Stage Fright

It was great to meet you at the Life Extension Conference this weekend.  It was a pleasure learning from you, and I look forward to seeing you again.

Regarding the question you said would be good to email you about:  stage fright.  I also experience a horrible irregular breathing problem right before I speak publicly… and it usually ends up in stage fright.  You briefly mentioned yours was due to something relating to CO2, vasodilation, and the neocortex.  Is there any resource you can point me to that solved your problem?  It would be a life-saver.  Thank you.

Vasodilation and blood-flow regulation is handled by diffusive (gaseous) neurotransmitters.  The primary one is nitric oxide (NO), which is widespread and controls peripheral circulation to the arms and legs.  Carbon dioxide is a vasodilator for the blood flow to the cerebral cortex, but not the limbic (emotional-motivational) brain systems.  This is probably the physiological underpinnings of the religious practice of chanting and singing as a pathway to enlightenment; both increase CO2 and cerebral blood flow.  The opposite side is panic attacks, fears, phobias and sympathetic activation (adrenal hormones, cortisol and epinephrine) which promote the fight-freeze-or-flight reaction, and which lower CO2 in preparation for physical exertion.   Presumably, when you get scared, there is something that you want to run away from.  The running causes massive CO2 loading to the blood stream, and the earlier you start to unload it, the further and faster you will be able to run.  So this mechanism is quite adaptive to survival.

The cerebral cortex connection to CO2 is also survival oriented.  The less time you take to think about the emergency means the faster you will start running.  When the bear is chasing you, you do not need to consider the spiritual and ecological consequences of getting eaten.  So why do you need blood flow to your thinking mind when your emotional-motivational mind knows exactly what to do on its own?

What happens when there is no massive CO2 loading?   Your body becomes CO2 deficient, which shuts down your thinking mind.

An excellent book reviewing this topic is Robert Fried’s textbook The Psychology and Physiology of Breathing.

What can you do?

1. If your metabolism is low (i.e., your basal CO2 production is low), raise your metabolism.  This can involve thyroid hormone, adrenal hormone (low-dose cortisol), and progesterone and/or testosterone replacement therapy.  This can also involve iodine therapy for converting estradiol, which lowers metabolism, into estriol.  This can also involve exercise to increase muscle production of CO2.  Read up on hypothyroid symptoms and see if the syndrome is familiar.

2. Learn to impose parasympathetic breathing patterns on top of sympathetic activation, in advance of sympathetic activation.  This can involve the “power breath” (breathe in for 4 seconds, hold breath for 4 seconds, and exhale for 16 seconds through pursed lips).  This can also involve acupressure on parasympathetic pressure points.  Learn EFT (emotional freedom technique) from a practitioner (or online) to become facile with parasympathetic pressure points.

3. Temporarily use beta-blockers to blunt the sympathetic activation that is automatic, so you can desensitize your cognitive fear triggers.

4. Take piracetam to improve brain function in the presence of lowered oxygen (hypoxia). Piracetam helps against altitude-induced aggravation of the stage-fright response (or brain-fog steady state).

5. Eat a coconut oil-rich meal or snack before speaking engagements.
Coconut oil and MCT oil are rich in medium-chain fatty acids, which are not carnitine dependent for metabolism into CO2.

6. Take mitochondrial nutrients to enhance energy production systems.  See if they work for you.  Carnitine or acetyl-L-carnitine (ALC).  Coenzyme Q10.
Lipoic acid (lipoate).  NADH (or NAD, i.e., coenzyme 1) which only works in a minority of people.  B-complex vitamins (B1 and B2 are involved with lipoate, B3 is the precursor for NADH, and other Bs participate indirectly).

7. Train with a heart-rate-variability device.

8. Other.  Hypnosis.  Cognitive therapy for maintaining contact with your audience.  Desensitization.  Study your pH balance, which can change the dynamic of CO2 binding and release from hemoglobin, and bicarbonate-CO2 exchange.  Study your allergic reactions to foods (delayed hypersensitivities can blunt your metabolism).

Hope this helps.    —Steve

All this is very helpful.  Much more than I ever expected in a response.  Thank you!!  Your list of things to do will be very helpful – now I just need to figure out where to start.  If I recall correctly, you mentioned that at some point you took beta-blockers (or was it something else mentioned below?) before your talks to initially help.  Was there anything else on your list that you find particularly most helpful?  Thanks again for your help!

I used atenolol, because it was more lipid soluble and had a longer duration of action than propranolol.  That way, I could take the propranolol in my hotel room and still have it working 2-3 hours later in Larry King’s TV studio.  I used a half dose, so the effect was small.  And I stacked the beta-blocker with smart drugs, which compensated for the minor “dumbing down” side effect of the beta-blocker, but also tended to offset the anti-sympathetic effect of the beta-blocker.  So, IMHO, the beta-blocker benefit was minor.

The three things that made the biggest difference were 1) desensitization, 2) breath control, and 3) focus on individuals in the audience, in that order of significance.

Desensitization was accomplished via weekend-long video workshops, 12 hours on Saturday, 12 hours on Sunday, and a 3-hour mid-week “graduation” wrap-up.  I chose the Summit Organization to do this.  It is hard to maintain fear when you are being utterly silly, or falling off your chair laughing, and you see how equally traumatic everybody else’s stage-experiences are.  Alternating experiences of being in front of the camera, then behind the camera watching, having stage experiences in groups, alone, small groups, doing improv skits, taking still photos, being videoed, etc. changed my orientation to the experience.  First, I took the workshop as a participant, then I assisted the workshop.  Then I took it again as a participant.  Then I assisted as cameraman, ran the video team, and finally managed the workshop.  These immersion experiences made the biggest difference.

Breath control (imposing a parasympathetic state) gave me the experience of reversing stage fright. And that gave me confidence that I could prevent it. These breathing techniques are discussed in Robert Fried’s book, The Psychology and Physiology of Breathing.  They are also all over the web.   EFT therapy on top of breathing control is amazingly effective.  It even works with PTSD-level sympathetic hyper-responses.

Once I became minimally comfortable with myself in a speaking situation, I was able to begin the process of focusing my attention on the audience.  I started by picking out a few people and talking directly to them.  One-on-one communication had always been comfortable for me, so I used that as a crutch.  Then I was able to shift my focus around the room to any person in the audience.  Then it no longer mattered, and I could freely focus my attention on anything, going into my head and coming back to the audience, seamlessly.  That evolved into my ability to be spontaneous, to be able to 1) prepare with a minimum outline and deliver a coherent and cohesive talk without scripting, and 2) not prepare at all, and take a presentation in any direction that occurred to me in the immediacy of the moment.  Lately, I have been able to circle back to previous points and maintain “themes” throughout spontaneous presentations.

Baby steps, all the way. —Steve

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