Beta Testing

An article this week on StatNews.com, a sister site of BostonGlobe.com, reported on a California startup’s plan to broadly market the medication propranolol as a quality-of-life aid, including to reduce nervousness associated with public speaking.

Companies looking to innovate and disrupt will continue to explore new solutions to old problems, and vice versa. But this particular idea causes me concern as a speech professional.

Beta blockers are a class of medications used to treat irregular heartbeat and/or high blood pressure by temporarily blocking effects of adrenaline, a hormone central to our “fight or flight” responses (in other words, that promotes our survival!). Developed in the 1960s, propranolol was one of the first beta blockers, and continues in clinical use.

Along the line, people discovered “off-label” uses in situations where “nerves” may be a factor, including precision activities like archery, golf, musical performance, and of course, public speaking.

In my experiences as a communication coach and medical speech pathologist, I’ve encountered a few people, often with more challenging speech conditions such as stuttering or vocal tremor, who reported benefit from beta blockers, in conjunction with speech work and other supports.

But the idea that a typical person who feels anxious about public speaking (possibly a majority of people in the world!) could simply turn to a pharmaceutical “little helper” in mint or watermelon flavor, is, if you’ll forgive the pun, a hard pill to swallow.

All medications can have side effects. Beta blockers and propranolol in particular are contraindicated as potentially dangerous for people with certain medical conditions, or who take certain other medications. And while they are generally not thought to be addictive in the physiologic sense, regular use in higher-pressure situations can foster reliance and the belief that they are necessary to deliver a satisfactory performance.

The idea of a quick fix for public speaking nervousness is enticing, but the personalized, skills-based approaches that I and my fellow Speech Improvement coaches use with our clients are preferable for many reasons. We help people recognize and replace negative thinking associated with past fear of speaking, building confidence in its place. We offer guidance with specific, time-tested techniques. And rather than beta-blocking the body’s signals, we can help people listen to and learn from them, even harnessing the energy of adrenaline in positive ways so a well-prepared talk or presentation can feel thrilling rather than terrifying.

A prescription can run out, but speaking skills developed through investment of time and effort are earned, one’s own, and can’t be taken away. So if, in the near future, a slick ad suggests that the answer to your public speaking concerns is in a pill: just say NO!

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