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Overcoming Stage Fright: Therapy for Performance Anxiety

Have you ever felt your heart pounding like a drum solo before stepping onto a stage? Or found your palms slick with sweat as you’re about to present at a meeting? If so, you’ve met the jittery beast known as performance anxiety.

girl having performance anxiety/ stage fright

What is performance anxiety?

Performance anxiety, colloquially known as "stage fright," isn't just for Broadway actors or Olympic athletes. It’s a widespread experience that can trip up anyone from a guitarist at a local bar to a student in a spelling bee. It's the body's alarm system sounding a red alert when we’re about to expose ourselves to the potential scrutiny of others. The signs include:

  • Physical Symptoms: A rapid heartbeat, sweaty palms, shaky hands, dry mouth, and sometimes nausea. These are your body’s way of preparing for a perceived threat - in ancient times, a wild animal, but today, maybe just a microphone.

  • Cognitive Symptoms: Negative thoughts, fear of failure, and worries about being judged are common when experiencing performance anxiety.

  • Behavioral Symptoms: Avoidance of performance situations, or on the flip side, over-practicing to the point of exhaustion.

When does performance anxiety typically occur?

Performance anxiety could crop up in a wide range of scenarios. According to psychologists, some common situations where individuals might experience performance anxiety include:

1. Public Speaking: Giving a speech or presentation in front of an audience is one of the most common triggers for performance anxiety.

2. Academic Settings:

  • Taking exams or speaking in class.

  • Performing in academic competitions like debates or spelling bees.

3. Professional Environment:

  • Leading or participating in meetings.

  • Pitching ideas to colleagues or superiors.

  • Performing in job interviews.

4. Artistic Performances:

  • Acting on stage or in front of a camera.

  • Playing a musical instrument or singing, especially in recitals, concerts, or auditions.

  • Dancing in front of an audience.

5. Sports Competitions:

  • Competing in sporting events, where performance is observed and judged.

  • Taking a penalty shot or free throw, or any scenario where the outcome is highly contingent on a single performance.

6. Social Situations:

  • Going on dates or attending social gatherings.

  • Speaking at weddings or funerals.

7. Sexual Performance:

  • Anxiety related to sexual performance can also be considered a form of performance anxiety due to the fear of failure or not meeting expectations.

8. Everyday Interactions:

  • Even casual interactions, like making a phone call or attending a parent-teacher meeting, can trigger performance anxiety in some individuals.

In each of these scenarios, the common thread is the individual's perception that their performance will be evaluated by others, which can stir up feelings of apprehension, fear of failure, or fear of not meeting expectations. In addressing performance anxiety, it's important to consider the specific context in which it occurs.

Where does performance anxiety stem from?

Research points to a mix of factors:

  1. Biological: Our bodies react to public performances as they would to any threat, by initiating the fight-or-flight response. Think of your body like a high-tech security system. When you're about to perform, your body sometimes misreads the situation as a threat—like an intruder. So it sets off the alarm, which we call the "fight-or-flight" response. This makes your heart race, your palms sweat, and your breath quicken—because your body is preparing to defend itself, even though there's no real danger. It's just trying to help, but it's a little overzealous.

  2. Psychological: Psychological factors include individual personality traits, self-esteem, past experiences, and learned behavior. A person with a history of negative evaluation or embarrassing public experiences may develop a learned fear response to performing. Similarly, people who have a tendency for perfectionism are at higher risk of experiencing performance anxiety due to their high personal standards and fear of making mistakes.

  3. Social and Cultural: Our social and cultural environment also plays a significant role in the development of performance anxiety. The fear of negative judgment by others and the perceived consequences of a poor performance are reinforced by cultural norms that equate our personal worth with success and competence. The increasing value placed on public success, often witnessed through social media, doesn't help either.

How can you overcome performance anxiety? Therapy-based inputs

There are different ways in which you can address performance anxiety based on therapy interventions. The simplest way is a technique called 'dropping the anchor', which we can condense into the acronym "A.C.E", borrowed from Russ Harris's interpretation of Acceptance and Commitment Therapy.

1. Acknowledge & Allow:

The first step is to really notice and acknowledge what you are experiencing. This is an underrated step. Often we're told to just "suck it up", especially in high performance contexts that are "tough" by nature.

Discover where it comes from and how it manifests for you: Each person's background and experiences are different. Deep diving into where it comes from and how it appears for you will help you approach it with more self-compassion and understanding. You may do this with the support of a therapist.

What is the feeling that you're experiencing? Give it a label. Instead of trying to push it away, try to make room for this feeling. Your body is just trying to keep you safe, and it's natural to feel this way.

2. Connect:

We often get caught up with out thoughts to the point where we are no longer focused on the present moment. Connecting with our body and our immediate physical environment brings us back to the present. Notice how the emotion feels in your body, as though you are a curious child. Where do you feel it? What is the sensation like?

You could also use your senses to connect with your surroundings. What can you hear? What can you see? Smell anything? Is there something you can taste?

3. Engage:

A core feature of anxiety is avoidance. We are tempted to avoid situations that could potentially be anxiety-provoking for us, which in turn makes them more scary, and therefore more anxiety-provoking, which leads to more avoidance and the cycle continues. Instead of avoiding the situation, ask yourself what you can do. For instance:

Preparation: Knowing your stuff can bolster confidence. Is there something you can do to prepare for the event?

Exposure: Gradually facing performance situations helps desensitize the anxiety response. Start small and build up. Could you practice with a friend, or do a role play, before the final event? If the whole performance seems too much, is there a smaller version of it you can try first?

Note: These are only a few first steps based on research, and I hope they have been meaningful to you. For more customised and detailed support, I would recommend personal therapy.

Diya John, counselor and psychotherapist

If you're new here, I'm Diya John, a counselor and psychotherapist with a Masters in Psychology and a Diploma in Counselling from Australia. I founded Therapy Garden to make evidence-based counseling more accessible to expatriates, immigrants and the international community. I am based in Tokyo, but I work with clients in different parts of the world via online therapy. You can book a free consultation or read more about my areas of specialisation and services.



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