Article:  Spahn, C., Echternach, M., Zander, M., Voltmer, E. & Richter, B.  Music Performance Anxiety in Opera Singers.  Logopedics Phoniatrics Vocology, December 2010, 35 (4): 175-182, UK.

Summary

A singer’s “business is emotion and sensitivity” (Janet Baker).  Singers have to create emotions in their audience, and also find “artificial” feelings related to their role, or the interpretation of their work.  On the other hand, a singer is full of his own personal emotions, and needs to deal with these while being on stage in a “role”.  The success of a singer’s career is highly dependent on how they deal with their own emotions.  Often feelings of insecurity are present in singers, since they are the only instrument that cannot hear themselves and are reliant on feedback from others.  

Musical performance for singers induces many feelings in them.  Often singers become “high” from their experience because of a release of the hormone beta-endorphin.  On the other hand, performance can lead to negative emotions, such as distress or anxiety.  This is called musical performance anxiety (MPA) and can occur on a scale from low to high.  Where it is high, it is pathological and needs to be treated.  One singer who suffered acutely from this was Enrico Caruso to such an extent that it “led everyone around him to despair”.  

Steptoe carried out a study of opera singers in five different environments- lesson, private practice, audition, dress rehearsal, performance.  In all five environments Steptoe monitored level of tension.  The best results of singing were in the environments where there was intermediate level of tension (performance) while the worst performances occurred in the environments with the greatest level of tension (dress rehearsal and audition).  Another study revealed a high state of anxiety for 18.8%   of a sample of singers, as compared to 15% in a sample of normal working adults.  

MPA functions at four different levels:

Affect:  Feelings of anxiety, tension, apprehension, dread, or panic.

Cognition:  Loss of concentration, heightened distractibility, memory failure, catastrophizing.

Behaviour:  tremour, difficulty in maintaining posture and moving naturally

Physiology:  Disturbances in breathing pattern, dry mouth, cardiovascular changes, gastrointestinal disturbances.

In terms of what happens in the brain, there are two pathways that occur.  

1. Stimulus --> Thalamus --> Amygdala --> Hypothalamus or PAG.  From the Hypothalamus hormones are produced which then affect the sympathetic nervous system.
2. Stimulus --> Thalamus.  From Thalamus --> a) Associative cortex --> Hippocampus or b) Sensory Cortex -->  Consciousness.  From the Hippocampus --> Amygdala and now follow path 1.

Essentially what is important is that one pathway is much longer and goes through parts  of the brain that the other does not.  It seems that the first pathways is associated with mere stage fright, which is low on the scale of MPA.  The second pathway is associated with high MPA.  

Study

This study looked at anxiety levels versus heart rate and blood pressure.  The heart rate and blood pressure were measured with a Somnoscreen, while the anxiety was monitored by a questionnaire.  The sample was nine musicians, seven singers and two wind players.  None of them suffered from pathological MPA.  

The results of the study were that heart rates on average were highest during the performance, and before and after the performance differed in the participants.  For the blood pressure, most participants had a higher blood pressure before and during performance, as opposed to after.  From the questionnaire, all participants had a higher anxiety state before the performance than after.  The results showed no correlation between anxiety and blood pressure/heart rate.  A possible explanation is that physiological arousal is necessary for MPA, but the presence of physiological arousal does not guarantee MPA.  Perhaps, certain performers react to physiological arousal differently- one finding it energizing, the other finding it leads to anxiety.

Treatment

This treatment is proposed from the Freiburg Institute for Musician Medicine.  It takes as its basis the cycle of MPA- perception --> thoughts and feelings -->  anxiety -->  somatic reactions -->  perception--> ...  It suggests ways of interfering with the cycle at each stage.  At the level of thoughts and feelings, it suggests positive imagination exercises as well as psychotherapy.  At the level of perception, it suggests watching successful performance videos of one’s own performance.  At the level of somatic reactions, relaxation techniques are suggested.  

They only recommend pharmaceutical therapy in a few situations, and even suggest that many of the drugs are bad for the voice.

Response

Yet again this article for me emphasizes how little we know about the brain, and how complicated the brain is!  This always amazes me and it is exciting to see how much further we could go!  Why this thought comes to mind in relation to the article is because of the study carried out in the article.   In the experiment, the only way they were monitoring anxiety scores was through a survey.  It was interesting to see that they could get hard facts about the other variables in the experiment- blood pressure and heart rate but not for anxiety.  I am used to scientific experiments being backed up by hard scientific facts and not by the opinions of the participants.  It would be interesting to see how in a similar study in fifty years, anxiety would be monitored.

I agree with the authors that the study is rather inconclusive, as heart rate and blood pressure can be affected by many things besides levels of anxiety, for example movement.  In fact, what was very interesting for me, was the one subject who seemed to suffer from more serious MPA, had completely normal blood pressure throughout the experiment.  

Something else which would have been on my “wish list” regarding the article, would be a further elaboration of the two pathways that MPA takes in the brain.  I find it fascinating that there are two pathways- one pathway faster and less conscious, and the other one slower, more conscious, and going through a larger portion of the brain (the cortex).  It is suggested that the slower one leads to pathological MPA, the other to mere “stage fright”.  I would love a further explanation of why this happens.  I wonder what the significance is of the shorter pathway skipping the cortex.  

As for the treatment suggested, I was extremely impressed with its thoroughness and multidimensional character, and how positive it aimed to be.  I was also amazed at how much dedication, work and preparation is required to carry out the treatment.  Much more challenging than popping a pill!  I believe that with true dedication, the treatment suggested could really help a singer with MPA.

This is an area of study which I would love to further look into.  I find it fascinating, complex and rather relevant as a performer and as a future teacher.  I have seen MPA within myself and many colleagues and think that knowing how to deal with it is a great tool for every performer, as well as for every voice teacher.