I commend you for taking a whole-life approach with stuttering; attempts at speech therapy, what’s going on mentally, your diet, and exercise. Few seem to look at it in this way, and the whole-life approach was absolutely key for me. That being said, most PWS want a “quick fix” or “cure,” but from my experience, stuttering is a long game; give yourself 3 to 5 years, or more. Whatever it takes. Speech Therapy: I discarded speech therapy because I could never find a therapist who was a stutterer for 20+ years and became fluent. So how could they help me based on theory? On something they’ve never done themselves? Stuttering is too intricate, too delicate, and too person-dependent to throw textbook theories at. Plus, speech therapy focuses on the physical speaking aspect of stuttering, which, in my opinion, is a by-product of other things. My best advice here is to simply speak a bit softer, slower, and speak on a gentle outflow of air, then start over when you run out of breath. If you have a block, just reapply and keep going; don’t give it the emotional attention, become stubborn towards the self-shaming. Do this for many years. Physical Aspect: You may try exploring hard cardio, yoga, Wim Hof, or other deep breathing exercises to help with the physical tension. Also, a low-inflammatory diet. You may even go down the food/environment allergy route. Inflammation increases physical tension in the body, and physical tension contributes to more disfluencies. I looked at it like this: if my physical tension was less then I would assume, I would have less blocks/stuttering. And if I could stutter 5% less over the next three years, then that’s 5% more references of speaking fluently for my mind to see. And the more fluency my mind experiences, my hope was it would slowly start to change the tide overtime to speaking more fluently as it became more familiar with it. Anxiety: In my opinion, the physical act of stuttering is in large part (not all) a by-product of what is going on mentally. Stuttering is not a cause; it’s an effect of something. As for anxiety, I believe stuttering in itself is an anxiety. I was a walking “anxiety” when I stuttered (although I never called it that). A life of absolute hypervigilance and fear. I lived looking ahead not only in sentences to avoid words but in life to avoid high-risk speaking situations. But I would always get caught in a block eventually and would self-humiliate, self-hate, and shame myself. This hypervigilance would seem to be the incessant thinking you speak of. I saw it as a mind pattern, something the mind is comfortable with at this moment, and this is something the mind will seek in all things, even if you became fluent right now; it’s what is familiar to it. I worked to slowly, overtime, lessen all thoughts associated with stuttering. Words, thoughts, and feelings about stuttering seemed to carry emotional weight within me, and my body reacted to this with tension, and this tension would seem to contribute to more disfluencies. For me, anxiety and low self-confidence were a byproduct of stuttering. It in itself didn’t seem to create it. But that doesn’t mean the two aren’t intertwined and dependent on each other. You can become fluent; just keep moving forward and observing. Look for clues that prove this. For example, one time I noticed I “forgot” to stutter on one of my major “feared words,” and that left a clue, something to explore deeper. Leave no stone unturned.