Olivia Jordan

Can Performance Anxiety Be Treated?

In my previous posts, I explored what performance anxiety is, why it happens, and what happens inside the brain when we experience it. That led me to my next question: What can we do to manage performance anxiety? As a figure skater and a violinist, my first reaction was always to practice more. Practice is essential because it builds skill, confidence, and muscle memory. However, practicing the same difficult element over and over can actually increase pressure and perfectionism.

People often experience physical symptoms of anxiety, such as a racing heart, tense muscles, or rapid breathing as part of the body’s stress response. Breathing techniques and relaxation exercises, such as diaphragmatic breathing, box breathing, and progressive muscle relaxation, can help activate the body’s natural calming system and reduce these symptoms. These strategies can be especially helpful during high-pressure situations. However, they may not completely address the thoughts and fears that create anxiety in the first place.

One of the most researched treatments for anxiety is Cognitive Behavioral Therapy or CBT, which focuses on the connection between thoughts, feelings, and behaviors. It helps people recognize unhelpful thought patterns, such as assuming the worst will happen or believing that one mistake defines an entire performance. Instead of trying to eliminate anxiety completely, CBT teaches people how to respond to anxious thoughts in a healthier and more realistic way.

Exposure therapy is another approach closely related to CBT. The idea is that avoiding something we fear can actually make the fear stronger. Instead, gradually facing situations that trigger anxiety in a safe and controlled way helps the brain learn that they are uncomfortable, but not dangerous. For example, a musician who feels nervous performing in front of an audience might begin by playing for one trusted person, then slowly increase the size of the audience over time.  

Mindfulness and meditation can help reduce overthinking and bring attention back to the present moment. I used to think that these techniques were simply about relaxing. I discovered that mindfulness is really about learning to observe thoughts and emotions without immediately reacting to them, which can be extremely valuable for performers. Instead of worrying about what might happen next, mindfulness encourages people to focus on what they are doing right now. Like many skills, however, it requires consistent practice.

Visualization and mental rehearsal are also commonly used by athletes and performers. Many performers mentally rehearse a successful performance before they step onto the stage, field, or ice. This type of mental practice can strengthen confidence and help the brain become familiar with a successful performance. However, visualization works best when combined with other strategies. Simply imagining success may not be enough if someone continues to struggle with intense fear, negative thoughts, or difficulty managing stress.

Some performers also use medication to manage performance anxiety, especially when physical symptoms are severe. For example, certain medications can reduce symptoms such as shaking or a racing heartbeat. However, although medication can reduce physical symptoms, it does not address the underlying thoughts and emotional patterns connected to anxiety. Additionally, decisions about medication should always involve a qualified healthcare professional.

Finally, a supportive environment can build confidence and resilience, which can make a significant difference. Encouraging coaches, teachers, family members, and friends can help performers feel understood and less alone. On the other hand, environments focused only on winning, perfection, or avoiding mistakes may unintentionally increase pressure and anxiety.

There is no single solution that works for everyone. Instead, managing performance anxiety often involves learning different strategies and finding the combination that works best for each person. Overcoming performance anxiety is not about finding a way to never feel nervous again. The goal is to understand our own thoughts, experiences, and challenges, then learn to manage them so anxiety no longer prevents us from performing at our best.

As I learned about these different approaches, I began wondering whether advances in technology could make these strategies more accessible and easier to practice in everyday life.

Coming Next…

Technology and Performance Anxiety: Can Apps Really Help?

In my next post, I’ll explore how technology is being used to support mental health and performance. I’ll look at different apps designed to help with anxiety, mindfulness, and mental training, and what I discovered about their strengths and limitations.

Reflection Question: Have you ever tried a strategy to manage stress or nervousness before an important event? What helped you the most, and what did you learn from the experience?

References

The ideas in this article are based on published research in psychology, neuroscience, sports psychology, and performance science. The references below are provided for readers who would like to learn more.

1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
2. Kenny, D. T. (2005). A systematic review of treatments for music performance anxiety. Anxiety, Stress, and Coping, 18(3), 183–208.
3. Spahn, C. (2015). Treatment and prevention of music performance anxiety. Progress in Brain Research, 217, 129–140.
4. Burin, A. B., & Osório, F. L. (2017). Music performance anxiety: A critical review of etiological aspects, perceived causes, coping strategies and treatment. Archives of Clinical Psychiatry, 44(5), 127–133.