Question

Imagine that you have a friend who has a social phobia associated with speaking in public. They absolutely hate public speaking and have panic reactions anytime they are forced to do so. They do everything they can to avoid it, including dropping classes that require it. Imagine that they have a catastrophizing mindset that raises their anxiety. What might they be saying to themselves? (be creative- there can be many things that go wrong in a presentation). What practices might be helpful to decrease their anxiety? What treatments would be beneficial? What future trends in this field might help with understanding and treating anxiety?

Answer 1

Fear and anxiety related to public speaking occurs when the individual is high on Communication Apprehension i.e. they are scared to communicate or feel extremely anxious while trying to communicate.

Q1. What might they be saying to themselves?

• Everyone is judging me
• Everyone is judging the way I am presenting and speaking.
• Everyone is looking at me.
• I must be sounding like a fool
• I dont think I am making any sense.
• They must think I'm dumb and incompetent
• I can't even give a simple presentation how will I ever succeed in life?
• I made a mistake, everyone will judge me now and think i am dumb.
• I fumbled. I look so stupid. I am making a fool out of my self in front of everyone.

Q2. What practices might be helpful to decrease their anxiety?

The below practices might be helpful in decreasing their anxiety:

• Practicing the speech or presentation throughly
• Practicing it by speaking to a mirror first.
• Practicing with a close friend or family member
• Practicing in front of a small crowd.
  

Q3. What treatments would be beneficial?

Since communication apprehension is heavily based on automatic and unconscious negative self talk, applying CBT techniques can reduce the severity of the negative self-talk which inturn will reduce the anxiety one feels while public speaking. One can use cognitive techniques such as identifying the negative automatic thought and try to reconstruct it using evidence.

For example, when the individual says, " I made a mistake, everyone will judge me now and think I am dumb " ,asking them to provide evidence about this statement will make them aware and also give them evidence that they are catastrofying. For example, "Can you tell me who called you dumb or came upto you after your speech and said you were dumb?"

One can also use behavioral therapies like gradual exposure wherein they are gradually exposed to the stressor. As the stressor gets severe it is coupled with a relaxation exercise to make them comfortable in that situation. Over time they associate the relaxated feeling with the stressor and the panic and anxiety felt while giving a speech reduces or becomes manageable. For example, thinking about speaking to 2 people and then gradually increasing the number of people to 10.

Q4. What future trends in this field might help with understanding and treating anxiety?

• Future research on genetic and environmental factors that make one susceptible to developing anxiety can be used for the betterment of treatment.
• Future research of medications that help anxiety can also be useful.

Once the individual accepts that this is an irrational response, understands why the situation is making him anxious and pin points his triggers half the battle is already won.

Understanding the unconscious mechanisms of anxiety, it's root causes, where it stems from and being aware of environmental stressors that trigger or exaggerate anxiousness can be very helpful in symptom management.