Controlling Performance Anxiety
Some performance anxiety, a few butterflies, perhaps a dry mouth, are symptoms that seem to be almost universal to musicians. In fact, there are many great musicians and teachers who insist they must experience pre-performance anxiety (even to the point of nausea) or they will not perform at their best level. These people recognize that pressure and fear can become too great, but they often insist that it is something to be kept within workable limits through extra practice and continued exposure.
There are some musicians for whom these ideas are undoubtedly true. They find something almost comforting in the fact that they are nervous before a performance. As confusing as it seems, their anxiety serves as a signal that all is well and the tension level goes no higher; it stays at (for them) a workable level and drops as the performance begins. There are a great many others, however, for whom this is not the case. For these people the initial fears seem to be interpreted as a signal that something is wrong. Their concern then feeds upon itself and the tensions get out of control.
It is easy to sit back and say that the only difference between these people is their mental attitude. The naive assumption then is that if the anxious musician would simply accept the anxiety, he would be able to go on. That's comforting to those who are in control and seems to explain their own experience. Unfortunately, there are some differences both in terms of personality and in terms of actual physical responsivity to similar situations that make an attitude change difficult, if not impossible. For the musician experiencing an excessive amount of performance anxiety, it is often not enough to practice more or to play more concerts. When the musician feels himself falling apart telling himself "you feel something else" is less than believable. Trying to convince himself it's "just another performance" when his total future is affected by the outcome is equally difficult.
A great many talented musicians accept lesser positions, give up, or drop out of the profession because they are unable to control their level of performance anxiety and because the exhortation to "not worry" fails to work for them. There is often little difference between these people and the stars in their field in terms of talent. It becomes a tragedy for the individual, for the teacher, and for the community when these talented individuals fail to reach their ultimate potential.
Performance situations are all potentially anxiety inducing. There are, however, factors which make some situations more threatening than others. The more critical and personally relevant the audience, the more we value their opinion, and the more potential there is for anxiety to debilitate performance. Thus, some musicians could play a very large concert with relatively little concern, yet to play in front of two or three highly valued colleagues might be extremely threatening.
A second factor which determines the amount of anxiety experienced has to do with the potential impact the performance can have on the person's life. Will the performance on that day say something important about the musician's future? Will it determine position in an orchestra, salary, etc.? Clearly, the perceived personal impact of the performance influences anxiety levels.
A third important factor is related to the amount of importance the musician places on music. In society many individuals seem to have multiple identities. People may have an occupation but may also identify themselves as uncles, fathers, athletes, Elks, Jews, etc. With so many identities the threat of losing one is minimized. A great many musicians, in contrast to other members of society, place their body and soul into their music. The more music is the total focus of their lives, the more potential there is for a threat to that identity to upset them to the point of impairing their ability.
For many students at the Eastman School a jury performance (a musical examination) has all of the elements of a very stressful situation and is an excellent model to illustrate the above points.
Often the student has come to school at some sacrifice to the family. In addition, the student may represent the potential achievement of the cultural and social aspirations of their parents. Many have support from their home town communities. This places pressure on them, they feel they must succeed; they cannot let down those they love who have sacrificed so much.
If the family pressure is not enough, their own desire is added to fuel the fire. Music is their life, and they have not yet reached the point of developing other interests. They have one goal: to perform. Now they find that they are in competition in a new league. Everyone in school is special and they do not stand out as clearly anymore. They find that they must compete for the things that they want, and they learn very quickly how critical and, at times, unsupporting their environment can be.
Although they have played before audiences before, never have these audiences been so esteemed, nor so critical. They must play their jury in front of a group of respected faculty that will decide what caliber of student they are. This group will decide whether they are worthy of being placed in a position to be recommended for one of the very few choice performing opportunities that may come along. This group can decide to hold them up as an example to other students or it can (in the student's mind and heart) turn its back and give up on them. Their entire life as they know it depends upon this performance, and no matter how hard they try they cannot convince themselves that it is "just another performance."
For many students the pressure from family, self, other students, faculty, and the jury situation becomes so great that performance actually deteriorates to the point of confirming their worst fears. Too often they become so discouraged that they give up, drop out of school, or develop some physical or psychological defense mechanism that provides an excuse for avoiding future performance situations.
Although a breakdown under pressure is often seen as a personal failure there is no reason it should be. If pressure gets high enough, and if the situation becomes critical enough, everyone will experience a breakdown in the ability to perform. This is true even of those faculty and students we seem to remember as never being out of control. What happens when pressure becomes too much is interesting because it provides the key to overcoming the problem.
Physically, as arousal and anxiety increase, the individual begins to experience corresponding increases in heart-rate, perspiration, respiration-rate, and blood pressure. These changes can lead to hyperventilation and feelings of dizziness as well as to actual heartbeat irregularities. Nausea may develop along with cramps from increasing muscle tension. Fine motor coordination becomes impaired and movements become clumsy and jerky. Fatigue develops rapidly due in part to increases in tension and the fact that this tension, then, makes the individual work harder to accomplish the same task.
Psychologically, increasing pressure is accompanied by a narrowing of attention and a reduction in the ability to integrate information and to analyze or plan ahead. It also results in decreasing contact with the environment. The result of these changes is that the individual begins to feel overloaded and confused as if things are happening too quickly. The musician may find himself losing his tempo and finishing a piece much too quickly. Often the anxiety results in a flood of thoughts which catch the person's attention, further reducing his ability to focus on important task-relevant cues. Instead of seeing the conductor, the individual is caught up in thoughts like, "What if I throw up? I think I'm going to be sick. What will people think? I might forget some notes. I've got to get out of here. What if I make a mistake? Will I be able to play it?"
Everyone, from time to time, will find himself in situations where he experiences these things. Usually he manages to survive intact because the situation was not actually as important as had been imagined. In the case of the jury, however, there are real casualties. The pressure and importance of a music education, the respect of faculty and peers, and the relevance of that performance to the future make the jury a situation that generates very real problems for many students. Given all of the potential for upset, it's a wonder that anyone survives. Yet most do.
Why do a number survive (some even excel) when others fall apart? Typically, it is not because they had any more talent, practice, experience, or dedication, though admittedly these can be important factors on some occasions. For a variety of reasons (that differ from student to student) the jury situation does not generate the same level of physiological and psychological disturbance. Research on anxiety has shown us that different individuals have different tolerances for pressure. Some, for reasons of birth or earlier learning, fall apart more easily than others. Still other students have less pressure exerted on them during the jury because of understanding faculty, parents, or fellow students. Those who survive are the fortunate ones, and the question remains concerning what can be done to help those who might otherwise be less fortunate.
Thanks to the cooperation and support of the administration, faculty, and students at the Eastman School of Music, we have had the opportunity to experiment with programs designed to help those students who might otherwise be less fortunate. The remainder of this paper is devoted to these ideas and findings.
Coincident with increases in our understanding of the effects of increasing anxiety on performance has come the refinement and development of self-control procedures. Biofeedback (feedback to the individual of various biological processes occurring in their body), behavior modification procedures, TM, Autogenic Training and Progressive Relaxation have all been used to help individuals gain more control over anxiety. In our laboratory we have tested individuals and then used various mixtures and modifications of relaxation procedures to help them perform at higher levels under pressure.
The first step in the work with Eastman students consisted of some psychological testing. As understanding of the effects of anxiety on performance has increased, so has our ability to measure and predict how a given individual is likely to respond. The Test of Attentional and Interpersonal Style (TAIS) is a 20 minute paper and pencil test which measures those attentional processes that are affected by increasing anxiety. This particular test has been found to be useful in predicting both who perform poorly under pressure and what type of mistakes they are likely to make. Some individuals react to anxiety with withdrawal and fail through avoidance and refusal or an inability to perform. Others react in a disorganized fashion responding almost impulsively to anything around them. Their feelings of becoming over-loaded and confused keep them from responding in a logical, integrated way. As a result they react, without thinking, to whatever is in front of them. Still others become very narrowly focused in an attempt to control and reduce the overload. This excessive narrowing makes them respond in a rigid fashion, and they tend to make the same mistakes repeatedly. They have great difficulty seeing the problem and hearing what others are saying to them. If the other person gets angry or frustrated and starts yelling instructions, the problem worsens.
By pre-testing students (not for purposes of selection!) to see how they respond, it becomes possible to anticipate problems and to prevent their development. Teachers can take student responses into account and adjust their own behavior accordingly. One concern at the Eastman School involved identification of those students who react to their anxiety by quiet withdrawal. Often these individuals drift along, performing at an acceptable level, but not achieving their potential and not getting needed feedback from instructors. They feel too anxious to ask for feedback and interpret the fact that it is not given as either rejection or a lack of concern. They see other (more demanding and vocal) students getting the time and attention. Their anger, resentment, and anxiety build and their confidence decreases. At first they blame others, and they may change instructors or schools. Ultimately the blame may be directed inward, accompanied by a feeling of unworthiness, and then the student may drop out entirely. In many instances the school may be mystified as to why the student left, since from the school's perspective, he was doing acceptable work.
By utilizing the Attentional and Interpersonal Style test results, increased awareness of individual students' response style is available. Students who may anticipate some future difficulty are extended opportunity (an interested ear) and encouragement to express concerns and feelings. At least initially, this is best accomplished in a relatively private situation on a one-to-one basis.
Many schools plan a guidance and feedback session with students each semester. The anxious type of student is the one who benefits least from these sessions; the reason is, this is the one conference where a problem is not expected. The student enters up-tight by the whole evaluative process and withdraws even more. The faculty member has seen no problem (and the hour before was probably spent with a student who was only too vocal) during the semester. Too quickly the student is asked a couple of questions without really being given time to respond. (This is an individual who normally needs a lot of time to respond.) Both of the participants are only too happy to end the conference early. The student leaves, temporarily reducing his anxiety, but, at the same time, reinforcing his thoughts that the evaluator or faculty member doesn't care. If the faculty member cared, he would have spent more time as perceived by the anxious student.
Pre-testing provides a warning and allows faculty and administrators to enter into situations with these students in ways which give them ample opportunity to talk and to receive feedback. Pre-testing can also be useful in helping to identify those students who might benefit from some program designed to teach greater control over performance anxiety, to keep it within workable bounds. At the University of Rochester we have developed several training programs to help in those situations where additional practice and verbal "I think I cans" are not enough. The results with Eastman students have been promising enough in terms of performance outcome and in terms of both the student and faculty members' response that we have listed them in the catalogue and made them a regular offering.
The programs combine training in relaxation, and the development of positive attitudes and images (correspondingly replacing old negative ones) with biofeedback to provide the student with greater self-confidence and control. The feedback of actual physical processes (levels of muscle tension) demonstrates the effects of anxiety to the students and provides proof to them that their training is improving their ability to control. Through feedback, when tension levels go down, they know it. As they see themselves doing the right things, their confidence rises.
Although we have experimented with several programs, two of them deserve special attention. The first is a program developed by Dr. Richard Wolfe as a part of his Ph.D. dissertation.
What Dr. Wolfe showed was that it was possible to develop a six-session (45-minute sessions twice a week) automated self-treatment program to help students cope with the anxiety of playing a jury. The actual procedures were quite simple. Students entered the biofeedback laboratory where a technician hooked them up to a machine that measures and feeds back information about the level of muscle tension. Tension was measured from the muscles in the forehead because these had been found by other researchers to be the best single muscle indicators of total arousal.
After connecting the equipment, the technician explained to the student both how to work the equipment and what was to be the task. The student was told that at the start of each session he was to take fifteen minutes, using whatever procedure seemed helpful to him (some used TM, other tried pleasant thoughts, etc.) to lower the click rate of the machine. He was told that decreasing click rate indicated increasing relaxation. Following the fifteen minutes of relaxation, a tape was played which instructed him to imagine two different playing situations. In the first situation the student is successful, and is relatively anxiety free. In the second situation the student imagines that he is playing a very difficult piece, in front of the jury. He is asked to look around and to notice the faces of hostile jury members. The student is then asked to attend to his own increasing fear.
Measurements of tension levels under the imaging conditions across the six sessions illustrated that students were able to learn to gain some control over their anxiety. In fact, the control reported by both student and faculty seemed to generalize to the actual jury performances. Students reported feeling better and playing better in actual jury situations.
The second program was developed out of Dr. Wolfe's research and out of earlier research on attentional processes as they relate to anxiety. Through work with healthy individuals in the biofeedback laboratory (Eastman students, business executives, professional athletes) it was found that control could be gained over tension levels very quickly, usually within two to three sessions. Even in Dr. Wolfe's study most of the change in tension levels occurred within this time period. This finding helped to develop an even more abbreviated program which was found very useful in treating anxiety generated by a wide variety of situations including juries, tests, having to give speeches, flying, etc.
The second program consists of four sessions. The first session involves an interview designed to get at the history behind the problem. An attempt. is made to identify what exactly happens when things go well and what happens when they do not. These two situations are contrasted in terms of the actual environment (who is in the audience, what is the importance of the concert, etc.) and in terms of the physical feelings, and thoughts that occur. This information is then used to develop a training tape for the person. The training tape is given to them in the second session, its relevance to their problem is discussed, and the material that is contained is gone over in detail. The tape consists of some breathing exercises designed to give the person some immediate control over his attentional processes (so he can direct his concentration to positive coping activities) and his arousal. Following the breathing exercises the two different situations that were articulated in session 1 are presented and the individual is asked to imagine them and to make them as real as possible. First the successful situation is presented and then the unsuccessful one. In this first presentation the individual imagines that he fails. The second time he imagines the two situations (on the tape), he is stopped in the middle of the failure situation and instructed to use the breathing exercises to regain control and to direct attention in ways which allow him to overcome the problem. The student is told to listen to this tape twice a day (the tape is fifteen minutes long).
Sessions 3 and 4 consist of discussion and, when needed, procedure modification, and biofeedback of tension levels during practice. The feedback serves to emphasize the control that is developing and to instill confidence in the procedures. Session 4 is always timed so that it occurs within 24 hours of exposure to the actual feared situation. All four sessions usually occur within two weeks, though the first session can be separated from the other three by several weeks and even months.
Both of the procedures presented offer individuals ways of coping with anxiety apart from simple additional practice or exposure. For some this alternative is an absolute necessity, for without it the individual would not be fortunate enough to achieve his goals.
There is one final aspect of the research programs that we have been developing for Eastman students which deserves some comment. Up to this point, comments have focused around ways of dealing with excessive pressure that develops because of peer attitudes, the importance of a situation, etc. These are cognitive factors which lead to physical and psychological changes that interfere with performance. It is also possible to have actual physical problems precipitate stress, to create emotional problems, and to further complicate the initial physical precipitants.
Many musicians, because of their dedication and intense practice, experience what physicians often refer to as tendonitis, or overuse syndrome. They develop pain and inflammation in muscles and tendons due to improper or excessive use. In the past the inflammation has been treated with medication, and individuals have been instructed to discontinue practice for long periods of time. To a professional musician or student the thought of having to stop practice generates a great amount of anxiety. The musician's future depends on his being able to perform.
As a result of the anxiety, students often avoid going to physicians until they have done some real damage. In addition, the increases in muscle tension that accompany the fears act to aggravate the condition. Thus, the physical problem created anxiety which increases muscle tension and further aggravates the problem, and an ever larger negative spiral develops.
It is possible to avoid much of the problem and pain associated with overuse problems. First, orthopedists are now grading pain and taking into account the emotional need to play. Often it is not necessary to completely discontinue practice. Treatments are changing too. The inflammation still needs to be treated by a physician. In addition, however, we have been able to use biofeedback of the muscle tension in the affected area to teach the individual to relax and reduce the strain. Anxiety no longer aggravates the injury and recovery is much more rapid.
We don't intend to imply that we have all of the answers for helping people cope with excessive performance anxiety and overuse problems. We think, however, that we do have enough awareness of individual differences to recognize that a number of different training procedures need to be employed if we are to help students and others live up to their ultimate potential. We have suggested some of the ways in which problems of performance anxiety can be approached. We hope that what we have said is stimulating and serves to generate new and better ideas as well as greater empathy and sensitivity.