Friday, April 13, 2012

Performance Anxiety and Beta Blockers

If you are ill-prepared to perform for an audience and dealing with high levels of  anxiety because of your incompetence, then it makes sense to hit the practice room and just learn the material.  But, if you are like many performers, anxiety reactions can escalate to the point that they seriously interfere with performance, and yet are not underscored by lack of preparation, poorly honed skills, personal insecurities or any other seemingly rational explanation.


   Irrational fears of performing, public speaking, or just being looked at by a bunch of people are extremely common.   Fear of public speaking ranks higher on the anxiety scale than fear of death.  On second thought, though, being judged and scrutinized for your appearance, demeanor, and your never-perfect performance by possibly hundreds of your friends and peers and critics, being stared at and talked about -- maybe that's not such an "irrational" fear after all!   Especially compared with clearly irrational fears like these actual real-life examples of serious phobias:


    whale tails
             butterflies
                  bathtub sharks
                       mermaids
                             aliens
             windmills
                 rainbows
                         mugs
                    microwaves  
                              walking up stairs at night
                    blueberry yogurt
               music playing backwards
                    belly buttons
               wiggling fingers
                         Hawaii
    calling people on the phone
                               mushrooms
               

   Musicians' performance-fears seem perfectly understandable compared to these!   In any event, I'm not going to dissect the psychology of performance anxiety and the therapeutic solutions... I'm here to talk about the DRUGS.



    Beta-Blockers
were first marketed in 1967 for heart rhythm issues or angina. These drugs inhibit the sympathetic nervous system, the fight or flight response, and found their way into the performing-arts communities (music, dance, public speaking, acting)  for that reason - though taken in much milder dosages.   Back in 1987 studies showed that some 27% of Professional Orchestra Musicians had used beta-blockers, and these are considered conservative estimates!   Who knows how many use them now!?   I know a bunch, personally.  Some use beta-blockers for every performance, more use on special occasions where anxiety is a particular concern, like for an audition or solo performance.  They seem to provide a ceiling for the fight-or-flight response that just prevents your adrenaline reaction from going "over the top" to keep you from going in to the dry-mouth, sweaty hands, shaking feet, pounding-heart-phase that can destroy all evidence of your hard-earned skills.  Some claim that they dull your senses, but many deny that.
         The most common Beta-Blocker is propranolol,  marketed as Inderal. 
 Use of this prescription drug for performance is hotly debated and I'm not advocating for one side or the other.  The debate rages about whether the drug inhibits your performance or reduces your emotional connection to the music.  Some say you should deal with the Psychology behind the problem, others say that doesn't work or can take years if it works at all.  Some say that a reasonable approach is to use the drug to learn to play free of uncomfortable anxiety and it is easy to phase it out later. Plenty of info is available with a Google search.

    But Beta-Blockers do something else.
  Oxford University reports that patients using propranolol test with lower subconscious racial bias.   It reduces Racism.  As measured by the "Implicit Association Test" developed at Harvard.  What that test actually measures is of course, up for grabs, but it is tantalizing to think that "racial bias" can be influenced by something that also has an influence on the brain's "fear center", the amygdala.  Fear and racism .... of course!  When I first moved to Salt Lake City in 1972, a fellow student who came here to study in the renowned Jazz Program that was here at the time, who was Black, had an impossible time finding an apartment to rent. It was pure fear-based racism, as there were very few non-Whites here at the time and nobody knew what to make of him.  I had no problems in this regard.  He eventually found a place but it took weeks and was a very sad and disheartening process.

 Please research in detail and consult a physician before embarking on any path that involves drugs!


Here is a terrific article about the debate about propranolol and performance-anxiety from the New York Times worth reading:

http://www.nytimes.com/2004/10/17/arts/music/17tind.html


    

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