How to manage performance anxiety

Psychologist David Juncos explains flexible responding: a new type of treatment for performance anxiety.

If you suffer from music performance anxiety then, this article is for you. But first, I want you to forget everything you know about your performance anxiety for one second… Really, I’m serious.

Give it a shot, just for a few moments. Try as best you can to forget any unpleasant thoughts or memories you may have about it. Forget any uncomfortable sensations it may conjure up, too. Forget the times when your anxiety compromised your talents as a performer and definitely forget any professional or academic impairment it may have caused you. Keep trying.

Ok stop. Were you able to forget anything? Probably not, right? In fact, at this moment, you’re probably recalling whatever thoughts, sensations, memories, or emotions your mind has associated with your performance anxiety. It might even seem like those associations are so poignant that they evoke equally as strong a reaction as an actual music performance does. That’s to be expected. In fact, that reactivity illustrates an important principle that psychologists call ‘cognitive fusion’.

Cognitive fusion is the tendency of our minds to react to our associations of negative events with the same emotional vigour as we do to the actual events with which they are associated. Whenever we buy into or believe these mental associations, we say we are being ‘fused’ with them and our behaviour becomes unnecessarily hooked or controlled by them. Luckily, we can learn to undermine this tendency to automatically believe what our minds tell us. By ‘defusing’ from what our mental associations tell us about our performance anxiety, or about any unwanted emotional states, we become less reactive to our minds.

I am a clinical psychologist in private practice and I use a newer therapy called Acceptance and Commitment Therapy (ACT) to treat both professional and student musicians with performance anxiety.

ACT is wholly different to other available therapies because its goal is not to reduce or eliminate symptoms of music performance anxiety (MPA). Rather, it teaches musicians to become more flexible in its presence, so that their behaviour is more focused on achieving valuable outcomes during their performances, even with MPA present, and less focused on attempting to get rid of MPA symptoms. Such flexibility requires a mindful acceptance of one’s MPA symptoms and a continued redirecting of one’s attention onto engaging in self-chosen behavior until the valued outcome is attained.

Musicians with MPA typically get stuck when they buy into their thoughts, and other associations, that tell them the MPA is bad or dangerous and needs to be eliminated. When one is fused with such thoughts, their behaviour is hooked by their mind during their performances and they may waste precious energy unsuccessfully attempting to get rid of anxious thoughts or sensations. On the contrary, when one is more accepting of their MPA, they become less fused with what their mind tells them about it, which allows them to persist with valued behavior, even with MPA symptoms present.

Let me elaborate on how defusing from one’s anxious thoughts can lend itself to engaging in valued behavior while performing, using a common scenario familiar to many vocalists. 

Let’s say you are applying to an elite music school for a degree in vocal performance and an audition is required. Obviously, there will be numerous applicants competing for a limited number of spots, which would likely be quite nerve-wracking. As you take to the stage to begin your performance, you notice your breath is much shallower than normal and your mouth is dry. You immediately panic, and your mind becomes flooded with anxious thoughts, such as, “If I can’t breathe properly, I won’t be able to sing the piece the way I’m supposed to” or “If I don’t remain calm and sing the piece properly, I’ll blow this audition”. Well, if you are fused with these thoughts, you will buy into them and attempt to calm your anxiety, while also trying to focus on your audition as best you can. This is a noble endeavor, but is an exercise in futility. It prevents you from mindfully accepting the physical MPA symptoms, because you’ll waste energy mindlessly ruminating on how the physical symptoms need to be eliminated. On the other hand, instead of panicking in response to your anxious sensations, or panicking in response to your anxious thoughts occurring after the sensations, you can learn to defuse from what your mind is telling you about your MPA symptoms.

ACT teaches a number of techniques to promote defusion. A common one is to preface your thought, either aloud or silently, with the statement, “I’m noticing (… I’m feeling anxious/panicking/breaking out in a sweat).” This simple technique helps you to stay present with your anxious thoughts as they’re occurring, while minimising the likelihood you’ll buy into them. It also helps you to mindfully accept the physical MPA symptoms. If done repeatedly, you may begin to take the content of your anxious thoughts less personally. You may even begin to view them differently, perhaps as uncomfortable clues that you’re in an anxious mood, just like a fever is an uncomfortable clue that an infection is present. A fever is not meant to be taken personally and neither are anxious thoughts, or uncomfortable sensations for that matter. Once you’re more practiced at defusing from what your mind tells you about your MPA symptoms, you can focus your mental energy on achieving valued goals during a performance, for example, conveying the meaning of a text, expressing emotion at key times, focusing on good technique. Achieving those goals requires an acceptance of the MPA symptoms and a simultaneous, diligent redirecting of your focus towards enacting those goals. This may sound difficult but, like most things, it gets easier with practice. Once you’re able to defuse regularly, you become more flexible in the presence of your MPA. In other words, you learn to persist with achieving valued goals during your performance, even with MPA symptoms present.


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David Juncos, PsyD is a 2014 graduate of La Salle University’s Clinical Psychology Doctoral Program in Philadelphia, PA. He is currently a post-doctoral resident with Ivyland Counseling Center, a group private practice with offices in Warminster and New Hope, Pennsylvania. His professional interests include treating student and professional musicians with performance anxiety and providing music educators with individual or organisational consultation for the management of students’ performance anxiety.