The neuroscience of stage fright — and how to cope with it

Public speaking is one of our most common fears, topping flying, financial ruin, sickness, and even death. The fear can get so bad that people become physically ill before getting on stage. But this fear — often called performance anxiety or stage fright — extends beyond the pressure to perform in the moment. It's about the underlying social psychology of exposing oneself to an audience. It's this vulnerability that sets off an entire cascade of physiological processes throughout the body in a defense mechanism that at one time served an important evolutionary purpose.

Understanding the science of stage fright can also help ease the fear.

A common fear

Back in 2007, I gave a talk at a futurist conference in Chicago that featured such speakers as Ray Kurzweil, William Shatner, and Peter Diamandis of XPrize fame. If this wasn't pressure enough, the day before my presentation I learned that one of my longtime heros, cognitive scientist Marvin Minsky, was going to be in the audience. It was at this point that my body started to rebel against me; I broke out into a nasty rash, began vomiting, and contracted a rather unpleasant case of diarrhea. The next day, I stood on the stage and desperately fought back the urge to panic, delivering a presentation that was stilted, awkward, and completely uninspiring.

Sadly, this was typical for me back then. But this experience finally made me snap out of my denial: I have stage fright — and I have it bad. And I am hardly alone.

The neuroscience of stage fright — and how to cope with it

Celebrities with stage fright include Rod Stewart, Barbara Streisand, Mel Gibson, and Carol Burnett (who reportedly threw-up before many of her performances). Many prominent athletes tend to suffer from it as well, including nervous hockey goalies and boxers who just can't seem to perform when everything's on the line.

Generalized anxiety

Stage fright is an emotional and physical response that is triggered in some people when they need to perform in front of an audience — or even an anticipated or perceived audience (such as standing in front of a camera).

While feelings of stress and anxiety are present during the actual performances themselves, individuals with stage fright often start to experience its effects days or weeks in advance (something that was particularly bad in my case). Consequently, stage fright is more than just a fear that's elicited during a performance — it's also very much about the lead-up. And in fact, for some, the performance itself can be a kind of cathartic release from the tension.

In addition to inducing the emotional effects of generalized anxiety, people with stage fright also exhibit a diverse range of physiological symptoms, including dry mouth, butterflies in the stomach, a pounding heart, shaking of the extremities, sweaty hands, facial ticks, and diarrhea. But this is a partial list; people with stage fright can exhibit any number of symptoms.

Inner chatter

Like most phobias, stage fright is a perfectly normal and even natural response to situations that are perceived to be dangerous or somehow detrimental. Psychologists who work with stage fright patients describe how their inner chatter tends to focus on those things that could go wrong during the performance and in the immediate aftermath of a potential failure. For people who have it quite bad, this can amount to a kind of neuroticism in which fears are exaggerated completely out of context — what psychologists call chronic catastrophizing.

The neuroscience of stage fright — and how to cope with it

And in fact, studies have shown that these fears can be driven by any number of personality traits, including perfectionism, an ongoing desire for personal control, fear of failure and success, and an intense anxiety about not being able to perform properly when the time comes (which can often serve as a self-fulfilling prophecy). Psychologists have also observed that people with stage fright tend to place a high value on being liked and regarded with high esteem.

Moreover, during the performance itself, individuals with stage fright tend to form a mental representation of their external appearance and behavior as they presume it's being seen by the audience. Consequently, they turn their focus onto themselves and interpret the audience's attention as a perceived threat.

In turn, this perceived threat creates fear; people with performance anxiety start to think pessimistic thoughts and assume that others are naturally critical and that a negative evaluation is likely (again, these ideations can happen either prior to or during the performance).

And once the fear sets in, that's when individuals with stage fright begin their downward spiral during which they're perpetually on the lookout for anything that would reinforce their fears. For example, though most of the audience may in fact be enjoying the presentation or performance, the performer will only notice negative cues, such as audience members yawning, frowning, chuckling, and so on.

Evolutionary biologists believe there may be a good reason for stage fright to exist. In the past, these sorts of cues could have signaled the loss of status or access to resources. In turn, the situation would trigger the fear response, what is also known as fight-or-flight.

Fight-or-flight

And indeed, stage fright is an evolutionary throwback — one that can be directly tied to our more primal neurological heritage.

The neuroscience of stage fright — and how to cope with it

The fear that is elicited by stage fright ignites the body's fight-or-flight response, which is what brings about its various physiological manifestations. Essentially, it's the perceived sense of danger that sets off the sympathetic nervous system, which mobilizes the body's nervous system in preparation for something that arguably never comes.

Specifically, catecholamine hormones, like adrenaline or noradrenaline, prime the body for violent physical action. This includes accelerated breathing and heart rates, the halting of digestive processes, constriction of blood vessels, releasing fat and glucose to fuel muscles, and tunnel vision (to focus attention away from the peripheries).

Of course, the response is completely disproportionate, and can be seen as a kind of false alarm. And needless to say, the psychological experience of all this, including the initial fear-response itself, is extremely unpleasant. Stage fright, it's fair to say, is not fun.

Longer term effects include diminished sexual response (including an inability for males to get an erection), constipation, anorexia, and difficulty urinating. It also compromises the body's immune system, making it vulnerable to infections and other problems.

Treatments

Thankfully, there are a number of things that can be done about it.

For me, one of the best ways to deal with my stage fright has been to get on stage as much as possible — regardless of the discomfort. I find that the more public speaking I do, the less anxiety I feel. And indeed, the longer I go between talks, the worse the stage fright becomes.

The neuroscience of stage fright — and how to cope with it

Now that said, this may not be an option for people who suffer from debilitating performance anxiety. In some cases, there are safer and friendlier opportunities to perform publicly, including Toastmaster classes. Most cities offer similar courses and opportunities to help dancers and musicians.

Another option is medication. Beta blockers are renowned for their ability to counter the effects of the fight-or-flight response. The exact mechanism of action is largely unknown, but beta blockers like propranolol have been used by performers for decades (some surgeons even use it to reduce hand tremors during surgery).

In fact, surveys have shown that upwards of 27% of symphony orchestra musicians use beta blockers to help alleviate the symptoms of stage fright. They're also used in sports, though they have banned by the IOC and are considered a performance enhancing drug.

There's also cognitive behaviour therapy to consider. Unlike beta blockers, CBT gets people to tackle the psychological and emotional underpinnings of their stage fright to help them counter much of the negative internal talk that's associated with the condition. Specific techniques include recognizing irrational and unfounded beliefs, avoiding the revisitation of an "activating event" (i.e. a recent negative experience), and learning how not to obsess over the fear of negative consequences. And just simply talking it out with a therapist has also been shown to be effective.

Other treatment options include hypnosis, meditation, and visualization. Visualization techniques can be particularly effective (especially for athletes), as it creates an identifiable, positive image in a person's mind about the desired outcome. Mentally projecting oneself after the performance does much to alleviate feelings of anxiety. I've used visualization techniques before, and I find them quite helpful — including visualizations of everything that could possibly go wrong, which I then come to accept as possibilities (sounds unintuitive, but it works for me).

Now all this said, it's important to acknowledge a couple of things.

First, people with stage fright shouldn't feel that they have to get over it and force themselves into situations that make them feel exceedingly uncomfortable. Every person with performance anxiety needs to consider just how important it is to them to deal with the effects of stage fright. Sometimes it's just simply not worth it.

And second, stage fright is not really something that anyone can truly "get over." For me, it will always be there lingering in the background — I'm just getting better at managing it.

Sources: Schultz & Heimberg 2007, Conroy and Metzler 2004, Hewitt et al 1995, Rapee & Heimberg 1997, Trower & Gilbert 1989, Fridlund et al 2003, Osborne & Franklin 2010, Steptoe & Fidler 1987.

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