By Tom McDonagh, Psy.D.
CA License #: PSY25741
WA License #: PY61408367
So a common theme we hear from clients here at Good Therapy SF is fear or anxiety about public speaking. Often this comes in at work situations where they have to either present a deck to their colleagues or to their skip level managers, or sometimes just in general the virtual meeting place, people got used to that and then they have to go back to in person meetings, the experience of being around people in person, while it didn’t used to be a bit of a problem, can be a bit of a problem now.
So there’s some public speaking or some social anxiety that’s going on here.
One of the general approaches we’ll take for this is making sure people remind themselves how to manage the symptoms that come with public speaking. Stress management skills are really important here.
The two main ones we always emphasize are deep breathing. So just some nice deep breaths in through your nose and gradually letting them out through your mouth, helps to regulate that fight or flight response. As well as doing some progressive muscle relaxation, and you might need to work with a therapist individually to get that really locked in for yourself.
But essentially the idea with progressive muscle relaxation is to constrict certain muscle groups for a certain period of time. Then allow them to relax. And then do that same constriction again and then allow them to relax. And kind of work throughout certain parts of your body where you feel more tension.
And again, these are really useful skills for managing the fight or flight response that happens initially before we do the public speaking.
Also in prep work ahead of time for public speaking, we want to focus on some imaginal exposure.
So what we can do is think about situations where you’ve been in the past or areas in which you think you’re going to be in the future. And you want to set up a bit of a scene for yourself in your mind and walk yourself through the scene. And imagine what you’re going to be experiencing.
However, in this imaginal exposure where you’re visualizing it or where you’re imagining it, you really want to try to imagine yourself using the more helpful coping skills. So you’ll imagine yourself feeling some sort of anxiety. And then you actually remind yourself that you can do some deep breathing or other types of relaxation skills in the moment.
So the idea there is to remind yourself and train your brain to think, Okay, when I feel this type of anxiety in this situation, there are helpful things I can do for myself. So it becomes a learned behavior over time. So you learn how to help yourself think in a more helpful way during these moments.
We also like to help people in the moment, help them recognize or train certain ways to focus on our thoughts outside of ourselves. One of the things we know about public speaking is that becomes much worse and more intense when we become much more internalized. Or when our thoughts focus more on ourselves. For example, instead of focusing on what we’re saying and presenting to the room, our thoughts tend to drift to, Oh, I can feel my face is getting flushed right now. Or I can feel myself my heart rate going up, and I can feel my voice wavering. We become hyper focused on ourselves, and that actually makes the cycle of social anxiety, or public speaking anxiety worse.
So there are ways in which we can help people externalize their thoughts away from themselves, and out towards the situation. And the more you’re able to focus externally from yourself, the less anxious you’ll be over time. And again, these are things you really want to work with the therapist more directly about because they tend to be more personalized.
One example I had was with somebody, they had difficulty presenting in meetings, to a particular person. So really, what we focused on were the memories this person had in the past of how they responded. And they were recalling these memories. And they were being really self critical. And I really felt like they were hyper focusing on small things that other people would not have noticed.
So we did a lot of thought records around those thoughts first. And then in the moment with them, I had them do a little bit of a practice, presenting to me one on one as though they would present to this particular person. And then I was mimicking and show them, okay, here’s how you use the relaxation skills right now that we focused on, in the moment. And gave them some guidance throughout this process, and then they ended up doing that and internalizing that for themselves as well.
So there’s a lot of different options you have here when you’re working with public speaking anxiety or social anxiety. They really do focus on managing your physiological responses through stress management.
Then there are also different types of exposure therapies. You can do as well, such as visual or imaginal exposure. And then they’re working with your thoughts as well that include often some type of thought record to help you restructure or challenge some of these unhelpful thoughts.
And if you’re looking for some help with your public speaking anxiety or social anxiety, please feel free to reach out to us at Good Therapy SF.
