Hospital Management
•Hospital Management
•35-year-old corporate professional, recently promoted, with marked anxiety about delivering a presentation to nearly 100 people in 2 weeks.
• Since learning about the presentation, he has developed persistent anticipatory worry, difficulty initiating sleep, poor concentration and repeated mental rehearsal of possible mistakes.
• He has had a long-standing fear of public speaking since adolescence. He was shy, slow to warm up and highly sensitive to criticism.
• During a school presentation, he forgot part of his speech and was laughed at by classmates. Since then, he has avoided speaking before large groups.
• He remains comfortable in one-to-one interactions and small familiar groups.
• His main fear is that he may forget the content, tremble, become blank or embarrass himself, leading others to view him as incompetent.
• He recognises that the fear is excessive but is unable to control it.
• On imagining public speaking, he develops palpitations, tremulousness, sweating, dry mouth and throat tightness.
• His attention shifts from the presentation to his bodily symptoms and the fear that others will notice his anxiety.
• He becomes excessively self-conscious and interprets neutral audience expressions as criticism or boredom.
• He uses safety behaviours such as memorising every sentence, reading from slides, avoiding eye contact, holding the podium and speaking rapidly.
• After presentations, he repeatedly reviews his performance, focuses on minor mistakes and discounts positive feedback.
• There is no history suggestive of unexpected panic attacks, generalised anxiety, psychosis, mania, substance dependence or significant depression.
•Extreme Stage Fear or in Group meetings
Childhood History
Adolescent History
Marital history
Occupation History
Systemic Examination