Musicians know stage fright before their performances - this is to a certain extent normal and often even helpful, in order to concentrate better on the concert or the lecture. However, if stage fright becomes so severe that every performance is a torment, the musician's doctors speak of performance anxiety.
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Performance anxiety represents a pathological anxiety reaction in the context of (stage) appearances, both by a mental (fear of loss of control over the situation, unreality experiences, negative cognitions) and a physical component (eg, sweating, tremors, shortness of breath, nausea, dizziness, tingling, urinary or fecal urgency, etc ...) is marked. To control anxiety, many sufferers develop safety strategies (such as sedatives or sedative rituals) throughout the course of the disease, or avoid appearances altogether. Although this helps to control anxiety in the short term, it leads in the long term to a chronification of the illness, a mostly pronounced psychosocial impairment and in many cases a danger to the professional activity.
As risk factors for the development of a fear of performance, negative experiences, a strong individual anxiety, excessive demands on performance, a high level of expectation and a pronounced perfectionism have emerged in scientific investigations. These individual characteristics are associated with neurobiological changes in the "emotional center" (the so-called "limbic system"), which in turn initiate and sustain the situation-specific physical response of the performance anxiety.
The treatment of the onset of fear is multimodal and includes not only a psychotherapy (behavioral and depth psychological approaches) but also movement and relaxation techniques, mental performance training, video feedback and trial sessions. Temporarily, so-called beta-receptor blockers may help to reduce the psycho-vegetative symptoms before gigs, a group of drugs that reduces the heart rate and thus contributes to anxiety reduction. The Berlin Center for Musicians Medicine (BCMM) offers help here.
In the context of a specialist medical presentation, after the diagnosis or assurance has taken place, a disease-specific, personalized therapy plan based on current scientific findings takes into account both the symptom severity and the respective social situation of the affected person. This is to achieve a timely and sustainable symptom decline and thus make it possible to play music without fear.