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The hardest problem I've always faced is that, by the time the an idea has formed into words, my brain has already moved on to several dozen different topics. In other words, the synapses get all cofuzzled and mixed together.
Try to think only of the subject at hand - don't let your mind stray too far from the words that you're saying. Slow down, until it sounds as if you're speaking at half the tempo that you usually do (this is especially true if you're from the northeast), and try to actually rationalize what you're saying - don't just say it.
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"I've made only one mistake in my life. But I made it over and over and over. That was saying 'yes' when I meant 'no'. Forgive me."
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