One focus of my practice is speech anxiety treatment. This type of anxiety, also known as public speech phobia, can be a challenging issue for many people for many reasons. Knowing the reasons for speech anxiety is not always necessary, but it can help guide treatment. Public speech anxiety is quite treatable, and often, initial results come quickly. I have worked with people whose difficulties occur only when there is a large group to speak in front of, but also some people who get anxious even in front of a small group or even one person.
Contact Me Regarding Speech Anxiety Treatment
Since the reasons people call for public speech anxiety treatment vary, I’d be happy to talk to you about your unique symptoms and what you are looking for, so don’t hesitate to schedule a consultation or contact me with questions. Here is an overview to get you started.
Public Speech Anxiety Treatment Approaches
Here are some speech anxiety treatment options:
Cognitive Behavioral Therapy (CBT) for Public Speech Anxiety
CBT is a common speech anxiety treatment approach. It focuses on identifying and challenging negative thought patterns and replacing them with more positive and realistic ones. Through cognitive-behavioral therapy for social anxiety, you can learn coping strategies and techniques to manage your fear before and during speaking engagements. You may see some small reductions in your public speech phobia fairly quickly with CBT, and this can be quite motivating. And the nice thing about CBT is that you learn ways to manage other types of anxiety as well. Here are some examples:
Cognitive Restructuring for Public Speech Phobia
- How: Identify and challenge negative thoughts about speaking, such as “I’m going to embarrass myself” or “Everyone will think I’m boring.” Replace these thoughts with more balanced, realistic ones like “I may feel nervous, but I’ve prepared and can handle this.”
- Why: Cognitive restructuring helps reduce anxiety by shifting your focus from irrational fears to rational, supportive self-talk, reducing the power of negative thoughts.
Thought Record Journals
- How: After each speaking experience, write down your thoughts, feelings, and any positive or negative outcomes. Challenge any unhelpful thoughts and record supportive, realistic ones.
- Why: A thought record helps identify and address negative thinking patterns, making it easier to manage them in future speaking scenarios.
Gradual Goal Setting
- How: Set small, achievable goals, like speaking up once in a group meeting or practicing a speech with a friend. Slowly increase the difficulty over time.
- Why: Building up to bigger speaking challenges allows you to accumulate confidence gradually and prevents public speech phobia symptoms.
Exposure Therapy for Public Speech Phobia
Exposure therapy for public speech anxiety involves gradually exposing you to the situations or stimuli that trigger your fear, in this case, public speaking. By facing their fears in a controlled environment and learning relaxation techniques, you can desensitize yourself to anxiety-provoking situations. For exposure therapy, the reasons for speech anxiety are not always necessary. We will go at a pace you are comfortable with – some people worry that exposure therapy will push them too hard, but that’s not the case. Here are two examples:
Exposure Techniques
- How: Gradually expose yourself to situations that trigger your speech anxiety, starting with less intimidating scenarios. For example, practice speaking in front of a mirror, then to a friend, and work up to larger groups.
- Why: Repeated, controlled exposure helps desensitize you to the fear, making you more comfortable over time and reducing avoidance behaviors.
Behavioral Experiments
- How: Test your assumptions by performing small “experiments.” If you think, “People will laugh at me if I make a mistake,” test this by purposely making a small error in a safe speaking environment and observing people’s reactions.
- Why: Behavioral experiments help disprove irrational beliefs and create evidence for more realistic beliefs, making speaking situations feel less threatening.
Mindfulness and Relaxation Techniques
Deep breathing, progressive muscle relaxation, and mindfulness meditation can help you manage your speech phobia symptoms. These psychotherapy treatment approaches promote relaxation and can be particularly useful in the moments leading up to a speaking engagement. Here are some examples:
Present-Moment Awareness
- How: Notice what you see, hear, and feel in the environment around you. Tune into the colors in the room, the sound of your breath, or the texture of an object you’re holding.
- Why: Focusing on physical sensations in the present moment can help ground you and reduce anxious thoughts about potential outcomes or judgments.
Acceptance of Emotions
- How: Rather than fighting feelings of nervousness, acknowledge them without judgment. Label them: “I feel nervous,” “My heart is racing,” “My hands are cold,” etc.
- Why: Accepting emotions as temporary rather than trying to suppress them can reduce the intensity of those feelings and help you manage them more calmly.
Non-Judgmental Self-Talk
- How: Notice any critical thoughts and gently reframe them. If you think, “I’m going to mess this up,” replace it with, “I’ve prepared, and I’m doing my best.”
- Why: Harsh self-criticism fuels fear, while self-compassion can help you confidently approach the situation.
Visualization and Positive Imagery
Visualizing successful speaking engagements and using positive imagery can help you build confidence and reduce anxiety. By mentally rehearsing presentations and focusing on positive outcomes, you can reframe your mindset about public speaking. It does help to know the reasons for speech anxiety to use this method effectively. Here are two examples:
Visualization of Success
- How: Visualize yourself giving the speech calmly and confidently. Picture the audience responding positively and you feeling relaxed.
- Why: This can help rewire your brain’s associations with public speaking so you view it as a more manageable and even positive experience.
Visualize Connection, Not Perfection
- How: Shift your focus from wanting to perform perfectly to wanting to connect with your audience. Imagine you’re talking to one person at a time rather than an entire group.
- Why: Focusing on connection rather than performance can take some pressure off and make you feel more comfortable and authentic.
Other Speech Anxiety Treatment Possibilities
Aside from the public speech anxiety treatment that I and other psychologists can provide, other options can help, including:
Speech Training and Practice
Building confidence through training and practice can help individuals feel more prepared and capable when speaking in public. Working with a coach or joining a public speaking group can provide opportunities for constructive feedback and support. Many people choose this method as an adjunct to treatment.
Medication for Public Speech Phobia
In some cases, medication may be prescribed to help manage severe symptoms. This typically involves medications such as selective serotonin reuptake inhibitors (SSRIs) or beta blockers.
Public Speech Anxiety Support Groups
Joining a support group or seeking peer support from others who experience public speech anxiety can provide a sense of validation and understanding. Sharing experiences and coping strategies with others who can relate can be beneficial in managing fear. This approach is excellent for those whose reasons for speech anxiety concern general social confidence.
Depending on the reasons for your speech anxiety and your preferences, you may want to explore different treatment options and find what works best for you. My integrative practice offers many possibilities to address your public speech phobia. With persistence and support, you can overcome this fear and become a more confident and effective public speaker.
Common Reasons for Speech Anxiety
This type of anxiety can stem from various underlying reasons. Here are some common reasons for speech anxiety:
- Fear of Failure: Many people fear that they will make mistakes or embarrass themselves while speaking in public. This fear of failure can create significant fear and self-doubt and is, therefore, one of the more common reasons for speech anxiety.
- Negative Past Experiences: Previous negative experiences with public speaking, such as forgetting lines, stumbling over words, or receiving criticism, can leave a lasting impact and contribute to this fear.
- Perceived Judgment: The fear of being judged or evaluated negatively by others can cause fear. You may worry about being perceived as boring, incompetent, or unprepared.
- Low Self-Esteem: Individuals with low self-esteem may lack confidence in their speaking abilities and fear that others will view them negatively. This lack of self-assurance can exacerbate worry.
- Social Anxiety: Public speaking fears often overlap with social anxiety disorder, wherein individuals experience intense fear and avoidance of social situations. The fear of being scrutinized or humiliated in front of others can be one of the reasons for speech anxiety.
- Concerns about Communication Skills: People who perceive their communication skills as inadequate may experience heightened anxiety about speaking in public. They may fear being unable to articulate their thoughts clearly or engage the audience effectively.
Other Reasons for Speech Anxiety
Less common reasons for speech anxiety include
- Perfectionism: Perfectionistic tendencies, wherein you may have excessively high standards for yourself, can be one of the reasons for speech anxiety. The fear of not meeting these high standards can create immense pressure and anxiety.
- Lack of Preparation: Insufficient preparation or lack of familiarity with the topic can heighten anxiety levels. People may worry about being unable to convey their message or answer questions from the audience effectively. We put this reason in the “less common reasons for speech anxiety” section because often the opposite is true – people with a public speech phobia often overprepare for speaking engagements.
- Physical Symptoms: The physiological response to fear, such as sweating, trembling, increased heart rate, and shortness of breath, can further exacerbate public speaking anxiety. These symptoms can be distressing and may lead people with a public speech phobia to avoid public speaking altogether. Interestingly, sometimes people experience these symptoms suddenly even though they do not initially actually feel nervous.
Summary and My Work
Understanding the underlying reasons for speech anxiety can help you address and manage their fears more effectively. Through targeted speech anxiety treatment interventions and support that I and other psychologists can provide, you can develop coping strategies to overcome this anxiety and become more confident communicators.
Speech Anxiety Treatment Example
Here is a fictitious example of speech anxiety treatment in my practice. Amanda is a 32-year-old who has just been promoted to a leadership position in her company and will now need to speak in front of large groups, including at board meetings. Her public speech phobia has existed for some years, but it has recently worsened due to this prospect.
Step One: Exploring the Reasons for Speech Anxiety
I start by educating Amanda about this type of anxiety. I help her understand that it’s a common issue and that she’s not alone. I explain the reasons behind her physiological responses associated with anxiety, how they relate to a fight or flight response, and how and why these can manifest during public speaking. We also explore her unique psychological reasons for speech anxiety, including feelings of being an “imposter” because she has been promoted so quickly and general feelings of not being prepared enough for speaking roles.
Step Two: Speech Anxiety Treatment
We then use cognitive-behavioral techniques to address Amanda’s negative thought patterns associated with public speaking. We can identify and challenge irrational beliefs about speaking in front of others, such as catastrophizing (“Everyone will think I’m incompetent if I make a mistake”) or overgeneralizing (“I always sound anxious when I speak in public”). At the same time, we make a plan to gradually expose Amanda to speaking situations that provoke anxiety, starting with less intimidating scenarios and gradually increasing the difficulty level. This exposure helps desensitize her to the fear of public speaking over time.
Step Three: Public Speech Anxiety Parallel Steps
During the active phase of treatment, I teach Amanda relaxation techniques such as deep breathing, progressive muscle relaxation, and visualization to help her manage anxiety symptoms both during preparation and delivery. We do some training in public speaking skills specifically tailored to her actual (vs. perceived) weaknesses, such as vocal projection, effective breathing techniques, and eliminating pauses. Building competence in these areas increases her confidence and reduces her anxiety. Finally, I introduce mindfulness techniques to help her stay present-focused and non-judgmental during speaking situations. Acceptance-based approaches also help her acknowledge and accept her anxiety rather than trying to suppress or control it.
Other Aspects of Treatment
As therapy moves along, we set achievable goals and celebrate progress. She also seeks support from friends, family members, and colleagues who share the same fears, all of whom can provide encouragement and feedback throughout the treatment process. Once she has made significant gains, I encourage her to tackle new challenges to maintain gains.
Speech Anxiety Treatment and My Practice
I offer public speech phobia therapy as a stand-alone and as part of treatment for a range of anxieties. Some aspects of public speech anxiety treatment also can be a part of my intensive therapy services, such as college admissions counseling and executive coaching. It can also be a subset of treatment for severe anxiety. While public speech anxiety is usually addressed in individual therapy, it can become a part of couples therapy if either member of the couple has the issues or one member wants to help the other overcome theirs.
Please feel free to contact me for more information about what treatment might do for you and what public speaking fear therapy might entail.
