Mechanisms of Change in Behavioral Cough Suppression Therapy for Refractory Chronic Cough

INCLUSION CRITERIA To be eligible to participate, participants must meet the following criteria: * 18 - 99 years of age * Diagnosis of refractory or unexplained chronic cough * Normal chest imaging (x-ray or CT scan) within past 2 years, without change in cough symptoms * If you a potential participant has asthma, the following criteria must be met: * Asthma diagnosed by a pulmonary provider * Documentation from a pulmonary provider that asthma is well-controlled * Agree to carry prescribed rescue inhaler to each study visit * Can tolerate, and agree to, avoid rescue inhaler use for 4 hours prior to each study visit. If rescue inhaler use is unavoidable within 4 hours of a study visit, agree to inform researchers in advance so that the session can be rescheduled. * Normal pulmonary function testing with spirometry (FEV1/FVC of at least 70% if diagnosed with asthma) within 2 years (6 months for those with a diagnosis of asthma), without change in symptoms since (NOTE: spirometry is included as part of cough threshold testing and can serve as this criteria if the participant has not had spirometry within the designated time.) * Laryngoscopy or stroboscopy within 2 years without evidence of structural pathology and no change in vocal quality since exam * Proficient reader/speaker of English * Willing to take a pregnancy test before enrollment (if applicable) * Willing to use contraception during the study (if applicable) * Access to reliable internet, working email address (for surveys) and a smart phone (for use with CoughMonitor Watch) * Demonstrates understanding in study procedures and risks in order to consent * Available, and willing, to comply to all study procedures and clinic visits. EXCLUSION CRITERIA Any of the following will be grounds for exclusion from the study: * Currently a smoker of any substance or has a positive history of smoking any substance within the last 6 months * Currently suffering from any signs of an upper respiratory infection (other than cough) * Hemoptysis (coughing up blood) within the last 6 months * Pulmonary diagnosis other than asthma * Asthma criteria - participant is deemed ineligible if screened for one or more of the following: * Use of rescue inhaler in response to active asthma symptoms ≥ 2 times per week * Respiratory related emergency department visit within the past 4 weeks * Respiratory related ICU admission within the past 12 months * Asthma exacerbation requiring systemic corticosteroid use within the past 4 weeks * Pregnant or trying to become pregnant * Any complaints or clinical symptoms of dysphagia * Live with someone with chronic cough or work with someone with chronic cough who is in close proximity (e.g., within 25 feet) on a daily or nearly daily basis * Known allergy to peppers * Currently receiving or has received BCS therapy for management of refractory chronic cough * Excluded concomitant medications: * Inhaled pulmonary medications (inhaled corticosteroids, short-acting beta agonists, long-acting beta-agonist, short-acting muscarinic antagonists), unless prescribed for asthma by pulmonary provider: 30 days prior to Visit 1 through completion of study participation * ACE inhibitor (benazepril, captopril, enalapril, fosiniopril, lisinopril, perindopril, quinapril, ramipril, trandolapril): 30 days prior to Visit 1 through completion of study participation. * Narcotic antitussive (hydrocodone, oxycodone, morphine, codeine, tramadol): 7 days prior to Visit 1 through completion of study participation * Non-narcotic antitussive (benzonatate/Tessalon, dextromethorphan/Delsym, carbetapentane/Solotuss): 7 days prior to Visit 1 through completion of study * P2X3 receptor antagonist (gefapixant/Lyfnua): 14 days prior to Visit 1 through completion of study * Any off-label prescription medication prescribed for cough (pregabalin/Lyrica, gabapentin/Neurontin, amitriptyline/Elavil): 14 days prior to Visit 1 through completion of study \*if a neuromodulator is prescribed for something other than cough, participant must be on a stable dose for a minimum of 7 days The following additional exclusion criteria will apply to participants who will undergo fMRI: * Presence of metal implants, devices or fragments (e.g., shrapnel) in the body * Claustrophobia