I'm 38/M and my journey with my stutter has essentially followed the arc of radical self acceptance over the course of my life. I say arc because there are still days, weeks, periods, etc where I noticeably experience a reduction in fluency but where I am now psychologically versus where I was in for example high school is a night and day difference. It sounds like, as others have said, that you are very high functioning and high achieving with a bit of a perfectionist quality and I sense just from what you've said that you have what seems like kind of a tight grip on things - yourself, your speech, your place. I can totally relate. The feeling in your body where you sit in tension everywhere - your shoulders, your jaw, your gut. So much so that it kind of hurts. Sincerely hoping it doesn't seem patronizing to say, but I'd really urge you to try to uncoil that tension and to give yourself a bit of a break. I imagine being in the industry you're in, you are very familiar with the different techniques you can use to loosen and limber up before a scene - body movements, jaw and mouth movements, etc. One of the biggest wins for me was discovering yoga (I like Vinyasa) which has quite a few benefits including breath work, the natural high of a workout, and a general sense of foundational grounding. I was diagnosed late in life with ADHD and my natural tendency is to be in a state where I feel like I'm physically and mentally all over the place. Yoga and specifically the breath work has really helped me to feel like I can more easily come back to myself and feel an easier anchored peace when I need it It does sound like you've got a challenging match up with your industry and work and I'm so sorry to hear about your anxiety around it. I'm a programmer and currently have the luxury of WFH which I feel grateful for but I actually think the increased isolation does hamper rather than help my stutter. I think the idea of exposure therapy really is positive as long as you wish to and are able to in any given moment. I hoped to echo the idea of using Virtual Reality to help with the exposure therapy too. I'm actually a VR developer and have personally experienced the positive interactions that are possible with apps like Rec Room, VR Chat, Big Screen, Walkabout Golf, etc. One of the big benefits of course there is that other players only see your virtual avatar so if you struggle with physical contortions (like I do sometimes) with your mouth, eyes, hands, whatever, no one knows but you and the social experiences and wins can boost your self confidence and help to reassure you which of course has a positive feedback loop I find in helping with better fluency. Good fluency leads to great fluency! I'd also encourage as part of self acceptance to being open to talking to your sister very candidly and openly about your speech. Since she's very close to you, she's obviously a safe resource to hopefully help you to dispel some of the harsher and probably inaccurate assumptions you have about your fluency, how you come across, etc. Remember, we are always our own worst, most harsh critics. One last part of the self acceptance bit I'd recommend and it's something that's helped me a bunch is to just at the onset of a conversation with a new person and where it's appropriate, I'll just tell them I have a "bit of a speech impediment" and basically just tell them I'm on the level should they even have a doubt (really I'm just reassuring myself). But just putting that out there right away tends to immediately put me at ease and makes it so I don't feel like I'm dodging and hiding something the whole conversation, just hoping they don't notice the thing that I'm spending 80% of my mind on when I should just be focusing 100% on the conversation itself. Anyway, I wish you the very best and since I'm writing this on my phone I'll stop here, but would be thrilled to keep chatting if anything helps!