Toastmasters press releases confuse a fear of public speaking with a social phobia

On October 15, 2019 Toastmasters International put out a press release titled Harrison Ford and Julia Roberts Top List of Celebrities Who Found Success Despite a Fear of Public Speaking. It begins as follows:

“From Abraham Lincoln to Winston Churchill and Mahatma Ghandi (sic), some of the world's most important historical figures have overcome their fear of speaking in public to achieve great success. Glossophobia, the fear of public speaking, is a common social phobia, with an estimated 75 percent of the population experiencing some form of anxiety before giving a speech. For the last 95 years, millions of people have joined Toastmasters to help with their fear of public speaking.”

The second sentence previously had appeared as the first in another October 21, 2015 press release titled Five Public Speaking Myths Debunked. Regrettably that sentence misuses existing terminology. It confuses a fear with a phobia, a mental condition which has a well-established meaning for psychiatrists. That confusion was spread by Henry DeVries in a Forbes article on October 27, 2019 titled Overcome speaking fear like Harrison Ford, Julia Roberts and Samuel L. Jackson.

The Venn diagram shown above succinctly describes the differences between a social fear and a social phobia - a phobia additionally is intense, persistent and interfering. The -phobia suffix in the word glossophobia incorrectly suggests a it refers to a phobia rather than a fear, although the dictionary definition for glossophobia just is of a fear of public speaking. Public speaking phobia would describe a performance type of social phobia.

Back in 1980 the American Psychiatric Association published the third edition of their Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-III. The chapter on Anxiety Disorders included a new one, 300.23, called Social Phobia. The 1994 fourth edition (DSM-IV) also says 300.23 Social Phobia (Social Anxiety Disorder), and the 2013 fifth edition (DSM 5) for 300.23 says Social Anxiety Disorder (Social Phobia). On October 11, 2011 I blogged about What’s the difference between a fear and a phobia? and quoted part of the definition from DSM-IV. Also, on December 11, 2013 I blogged about Spouting Nonsense: July 2013 Toastmaster magazine article fumbles fears and phobias.

There is a web page at the National Library of Medicine with a detailed table that compares diagnostic criteria for social phobia from the fourth and fifth editions of DSM. A detailed description of the diagnostic features for social anxiety disorder (social phobia) starting from page 203 of the fifth DSM edition is:

“The essential feature of social anxiety disorder is a marked, or intense, fear or anxiety of social situations in which the individual may be scrutinized by others. In children, the fear or anxiety must occur in peer settings and not just during interactions with adults. (Criterion A). When exposed to such social situations, the individual fears that he or she will be negatively evaluated. The individual is concerned that he or she will be judged as anxious, weak, crazy, stupid, boring, intimidating, dirty, or unlikable. The individual fears that he or she will act or appear in a certain way or show anxiety symptoms, such as blushing, trembling, sweating, stumbling over one’s words, or staring, that will be negatively evaluated by others (Criterion B). Some individuals fear offending others or being rejected as a result. Fear of offending others – for example, by a gaze or showing anxiety symptoms – may be the predominant fear in individuals from cultures with strong collectivistic orientations. An individual with fear of trembling of the hands may avoid drinking, eating, writing, or pointing in public; an individual with a fear of sweating may avoid shaking hands or eating spicy foods; and an individual with fear of blushing may avoid public performance, bright lights, or discussion about intimate topics. Some individuals avoid urinating in public restrooms when other individuals are present (i.e., paruresis, or ‘shy bladder syndrome’).

The social situations almost always provoke fear or anxiety (Criterion C). Thus, an individual who becomes anxious only occasionally in the social situation(s) would not be diagnosed with social anxiety disorder. However, the degree and type of fear and anxiety may vary (e.g. anticipatory anxiety, a panic attack) across different occasions. The anticipatory anxiety may occur sometimes far in advance of upcoming situations (e.g. worrying every day for weeks before attending a social event, repeating a speech for days in advance). In children, the fear or anxiety may be expressed by crying, tantrums, freezing, clinging, or shrinking in social situations. The individual will often avoid the feared social situations. Alternatively, the situations are endured with intense fear or anxiety (Criterion D). Avoidance can be extensive (e.g., not going to parties, refusing school) or subtle (e.g., overpreparing the text of a speech, diverting attention to others, limiting eye contact).

The fear or anxiety is judged to be out of proportion to the actual risk of being negatively evaluated or to the consequences of such negative evaluation (Criterion E). Sometimes the anxiety may not be judged to be excessive, because it is related to an actual danger (e.g., being bullied or tormented by others). However, individuals with social anxiety disorder often overestimate the negative consequences of social situations, and thus the judgment of being out of proportion is made by the clinician. The individual’s sociocultural context needs to be taken into account when this judgment is being made. For example, in certain cultures, behavior that might otherwise appear socially anxious may be considered appropriate in social situations (e.g., might be seen as a sign of respect).

The duration of the disturbance is typically at least 6 months (Criterion F). This duration threshold helps distinguish the disorder from transient social fears that are common, particularly among children and in the community. However, the duration criterion should be used as a general guide, with allowance for some degree of flexibility. The fear, anxiety, and avoidance must interfere significantly with the individual’s normal routine, occupational or academic functioning, or social activities or relationships, or must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion G). For example, an individual who is afraid to speak in public would not receive a diagnosis of social anxiety disorder if this activity is not routinely encountered on the job or in classroom work, and if the individual is not significantly distressed about it. However, if the individual avoids, or is passed over for, the job or education he or she really wants because of social anxiety symptoms, Criterion G is met.”     

The Our Mission web page at the Toastmasters International web site says the organization’s Envisioned Future is:

“To be the first-choice provider of dynamic, high-value experiential communication and leadership skills development.”

In order to accomplish that mission Toastmasters needs to finally get their terminology about fear of public speaking straight.