I'm very fluent and chatty in quiet environments. The more noise/distraction there is the more I block up- I just block (I can't get words out) and the only sentence I can say in frustration is "Forget it, I don't know." Although I like singing/chanting to myself outside to other noises...I'm alright then. I saw a great speech therapist around the time I was first referred to mental health services (the first psychiatrist I had also had a stutter- he said I was "hot", (WTF?!). after questioning, I found out he meant 'astute') and I pretty much became fluent very quickly with her technique and approach- she said she hadn't seen a person make so much progress so quickly.