In my opinion, the problem may be our intolerance to the sensation of a perceived loss of control (resulting in a drop of post-synaptic dopamine release), and then we stutter. On the other hand, stuttering remission may occur, if the novelty effect of a therapy lasts long enough to enable the development of faith in one’s ability to speak without stuttering. This may explain why some therapists with a convincing manner, succeed in eliciting better results, regardless of what type of therapeutic approach they adopt. This belief in the strategy's efficacy (or faith in one's ability to speak without stuttering) might compensate for the perceived loss of control (resulting in normalizing dopamine release). Of course, I oversimplified that quite a bit. Truth is, we likely have many distorted beliefs, and perceived errors - reinforcing each other. In other words, conditioning takes place, which includes: * reduced reward sensitivity and reduced striatal anticipatory response to choice opportunity - which could be a result of prolonged stress and behavioral dysfunctions * leading to reductions in perceived control * leading to anxiety associated with increased vigilance for threat, or an intolerance for uncertainty * leading to fear of losing control, and thus, subsequent maladaptive forms of control-seeking behavior, such as avoidance, compulsive behavior and the use of anticipation. Deliberate use of anticipation (which is a maladaptive instrumental action that belongs under cognitive distortions) is used to promote an illusion of control, but in fact does the opposite and likely reinforces the stutter disorder instead * leading to constantly trying to balance our perceived sense of control, such as by trying to maintain a fake confident feeling and other maladaptive responses * leading to a fixed mindset (promoting the belief that an ability is fixed rather than improvable) * leading to its affective and behavioral consequences (along with future decision making) entering into a vicious and pathological cycle This is just my own take on it. **Your thoughts?**