Golfers speak of "getting the yips". This expression means that they have entered a mental state in which they play badly and evidences their experiencing performance anxiety. Golfers also speak of "entering the zone". To them, this means that they have entered a mental state in which they play well and evidences their experiencing performance enhancement. The two states are mental or emotional and are the opposite sides of the same coin.

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Performance Anxiety

An experienced professional singer was sent to me by a very competent singing teacher. The singer, in her early thirties, had more than fifteen years performing professionally. She sought help from the teacher because she was to audition for a major role in an important musical. The teacher found that the singer was more than competent and professional. She had no problems with her singing technique.

You might correctly ask, as I did, why did she seek professional help?

She had gone to the singing teacher because she was greatly concerned about auditioning. The few experiences she had early in her career had not gone well. Since then, she always sought safety in taking jobs offered to her without requiring her to audition. The singing teacher wisely determined that her problem was not in her talent or technique but in performance anxiety. Fiddling with her technique, style or repertoire would have been to no avail.

The singer needed to find out why, in spite of the reality of her success and obvious talent, she had such a level of irrational fear of failure that she caused herself to perform badly just when she needed to show herself off at her best. She then needed to eliminate this fear. Fear was the element that created a barrier to her expressing her true talent. Fear is a common cause of failure to achieve one’s potential. It may cause some to perform below their true standard; it causes others to procrastinate (ie to put off doing what they fear) and it causes others to avoid even try giving it a shot.

Performance is required in more than the arts and sports. People in commerce need to compete optimally; indeed, in most professions performance is called for in one form or another. As an example, I have treated a barrister who gave up his profession because he was so upset before he had to perform in court that he vomited. This led him to conclude that he wasn’t suited to court performance and he gave it away. Another patient who came to me had given up being a surgeon many years before because that patient could not bear the attention of many eyes while working at the operating table. This potential surgeon became a pathologist, in which medical specialty the practitioner could gaze into a microscope all day without again having to perform in front another human being.

What wastes of potential!

Public speaking is one of the commonest phobias of all.

My own phobia was having to perform in court as an expert witness. So strong was my fear that I have contradicted my own written report because I felt confused when I was being "attacked" on the witness stand. Life brought me an opportunity to desensitise my fear when I was placed in a role that required me to appear in court regularly. I had to apply to myself what I knew to be theoretically correct. You see, knowledge itself is not enough; it did not make me immune from this problem. Now I actually enjoy court performance and the more challenging the opposition, the more I enjoy transcending the experience. There is a saying "choose a doctor who suffers the same disease". There could be some truth in the saying provided the doctor has some success in overcoming his/her own condition; the doctor would know about the disease in more than just theory.

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Some people deal with their performance anxiety by just denying that there is a problem. Fooling oneself seems a poor way to deal with life’s problems. Amongst this group are the "excuse makers" who say "I’m not really that bad others are worse than me anyway, why should I have to do it if I don’t enjoy it?" Others avoid doing the things that cause them to feel uncomfortable. Others drink, get stoned or take valium or beta blockers. Of course, they would say "why shouldn’t I, if it makes me more comfortable performing?" Some of these rationalisations are addictive, none enhance performance and some may dull the anxiety to some degree - but dull the senses at the same time. None of these rationalisations enlarge you as a person or raise you above your fears.

Beware the over-simplified explanation that your performance anxiety exists just because you don’t have enough "self-confidence". If this was true, the "simple" remedy is to somehow instill more self-confidence. How is this to be achieved? Pour it in with a funnel?

In fact, after watching the responses of many of the competitors in talent quests on television reacting aggressively to their judges, I suspect that some people have too much unwarranted self-confidence. A considerable number of patients who come to me have already been to "assertiveness" courses. I suppose there would be others who have been to such courses who have achieved some measure of success. I suggest that you reflect on your mode of thinking, and see if I am correct in suggesting that your self-confidence is actually eroded by irrationally fearful thoughts like "what if I make a fool of myself?", "what if I dry up?", "what if they think I’m stupid?" and "what if I fail?".

The task for you is to determine:

• where do these fearful thoughts came from?
• how do I get rid of them?

Overcoming irrational fears can be accomplished - but not by denial, not by avoidance, not with drugs (excluding non-addictive medications, which can be quite helpful) and certainly not by the inertia of doing nothing.

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Performance enhancement

One of the many interesting aspects of my work is the treatment of overseas and Australian entertainers.

I encountered my first case of "First Tour Syndrome" in the mid-1980s. I coined the name only after I saw several more cases as the years passed. In my first instance, I was asked to treat the lead singer of a touring band. The singer was suffering voice problems sufficient to require cancellation of concerts - something disconcerting for the fans, the performer and the tour organiser. After the second and third instances of such cases with other performers, I was caused to reflect: what is going on?

The common denominator was the fact that the performers most vulnerable to this condition seemed to be those doing their first world tour, or first solo appearance after leaving their band or doing their first tour after a solo album and so on. Of course, a number of other factors are involved such as constant changes in atmospheric condition, the loneliness of a long tour but most important of all was the stress of the significance of this particular tour. This is in the mind of the performer, and maybe it is made more prominent by their advisors, but, nonetheless, the voice strain is due to the extra effort caused by the stress in the mind of the performer. This is a variation on the theme of performance anxiety.

I reflected upon the Yerkes-Dodson curve, which simply explains how performance improves progressively with the rise in arousal of the performer - but only to a point. Once past the peak level of performance, further arousal acts as a stress and performance declines. For example, the chronically unemployed person is often chronically depressed and underperforms; the over-challenged worker is stressed past their optimal level and also underperforms.

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