Dread and the Ticked Box

The Checklist Illusion

Mara: Jenna Jakubisin, telling her own story, goes back to one presentation at the end of a college semester. It was for a social science credit. She says it still haunts her. She remembers, in her words, 'the hot flush of my cheeks, the stuttering of my heartbeat, and the sickening realisation that my audience was too uncomfortable to make eye contact.' As graduation got closer, she started crossing careers off. Teaching, gone. Law, gone. She pictured herself as a book editor instead, with a red pen and 'the relative safety of solitude.'

Eli: A listener sent us the question sitting under that whole scene: why do so many people fear public speaking more than death, and can anyone actually get over it? Today's angle is the transformation of primal stage fright from an unbearable death-threat into communicative energy.

Mara: Her fear was the kind that rearranges a life quietly, one avoided room at a time. Whether a terror like that can be trained out of a person, or is simply wired in, her own life ends up testing.

Eli: College wasn't where it started for her, though.

Mara: No. She says she's unsure when or why her glossophobia started. But by high school she avoided public speaking 'at all costs,' and she writes that the choice 'profoundly shaped my experiences, friendships and mental health.'

Eli: Strong enough to steer a life?

Mara: Strong enough that good news could turn on her. In November 2022 her sister announced her engagement. Jakubisin's reaction, as she tells it, was 'Oh, crap.' She asked whether she'd have to give a speech at the wedding. 'Yep,' her sister confirmed. The excitement turned to dread, and Jakubisin says she spent 270 days dreading it.

Eli: All spent on one toast?

Mara: And she'd have heard the famous line that a fear like hers outranks dying.

Eli: That line has a paper trail. Jerry Seinfeld gets credit for the joke that most people would rather be in the casket than delivering the eulogy. Behind it sits a 1973 survey by a firm called R. H. Bruskin Associates. People were handed a list of fears and checked the ones they had. Speaking before a group came out on top, picked by about 41 percent. Death came in seventh.

Mara: Jennifer Fidder and Morty Lefkoe take that ranking at face value. Their reading: speaking is a close, concrete risk people run into all the time.

Eli: Mara, the other reading says the list never measured that. Checking a box counts how many people mention a fear. It doesn't say how strongly they feel it. More ticks for speaking than for death doesn't show that speaking feels worse than dying.

Mara: So the most famous fact about this fear rests on a tally of ticked boxes.

The Threat Alarm

Eli: Here's what happens in the body when the faces turn toward someone like Jakubisin. An audience can register as a threat before the brain has consciously sized it up. The alarm is the amygdala's, think of it as the brain's smoke detector, and it goes off as if danger has walked in. Fight-or-flight follows. Adrenaline and cortisol surge. The heart rate climbs, palms sweat, hands tremble, the mouth goes dry, the voice shakes.

Mara: That's her college presentation almost exactly: flushed cheeks, a stuttering heartbeat.

Eli: And the trigger isn't mainly fear of fumbling words. Scientists quoted in one account say the likelier culprit is fear of ostracism, of being shunned by the audience. Evolutionary accounts say being pushed out of the group could cost its protection, and with it, survival.

Mara: A comedian, Deborah Frances-White, put it this way in a 2015 TED Talk: fear of public speaking is essentially the fear of being eaten, because audiences look a lot like lions.

Eli: The lions are a joke. The pain part isn't. Neuroimaging, brain scans that measure brain activity, has found social rejection activating some of the same brain regions that process physical pain. Being cut off by a room registers a bit like being hurt.

Mara: Which is why a roomful of polite strangers can feel like a threat.

Eli: Then comes the freeze. Stress chemistry can disrupt the prefrontal cortex, the planning part of the brain, and with it working memory and recall. A doctor at Case Western University Hospitals describes the spiral: the brain starts to freeze, stress climbs, the stress hormones go higher still, and that disconnects the frontal lobe from the rest of the brain. The memories get even harder to retrieve. That's the alarm Jakubisin carried for years, Mara: old, fast, and convinced a room of listeners is dangerous. The first thing she tried against it came on a prescription.

The Chemical Shield

Mara: It's 2015, an annual checkup. Jakubisin blurts out that public-speaking anxiety is ruining her life. She has friends who take Xanax for anxiety disorders, she explains. Is that an option for her? Her doctor says she has the same fear, and copes by taking a beta-blocker before speaking at conferences. She prescribes Jakubisin propranolol, to take thirty minutes before speaking.

Eli: A beta-blocker quiets what adrenaline does to the body, not the thoughts. And for this, it's off-label.

Mara: Off-label meaning propranolol isn't FDA-approved for performance anxiety. And she found the split you'd expect from that description. She took ten milligrams and says she felt steadier. The profound dread stayed put. The fight-or-flight surge was half turned down: the body quieter, the mind still sounding the alarm.

Eli: A controlled trial tested that gap. People gave speeches after taking propranolol or a placebo. Their distress and anxiety scores dropped afterward. The researchers report propranolol didn't reliably outperform the placebo, and that finding is contested.

Mara: If the drug even helped.

Eli: And the bodies didn't budge. Andrew Huberman and Lesley Stephenson note that their physiological responses to the speech were the same at the test session as at the treatment session.

Mara: MentalHealth.com reports that medication can manage the physical and emotional symptoms, but doesn't address the root psychological causes. So here is Jakubisin, years before that engagement, with steadier hands and the same dread underneath. Whether that dread can be unlearned at all is still unknown to her. A pill that quiets the heart and leaves the fear intact means the fear lives somewhere the pill doesn't reach.

Rewiring the Amygdala

Eli: Back to that 1973 checklist. In 2012, Karen Kangas Dwyer and Marlina Davidson ran the question again. They surveyed 815 college students in a communication course, before any speech instruction. On the checklist, public speaking was ticked more often than anything else, just like in 1973. Then the students named their single top fear. Death came first.

Mara: So 1973 was right about the ticks and wrong about the dread.

Eli: That's the checklist artifact, a distortion built into how the answers get counted. Researchers showed that when a survey lets people tick several items from a list, common, close-at-hand situations get picked more often than death. Counting ticks creates the illusion of greater fear. Asking for a ranking puts death back on top.

Mara: It's still the most-ticked fear, though. Common isn't the same as small.

Eli: Which is why treatment matters, and it works on two fronts. Cognitive techniques have people list what they're worried about, what else could happen, and the evidence for and against, the way the Mayo Clinic lays it out. Exposure handles the rest. It rests on extinction learning: the old link between podium and danger isn't erased. Each time someone speaks and nothing terrible happens, the brain builds a second, competing link, that this situation isn't actually dangerous. The fear gets less dominant. It may never vanish.

Mara: A new path laid beside the old one, not the old one wiped.

Eli: And the effect is reported as big. A 2025 meta-analysis pooled 26 studies of treatments for speaking anxiety. Together they covered more than 2,000 people. Across exposure, cognitive work and combinations, psychological treatment had a large overall effect.

Mara: The brain scans show it too. Before cognitive behavioral therapy, CBT, people with social anxiety had a stronger right-amygdala response to criticism aimed at themselves than healthy people did. After CBT, the difference was gone.

Eli: And after CBT, shrinking gray matter in both amygdalae and the insula went along with less anxiety about an upcoming speech. To Morty Lefkoe, learning changed what the scanner saw, Mara. A scanner isn't a wedding reception, though, and Jakubisin still had a toast to give.

The Toast

Mara: In 2021, Jakubisin took what she calls a big step and found a therapist. She calls her Erica, not her real name. Erica wasn't seeing patients in person because of the pandemic, so they met through telehealth, which suited Jakubisin fine. And Erica helped her see adrenaline differently, as something that could be energizing.

Eli: That's reframing arousal: reading the racing heart as excitement rather than danger. Andrew Huberman describes nervousness and excitement as one continuum, with the same automatic body responses.

Mara: A training program called Corp-Oral built that into its lessons. It taught students to recognize their bodily sensations when anxious, and to transform that discomfort into, in its words, 'communicative energy.' Lesley Stephenson says speaking gets easier over time as fear gets replaced by 'a lovely sort of buzz of excitement.'

Eli: The real test is doing it without those ten milligrams.

Mara: Mid-August 2023, and the 270 days run out. She's written what she calls a heartfelt, funny toast, and she's decided to give it without propranolol. At the reception, with her sister and her new brother-in-law there, she gives it. Her heart races. What she feels, she says, is mostly sincere joy. Afterward, she's still working up the courage to watch the video.

Eli: Heart racing, and joy anyway. The arousal showed up regardless.

Mara: That's one reading of the evidence. Andrew Huberman and Lesley Stephenson hold that this arousal is built in, and a public-speaking textbook says the innate physical reactions can't be stopped. Anxiety can't be completely eliminated, it says, but people can change how they process it and what they do next.

Eli: The other reading goes further. Morty Lefkoe argues the fear isn't simply human nature, and that it can be overcome. A counseling practice calls it very treatable.

Mara: Lefkoe says some of his clients turned down promotions rather than speak regularly.

Eli: A 2013 virtual-reality exposure trial backs his side. Four to six years later, the gains had held. A follow-up checked 28 of those patients, and more than half were reported in complete remission.

Mara: So that famous ranking was a tally of ticks, never a measure of dread. And yes, people do get over this, through exposure and reframing, even if the racing heart never fully leaves. The student who read her classmates' averted eyes as discomfort, and crossed teaching and law off her list, gave that toast at her sister's wedding without a pill.

Eli: Two signals to watch. The original 1973 sampling records aren't archived online, so exactly who Bruskin's firm polled still can't be checked. And nobody has tracked remission over decades in ordinary people outside a clinic. Why some people reach full remission and others keep managing for life is still open.

Mara: A term to look into: glossophobia.

Eli: Listeners can follow health with us to explore what helps people overcome fear.

Mara: Thanks for listening. I'm Mara.

Eli: And I'm Eli. Until next time.