Stuttering affects approximately 1% of adults. Therapies based on imitation offer only modest benefits when individuals observe external models. Neurobiological research reveals a key asymmetry: some studies suggest self-face recognition activates ventral tegmental area (VTA) reward circuits more strongly than observing others’ faces, and positron emission tomography (PET) research shows increased dopamine synthesis in some people who stutter. The Synthetic Self Hypothesis (SSH) proposes that th