>*Maybe a better way I can phrase my question is if the physiological or mechanical reason for a speech block is not a sort of involuntary valsava maneuver. Then what is?* You can test this out for yourself: (1) right now, tense your abdominal muscles or your throat muscles as much as possible, and (2) pronounce the word '**apple**'. Conclusion: See? We are able to say the word without blocking if we tense our muscles at maximum. In other words, tensing the abdominal muscles or throat muscles can never in any way lead to a speech block. To answer your question better, I'd like to pose a question: Question: If the woman (in [this](https://www.tiktok.com/@supershan1977/video/7003088417458310405?_r=1&_t=8Y57Ckvfw4U&fbclid=IwAR3P1Bz8h_8JrYZDqZmzqrFwyML66GhvanmxBY8w9sBRQuATLWIl7eeP3NU&is_from_webapp=v1) video) blocks, what happens exactly? **A)** She stops breathing out, or **B)** she stops moving her tongue, larynx, and other speech muscles? Answer: she stops moving her speech muscles which prevents her from forming the next sound in order to say the next letter. Now, you can tryout and simulate this: * (1) say the word '**And**' by **(1)** exhaling (so that we can hear your voice), **(2)** but without moving your larynx/vocal cords (so that the vocal folds won't open completely) * This is how the woman blocks in the video Yes indeed, normally a trigger (*like anticipatory fear*) would give us a good enough reason to stop moving these throat muscles. Research states that PWS are 90% of the time correct when they predict a stutter. Of course, human beings are not able to truly predict the future, but this is how strong we habitually immerse ourselves in anticipatory and intrusive thoughts and feelings that give us the impression that we can't move speech muscles. The fact that speech therapy claims that adults cannot outgrow stuttering doesn't help either, in fact, it will only justify and reinforce the anticipatory and intrusive thoughts in the lack of a better solution, in my opinion. Human beings are not able to directly operate muscles, for example, if we want to walk then we are not able to wilfully move neurons in the nervous system, move the blood flow and send electrical signals to this and this part of the brain in order to move the leg muscles. The only way that humans are able to move muscles is by instructing/deciding to move them. So, if the physiological or mechanical reason for a speech block is not a sort of involuntary valsava maneuver. Then what is? In my opinion, the reason that PWS stop moving speech muscles (resulting in a speech block), is because we have developed an unhelpful habit of distracting ourselves from: "instructing to send command signals to move speech muscles". For example, we distract ourselves from this by excessively focusing on: 1. tension (secondary characteristics) 2. blaming 'tension' or other triggers (defective conditional expression) 3. trying to reduce tension (unhelpful strategy) 4. feeling bothered (reaction to triggers) 5. locating, feeling (and tracking the outcome of) speech muscles in order to '**try to directly operate the muscles**' - which of course is impossible for PWS and non-stutterers as explained above (sensory feedback) 6. or focus on anything else to replace 'instructing to move speech muscles' Conclusion: The issue (or behavioral compulsion) is: we stop moving speech muscles (causing a speech block). In my opinion, the solution to move speech muscles is not by focusing on above 6 bullet points, rather to focus on instructing to move speech muscles or any other fluency law that non-stutterers apply (like focusing on the speech rhythm in order to focus on maintaining the forward flow of speech). Whether we focus on (1) 'instructing to send command signals', or (2) speech rhythm, both are considered a distraction technique in my opinion, because by focusing on one of these two fluency laws, we stop paying attention to stuttering, the stutter cycle or above 6 bullet points.