Tag: stage fright

I vomited before my first board presentation at JPMorgan Chase.

Not metaphorically. Literally. In the executive bathroom, fifteen minutes before I was supposed to present quarterly results to senior leadership.

A colleague walked past afterwards and said, “Just breathe. You’ll be fine.”

I wanted to scream. I’d been breathing. I’d tried every relaxation technique. Every visualisation. Every piece of advice anyone had ever given me. None of it worked when the moment arrived.

That was 2003. I spent the next five years terrified of presenting — the kind of terror that started three days before any presentation, woke me at 4am with my heart pounding, and made me consider calling in sick rather than face another room of executives.

Twenty years later — after becoming a clinical hypnotherapist and treating hundreds of clients with presentation anxiety — I understand exactly why that advice failed. And I’ve developed what actually works.

Why “Just Breathe” Fails When You’re Actually Terrified

Here’s what happens when someone with genuine stage fright tries to “just breathe” moments before presenting:

Your amygdala — the brain’s threat detection centre — has already triggered a full sympathetic nervous system response. Adrenaline is flooding your body. Cortisol is spiking. Blood is redirecting from your digestive system to your major muscle groups.

Telling someone in this state to breathe deeply is like telling someone whose house is on fire to admire the curtains.

The breath advice isn’t wrong — it’s incomplete. When your nervous system is in genuine fight-or-flight, a few deep breaths won’t override millions of years of evolutionary programming. You need a more comprehensive intervention.

The Three Reasons Standard Advice Fails

Reason One: Most advice targets the symptoms, not the source. Your shaking hands aren’t the problem — they’re a downstream effect of your nervous system’s threat response. Address the threat response, and the symptoms resolve themselves.

Reason Two: Generic techniques don’t account for timing. What works the night before is useless 60 seconds before you present. What works 60 seconds before is different from what works mid-presentation when you’ve lost your train of thought.

Reason Three: Standard advice treats all fear as the same. But the executive who’s mildly nervous about a board presentation has fundamentally different needs than the person who’s been avoiding presentations for years because of genuine terror.

For more on managing nerves with specific techniques, see my guide on how to calm nerves before a presentation.

The Neuroscience Behind Stage Fright (And Why It’s Not Your Fault)

Your brain can’t distinguish between a sabre-toothed tiger and a room full of executives waiting to judge your quarterly results. Both trigger the same ancient survival response.

When your brain perceives threat — and being evaluated by others is perceived as threat — your prefrontal cortex (responsible for rational thought, complex reasoning, and remembering your presentation) goes partially offline. Blood flow decreases to this region while increasing to your amygdala and brain stem.

This is why you can rehearse perfectly at home and blank completely in the moment. It’s not nerves. It’s neuroscience.

The Polyvagal Perspective

Dr. Stephen Porges’ Polyvagal Theory explains something I observed for years in my hypnotherapy practice: fight-or-flight isn’t the only fear response. Many presenters experience freeze — a state where you feel paralysed, disconnected from your body, watching yourself from the outside.

This freeze response is actually a more primitive survival mechanism. It’s what prey animals do when escape seems impossible. And it’s what happens to many executives when they walk into a boardroom and feel overwhelmed.

Understanding this changed everything about how I approach stage fright. Because the intervention for fight-or-flight is different from the intervention for freeze.

The First 60 Seconds Protocol

The moment before you present is when fear peaks. These 60 seconds determine whether you’ll start strong or start struggling.

After treating hundreds of clients and testing countless approaches, I’ve developed a specific protocol for this critical window:

Seconds 1-20: The Physiological Reset

Before anything else, you need to interrupt your body’s threat response. The fastest way is through your breath — but not how you’ve been taught.

The Extended Exhale Technique:

Inhale normally through your nose for 4 seconds. Then exhale slowly through pursed lips for 8 seconds. The key is the extended exhale — it activates your vagus nerve and signals safety to your nervous system.

Repeat twice. Total time: approximately 24 seconds.

Why this works when regular breathing doesn’t: the extended exhale directly stimulates the parasympathetic nervous system. It’s not about relaxation — it’s about physiology.

Seconds 21-40: The Grounding Anchor

With your nervous system beginning to settle, you need to ground yourself in the present moment. Racing thoughts about what might go wrong are future-focused. You need to be here.

The Feet-Hands-Face Sequence:

Press your feet firmly into the ground and notice the sensation. Squeeze your hands together once, then release. Finally, relax your jaw and unclench your face.

This sequence interrupts the mental spiral by forcing attention back to your body. It also releases physical tension that would otherwise show in your voice and posture.

Seconds 41-60: The Mental Reframe

Now that your body is calmer, you can engage your mind productively. But not with positive affirmations — they often backfire because your brain recognises them as false.

Instead, use what I call the Purpose Anchor:

Complete this sentence silently: “In the next 20 minutes, the one thing I want them to understand is…”

This shifts your focus from self-concern to purpose-concern. You’re no longer thinking about how you’ll perform — you’re thinking about what you want to communicate. This subtle shift reduces self-consciousness dramatically.

The Physical Reset: What to Do With Your Body

Stage fright lives in your body before it lives in your mind. Addressing the physical manifestations isn’t just about looking confident — it’s about changing your internal state.

The Pre-Presentation Power Pose (But Not What You Think)

You’ve probably heard about power posing from Amy Cuddy’s TED talk. The research has been debated, but here’s what I’ve observed clinically: the pose matters less than the duration.

Standing in an expansive posture for two minutes changes your hormonal balance — testosterone increases, cortisol decreases. But the specific pose is less important than opening your body rather than closing it.

If you’re in a toilet cubicle before presenting (where many of my clients do their prep), simply standing tall with shoulders back and chest open for 90-120 seconds will shift your state.

The Voice Warm-Up Nobody Talks About

A shaky voice is one of the most common stage fright symptoms — and one of the hardest to hide. But there’s a simple intervention:

Hum. Literally hum at a low pitch for 30 seconds before you enter the room. Humming relaxes your vocal cords and activates your vagus nerve simultaneously. Start low and slide up, then back down.

This is why opera singers and actors warm up before performing. It’s not about technique — it’s about physiology.

For more techniques on building lasting confidence (not just managing symptoms), see my guide on presentation confidence.

The Mental Reframe: Changing Your Relationship With Fear

Here’s the counterintuitive truth I’ve learned from treating hundreds of anxious presenters: the goal isn’t to eliminate fear. It’s to change your relationship with it.

Some of the best presenters I’ve worked with still feel nervous. The difference is how they interpret that nervousness.

The Excitement Reframe

Research by Alison Wood Brooks at Harvard Business School found that people who said “I am excited” before a stressful task performed significantly better than those who said “I am calm” or said nothing.

The physiological states of anxiety and excitement are nearly identical — elevated heart rate, heightened alertness, increased energy. The difference is interpretation.

When you feel your heart racing before a presentation, try saying to yourself: “I’m excited about this opportunity to share what I know.” Your nervous system doesn’t know the difference. But your performance does.

The Competence Anchor

One technique I use extensively in my hypnotherapy practice is anchoring to past competence. Before presenting, briefly recall a time when you handled something difficult well. It doesn’t have to be a presentation — any moment of competence works.

Spend 30 seconds re-experiencing that moment: what you saw, what you heard, what you felt. This isn’t about confidence — it’s about reminding your nervous system that you’ve handled challenges before.

Case Study: From Frozen to Fluent in 6 Weeks

James came to me after a career-threatening incident. A senior director at a pharmaceutical company, he had frozen mid-presentation to the executive committee. Not just lost his place — completely frozen. Unable to speak for what felt like minutes but was probably 30 seconds.

He’d avoided presentations for three months after that. His career was stalling. His confidence was destroyed.

“I don’t understand it,” he told me in our first session. “I know my material better than anyone. But when I stand up there, it’s like my brain shuts down.”

That’s exactly what was happening. His brain was shutting down — specifically, his prefrontal cortex was going offline due to the perceived threat.

The Six-Week Protocol

Weeks 1-2: We focused entirely on the physiological response. James practised the extended exhale technique twice daily, regardless of whether he had presentations. He needed to build the neural pathway before he needed to use it.

Weeks 3-4: We added the grounding sequence and began graduated exposure. He started presenting to one colleague, then two, then five. Each time, he used the First 60 Seconds Protocol before beginning.

Weeks 5-6: We worked on mental reframing and anchoring. James identified his Purpose Anchor and practised the excitement reframe. He also learned recovery techniques for if he did lose his place mid-presentation.

The Result

Six weeks after we started, James presented to the same executive committee that had witnessed his freeze. He used every technique we’d developed.

“It wasn’t perfect,” he told me afterwards. “My heart was still pounding. But I didn’t freeze. I didn’t lose my place. And by the end, I was actually enjoying myself.”

That’s the goal. Not eliminating fear — but performing despite it. And then, eventually, transforming it.

What to Do When Stage Fright Strikes Mid-Presentation

The First 60 Seconds Protocol prepares you for a strong start. But what happens when fear ambushes you during your presentation? When you lose your place, or your mind goes blank, or you feel the freeze response creeping in?

The Recovery Pause

First, stop talking. This feels terrifying, but a deliberate pause looks confident, not panicked. Take a breath. Take a sip of water if available.

Then, use what I call the Grounding Sentence: say something that buys you time while you recover.

Options include: “Let me make sure I’m being clear here…” or “That’s a critical point, so let me expand on it…” or “Before I continue, let me check — any questions so far?”

These sentences sound intentional. They give your prefrontal cortex time to come back online. And they shift attention from your internal panic to external engagement.

The Place Recovery Technique

If you’ve genuinely lost your place and can’t remember what comes next, don’t pretend. Briefly look at your notes or slides. Say, “Let me just check I cover everything important.” This is what competent presenters do.

What audiences remember isn’t whether you lost your place — it’s whether you recovered gracefully.

For more on strong presentation openings that set you up for success (even when nervous), see my guide on public speaking tips that actually work.

Frequently Asked Questions About Stage Fright

Is stage fright the same as glossophobia?

Glossophobia is the clinical term for fear of public speaking, and stage fright is a common manifestation of it. However, stage fright often refers specifically to the acute fear response before and during a presentation, while glossophobia may include anticipatory anxiety days or weeks before presenting. The techniques in this article address both the anticipatory and acute components.

How long does it take to overcome stage fright?

With consistent practice of the techniques described here, most people notice significant improvement within 4-6 weeks. However, the goal isn’t to eliminate all nervousness — it’s to develop strategies that allow you to present effectively despite the nervousness. Some of the most accomplished presenters I know still feel nervous; they’ve simply learned to work with it rather than against it.

Should I take beta blockers for stage fright?

Beta blockers address the physical symptoms of anxiety — racing heart, shaky hands, trembling voice — without affecting mental clarity. They’re commonly used by musicians and surgeons for high-stakes performances. However, they’re treating symptoms rather than causes. I recommend exploring non-pharmaceutical approaches first, and if you’re considering beta blockers, consulting with a medical professional about whether they’re appropriate for your situation.

Why does stage fright get worse the more senior I become?

This is extremely common and has a clear explanation: as you become more senior, the stakes feel higher. You’re presenting to peers rather than superiors, which paradoxically can feel more threatening. You’re expected to have mastered public speaking by now, so any sign of nervousness feels like evidence of incompetence. And you may have accumulated more negative presentation experiences over the years. The techniques work regardless of seniority — but you may need more consistent practice to override years of accumulated fear responses.

What if I’ve tried everything and nothing works?

If standard anxiety management techniques haven’t worked for you, it may be worth exploring deeper interventions. Clinical hypnotherapy (my background) can address the root causes of presentation anxiety at a subconscious level. Cognitive behavioural therapy (CBT) with a therapist who specialises in performance anxiety is another evidence-based option. Some people benefit from EMDR therapy if their stage fright stems from a specific traumatic presentation experience.

Can stage fright actually help my presentation?

Yes — when channelled correctly. The heightened alertness that comes with nervous energy can make you more responsive to your audience, more dynamic in your delivery, and more memorable overall. The goal isn’t to feel nothing; it’s to feel the right amount and interpret it as excitement rather than terror. Many professional performers describe needing some nervousness to give their best performance.

The Path Forward: From Surviving to Thriving

I want to be honest with you about what’s possible.

If you’ve experienced genuine stage fright — not mild nervousness, but the kind of terror that affects your life — you won’t become a completely relaxed presenter overnight. The neural pathways that create your fear response were built over years. They won’t be dismantled in days.

But you can develop strategies that work. You can learn to recognise the signs of escalating fear and intervene before it peaks. You can build a toolkit of techniques that are available when you need them most. And gradually, over time, you can transform your relationship with presenting from something you dread to something you might even — dare I say it — enjoy.

That journey started for me in a JPMorgan boardroom over twenty years ago. It took me years to figure out what actually works. I’ve condensed that learning into the techniques I’ve shared here and the comprehensive system in Conquer Speaking Fear.

Wherever you are on that journey, know this: stage fright isn’t a character flaw. It’s not evidence that you’re not cut out for presenting. It’s simply your nervous system doing what it evolved to do. And with the right tools, you can work with it rather than against it.

Your next step: Before your next presentation, practice the 60-second protocol three times — not when you’re about to present, but in low-stakes moments. Build the neural pathway before you need it. Then, when the real moment arrives, your body will know what to do.

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About the Author

Mary Beth Hazeldine is a qualified clinical hypnotherapist, NLP practitioner, and Managing Director of Winning Presentations. After 5 years terrified of presenting, she built a 24-year banking career at JPMorgan Chase, PwC, RBS, and Commerzbank. She has treated hundreds of anxiety clients and trained over 5,000 executives to present with confidence and impact.