Performance Anxiety, Visigoths, and Sabre Toothed Tigers

Performance Anxiety, Visigoths,
and Sabre Toothed Tigers

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Catherine W. Britell, M.D.
It’s the stuff nightmares are made of. You’re standing on stage. You can feel the sweat trickle down your sides, and your knees won’t stand still. Your heart is pounding in your ears. You open your mouth to speak, and a quivery voice that seems to belong to someone else emerges from way in the back of your throat making you forget what you planned to say. You start to play and your hands shake, fingers slipping off the buttons. Your right hand feels as though it’s made of wood.

Of course you recognize this. We have all so been there, to some degree! And it doesn’t even take an actual stage to set it off. It could be a jam or song circle where it’s your turn to lead a song. It could be in a class where the instructor asks you to play something. It could even be in a private lesson. Or a church service or a birthday party. What makes it even more maddening is that you know it’s silly, you know you have nothing to worry about, yet you can’t control it. Stage fright has taken possession of your body.

Stage fright or performance anxiety is the anxiety or fear which may be aroused in an individual by the requirement to perform in front of an audience. This may be associated with any activity involving public self-presentation. One thing is definite—we’ve all been there. Any musician at any stage in his or her life has had to deal with conquering nerves. Mark Twain said, “There are two types of speakers. Those who get nervous and those who are liars.” Like public speaking, playing an instrument in public can be an anxiety-filled experience, and there isn’t a music student or professional musician around who hasn’t felt this way at least once, and usually quite a few times.

On the surface, stage fright doesn’t make sense. The vast majority of us play and sing because we enjoy it. We relish learning new music, exploring beautiful sounds, and challenging ourselves to experience new levels of musicianship and technical skill. And we really want to bring our music out beyond our living room! So why then does it all sometimes fall apart when it comes to sharing our work in public with others?

Why does my body do these strange things?

No matter what triggers them, your stage fright symptoms are part of the body’s Primary Threat Response, which is also known as the “fight or flight response.” This is a set of healthy physiological responses that allow a human being to take emergency action—running away or fighting—when attacked. This was really important when we needed to run away from saber-toothed tigers or fight off the marauding Visigoths. Most performance situations aren’t life-threatening, and don’t require you to do anything that physical, but your body doesn’t know that. Your brain, nerves, muscles and blood vessels receive a flood of a neurotransmitter (message-bearing chemical) called epinephrine (also called adrenaline) and your body assumes that some sort of attack is possible, and simply prepares you for the worst. So, you can thank your body for doing a few very sensible things:

1. All of your muscles get tight. You are now prepared to spring into action with a burst of energy. In particular, the neck muscles contract, pulling the head down and the shoulders up to protect your spinal cord should a spear or set of jaws come at you from behind. At the same time, the back muscles try to draw the spine into a fetal position, to protect your soft underbelly and genitalia. So your body has done all the right things to protect your vital organs from saber-toothed tigers, but there’s not a wild animal in sight. Instead, you have to stand still and straight in front of the audience. Your muscles, still contracted, begin to tremble. And the harder you try to hold your muscles still, the more they shake! Your diaphragm is constricted, your breathing shallow and rapid, and your vocal cords and neck and throat muscles are all tight, making your voice difficult to control.

2. Your blood rushes to your muscles and vital organs. Your body knows it has only so much oxygen and blood, so it chooses carefully where to send it. The tiny blood vessels serving your toes, fingers, ears and nose constrict. Of course, this leaves you with a sensation of cold hands and feet (and perhaps a cold nose and ears as well), along with numbness and tingling.

3. Your blood pressure and heart rate increase. In order to make sure that enough blood gets to your muscles and vital organs, you heart will start working harder and faster. This causes your heart to seem as though it’s in your throat.

4. You make more urine. Because of the shunting of blood away from your skin and toward your heart, lung, liver, and kidneys, you often find that your bladder fills up quite fast. So that nasty urge to urinate may hit while you’re onstage. That’s all you need, at this point!

5. You’re sweating like a pig at this point. We have two kinds of sweat glands: ecrine sweat glands that get rid of water and salt, and respond to heat, and apocrine sweat glands that respond to…you’ve got it…adrenaline. So, basically, you get two kinds of sweat. Frequently, the body must begin sweating all over in order not to overheat, since your metabolism has gone up. So you get clammy and moist all over. In addition, your apocrine glands spring into action. They are nestled in with the hair follicles in your scalp, underarms, and groin. These glands respond to the adrenaline that’s produced when people get nervous or scared, producing a more profuse sweat that contains fatty oils. Their job is to produce a particular smell that will warn assailants not to mess with you, and perhaps also warn family members to hide or run. In our modern society, we call it B.O.

6. You’re actually panting! The body’s need for a steady supply of oxygen requires rapid, shallow breathing, which cycles the largest volume of air in and out of the lungs and protects your lungs from being punctured in an attack. This messes up your singing tremendously, and even when you’re talking, you seem to be gasping for breath.

7. The gut shuts down. Food processing is deemed a low priority by the body under stress, and your digestive system shuts down for the duration of the emergency. Any foods already in the system just sit there, waiting for stomach acid and saliva secretions to resume. The resulting sensations are the familiar “lump” or “butterflies” in the stomach, along with a dry mouth and nausea.

8. The frequency of brain activity speeds up, allowing you to think more quickly, process more information, and make quick decisions. After all, the tiger or the Visigoths aren’t going to wait for you to mull things over! This can make you feel as though time is distorted. Your natural pace of thinking and reacting is disrupted, which can throw off your musical timing, make you play too fast, or not take enough time to get ready to play. If you’re talking, you often think of new things to say in the middle of a sentence causing you to ramble about ideas you hadn’t prepared. If you’re playing a piece of memorized music, you’ll often lose your way, because your mind has raced ahead to the next movement, and you’re no longer “in the moment” of what you’re playing.

Are there also emotional/behavioral factors that are important in causing stage fright?

In the 1980s, some psychologists at West Georgia University conducted a frequently cited experiment on performance anxiety, employing the methods self-observing, self-reporting and self-discovering. (Barrell, et al, The Causes and Treatment of Performance Anxiety: An Experimental Approach. Journal of Humanistic Psychology, 25 (2), 106-122)

They found five statements to be true in a significant percentage of individuals who experience performance anxiety. They are as follows:

(1) I perceive or imagine the presence of significant others who are able to judge me.
There’s somebody out there listening/watching you whom you respect or like, or at least want very much to impress. You just don’t want to blow it in front of that person/those people.
(2) I consider the possibility of my visible failure at a task.
This is really a pretty difficult piece. Have you practiced enough? Did you tune well? Will you remember what you’d planned to do with it? These questions and more haunt you as you walk onstage.
(3) I feel a need to do well to avoid failure.
You really, really want to be able to do this well. You’d love to be a good performer! You want to be in the contest finals. You want to get hired again at the winery. You want to be asked to play in church again.
(4) I feel uncertain as to whether I will do well.
You’ve done it before; you could do it again. You could screw up! You could very well screw up. As a matter of fact, you are more likely to screw up than not.
(5) I focus on my own behavior and appearance.
You’re wearing a dorky shirt. Are dark spots forming under your arms? The hair is blowing in the wrong direction. You think you look way too fat. Your voice feels weak. Your instrument feels heavy. You hope nobody takes a picture.

Do any of these seem familiar to you? The good thing is that they suggest some effective ways of managing this issue. We’ll get to that in a minute.

So…now I understand stage fright a little better, but what I really want to know is how I can overcome it.

The first thing that people ask when they have a physical or emotional issue that they need to address is, “Isn’t there a pill for this???” The pharmaceutical companies, advertising agencies that they hire, and TV networks who sell advertising time to them all would assure you that there is indeed a pill for everything that ails you, and that if you take their pill, your life will become immediately and immeasurably better; filled with green trees, flowers, butterflies, smiling, beautiful children, adoring border collies, and gorgeous loving spouses.

In truth, there are individuals with serious anxiety disorders, who have these symptoms when talking on the phone, visiting shopping malls, interacting with co-workers, or even driving a car, for whom medications and psychotherapy are not only helpful but necessary in order to live a comfortable and productive life.

The rest of us might have some relief of performance anxiety symptoms from medications; but many times the benefits of these chemicals are not worth the side effects, and taking medications for performance anxiety can actually inhibit your experiencing the emotional growth necessary to overcome it.

That said, there are two chemical approaches available by prescription and some others that are sometimes used by people with severe performance anxiety symptoms.

The first is Beta blockers. These are cardiac medications that were first marketed in 1967 in the United States for disorders like angina and abnormal heart rhythms. The most common is propranolol (brand name: Inderal) Propranolol works by blocking the action of adrenaline and other substances,and muting that “fight or flight” reaction. More and more musicians began to use beta blockers after their application to stage fright was first recognized in The Lancet, a British medical journal, in 1976. By 1987, a survey conducted by the International Conference of Symphony Orchestra Musicians, which represents the 51 largest orchestras in the United States, revealed that 27 percent of its musicians had used the drugs. Lately, those numbers have decreased. This is because beta blockers have some adverse effects. They can make you feel drowsy, slow down your thinking, and make you less able to respond to stimuli. In susceptible individuals, they can also trigger asthma attacks. Many performers who have used them find that they will indeed suppress the performance anxiety; but also will decrease the performance excellence.

The second class of drugs sometimes used for anxiety are benzodiazepines. You may know these by their brand names of Valium, Atavan, Xanax, Klonipen. They can be effective for those people with serious anxiety disorders. But despite their potent anti-anxiety effects, the medications have their drawbacks. They work by reducing brain activity, and of course, this leads to side effects beyond anxiety relief. They can make you feel sleepy, foggy, and can make you accident-prone. For this reason, they can seriously decrease your ability to perform well. Because benzodiazepines are metabolized slowly, people will often become very sleepy when the anxiety-producing stimulus (i.e., performance) is over. Also, they have a significant potential for addiction. Overall, benzodiazepines are a bad idea for performance anxiety.

Then there are “over the counter” medications and substances. Sadly, alcohol has been used by musicians to “treat” performance anxiety issues for eons. In fact, alcohol acts in much the same way as benzodiazepines, and it’s always a bad idea, because use of alcohol in this way easily leads to addiction, ruins lives, makes people sick, and kills them. More recently, “natural” preparations have become popular. It’s important to remember than just because it’s “natural” or “herbal” doesn’t mean it’s harmless. Many of these preparations or “supplements” have strong psychoactive properties, and because their chemical composition isn’t listed or even often known, their effects may be unpredictable.

So, there are some good health reasons to avoid using drugs. But probably more important is the psychological/functional reason. Here’s the secret: You can overcome your performance anxiety more effectively, more permanently, and with the outcome of delivering a better performance and having more fun without drugs!

OK…so drugs aren’t the answer. But how, then, do I get over this?

It’s actually a lot like learning how to play the autoharp. You need to learn some basic principles, and then you need to practice. And practice some more. Until you get it.

We can start by looking again at the work of those Georgia psychologists. and remembering the thoughts and feelings that most people with stage fright experienced. We can consider some useful responses to them:
(1) I perceive or imagine the presence of significant others who are able to judge me.
When we have stage fright, we often invest the others with imagined power, especially in their ability to affect us through their evaluation of our performance. We need to get real about this. After all, why are people in the audience? They came to see/hear you play because they like you, like what you do or have heard that you make lovely music. And here’s a little psychological secret: They really want you to do well and because of that, will actually remember and pay attention to what you did well and tend to ignore or forget your mistakes. Once you figure this out, the audience will become a positive force in your performance.

(2) I consider the possibility of my visible failure at a task.
First, you want to minimize the chances of screwing up by being musically well-prepared. This is the number one rule for calming your nerves. There is no substitution for knowing your material inside and out before a performance. Being nervous is a natural, normal feeling that you will most likely not get over until you have a lot of experience performing, but knowing the material really well gives you one less thing to worry about. Preparation is a hard lesson to learn and most of us will have at least one (if not more) disastrous performance before we realize how important being prepared is. You need to know you’re good, but in order for that to happen, you have to be good!

(3) I feel a need to do well and to avoid failure.
It’s important to keep the performance in perspective by seeing its outcome as insignificant in relation to the totality of one’s life. By realizing that nothing catastrophic is likely to occur, the need to avoid failure may decrease and switch to a more positive goal. An example of a positive goal would be to provide others with pleasure. Probably the best tool is to focus on the process, the moment-to-moment experience, rather than the results of a performance. Don’t worry about whether this evening will bring you to Carnegie Hall or win you a trophy or beautiful autoharp. Just concentrate on making fantastic music. And most importantly, realize why you do the music in the first place. It’s fun!

(4) I feel uncertain as to whether I will do well.
Again, being well-prepared will help. But the most important thing in conquering the uncertainty of success is positive performance experience. Learning is such a very important determinant of how we feel. If we experience one performance success, we’ll learn from that, and expect success in the future. Of course, there’s a way to approach this. Just as you wouldn’t learn to swim by jumping out of a ship in the middle of the ocean, you don’t learn to perform by walking onto a brightly lit stage in front of a hundred people, or by entering a national autoharp contest. You take it in small steps, starting well within your comfort zone, perhaps in front of your family, then branching out to an informal jam or song circle, maybe a workshop, then perhaps a local open stage, and go from there, each time branching out a little farther as you have positive performance experiences.

(5) I focus on my own behavior and appearance.
Acute awareness of oneself is a common component of performance anxiety. It’s so easy to focus one’s attention on the visible appearance of the performance. One way of reducing this is to increase one’s awareness of others without considering them as judges. And of course, it’s all about the music. If you are lost in your music, you won’t have a moment to consider either the performer or the audience.

Are there other specific actions that can help?

1. Enjoy the arousal caused by your adrenaline. Recognize the stress as excitement. Indeed, the symptoms of stage fright are virtually the same as those you’d experience if you rode a roller coaster, went over rapids on a river raft, or had an “intimate relationship encounter”. The difference is that you have learned to associate “fright” with being on stage and “fun” with being on a roller coaster. The goal of stage fright control is not always to make the symptoms go away; but to learn ways to make the adrenaline rush work for you, rather than against you.

2. Force yourself to use your large muscles. All of your juiced-up tense muscles are waiting for you to throw a spear at a saber-toothed tiger, and until you do, they can’t relax. Go for a brisk walk (watching out for wild animals, of course.) Throw your arms around, do some jumping jacks, Clench your fists, scowl, make ugly faces, and then relax those smaller muscles too. Roll your shoulders around, and focus on your back and neck muscles, stretching and rolling your head until they relax.

3. Breathe. Take deep breaths, from the diaphragm. When you force yourself to take a deep breath, the oxygen/carbon dioxide balance is restored, and the body interprets the big sigh as an “all clear” signal. As you breath slowly and deeply the stress levels begin to decline, and you will relax.

4. Manage your food intake wisely. For many people the most debilitating symptoms of stage fright are the consequences of the digestive system shutting down. Figure out what your own digestive system does (or doesn’t do) under stress, and see that you time your food intake to accommodate it. Most performers avoid milk products because it increases secretions. Coffee and caffeine containing drinks can make your symptoms worse. You need to keep your energy level up without overeating.

In summary, here’s the best advice for overcoming performance anxiety. Learn to play well, live in the moment, and think of others rather than yourself, and just do it.

About the author:
Dr. Britell (we know her as Cathy) is Clinical Associate Professor of Rehabilitation Medicine at the University of Washington, is 2005 International Autoharp Champion, and has experienced many of the feelings described in this article.

Acknowledgement: Sincere thanks to Ron Bean, M.D., for proofreading and checking psychiatric facts.

© 2016 Catherine W. Britell, M.D.