I’m working with a client to prepare him to speak at a conference in front of literally thousands of people this month: a huge plenary session in Europe.
He’s highly experienced as a presenter, and already sometimes takes beta-blockers. They work for him – and we only had a quick chat on the topic.
But because this drug class is something I’m asked about – and trialled myself years ago – here’s my most recent thinking.
Beta blockers are often touted as a quick fix for performance nerves in general, including public speaking – especially the racing heart, shaky hands, and trembling voice that can surface under pressure.
So, are they a useful support?
Or a crutch that gets in the way of building real confidence?
I believe – from the research and my experience with clients – that the answer’s “it depends”.
My concert trial experience
I tried beta blockers years ago for a challenging concert when I was still a professional pianist. The repertoire, amongst other pieces, was Prokofiev’s Five Melodies with a solo violinist.
Some of these are very delicate in effect – which is harder to control than loud when you’re nervous…and I knew I’d be dealing with a heavy, bright-sounding grand piano.
(By heavy, I mean controlling the weight of the keys – not the piano itself!)
It was, in the end, a weird experience – ironically because I was so used to dealing with a raised heart rate which felt normal under pressure.
When my body was completely calmed by the drug, I felt totally disconnected from the music.
And I lost access to the emotional component of playing…which is what audiences pay to experience from musicians on stage!
I never tried them again.
For public speaking though, they may be worth looking at, depending on your situation – even as a short-term solution.
For some clients, the very fact that they feel physically calm is enough to shift the dial dramatically.
Things to consider before making them part of your toolkit:
How they work
Beta blockers like propranolol help manage the physical signs of public speaking anxiety by blocking adrenaline. But recent research confirms – as we’ve known for a while – that they don’t treat underlying emotional or generalised anxiety.
They:
Target physical symptoms: slow your heart rate, lower blood pressure and stop tremors or sweating without causing mental fog.
Are not a “chill pill” – although some people are using them as such. They control body reactions, but they don’t stop anxious thoughts or change your emotions.
Are fast and non-addictive: Unlike benzodiazepines, they work quickly when taken about an hour before an event and are not habit-forming. Recent insights from a psychiatrist at Colorado University Anschutz are here.
Are dangerous for people with asthma, chronic obstructive pulmonary disease (COPD), very low heart rates, or diabetes.
May have side effects: Common issues include fatigue, dizziness, cold hands, and sleep disturbances. Discussions in popular culture like this report from The Guardian highlight rising casual use, but doctors stress they require formal medical supervision.
When and why clients ask about them
My clients are often terrified of the physical symptoms and see them as a cue that something is badly wrong. And adrenaline is an enemy that needs to be suppressed.
In fact, these symptoms are the body’s very normal response to stress, kicking in to support you by sharpening your system and making you more alert and responsive.
You might be thinking “well that’s all great Sarah, but it doesn’t actually help me – my symptoms are overwhelming!”
In fact, given some time and implementation the following ideas will make a real difference, and you will be able to harness the stress more effectively.
But timing and practice of course, vary – and that’s the potential issue. So if they help and aren’t contra-indicated, there’s commonly no reason to be concerned about using them.
Methods to explore instead, if you prefer not to rely on medication or would like to cut down if you’re already using them:
Purposeful movement and breathing: both before (for example shaking out limbs, expansive gestures) and during (deliberate movement that safely channels that physical adrenaline).
Mental reframing and visualisation beforehand. Working with self-talk and mental rehearsal.
Finally
A reminder to always consult your doctor or qualified healthcare professional before considering beta-blockers or any medication. I’m not qualified to offer medical advice, and am simply sharing my own opinion and some reference points to explore if you’re interested.
Step Up | Be Heard | Stand Out
