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You're hanging out for that promotion but when it comes time to address the board about your vision for the company's future you freeze. You're more than adequately prepared but the anxiety of speaking in front of a roomful of people has left your mind blank.

Difficulties with presentations can be a serious impediment to getting ahead in your career and are surprisingly common.

"People often rate a fear of public speaking as worse than their fear of dying," says Dr Timothy Sharp, a clinical psychologist and founder of the Happiness Institute.

Some people with a speaking phobia deal with the issue by totally avoiding public speaking. But as their careers advance, avoidance becomes harder. "It's common for us to see senior managers and executives who can't avoid public speaking because they have to manage meetings," Sharp says. "They usually spend hours preparing, trying to compensate for their anxiety."

So what are the causes of the anxiety? And what are your options if the idea of public speaking leaves you in a cold sweat?

Sharp says the core of many people's difficulties with public speaking is an expectation they will be poorly received and rejected. This fear undermines presentations and affects how individuals address clients, colleagues and audiences. It can influence how capable they are of intelligently responding to questions at a meeting and ultimately stall a career.

"Promotions, for example, are often based on people's public personas," Sharp says.

Recruiters also pay attention. Barbara Warren, head of corporate performance at the National Institute of Dramatic Art, regularly evaluates candidates' public speaking and communication skills on behalf of recruitment firms.

"An applicant may be asked to give a formal presentation or we simulate a board meeting and play the role of a board member who wants to interrupt and ask a question," Warren says. "Some applicants are so set on their path that they cannot answer questions during the presentation at all."

NIDA has a range of short courses on corporate communication, which aim to help participants identify and overcome anxiety about public speaking.

"In our business we call it stage fright," Warren says. "These are psychological habits that manifest themselves in high-stakes moments, like forgetting everything you have prepared."

Warren says the first step is learning to be present. She rejects the cliched suggestion of calming nerves by imagining everyone in the audience naked.

"When you do that you're imagining you are somewhere else," she says. "You want to connect with the audience, you want to make eye contact, they are who they are. An excellent public speaker is one who knows that the presentation is less about themselves and more about the people who are there to get the information."

Anxiety about public speaking doesn't have to be extreme to affect your ability to communicate. Jade Richardson, director of women's mountaineering and mentoring company, Girls on Top, thought she was an excellent communicator until she watched herself on video.

"I saw myself hopping around from one foot to the other, shielding myself from the audience, trying not to breathe or look at them," Richardson says. "When I delivered my message there was quite a lot of rushing. The presentation wasn't as powerful as I thought it could be."

She completed NIDA's two-day Corporate Performance course and hasn't looked back.

Ian Chick, a salesman, estimates that his hit rate increased from between 3 and 5 per cent to an astonishing 90 per cent after he joined not-for-profit public speaking organisation Toastmasters seven years ago.

"I communicate better and I can now read a situation in two minutes," he says. "Rather than wasting an hour with people, I can close the sale."

Chick, who is now in charge of marketing for Toastmasters, says that anyone can join a Toastmasters club. "There are hundreds in NSW alone," he says. "Major organisations like Qantas, National Australia Bank and Corporate Express have in-house clubs."

Meetings are held weekly. Members learn how to respond to questions, run a meeting and address an audience confidently. "We have a lot of people who come on the recommendation of their employer," Chick says. "Some faint when they first get up to speak."

Psychologist Sharp says cognitive behavioural therapy, where people are taught to change their thinking about certain behaviours, can also be extremely effective.

Another alternative is one-on-one coaching. Darren Fleming, founder www.executivespeaking.com.au, helps clients overcome public speaking jitters by changing their outlook. "One of my clients sold highly technical security equipment but didn't make eye contact with clients and mumbled through his presentations."

His sales figures were below par. With coaching, he learned to maintain eye contact with clients and speak confidently - translating into increased sales. "His boss was over the moon," Fleming says.