The life of a creative individual, especially musicians, often seems to require being perpetually ‘on’. But what happens when the stage transforms from a place of joy into a source of fear? To explore this common issue of performance anxiety among musicians, we spoke with Dr. Jessica Quiñones, a specialist in psychotherapy for musicians.
NB: I always hear about psychology relating to athletes and I wondered if there was an equivalent for music… that search led me to you. Before we go into that, though, Jessica, can I ask you about how your music journey started?
JQ: I started my career as a flute player in the UK. I pursued all my degrees in performance. So having gone to conservatoire for my undergraduate, my masters, and then my doctoral degree in Performance Musicology, which is again surrounding anything to do with performance interpretation, flute playing. With that background, I also have done a lot of work as a teacher and educator in academia.
The thing that kept coming up for me as an educator in music, especially with working with high- level performers (so we’re talking conservatoire graduates that are undergoing the audition circuit for orchestras, or even amateur adults that were coming to me), it really dawned on me that a lot of times some of the things that I thought that needed to be addressed, were not necessarily music related at all, it was something much deeper around self-belief, confidence, maybe even some trauma history that I was encountering. One thing I was really frustrated by was my training wasn’t ready to tackle those things. Ethically, I couldn’t work in that field with somebody and I thought, what I want to do is study and become a psychotherapist for musicians. So off I went and did all my training to become a psychotherapist in the UK and decided to really focus in with musicians and work in that niche. It’s been a highly, highly successful career addition, because I still perform and teach and play and still keep my own music going while working as a therapist with musicians.
NB: Do you tend to see any trends with performance anxiety such as certain genres, or personality type (introverts more than extroverts) or is it more based on negative experiences in your past? Or maybe, it’s something that can happen at any point of a career to anyone?
JQ: That is such a good question because it’s all of the above. What I see in my clinic is literally every end of that spectrum.
So a range from people that when they were younger, even to a certain time period in their life, they were fine. They were free-flying, they enjoyed their performance. Then something happened there, there’s a shift, either some kind of traumatic event or something knocked some of that self-belief. Then the performance afterwards started to become more traumatizing when someone is on stage.
Or somebody that has always been nervous on stage and has coped with it to a certain extent, but then just decided they wanted to come see somebody because they don’t want to live that life on stage anymore. They don’t want to have to suffer and struggle.
It’s people that are introverted, people that are extroverted, people that on-stage, you would never even know they have performance anxiety, but they still want to work on it, because it’s such a struggle, and they don’t want to have to pretend and put on masks on the stage anymore.
So it also is not about a certain age, it’s not about a certain background, because I see musicians from all socioeconomic statuses, all types of people from all over the world. So I think that’s something to really normalize that there’s not one type of person that will experience performance anxiety.
NB: Once someone has decided to seek help for performance anxiety, let’s say the goal is to get back onstage after a long absence, what would you recommend?
JQ: I would recommend speaking to somebody like a therapist, if one is available, and it feels like something that’s economically viable, because I think therapy can be expensive and that can always be a barrier– I’m going to be very realistic about that. But there’s something about trying to decide what life would be like if you didn’t have performance anxiety. So looking at it from the opposite perspective, like what would you be doing differently and really tapping into that.
So an example might be, “If I don’t have performance anxiety, I probably will be able to be more free in my singing.” Then you can start to be a little bit more specific:
What would be more free? “Well, I probably won’t have the throat tension that I have”. Okay, so then what would that do for your singing? “I probably would be able to have more resonance in the throat. I’d be able to have more color added to some of the lyrics that I’m singing.” Okay, but then why would that do? So we just keep going on this journey. Like what exactly what is going to happen if you get rid of the performance anxiety, what’s going to be in its place instead? What’s going on? Because sometimes performance anxiety, from my work with several musicians over many years, is something that is preventing some kind of attachment or relationship to your audience. Or it’s like something that is a safety-net for holding one back. I’m not saying that it’s like that for everyone. But it’s like, what would really happen if you got rid of the performance anxiety and why is that important? Because that’s really what we’re working for.
NB: Wow, that really changes the way I’m thinking about my own performance anxiety! So if someone realized, for instance, that they are afraid of vulnerability – what does that journey of recovery look like for them?
JQ: The therapy goal becomes different. It’s not, “How do I get rid of the performance anxiety?” It’s, “What permissions do I need to give myself to be vulnerable?” Then we start to work on what vulnerability looks like to you. And where did you learn how to be vulnerable? Who was vulnerable with you when you were a child? We start to look a lot at the past, maybe decisions that were made from early developmental stages to maybe affecting your belief system today about vulnerability. That’s like a very small example.
The other thing that I should mention is in the industry, there’s a really interesting performance survey called K-MPAI. That’s a really fancy acronym for the ‘Kenny Music Performance Anxiety Inventory’. It’s this fantastic forty question, self-filling type of survey. It functions on a Likert scale. So it’s like zero to six, and you circle the number. It asks different ways that you feel not only about yourself on stage, but asks a little bit about family history with anxiety, it asks about what kind of somatic symptoms you might be experiencing. I use this tool a lot in my work with musicians, because it’s a really good starting way into understanding how a performer presents on stage and how they think they present on stage… it allows a little bit more categorization of what’s going on for you.
So, according to this survey, it looks like you have a lot of traits of anxiety in your family? Well, that’s a different type of therapy work, because that means it’s something that is maybe more physiological that we’ll be working with.
Whereas if someone says, I have a lot of cognitive dread before performances. So cognitive dread is a way that we speak to ourselves, and we kind of catastrophize what’s going to happen before performance starts. That’s a different type and aim of therapy. So that therapy will then be directed to how we talk to ourselves internally, and looking at all the different ways that we internalize… the inner voice.
Whereas another presentation might be solely somatic symptoms, like a lot of somatic symptoms, specifically, like, shaking. So then we focus on… “Okay, so let’s talk about the shaking, what’s happening to you? Tell me, when does it start?” So we start to look, to do a lot of somatic work.
So the therapy is not necessarily always about performance anxiety as one big generic thing. But it’s the work that I do with musicians, it’s always siphoned down, siphoned down, siphoned down, looking at not only root causes, but also, what does it mean to get rid of it? And how will your life be different? So looking at the change in a positive way, instead of trying to just slowly eliminate something—because then something has to come in its place.
NB: I love that. I feel like you’ve given me a lot of food for thought. Can you share any breakthrough moments you’ve experienced as a therapist working with musicians?
JQ: I can’t speak specifically about the clients, but I think the thing that excites me the most is when a client comes and says that though they’re at the point where they’re professional performers so they can manage the performance anxiety on stage, but afterwards they might be totally falling apart. After performances, they have to go to bed for two days because it was so traumatic for the nervous system to perform in that setting with that audience, etc. Seeing somebody that’s come from that type of scenario, then be able to actually enjoy themselves on stage, be able to come into their session, maybe the next week and say “Jessica, you’ll never believe I actually enjoyed my time on stage!” And I’ll say something like, “Tell me more.” And they’ll say, “I actually felt like I enjoy music. I enjoy making music again, enjoy being with an audience again.” So there’s something there that I think is really special.
I guess on the flip-side of that, is to also know that sometimes these changes are really nuanced. So it might be like, “Jessica, I had a breakthrough, I actually enjoyed my performance for five minutes. Whereas before I hated it”. So I’m like, okay, five minutes, that’s a great starting point! You’re able to maybe integrate yourself on the stage for five minutes, even one minute, how brave and what a big thing that is. That’s my hope for all performers, really, is that there’s a sense of being fully present, integrated, authentic, and not afraid to be vulnerable and imperfect, obviously, within professional boundaries, and to be human on stage, because I think that’s what people are interested in.
NB: If someone reading is interested in pursuing a career in psychotherapy for musicians could you give them any advice? Would you say there’s any character traits or specific education they should pursue?
JQ: Definitely having some kind of knowledge of the music field or industry helps. Having been a musician, or even learning an instrument, I think is detrimental. Because of the process of what it is to be a musician, you know how much energy it takes to be a musician in today’s world. So I think definitely having a background in the field is key.
Secondly, I would say that musicians generally have many of the skills that therapists use. So as an example having a good ear, being able to recall themes, being able to have memory in terms of what intonation people use, being able to carry a story, and being able to string sentences together like a musician does – so there’s already a lot of skills that musicians will have.
I would say that there’s something about not feeling that one genre is better than the other… Being very open minded about what constitutes a musician in today’s genre… having a value system that can be open minded about different levels of musicianship as well, I think that’s important.
And one other thing is something about realizing that the cultural framework that musicians work in is going to be different across genres… and the cultural framework of a classical musician is very different than, for example, some of the artists that I work that are in the rap industry, or that are in electro, acoustic and they’re DJs, at festivals, – it’s a very different cultural set of values. I think really knowing that and honoring that they change from genre to genre is an important part of this work as well. So not appropriating values to one genre, particularly, and always being curious about how people see it for themselves as well.
Schedule a free consultation with Dr. Jessica on her website!
