Thank you so much for your question.
You might be familiar with a lot of this already, but I sometimes find it useful to consider the different roles that distinct areas of the body tend to play when it comes to external stimulus. The prefrontal cortex part of the brain for example, is responsible for regulating our emotions as well as allowing us to solve problems in a pragmatic and controlled manner. During moments of anxiety, a much more ancient part of the brain known as the limbic system, or paleomammalian cortex, takes the steering wheel and those aforementioned areas of the prefrontal cortex are relegated to the passenger seat. Furthermore, the limbic system might put on its own playlist and then turn up the volume on the stereo to drown out the prefrontal cortex’s boring suggestions. After all, nobody likes a back seat driver.
The amygdala, a key asset of the limbic system, is one of the few parts of the brain and the nervous system that is fully formed when we are born, whilst key parts of the prefrontal cortex are thought to take around 30 years to fully mature. I think this speaks volumes about our tendency to react in certain ways to unpleasant situations. One of the primary functions of the limbic system is essentially to identify threats and tell us to respond in a way that is designed to keep us safe. We might dissociate, get the heck out of there, or become aggravated to meet the challenge. Upon registering a threat, parts of the limbic system such as the hippocampus may remind us that we’ve seen this kind of situation before and perhaps that it didn’t end well. A chain of events may then occur within the body. A cocktail of neurotransmitters and hormones may prepare us for action, and we might find that our heart rate and respiration rate increases, that we perspire more, we may need the toilet as oxygenated blood is moved from the digestive system to our limbs, and we may even experience tunnel vision, become irritable and become more attuned to details such as sound. In more severe cases, this experience can produce a visceral experience known as a panic attack.
Challenging anxious or intrusive thoughts is perhaps a little easier when we are able to engage the prefrontal cortex. This is because the same parts of the brain responsible for things like task initiation, organization and working memory are also the same tools that we use for functions such as self-monitoring, emotional regulation, and impulse control. There are a number of ways that you can do this, and it is possible to strengthen connectivity within the prefrontal cortex with exercises that target specific functions of your brain such as word and memory games, or puzzles. These exercises can encourage neuroplasticity and reinforce essential neurological interconnections. You might also try learning something new, like a language, or other skill. This is even more effective than word games at engaging and exercising the prefrontal cortex, as it requires those parts of the brain to adapt so that it may understand and piece together new information. Cooking is an activity that engages multiple areas of your brain, including various senses, making it a great grounding activity with a lot of sensory stimulus that can anchor you to the here and now. Cooking requires hand-eye coordination, concentration, multitasking, planning, and working memory to execute a recipe correctly, all of which are executive functions of the prefrontal cortex.
I get however that you can't whip up a recipe when delivering a presentation (unless of course you're presenting a dish!), so perhaps you can try other things that require only a pen and paper to ground yourself in preparation for standing before your audience. Solving math problems with increasing difficulty, for example, can help. Math problems require the use of logic, analytical skills, and trial and error to arrive at correct conclusions. They may also be more in line with the kind of skills you are trying to use when you're feeling that pressure in a work environment, for example.
All the while, control your breathing. It doesn't have to be in a way that feels forced, and you don't have to count for however long you spend holding a breath etc. You can start by taking an inward breath through the nostrils, feeling the coolness of the air as it enters your body and fills your chest, hold it for an undetermined amount of time that feels natural and organic, and then release it through your mouth. Pursing your lips can help to slow the outward breath. You can do this at any time, and continue it whilst engaging in an activity that engages the prefrontal cortex.
If you want to work directly with the intrusive thought, then you could perhaps use that as the source material when you attempt to engage in an activity that helps. You could write the thought down, consider what assumptions you are making, ask yourself why you are making those specific assumptions, consider the evidence that supports those assumptions, ask what other assumptions could also be made based on the same evidence, and in doing so challenge the thought using Socratic methods.
Working with a therapist can be a very effective way to explore this experience in search of ways to manage those feelings. An autonomous and comfortable exploration of these experiences within the safety afforded by a professional therapeutic relationship can provide you with space to unpack what is going on for you, identify triggers and potential coping strategies, and discover meaningful ways to move forward with your personal goals. You might explore breathing exercises, grounding and mindfulness techniques, cognitive behavioural methods for challenging intrusive thoughts, and other ways to manage triggers in relation to public speaking.
Whilst unpleasant, it is perfectly natural to feel overwhelmed by the consuming, collaborative efforts of the cognitive and physiological processes that contribute to the experience of anxiety, and there is nothing unusual or erroneous or about the way that you might be feeling in these moments. Our emotions have important functions. They are an adaptive feature of our survival. Anger, dread, or any of the hues that form a particular shade in our rich emotional palette are a product of our body and mind doing their job, albeit a little too well on occasions perhaps. Those emotions can provide incredibly useful data which we may employ in our pursuit for personal growth. They can sign post things for us, validate us when we’ve experienced something distressing, and motivate action.
So, what does that fear around public speaking mean for you?
If you sit with those feelings and let them guide you, where do they lead?
What do you feel is driving that fear?
Have you felt this way before in other situations?
Does it bring back particular memories?
Do you experience any intrusive thoughts when you think about public speaking, or visualize a ‘worst case’ scenario?
Good luck, and I hope you find all of the answers that you are looking for.