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Gina P
Gina P , LCSW
Category: Mental Health
Satisfied Customers: 175
Experience:  MSW, LCSW, PIP
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Hi - I have just realised after years (I am 43) that i may

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Hi - I have just realised after years (I am 43) that i may have social phobia (have looked on the internet and all the symptoms are very familiar). I was VERY shy a child; and never really grew out of it; ok in one to one situations (in fact people think i am very confident) but have an excessive fear of public speaking - (not when asking questions (as can do this easily - prob because people are facing away from me) - but I get physiologically distressed -blush/ sweat profusely as if I've been on a run- shake- voice tremors - and think about the speech and practice obsessively (when I haven't been avoiding it) for weeks before hand.
Can you suggest -treatment for me - live in Auckland -don't want a DSM1V diagnosis but would like to do something about this (it's ruining my career!!!!)..

Submitted: 6 years ago.
Category: Mental Health
Expert:  Gina P replied 6 years ago.

Hi, Fear of public speaking is number one fear among people. It is a symptom of social phobia, but does not sound as if you have this disorder. Many people have extreme anxiety with symptoms you describe.

Medicational treatment to include beta blockers and benzodiazepines. Also SSRIs such as celexa, zoloft, paxil are used as well.

Sometimes these are enough to make you feel comfortable. You are probably aware the benzos and beta blockers are much faster and instantaneous, and the SSRIs usually take about 4 weeks to reach maximum potential.

Cognitive behavioral therapy is the preferred treatment method for addressing this issue, but there are also many online courses to address this as well.


Doing some things for yourself can help a bit such as saying aloud "I'm a little nervous" during your talk, telling a joke loosens up you and the crowd a little. Some people prefer to sit down on a stool or chair while speaking. This puts you on a more even keel with everyone, and you don't feel so much in the spotlight. As you gain more confidence you can stand up. If you are lecturing, standing in the back of the room with an overhead, allows the eyes off of you, and on to something else. Finding one person in the room who is paying attention and looks "kind" and focus on them. As you look around during your speech, focus on the bridge of the nose rather than the eyes of your audience. This appears as if you are looking directly at them, without seeing the eyes on you. You are already addressing this through Toastmasters, which is excellent. The more you practice anything, the more comfortable you feel.

One or a combination of these treatments can help you over come this common fear. Please let me know what other questions you have. Gina

Customer: replied 6 years ago.

I have been trying Toastmasters on and off since for 10 years (I've probably joined about 10 clubs so far) - they don't seem to work on their own for me as I get very apprehensive and anxious when I have to mix with other people in a club situation.

When a group conversation starts I always try and stop it and return to a one to one conversation.

I have also tried the beta blockers but they didn't work with me.

I suppose social phobia is also a bit of a continuiim?




Expert:  Gina P replied 6 years ago.

Hi K

You know, it does have a lot to do with living in a bubble.
The bubble is the comfort zone. We allow certain people and situations to be inside the bubble, because we feel comfortable around them. The bubble stretches and pulls in other things as we feel they are mastered, or with certain people who are not threatening to us. So, yes, it is like a continuum in a way.

The more you do something, the more your confidence builds in your ability to succeed at doing it, and then eventually it slips into the bubble. So we aren't nervous about it anymore. Like riding a bicycle, so to speak.

Public speaking is a little different, because most of us don't have to do it everyday, so we lose a little confidence in between. I think that is why it is so threatening to us. If you ever have to do a daily speech or class, you would find at the end of that period of time, you would feel pretty good about your abilities.

Please let me know if you have other questions. Gina

Customer: replied 6 years ago.

Yes -I have framed it that way myself (the bubble).


From what you are saying then - perhaps it's an ecclectic kind of approach - if I'm on a continuiim than I could take some useful tips from people about social phobia kind of treatment which might be useful - e.g cognitive therapy/ desensitisation etc ??

Expert:  Gina P replied 6 years ago.
Yes, Some behavioral treatments such as graded self exposure which involves repeatedly allowing yourself to face certain situations and rate how you feel, along with symptoms, until you become comfortable. Cognitive restructuring is when you are able to reframe your beliefs about what is "suppose" to happen such as, always being confident in front of a crowd. When you fear you do not appear confident then the panic and fear get worse, thus the sweating, blushing, etc. Also some visualization exercises can help, and shifting of attention which is where you are taught to change your attention from yourself to the audience or particular persons. There are many techniques that can help. A combination of medication while you are learning some of these would help you feel more confident. Hope this helps. Gina
Gina P, LCSW
Category: Mental Health
Satisfied Customers: 175
Experience: MSW, LCSW, PIP
Gina P and other Mental Health Specialists are ready to help you
Customer: replied 6 years ago.
Thanks for this - very helpful
Expert:  Gina P replied 6 years ago.
Good, please let me know if I can help you again. I wish you well. Gina

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