Dear Dr. Paster,
I hate public speaking. I dread getting up in front of an audience but often I have to. It's part of my job. Every time I do, I break into a sweat, my skin turns red, I feel a hot flash coming on and I start to perspire. It's just awful! It doesn't seem to matter that I know my topic better than everyone else in the room, I just can't shut off this embarrassing response. Can you help?
— Driving me nuts
Dear Driving,
Rest assured, you are not alone. When Americans are asked what's their number one fear, most say it's getting up to speak in public. It was mine too. I blame Miss Shutte, my nightmare elementary school teacher who embarrassed me every time she called on me to "read out loud." I always pronounced something wrong, all the boys and girls in the class would snicker, and Miss Shutte seemed to have a wry smile on her face. I can still see it. In fact I still get flushed when I think about it.
Many of you have similar stuff buried in your subconscious. This type of social phobia termed, "stage fright" often begins in childhood and lasts forever. Let's go through what's happening in your body.
The sympathetic nervous system, which regulates the "fight or flight" mechanism, switches on as soon as you think about "speaking." You subconsciously release neurochemicals in your brain that cause your adrenal gland to shoot out adrenaline activating the "fight or flight" mechanism. This evolutionarily important mechanism is nature's way of getting us ready to fight or getting us ready to flee. The hormone causes your heart to race, your blood pressure to rise, your mouth to dry up and your cheeks to blush. You are ready to go! You sweat, blood goes to your muscles, they activate and tremble. You can just feel it all over your body. By the way, when your voice muscles tremble, your voice cracks and you have that "shaky" sound. This "rush" is very uncomfortable and often interpreted by the brain as anxiety or nervousness. It's really stage fright.
A couple of options:
Consider therapy. There are some psychotherapists in Madison who specialize in helping people get over this "hyper" response. They do this through several different therapies that tamp down the system. Check with your doc and insurance company. Desensitization training might do the trick.
For others there is a simple pill that usually works called propranolol. It's in the beta blockers class of drugs commonly used for high blood pressure and recurrent heart attacks. Just 10 mg before you speak will reduce the adrenaline surge, lower heart rate and keep all that other "commotion" that adrenaline causes in check. It's estimated that more than half of all professional violinists take this before they preform so that they don't have that messy tremor.
The adrenal surge affects both the body and the mind. A few years ago I treated a radio personality in Chicago who often had to go on TV. Every time he was on set and given the 10 second cue, he'd begin to sweat, his pulse would shoot up and a funny thought would come into his mind, "Don't say the "S" word." Now he was a radio guy and knew how to keep his potty mouth shut. But each time he was on the set this "thought" would pop into his mind. So … when I put him on a beta blocker not only did he stop flushing and sweating but the worry about swearing simply vanished. The thought disappeared.
Stay well.
