Harold was the Executive Director of a philanthropic organization. Anita was a professor. Carol was a writer. Oliver was a musical performer. Bill was an elite athlete. Although they had never heard of nor met one another, they shared something in common. Each person suffered from haunting, debilitating stage fright.

Harold presented his weekly and annual reports at Board meetings and conferences under great psychological duress. He tended to stutter, shake, and feared his Board members would notice his quivering voice which would leave him feeling ashamed. Anita could not stand in front of the class without her knees shaking. She worried she would not know answers to questions that her students posed to her. Sometimes she feared she would pass out in front of a group because she hyperventilated. She put off her tenure review. Carol was a talented author but could not write a word –no ideas flowed as her deadline neared. Her head was as empty as the blank computer screen in front of her. Oliver literally threw up backstage before walking on. His pre-performance nausea was exacerbated by his conviction that he would be exposed as a fake in front of his audience – despite hours of preparation and ample talent. He felt he could never play like other performers with whom he compared himself – always falling short. Bill  froze at the moment of the final sprint in speed skating. He never accomplished his goal to make the Olympic Team. His personal life was in shambles.


Fear. Worry. Physical symptoms. Avoidance. Shame. Embarrassment. Comparisons with others. Falling short of expectations. Goals not realized. Ruined relationships.

All of these people suffered from low self-esteem, self-doubt, and high anxiety. They all shared psychological and/or physical symptoms that prevented them from feeling and performing their best when the chips were down, the spotlight was shined on them, and the deadline loomed. Several had tried various sorts of self-help including exercise (always a good idea) and diet changes (no, eating bananas didn’t help anxiety although they are a healthy food). A couple had engaged in cognitive therapies, and several people had used beta blocking drugs to calm the physical symptoms of stage fright. While shaking, sweating, nausea, muscle tension, and irritability temporarily subsided, performance anxiety remained a persistent and unyielding psychological impediment. It was not cured by affirmations, relabeling negative self-statements into positive self-praise and reassurance, trying to eliminate irrational feelings (is any feeling “irrational”?), or using medications.

Stage fright is often defined by its symptoms. Its “cure” typically is measured by the elimination of them.   But this is paradoxical. Why, if smart, talented, and well-prepared people follow verbal prescriptions (sometimes medication prescriptions) for relief, does so much anxiety continue to haunt both the famous professional and talented amateur? Why are careers disrupted, dreams dispelled, and often personal relationships dissolved or avoided?

In our Age of the Quick Cure fueled by the Pharmaceutical and Insurance Industries, why is performance anxiety not more amenable to amelioration? Because there is no cure? Or should we consider other ways that might be more helpful to conceptualize this psychological monster? Need I tell you that I believe the latter. You need to scratch more than the surface.

In the last issue of The New Yorker, (http://www.newyorker.com/magazine/2015/08/03/i-cant-go-on) Joan Acocella cited the recent book, “Playing Scared” by Sara Solovich (http://sarasolo.com) to illustrate how the tentacles of stage fright have affected all kinds of performers for ages. Ms. Acocella also noted some of the psychological resources that I cited above as not having a curative effect to tame the foe of low self esteem in performance. She concluded that the topic is not worthy of writing a book on the topic and claimed there is no cure for stage fright. That conclusion by a respected author such as Ms. Acocella is frightening in itself. No hope, no cure.

Ms. Acocella failed to recognize the excitement and spontaneity inherent in a live performance or that having a creative idea or speaking effectively in front of others is exhilarating enough that people persist despite their fears. Ms. Acocella seemed not to appreciate that stage fright is not an incurable disease but rather an ongoing struggle within a performer who uses that struggle toward self-expression. And she overlooked the enormous psychological resources within all of us that begin in infancy and can be brought to the struggle that leads to greater and deeper self-understanding and a sense of fulfillment. Ms. Acocella concluded there is no cure. A terminal diagnosis.

As a Juilliard trained concert pianist who suffered from performance anxiety and who long ago modulated to my current career as a psychotherapist and psychoanalyst who treats individuals with paralyzing stage fright from various disciplines, I agree and disagree with her prognosis.  There is no cure.

It is not difficult to recite the long list of ominous and fearsome symptoms that define stage fright. Yet people are not defined by symptoms nor cured by removal of them.   Symptoms of all kinds need to be understood in the broader and deeper context of the whole person who brings a life history to performance (music, business, writing, teaching, athletics and other professional and personal situations).

Appearing before an audience, who represents in displacement, performers’ earliest relationships who can love or leave them, holds deep and life long meaning.   The performer’s life history will not disappear with deep breathing, cognitive restructuring, stoic attitudes, drugs such as beta blockers and so on.  This is impossible.   But an anxious performer can learn about unique multiple contrapuntal issues that both fuel and perpetuate the psychic monster that undermines talent, ambition, as well as personal and professional aspirations.  Some people do this in therapy, others through various life experiences.

In the process of getting to know oneself on a deeper level than symptoms, people can come to better  terms with what they can and cannot be – on and off stage. For those who perform, this can include replacing an unquenchable quest for perfection and omnipotence with pride in competence and self-acceptance.   This realization has powerful tentacles that stretch out to the performer’s psyche, but is not a cure in the traditional meaning of getting rid of symptoms.   Self-knowledge and self-appreciation is a more comfortable way to accept and know oneself on an everyday basis, to feel calmer in asserting oneself, and to allow ambition to flow without debilitating interference. This attitude, not some mental technique, transfers to appearing in public.    Consider that this non-cure is worth the effort.

This blog is Part I in a multi-blog series about “curing” stage fright. Stay tuned for “Cure – Part II” which will introduce you in greater detail to several performance anxious individuals who wrestled with emotional and physical pain that led them to search for a “cure”.

Please write to me with your thoughts and questions.

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Photo by Will Marlow