I am a speech language pathologist. I have a 19 year old patient who grew up with a number of different speech impediments (not a stutter). He was bullied a lot, and because of this he is very sensitive about how he speaks.
Recently, he has become so anxious about it he has developed a stutter. Note that stuttering was not one of the impediments he grew up with. He only developed it a couple of months ago because of his anxiety. He is not in a financial position to afford a psychologist, so I decided to help him with his anxiety. I know I'm not in a position to get rid of his anxiety; thats outside my scope of practice - I'm only trying to help with the manifestation of his anxiety in his speech, which is within my scope.
He blocks completely - in other words, when trying to pronounce certain words, he becomes completely silent for a couple of seconds as he tries to "push" the word out. Rather than the usual case of repeating the same sound over and over again, he simply becomes silent while he waits for the word to come out.
His main fear is not being able to get the word out and just being completely silent while the other person is waiting for him to complete his sentence. This fear is quite justified unfortunately - most of us would be confused if a person just stopped talking and would ask him to continue. I've used CBT for a stutter before, but that was to show the patient that some of their fears (i.e. being laughed at) were irrational.
How do I address the anxiety that stems from a fear that is relatively justified and logical?