It is neurological, but it doesn’t mean it isn’t also affected by your mental state. Stuttering is primarily a motor control issue in the brain. Research shows that people who stutter often have disrupted connectivity in the areas responsible for timing (basal ganglia) and speech sequencing (white matter in left hemisphere). When you are in an intense discussion or speaking to a superior, your limbic system (the brain's emotional center) hits the gas. This creates a massive amount of "neural noise." And because the pathways you use to coordinate speech are already a bit "fragile" or less efficient, this extra emotional noise overloads the circuit. It’s not that the anxiety creates the stutter; it’s that the anxiety lowers your brain's ability to compensate for its internal timing glitch. Regarding your case, there is Anticipatory Struggle Hypothesis. It’s basically a closed loop: - You anticipate that you will stutter in a stressful moment - This anticipation triggers the limbic system - Limbic system overloads speech motor center - You stutter - Stutter confirms the fear, thus reinforcing the cycle It is recommended to do both speech therapy and CBT. Speech therapy helps to learn how to control your speech timing instead of it being automatic. And CBT helps with psychological responses and managing emotions