FAQ

Public Speaking Phobia

What is it?

A public speaking phobia involves physical panic symptoms, anticipatory anxiety and avoidance centered  on various performance situations.   Physical panic symptoms include rapid heart beat,  breathing pattern changes, a sense of blushing, voice tremors, limb  tremors, dry mouth, gastrointestinal disturbances, dizziness, mental confusion/blanking out, a sense of urgency to leave the situation.  The thought process involves a hyperawareness of the focus of the  attention of other people, an assumption of an embarrassing outcome and a harsh self-assessment of themselves.  The feared  situations range from formal speech settings to unexpected spontaneous talks to reading in public to introducing oneself to a  group to one on one phone calls.  Anticipatory anxiety is a major component in the distress caused by this phobia and usually begins the instant the phobic person becomes aware of the possibility of having to perform.  There are strong urges to avoid, often regardless of the cost.  Most people with this phobia have adequate speaking skills and many are actually talented speakers.  However, major life decisions have frequently centered on the need to avoid any possibility of performance situations.

How is it treated?

There is effective treatment available for public speaking phobics.  This includes cognitive-behavioral treatment, medications or a combination of the two approaches.  Cognitive-behavioral therapy involves the correction of irrational (catastrophic/perfectionistic) thoughts to more reality-based thought patterns regarding performing, education regarding distracting and panic-management techniques to use during speaking instances, practicing and desensitizing.   Medications are most often prescribed by psychiatrists with specific experience treating this phobia and may include various medication options (antidepressants, antianxiety agents, beta-blockers).