Personally, I like to agonize obsess and fret, not actually do anything constructive to face my fear, and then maybe throw up. (My first year of Peace Corps, when I was teaching, which was a profoundly unpleasant and discouraging experience, involved no small amount of stress vomiting. This habit is even less charming in a low grade plumbing situation.)
This experience of anxiety, of course, just ends up reinforcing the fear. I don't like public speaking; therefore I stress out about it; therefore I associate it with being totally freaked out.
It's particularly hard for me to remember that all my fears are self-generated; I am not in fact a terrible public speaker or a wretched driver or so uniquely susceptible to gravity that I will inevitably slide off any precipice. All these demons are internal, although they may be set off by external circumstances. (It is true enough that sometimes I speak uncompellingly, drive ineptly, and fall down, but the risk of failure is a price of experience - just one of the costs associated with being alive.)
I don't think I can ever stop being scared of some things (nor should I - local aenesthetic is quite genuinely horrible) but I do hope I can learn to acknowledge my fears, and then gently put them aside and proceed unencumbered.
(Also: gave a presentation a few weeks ago, could not sleep beforehand but did not actually lose my Cheerios on the way there. Progress!)
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