What would more than four out of 10 people rather do than speak in front of a group?
For starters, die.
They would also, according to a survey conducted by the London Sunday Times, rather be plagued by bugs or insects, suffer financial crises, risk drowning in deep water or be felled by illness. The survey asked 3,000 Americans what they feared most, and speaking before a group was No. 1 on the list.
Which would, according to this survey, qualify stage fright--among the most acutely afflicted, at least--as the most severe, debilitating, stomach-churning, adrenalin-pumping fear in the entire human experience.
Call it butterflies, the jitters, cotton mouth, flopsweat--it all adds up to grief for anyone performing before an audience.
"The whole autonomic nervous system goes bananas," said Mary Ommanney, an Anaheim psychologist who has treated many patients suffering from stage fright. "People go into a major anxiety reaction. They can't speak. They just can't function at all."
The technical name, Ommanney said, is "exhibitionism anxiety," and it's born of a need, simply, to please others. The speaker before a group, the executive giving a presentation in a meeting, the musician performing a difficult piece, the comedian working the house--all are trying to please their audience and look good in the process.
It's when they try too hard or attach too much importance to the audience's reaction that people suffer from stage fright, Ommanney said.
"The root cause," she said, "is when a person goes from being internalized to being externalized. They should try to slow down and compete with their own best performance rather than try to satisfy the expectations of an impersonal audience.
"I think every good actor or lecturer has some stage fright or they're not worth their salt. It's when it goes from low-level anxiety to an incapacitating level that it becomes a problem."
Ommanney and her husband, Pierce, also a psychologist, said they have seen several debilitating cases of stage fright come through their clinic. Mary tells of several students who dropped out of school rather than make oral presentations before a class.
Pierce recalled "a fantastic case" in which a former patient of his "went out to sing a song and play guitar on stage in front of his high school friends, and he had such a severe attack of stage fright that he literally crawled off stage. But once he got off, he told himself that if he stayed there he'd likely never play the guitar or sing again. So he came back out again and did it and got a tremendous ovation. Today he's a professional singer."
The Ommanneys said they have had good luck treating severe cases of stage fright with group therapy.
"There are things in life that make these people feel inferior, like a colleague telling them how incapable they are," said Pierce. "They then torture themselves and put themselves down. Freud called it the superego, which criticizes itself. In group therapy, these people are in a comfortable environment and get moral support. If I ask them to stand up before the group and talk, they'll experience their symptoms, but over time they're more comfortable."
Stage fright, said Jerry Kasdorf, a clinical psychologist, is a phobia in the same category of mental disorders as fear of heights or fear of crowds. Kasdorf is the director of three Phobiacare Treatment Centers (in Santa Ana, Huntington Beach and Fullerton) where phobias are treated with individual and group therapy.
One particular group therapy session at the centers involves mostly business people who must, as part of their jobs, speak before groups, but find themselves paralyzed by stage fright.
"The first thing we try to do," said Kasdorf, "is make sense out of the fright. Most people think that stage fright or performance anxiety is something that is unique to them. Actually, it's by far the most common phobia that exists. Everybody, virtually, has some of that kind of feeling."
The uncomfortable rush of adrenalin that speakers feel when they experience stage fright is an ancient human reaction--the so-called "fight or flight" response, Kasdorf said.
"The adrenalin," he said, "prepares you to fight or to flee, and in the case of speaking, what you want to do is flee. Your body is being prepared for intense action, but when you're speaking, you're immobilized. People become afraid that they're going to lose control."
Kasdorf's groups meet once a week, over 15 weeks, for slightly more than an hour per session. Kasdorf said each session costs $35 and that, as far as he knows, no insurance company has yet picked up the tab for a group member.
In his sessions with the would-be public speakers, Kasdorf advises executives to concentrate on the speech itself rather than on how the audience is reacting. He also emphasizes advance preparation, even over-preparation--particularly of one's opening lines.
"You must do it over and over and over again in order to get better," he said.