Public Speaking Anxiety & Fear of Being Noticeably Nervous: Mind Surgery for High Performers
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EPISODE
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Performance Anxiety and Hyper-hidrosis Resolved Without Medication: Successful Lawyer

Kevin, a successful lawyer, describes overcoming public speaking anxiety driven by hyperhidrosis and fear of appearing noticeably nervous. By learning to control his internal critical dialogue and perfectionism, he reduced his sweating and shifted his focus from trying to be perfect to performing his best.
Episode Overview

What This Episode Is About

“Kevin,” a successful lawyer, describes his struggle with hyperhidrosis-driven performance anxiety and fear of being noticeably nervous. His primary symptom was unpredictable, excessive sweating that could be triggered when attention suddenly shifted toward him, when he felt criticized, or when he was directly challenged. These situations created an immediate fight-or-flight response, rising body temperature, and perspiration that could spread throughout his body. Although the condition did not prevent him from maintaining a successful career, it had a substantial effect on his happiness and confidence. Through treatment, Kevin learned to recognize and control his internal critical dialogue, address perfectionism, and respond differently to the physiological sensations associated with anxiety. He describes an important shift from trying to be perfect to simply doing the best he could. His experience also emphasizes self-acceptance, reducing self-criticism, remaining engaged instead of avoiding situations, and learning that greater comfort and confidence can develop through practice.
At a Glance

This podcast is best for:

CEOs, executives, clinicians, attorneys, students and performers whose careers depend on speaking — and who have found that competence alone did not resolve the fear.

Episode Details:

13
 min, 
31
 sec
May 17, 2024
Full Transcript

This episode's transcript:

[00:00:00]
I’m talking to Kevin who has an extremely compelling, interesting, and unique story to share with the listeners. Kevin, could you describe it as much detail as you can, what your condition was that resulted in your coming for help? Well, the physical symptom of my condition was sweating. What I now know is hyperhidrosis and as a reflection of anxiety, I would feel, and either social or business situations.
[00:00:50]
And I would have episodes that would be unpredictable, meaning I could be in a situation where I might expect to feel anxious or stressed and have no symptom, or I could be in a situation where I would think or I might predict that I would be comfortable and where I would have symptoms of anxiety that would be manifest in sweating. Okay, and could you describe in a little more detail so you would have been one of these situations and then what would happen to you? Either it’s some unexpected, either turn of attention towards me or criticism of me or direct challenge to me.
[00:01:46]
Would you catch me off guard or catch me in a way that I wouldn’t expect it and my body temperature would rise. I would feel sort of a fight or flight reaction and I would start to perspire. Perspire a little a lot where it would begin slowly in the head and hair and the arms, in the back and eventually, all over. So I’m person who tends to have a high body temperature in any event and get revved up in any event. So it’s sort of a ignite trigger. Alright now you are a pretty active guy. You’re a successful lawyer. How was this condition impacting your life?
[00:02:39]
Well, it was more impacting my happiness than necessarily adopting me from doing things. I did choose a career that was a public sphere and that was naturally confrontational in spite of having a baseline level of anxiety and this symptom. So it was just making me not feel as comfortable and successful as I wanted to be. It was impacting my happiness and how I felt about myself, maybe the bigger with which I chose to pursue business and social situations.
[00:03:29]
What would happen, for example, when you would have one of these sweating episodes in court or during a business interaction? I would be embarrassed and I would lose effectiveness because I would lose focus and my focus would then be on not being embarrassed and having to stop and not pursuing whatever it was I was doing. Were there not times, I don’t mean to sound like a lawyer here, but were there not times that you did leave the venue and you needed to compose yourself? Absolutely, yeah. I would take bathroom breaks and try to catch my breath and recompose myself and seek opportunities to regain control of my physical person.
[00:04:25]
Now I’m assuming that during this time that the symptoms are really impacting you, you did start to, you were involved rather, in obsess, were you not involved in obsessive worrying about when it was going to happen? I would. There’s two sides to that coin, I think. You never know what’s going to happen, so you’re always kind of worried it could happen and if you start to feel symptoms of it, then that’s all you can think about. But that I’m doing much better, but then I have a better self-awareness and understanding of it, I think it’s almost important to know and recognize and embrace that it could happen because it’s not at that big a surprise to you and it’s something that you accept.
[00:05:19]
Well now you’re talking about how you got well. Back then, you were involved in obsessive worry and that was one of the things that was creating the symptoms more and more. So listen. Yeah but I think you also, you tend to pretend and avoid your condition. And avoid thinking about that you suffer from this condition, that you have these symptoms and you rather pretend that you’re a very confident person who doesn’t have this level of anxiety and so you don’t feel it. Excellent point. All right now, for the sake of relativity, the symptoms, the problem, the impact, happiness, mood, etc. On a scale of one to ten, if you started again for the sake of relativity at a one, where would you say you’re at in terms of meeting your therapeutic goals, expectations, etc.
[00:06:14]
I would say eight plus. Okay that’s huge. Now the critical question is in your own words, you know, without saying okay, I came to Jonathan, whatever. You describe how you got to an eight, what you had to do with your thinking, your emotions, your physiology, whatever you can say to the listener. It’s going to sound kind of like, you know, oh it’s so easy and I mean that sarcastically. For me it’s been a matter of accepting it and understanding that I have physical symptom that comes with adrenaline and also is paired with anxiety and it can go good and it can go bad.
[00:07:05]
But you have to know that that is a way that I react and to work with it. Okay talk about, because this is very confusing for most people, talk about the acceptance of the dynamics. You know the part of what would make me anxious and sweat is when it would start, you start to worry about what would people, what would people think about me if they can see me sweating and seeing me being nervous or anxious. And then it sort of feeds upon itself. When you start, when I start to let go of well I don’t really care if people see me sweat or I’m going to have to live with the fact that people might see me sweat, then you become much more in control of the level and frequency of whether I do sweat at all.
[00:07:59]
You told me a situation recently where you were at work, you were in some kind of meeting and you did sweat, you felt the sweating happening and you were able to do something that really aborted the cycle. Well, you know I was in the middle of something and I was presenting and there was no opportunity for me to really leave or try to gain control or flee I guess. So it’s not a fight but to fight, engage in flight. And you know rather than sort of sit there and crash and burn and be a sweaty, ineffective mess I decided I’m really going to care more about doing a good job of what I’m doing right now which I know I’m very good at.
[00:08:50]
And if I sweat, you know, well everyone’s going to have to understand that and live with it because you know that’s who I am. And the sweat always started to survive and that did a really good job and you know people saw me sweat a little bit but you know I think at the end of the day what they thought somebody did an awesome presentation. Great. Can you just go for another moment when you say that the quality of your life is an eightish now, describe them? Well I spend a lot more time thinking about being in a good mood and feeling good about myself and trying to be me and again that sounds sort of overly simplistic but I spent a lot of time for a long time trying I think to be somebody else and sort of pretend that I was this super confident other person rather than being great at being me I was trying to be somebody else.
[00:10:02]
And you know you could never accept some of my flaws and I can be a lot better at the things that I am good at. So I think the vibrancy of my personality even at this you know medium stage of my life is starting to come out in full bloom and I think I’m funnier and more interesting person. The funny interesting you know entertaining vibran person I always knew I was but that I was mad that people weren’t embracing I think I’m becoming more and more each day. So what you’re describing in our terminology is that you really invested in some self nurturing and you put your internal critical script in its appropriate perspective. Yeah and you know it’s still there and it’s you know I liken it to being you know somebody you know like you know an alcoholic or somebody who has habits you know that they need to deal with it.
[00:11:02]
There’s a tendency to be overly critical for me to be overly critical and I have to catch myself when I start to do it and it gets easier and easier at the beginning it seemed not hopeless because I you know I had great hope for myself but very daunting task and now I’m just having I know when I’m starting to do it and I catch myself and I start just doing things in a much more positive fashion and just life is I know coming a little easier. Excellent one last question any other specific piece of advice that you would give to someone who’s suffering from the same thing. You can work on it you can you can you can do a lot better and you can be a lot happier. You just got to take a little bit of a leap of faith in yourself and leap of faith that people will really cut you a lot of flack if you try to share yourself with them and don’t don’t run away. Excellent. Excellent Kevin listen thank you so much for sharing.
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Meet the Speaker

Jonathan Berent, LCSW

Psychotherapist & Author — Social Anxiety and Performance Anxiety

Jonathan Berent, L.C.S.W., A.C.S.W., is a psychotherapist who has been practicing since 1978. He has created the Berent Treatment Method for Social Anxiety, which is the result of his clinical work with thousands of individuals of all ages with social anxiety since 1978. He has extensive clinical experience with avoidance and dependance personality disorder, and is the author of Work Makes Me Nervous: Overcome Anxiety and Build the Confidence to Succeed (Wiley, 2010), Beyond Shyness: How to Conquer Social Anxieties (Simon & Schuster, 1992), and Social Anxiety: The Untold Story, which is a training course for mental health professionals in using the Berent Method to treat social anxiety. (Andrew Kukes Foundation, 2011).
SocialAnxiety.com, has served millions of unique visitors as a multimedia clearinghouse for patients, parents, and fellow mental health professionals in search of articles, educational materials, and books on social anxiety and related subjects. His library of clinical interviews appears to be the most documented clinical success with social anxiety.

Guest Speaker

Frequently Asked Questions

Common Questions About Social Anxiety Treatment

Probably because you are prone to hyper-hidrosis. Anxiety activates the body’s sympathetic nervous system, which can increase perspiration. When excessive sweating becomes a major focus of attention, a person may begin worrying about whether others can see it. This internal script can further increase adrenaline and perspiration, creating a cycle similar to fear of blushing.

Hyperhidrosis refers to excessive sweating. For some people with social or performance anxiety, sweating becomes a particularly feared physical symptom. They may worry about visible perspiration during presentations, meetings, or social situations and begin organizing their behavior around preventing or hiding it.

Yes. Perfectionism is OCPD. That means obsessive compulsive personality disorder. Unrealistic expectations can create terror and toxic pressure

Because it takes a lot of misplaced energy. Trying desperately to conceal anxiety requires constant self-monitoring. Instead of focusing on the conversation, audience, or message, attention becomes focused inward: “Am I blushing? Is my voice shaking? Can they see me sweating?” This heightened monitoring can increase anxiety and make normal physiological sensations seem more threatening.

Because it becomes an ingrained psycho-physiological (mind-body tic). When you closely monitor yourself for signs of nervousness, normal changes in heart rate, body temperature, breathing, or speech can become threatening. That perceived threat can produce additional adrenaline, which increases the very sensations you are trying to prevent. Breaking this cycle involves changing both the response to adrenaline and the underlying thoughts and emotions.

Take the Next Step

You Do Not Have to Manage This Alone

Public speaking anxiety, performance anxiety, and social anxiety respond to treatment. If this episode described your experience, a conversation is the great next step.