherapy. It took me several years to work up the courage to get professional psychological help, and even then it was a bit hit and miss. I had done a hell of a lot of psychological work myself, but couldn't deal with the deep traumatic stuff alone, and eventually found a counsellor who specialised in trauma. She helped me work through decades of suppressed emotions and gave me techniques I could use when not in the therapy room. My speech continued to improve. This is not to say there is no neurological component. Emotions, social situations, all kinds of things can lead to inner conflict, and this goes through the speech centre of the brain in such a way that causes dysfluency. This is a simplistic way to put it, but when you're pushing shaped blocks through shaped holes (like a baby's toy) you can't just shove them in - you have to get them in order so they fit. Same with expressing thoughts verbally - they have to be ordered enough to fit through the speech production hole. Of course dealing with psychological issues leads to confidence, inner security and serenity, which has a positive effect on self-expression. That's not to say there will be no more emotional upset, or that dysfluency will ever be completely cured. For me, that was never the goal. The goal was to be broadly content and be able to express my authentic self, and generally I can do that thanks entirely to dealing with those issues, and very little to do with conventional speech therapy. It's ongoing work. There are still situations and areas of my life where I struggle to express myself. Each time it happens gives me something to work with to figure out what the conflict is, and find a way to resolve it. Lastly, a word about acceptance. Love it or hate it, it's necessary. But not with resignation that nothing will change. There needs to be acceptance of the current state of things, acceptance of what cannot currently be changed, acceptance of what can be changed, acceptance that change may be difficult and challenging, and acceptance that if the status quo is not satisfactory, then change is necessary, however difficult it may be.