Stage Fright and How to Conquer It

A condition commonly plaguing performers can be overcome.

Is there anyone amongst us who has never had some stage fright?  My question is, of course, rhetorical.  Stage fright is a “common denominator” of musical performers, at one time or another.   Moreover, the general psychological phenomenon of performance anxiety is not limited to stage fright per se; it also applies to one’s emotional response to any kind of performance; for example, doing a job interview, giving a toast at a wedding, going on a first date, and “rounding third base” some time after that first date… 

Not only is some degree of anxiety entirely normal before and/or during a musical event, it’s actually necessary for optimal performance.  Consider the Yerkes-Dodson Law:  The relationship between anxiety (manifested by physiologic arousal) and cognitive-behavioral performance can be graphed as an inverted u-shaped function.  That is, peak performance occurs when you have a mild-to-moderate amount of anxiety!  This motivates you to do your best.  On the other hand, too much anxiety results in poor performance, because while you’re in panic mode, you freeze.  To use an old automotive analogy, an anxious over-reaction is much like “flooding the carburetor.”

So you may be asking, what’s the solution?  Severe “stage fright,” or diagnosable performance anxiety, is a type of phobia, which is a learned response to a situation or an activity.  And sinceit is learned, it can be unlearned.

Yes; there may be a genetic component– some people are neurologically “wired” to experience panic episodes more readily than other people.  This is called “panic disorder.”  Although a physiologic problem sometimes requires a physiologic component to the treatment plan, i.e., medication, the phobic behavior still must be unlearned to achieve a complete recovery.

Needless to say, psychological treatment will be entirely ineffective if the musician has neglected to prepare.  Musicians are, of course, well aware that they must diligently refine their skills and spend hours and hours in rehearsal.  This essay advises what to do if you have severe performance anxiety despite adequate musical preparation.

The well-established, state-of-the-art therapy for performance anxiety is an application of cognitive-behavioral treatment (“CBT”).  As the name indicates, this consists of two components:

COGNITIVE THERAPY:   Anxious people inadvertently tend to make themselves more anxious with excessively negative self-talk, imagining worst-case scenarios.  This over-stimulates one’s alarm response,  which disables the ability to perform.  So if you approach a performance by anticipating and visualizing embarrassing missteps, you will probably create a self-fulfilling prophecy.  Cognitive therapy teaches the person to challenge unrealistically catastrophic assumptions and re-program the self-talk.

 BEHAVIOR THERAPY:   The core of this component is systematic desensitization, or exposure/response-prevention (“ERP”).  In the safety of the therapist’s office, the patient first undergoes several weeks of training in anxiety-reduction techniques, e.g., progressive muscle relaxation, self-hypnosis, and/or meditation.  Next comes imaginal desensitization, in which a “hierarchy” of feared performance situations is formulated, after which the patient is gradually exposed to each of those situations in his/her imagination while in a deeply-relaxed state.  Once mastery of those steps is achieved, the final phase is in vivo exposure to those performance situations, in ascending order of difficulty.  Of course, the process begins with simulations in the therapist’s office and only later moves on to real-life  situations. 

What follows is a hypothetical story that illustrates a typical course of treatment.  (Regulations regarding privacy prohibit a description of an actual, specific case.) 

Susan was First Violin for a prominent orchestra.  Her family doctor referred her for treatment of a severe case of performance anxiety.  When Susan was a child, her parents had recognized her prodigious musical talent and arranged for violin instruction.  Unfortunately, the instructor’s teaching style was harshly critical, instilling in Susan an excessive fear of mistakes.  Nevertheless, Susan’s talent and hard work led to a rise through the ranks of school orchestras, and she earn a scholarship to one of the most highly-regarded musical colleges in the world.  She subsequently joined a major orchestra and ultimately became the youngest Concertmaster in that organization’s history.  

All of this achievement, however, came at a great personal cost.  Just prior to every performance, Susan would experience a panic episode, consisting of rapid heartbeat, hyperventilation, intense perspiration, dizziness, and nausea  –  so much so that she would often involuntarily vomit in a restroom just before going on stage.   Treatment began with hypnotic relaxation training, followed by imaginal systematic desensitization.  Once she was able to keep the anxiety under control while visualizing a solo during a concert,  in vivo desensitization began.  During repeated office visits, Susan played the violin after going through the hypnotic relaxation procedure.  Next there was a series of private, solo performances in an actual recital hall, attended by trusted friends.  

Susan’s “graduation” from treatment occurred after she had performed a solo during a major, televised, recorded concert.  Her performance was flawless, and her anxiety remained under excellent control.  Moreover, the rave reviews that she subsequently received from the press further bolstered  her self-confidence.  In a follow-up office visit, she remarked that she had “vanquished the old demons!”

In summary, dear reader, TAKE HEART:   Some amount of stage fright is entirely normal, and even if it becomes severe enough to interfere with performance, it is eminently treatable!  

Tony Ziesat is a jazz vocalist and a BJA member.  But you know what we musicians always say:  “Don’t quit your day job!”  So for many years, Tony has also been a clinical psychologist, specializing in the treatment of anxiety disorders.

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