Fear of presentations: How EMDR can help with phobias

“I’m terrified of giving presentations – I’m fine one-to-one, but if I have to stand up in front of a group, I panic, I can’t breathe, and my legs turn to jelly.” I often hear these words, or something similar, when I ask someone what is bringing them into therapy. 

It’s surprising how many otherwise successful, confident, highly competent people find they get highly anxious when making a presentation and that this holds them back at work or in their studies. No amount of preparation and practice seems to reduce the mounting panic they feel before and during the presentation. If you get anxious about presentations, you may find it helpful to speak with a therapist.

EMDR (Eye Movement Desensitisation and Reprocessing) is a form of therapy developed in the 1980s to help people recover from trauma, but as trauma is often at the root of many problems, the approach can help with a range of other issues, such as chronic pain or, in this case, phobias.

A phobia is a fear of something – flying, heights, or public speaking, for example – and can happen because of a related, unresolved trauma from the past, which keeps repeating in the present whenever you find yourself in a similar situation. Resolving the original trauma can reduce the anxiety felt in the present.

This happens because of the timelessness of trauma. When we go through a traumatic, frightening or highly stressful experience, the sensory experience of the trauma (the thoughts, emotions and physical feelings we experience as we go through it) cannot be processed by the brain’s memory processing system as that system has become overwhelmed by the sheer volume of sensory information.

The raw experience gets stuck in the Amygdala, the brain’s alarm system, instead of being processed and stored in the Hippocampus, the brain’s library. This matters because the Hippocampus understands time and place while the Amygdala does not. If an experience is stuck in the Amygdala and something similar happens to you, even years later, the brain will think the same incident is happening again and will make you experience all the thoughts, emotions and physical feelings you felt at the time by sending the same stress hormones and signals into the body to initiate your fight/flight/freeze or submit response, to keep you safe at the moment of threat.

The panic and anxiety you feel at the thought of giving a presentation could be caused by a difficult experience from the past, such as a stressful experience of another presentation earlier in your career or a memory of being called to speak in front of the class at school. An EMDR therapist can help you explore the distress you feel when giving a presentation to understand exactly what it is making you anxious and where this anxiety comes from – what are the earlier experiences which are repeating when you present?

A simple way to understand this is that it's as if in one part of your mind, you’re living in the present, you are the age you are, you know you are really good at your job, confident and articulate. In another part of your mind, you are still nine years old, feeling embarrassed about talking in front of the class. Because of the blockages in processing information about difficult experiences mentioned earlier, these two parts of your mind are not in contact with each other, so the adult, confident part can’t talk to the younger, less confident part to reassure them. Every time you think about doing a presentation, that younger part wakes up, and you experience life through your younger self again.

The Amygdala is also in the non-verbal area of the brain, so an experience stuck there cannot easily be put into words. Instead of asking you to talk in detail about your experiences, an EMDR therapist uses eye movements and other forms of bi-lateral stimulation (BLS) to give your memory processing system a kick-start.

Research has shown that if someone engages with an image of a memory and the thoughts, emotions and physical feelings that go with it and then has their attention directed from left-to-right, the previously unresolved experience can be processed and moved from the Amygdala to the Hippocampus. Once it’s there, your brain will know that the experience is just a memory, that it is over, and you are safe in the present, which can be a relief. It can feel like your confident, safe, adult self has been able to meet your younger, distressed self and reassure them that they are safe now and no longer needs to worry.

Once the past experiences which might have been causing your fear of presentations have been processed, you may feel less anxious as your confident, adult self takes over again. The EMDR therapist would then ask you to visualise yourself giving a presentation in the present to identify your “triggers” – what is it about presenting that makes you anxious (people looking at you, people being uninterested/asking questions or whatever aspect you find most difficult). These triggers can also be processed using EMDR – the therapist would ask you to visualise the situation and the thoughts, emotions and physical feelings that go with it and then use eye movements to help you work through the triggering situation until it no longer makes you feel uncomfortable. Finally, the therapist might ask you to visualise yourself giving a presentation, while using eye movements, repeating the exercise until you can picture yourself speaking to a group of people clearly and confidently, without any anxiety.

Before starting to process memories, EMDR can be used to help build up your confidence, getting you back in touch with the adult, competent, articulate parts of yourself and most therapists can teach you exercises, including breathing and grounding, to help you calm your nervous system before and during a presentation, so that you are fully present in your confident, adult self throughout.

If you get anxious at the thought of doing a presentation, it might be worth speaking to a psychotherapist to try to discover where the issue originates as there may well be ways the therapist can help you live more fully in your confident, adult self by working though unresolved traumas from the past and helping those younger parts of you feel safe. EMDR can also assist with a range of other phobias, so it may be helpful to consult a therapist to see how the therapy might be able to help you.