Part I
Performance anxiety and the use of psychodynamic interventions
1 Exploring performance anxiety
Challenging the dogma of preferred therapies in current use
Performance anxiety is thought to be a type of social anxiety where individuals experience psychological discomfort in certain situations.1 It is the arousal experienced when having to perform in front of an audience: the fear of being judged in a situation deemed to be threatening where individuals feel that they are on show or in the spotlight. A public performance of any kind may heighten the degree of anxiety experienced embracing a gamut of mental, emotional and physical feelings. The problem is widespread and is frequently reported in performance situations in various domains. In fact, well-known professionals have described having bouts of acute performance anxiety. In the field of music: Maria Callas, Luciano Pavarotti, Barbra Streisand, Adele, Michael Jackson and Carly Simon. Similarly, in stage and media performances: Sir Laurence Olivier, Peter O’Toole, Oprah Winfrey, Burt Reynolds, Johnny Depp, Emma Stone and Brooke Shields. And in sport: David Beckham, Pete Harnish (baseball) and Charlie Belijan (golf) all acknowledge that they have been afflicted with the condition.
What is cognitive anxiety?
A description of anxiety was given as early as the first century AD by Seneca, a Roman philosopher, who suggested that there are more things to alarm us than to harm us, and that we suffer more in apprehension than in reality.2 Two thousand years later anxiety and its many complexities relating to the cognitive, emotional and behavioural aspects of human performance illustrate the wisdom of his words. Cognitive anxiety usually occurs when individuals feel that they are being scrutinised and anticipate that their behaviour will fall short of what is expected, experiencing a fear of not matching one’s own or others’ expectations leading to embarrassment and humiliation.3
Psychologists generally differentiate between two types of anxiety: trait and state. Trait anxiety is an individual’s normal level of anxiety when in a non-threatening situation, and it has been suggested that it is influenced by genetics.4 State anxiety, on the other hand, is a temporary condition which can change according to environmental situations and pressures. It is the anxiety that is experienced during a public performance and has been described as overestimating the severity of a feared event and underestimating the coping resources and rescue factors which could be adopted to help the situation.5 However there is a relationship between the two anxiety states in that individuals with high trait anxiety will experience correspondingly high state anxiety in a situation they see as threatening.6
Self-focused negative attention on forthcoming events plays a key role in the conception and maintenance of anxiety.7,8 In fact it is argued that cognitive anxiety is exacerbated through the interactions of fearful thoughts, arousal of the autonomic nervous system (ANS) and overt behavioural responses to a perceived threat.9
Arousal and performance
The ANS is the body’s emergency system which becomes activated in response to external events and instigates arousal. The ‘fight, flight or freeze’ response prepares the body for appropriate action including the effects of increased adrenalin in the blood stream ensuring the enhancement of physical and psychological energies.9 However, in a performance situation, arousal can exacerbate anxiety resulting in a variety of unpleasant symptoms which can have a detrimental effect on performance quality.10 Over-arousal can generate physiological (increased heart rate) and somatic symptoms of anxiety (nausea, increased muscle tension, trembling/shaking, dry mouth, sweating and ‘butterflies’.11,12 When arousal interferes with performance, concentration is interrupted and memory blocks occur which impact negatively on performance.13
A number of different theories have been suggested regarding the degree of arousal appropriate in performance and it is argued that there is an individual zone of optimal functioning (IZOF).14 It is further suggested that these levels vary for different individuals depending on their personality and characteristics.15 When arousal is low to moderate, the individual’s attention on the performance is greater; however focus decreases as the levels of arousal are raised.16 Task mastery, the complexity of the task, peer pressure and audience effects are also factors that affect arousal in performance.17,18 Compounding these factors cognitive appraisal of the situation also affects emotional behaviour; the problem is a complex one.
The cognitive/emotional connection
Anxiety has been defined as a complex (learned) emotion where fear is combined with other emotions such as anger, shame, guilt and excitement. In fact when fear and anxiety are generated in a threatening environment emotion plays an integral part in the outcome of the situation.19 Anxiety places an emotional burden on individuals and can be extremely disruptive,20 and it is claimed that tendencies towards emotional instability significantly predispose performing artists to symptoms of panic in situations perceived as traumatic.21 When an environment is thought to be threatening psychological problems may develop22 leading to an emotional episode,23 when the components of anxiety, physiological arousal, subjective feeling and dysfunctional behaviour interact.24 Performance is said to be based on this complex set of interactions that operate in cognitive and emotional states.25
Highly relevant to the therapies adopted in the case studies documented in this book is that some cognitive components and emotional processing operate outside conscious awareness.26 In fact it is argued that unconscious emotional processing can leave a negative memory trace connected to a similar experience, no longer consciously remembered, which will impact on the present-day experience. In other words forgotten negative experiences can have a direct effect on a future event. Let us consider the implication of this and the importance of memories when operating in a performance situation.
Memories, emotions and behaviour as contributors to anxiety
Research has shown that implicit processes (processes no longer in conscious awareness) sometimes referred to as automated mental processes, produce an automatic response27 and can trigger latent patterns of thoughts, emotions and behaviour, resulting in a viciou...