music performance anxiety in opera singer

Correspondence: Prof. Dr. med. Claudia Spahn, Freiburg University Medical Center, Institute of Musicians ’ Medicine, Breisacher Str. 60, Freiburg, 79106 Germany. E-mail: [email protected]

(Received 22 December 2009; accepted 21 February 2010)

ORIGINAL ARTICLE

Music performance anxiety in opera singers

CLAUDIA SPAHN 1 , MATTHIAS ECHTERNACH 1 , MARK F. ZANDER 1 , EDGAR VOLTMER 2 & BERNHARD RICHTER 1

1 Freiburg University Medical Center, Institute of Musicians’ Medicine, Breisacher Str. 60, Freiburg, 79106 Germany, and 2 University Friedensau, Department of Health and Behavioural Sciences, Friedensau, Germany

Abstract Music performance anxiety (MPA) represents a high challenge every vocal performer has to meet. MPA can be defi ned on a continuum going from a low to a high level. MPA and its phenomena can be considered in terms of four levels: affect, cognition, behaviour, and physiology. A study carried out on seven opera singers and two instrumentalists during perform-ance situations showed highly elevated values for the performers ’ heart rate and blood pressure. This study, as several others, yielded no clear evidence pointing to a correspondence between the level of anxiety and of physiological arousal. At the end of the article a multimodal approach to the treatment of MPA is illustrated consisting of different psycho-therapeutical and body-oriented methods.

Key words: Blood pressure , heart rate , instrumentalists , music performance anxiety , opera singers , psychological aspects

Introduction

The emotional expressiveness of voice is fundamen-tal in all human communication. In fact, we some-times call our voice ‘ the door to our soul ’ . People whose profession involves using their voice con-sciously employ the voice ’ s expressive possibilities. Clearly emotions, feelings, and affects are paramount issues to musicians in communicating and under-standing music.

The famed singer Janet Baker, in an interview published in The Observer , stated of singers in general that ‘ … our business is emotion and sensitivity—to be the sensors of the human race ’ (1).

Emotions are of fundamental importance from several perspectives: the perception of a voice and of its expression, as well as the emotions induced in the listener, does not coincide with the point of view of the performer inducing these emotions. The craft of professional singers consists in con-sciously generating the emotions a theatre piece or opera requires.

The requirements a vocal performer has to meet are high: ‘ artifi cial ’ feelings are to be presented with absolute technical mastery and perfection. But how

does the performer deal with his own feelings, his present mood, his fears of not fulfi lling certain expec-tations? As individual feelings and small insecurities have a direct repercussion on the vocal performance, a successful handling of his own emotions is of deci-sive importance for a professional singer.

Handling one ’ s own voice represents a particu-larly big challenge, as the voice is part of one ’ s iden-tity—both the artistic and private: ‘ A violin is played by a person, a piano is played by a person, but a voice is a person ’ (2). Exercising control over one ’ s own voice is not possible alone by the singer him or herself. Singers are therefore dependent on other people ’ s feedback. This interrelation may create a tension between dependency and self-confi dence necessary on stage.

All this demonstrates how a performer ’ s capacity to deal with his or her emotional factors has a decisive infl uence on his or her own performance. Competence in this particular fi eld, next to vocal education, is a fundamental factor for a singer ’ s career development.

In this context, music performance anxiety is an important issue, especially for singers, as of course

Logopedics Phoniatrics Vocology, 2010; 35: 175–182

ISSN 1401-5439 print/ISSN 1651-2022 online © 2010 Informa UK, Ltd.DOI: 10.3109/14015431003720600

176 C. Spahn et al.

for all musicians. This article discusses the specifi c requirements placed upon professional opera singers, and focuses on the issue of music performance anxiety (MPA).

Phenomenology of MPA

Musical performance induces extraordinarily posi-tive feelings in many players and singers. Participa-tion in a successful and exciting performance often leads to feelings of euphoria. The baritone Thomas Allen is describing his feelings at the end of a perfor-mance of Don Giovanni in Japan: ‘ I could have walked over the house-tops I was so high ’ (inter-viewed in The Independent on Sunday in 1990).

A study involving singers demonstrated how the action of singing causes an increased release of beta-endorphin, commonly known for inducing feelings of happiness (3).

Unfortunately, musical performance may also induce negative emotions, including distress and anxiety, which in some individuals can approach extreme levels of terror, impair quality of perfor-mance, and have debilitating effects on professional careers (4). Berghs (5) even described a loss of con-tact with reality in singers, associated with types of increased or decreased muscle tonus.

MPA can be considered on a continuum from low to high (Figure 1). The low to middle range of MPA—for which also the term stage fright is used—is a normal and positive phenomenon for performance on stage. High levels of MPA belong to pathological forms of MPA and do need treatment.

In 1983, Steptoe carried out an interview study with young professional opera singers (6). First, par-ticipants were asked to evaluate the quality of their performance in fi ve different settings: lesson, private practice, audition, dress rehearsal, and public perfor-mance. The second step consisted in assessing the singers ’ emotional tension in these fi ve situations. Emotional tension values were represented on a nine-point scale.

The study showed that the best singing was pro-duced at an intermediate level of tension (in public performances). In contrast to this, the situations associated with greater tension (dress rehearsal and

audition) were those in which the performance level was lower.

The results of this study are consistent with the inverted U-pattern, the Yerkes-Dodson curve (7) (Figure 2). Therefore it can be stated that any kind of stage appearance training, and any kind of treatment for MPA, ought to aim at allowing the person on stage to reach the individual optimal zone during his performance (Figure 2). In this regard MPA can be understood in terms of some-thing continuous (see Figure 1). The change from normal to pathological and clinically relevant MPA occurs when the singer is personally suffering a lot, and/or when he cannot deliver his optimal perfor-mance on stage.

Epidemiology

There are various examples of well known opera sing-ers who suffered from stage fright. One of the most famous is Enrico Caruso. His impresario wrote in the memoirs: ‘ With him, stage fright took on indescrib-able dimensions, robbed him of all reason, whipped his nerves and led everyone surrounding him into despair. On performance days there had to be deathly silence in all rooms. Every word spoken aloud dis-tressed him. Breakfast, lunch, food absolutely easy to digest and consumed in tiny quantities—nothing of it he could keep to himself, and after drinking two cups of chamomile tea he drove to the theatre. ’ (8)

The impresario ’ s memoirs also reveal what means Caruso would use to cope better with his stage fright. He had applied inner pockets to his tail-coat, in which he would keep small bottles out of which he

low high

Music Performance Anxiety

pathological formstage fright

Figure 1. The continuum of music performance anxiety (MPA).

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Figure 2. Correlation between performance and arousal. The optimal functioning zone of music performance anxiety (MPA) is at a middle level of arousal (7).

Music performance anxiety in opera singers 177

drank on stage, with his back to the audience. The liquid in the bottles was a made up of distilled water, orange drops, and a pinch of salt.

All performing artists experience MPA in differ-ent states across their professional lifetime. We have no epidemiological data on how many professional solo singers suffer from a pathological form of MPA and therefore would need treatment.

A study by Kenny et al. (9) carried out on 32 opera chorus artists revealed a high state anxiety for 18.8% of the singers. As a measure of comparison, only approximately 15% of a sample of normal work-ing adults are expected to score comparatively high values (9).

Models of MPA

If we observe the phenomena of MPA more closely, we can distinguish between four levels: affect, cogni-tion, behaviour, and physiology (Table I).

Our understanding of how these levels interact and of how emotions can be conceptualized has undergone considerable change. William James (1842–1910) defi ned emotion as a purely physical phenomenon, namely as an experience of bodily reactions, following the perception of an exciting

stimulus (10). Stanley Schachter (1922–1997) defi ned emotion as an experiencing state, which results from the interaction of stimulating percep-tions and certain cognitions (11).

Joseph E. Ledoux analysed fear in terms of neu-rophysiological reaction (12). He was able to ascer-tain that situational fear is learned in relation to corresponding stimuli. This can be applied to MPA and the way it develops.

Nowadays we assume that there are two signal paths for performance anxiety (13) (Figure 3): The fi rst one is fast and is an unconscious process. This path leads through the thalamus and the amygdala and activates the so-called periaqueductal grey (PAG) and the hypothalamus. Here, the reaction chain of the vegetative, autonomous nervous system is put into motion, with its hormones adrenaline and nora-drenaline.

The second signal path is considerably slower and represents a conscious reaction. This path involves higher cortical areas and offers a more detailed analysis of the situation. From the hippocampus, brain information is provided concerning emotional signifi cance.

Investigation of opera singers on stage

In order to gather information about the physio-logical parameters of singers during their stage appearance, we carried out a study on opera singers at the Freiburg theatre, Germany.

Sample and methods

In this study we analysed nine musicians, seven singers and two wind players, during performance situations as well as during rehearsal and the

Table I. The four components of music performance anxiety (MPA).

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

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

Behaviour: Tremor, diffi culty in maintaining posture and moving naturally

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

Stimulus

ThalamusSensory Cortex

Associative CortexConsciousness

Hippocampus Amygdala

Hypothalamus PAG

First pathway

MEMORY

Second pathway

hormone

Sympathetic nervous system

Figure 3. Central pathways of music performance anxiety (MPA) (13).

178 C. Spahn et al.

daily routine situations of the regular theatre busi-ness. There were missing data in different singers and situations (see Figures 5, 6, and 7). The nine subjects were four women and fi ve men, and all except one young singer had a several years of stage or orchestra experience. The youngest singer was 26 years old, the oldest 58, and the rest of the musicians were aged between 20 and 37 years. The study was conducted in collaboration with the local theatre. We drew important information about experiences on stage from individual interviews with the musicians, as well as from the artistic direc-tion of the theatre. None of the musicians who par-ticipated in our study met the criteria for a pathological form of MPA in regard to both their self-evaluation and the judgement of the theatre ’ s artistic direction.

Heart rate and blood pressure were measured with the Somnoscreen (Fa. Somnomedics, Würzburg, Germany), a standardized device which was origi-nally conceived for application in sleep medicine and which was adapted for the use on stage.

The Somnoscreen consists of a small box, which is wired around the waist of the musician, and of a measuring electrode and cable, which are fi tted on to the little fi nger of the proband. Heart rate and blood pressure were generated by the pulse transition time (PTT) (14).

At the same time the subjects completed the questionnaire on state anxiety (15) before and after their stage appearance.

The Spielberger State-Trait Anxiety Inventory (15) comprises a 20-item self-report, assessing state anxiety (i.e. feelings of apprehension, tension, ner-vousness, and worry). It is a standardized and inter-nationally established instrument.

Results

Figure 4 shows the average heart rate before, during, and after the performance. In all musicians the heart rate was at its highest during the performance and reached average values of between 110 and 140 beats per minute (bpm) (except for subject 9). Before the performance, most heart rates were slightly or sig-nifi cantly higher as compared to normal values for people of the same age. The subjects also showed a higher heart rate during the performance in com-parison to their own heart rate in a state of rest. After the performance, some musicians ’ heart rate sank to values lower than before the performance, in other musicians it remained higher or went down to the same level as before the performance. As can be seen in Figure 5, the subjects showed the highest peak values during the performance. These values go up to 200 bpm.

The systolic blood pressure could only be measured correctly in six singers. These subjects show similarly high values before and during the performance, and lower values after the perfor-mance (Figure 6). Only subject 4 has a higher rate before the performance compared to during the performance.

They lie between 110 and 190 mmHg and thus mostly lie above the medical normal range of 90–120 mmHg (16).

Evaluating the questionnaire on state anxiety, we found that all fi ve singers (only fi ve singers

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heart rate mean during performance

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Figure 4. Mean heart rates before, during, and after performance in a sample of nine musicians (subjects 1–7 opera singers; subjects 8 and 9 orchestra musicians).

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Figure 5. Maximum heart rates before, during, and after performance (subjects 1–7 opera singers; subjects 8 and 9 orchestra musicians).


fi lled out the questionnaire) showed higher anxiety values before the performance as compared to after the performance, with one exception. In comparison to a reference sample of students before an exam, the subjects showed altogether relatively low state anxiety values (Figure 7).

After comparing psychological and physiologi-cal parameters we found that individual anxiety values and systolic blood pressure show different characteristics and a different development in the analysed subjects. For example, subject 2 has high

anxiety values but almost normal blood pressure values (Figure 8).

Discussion

The physiological parameters measured in the con-text of this study do not of course depict exclusively the cardiovascular sympathetic arousal caused by stage fright. The singers move a lot on stage during the performance. In addition, their heart rate and blood pressure rise during singing alone. The instru-mentalists (subjects 8 and 9, respectively) do not move a lot while playing in the orchestra pit but still show a higher heart rate and blood pressure while playing. This is due partly to the intensity of the play-ing and blowing act for brass instruments.

Referring to the literature on the fi eld of MPA, there are—to our knowledge—only very few studies on singers, and till now there are no studies in which singers were monitored and analysed during their stage appearance with reference to physiological and psychological parameters.

Haider and Groll-Knapp (17) investigated instru-mentalists and determined a mean heart rate among members of the Vienna Symphony Orchestra of 93.9 bpm during concerts, which means an increase of heart rate of 27.7 bpm on average.

In comparison to a reference sample of students before an exam, our singers showed altogether rela-tively low state anxiety values. A possible explanation could be that we had a very small sample of singers

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Figure 6. Values of systolic blood pressure before, during, and after performance (subjects 1–4, 6, and 8).

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Figure 7. State anxiety scores in the State-Trait Anxiety Inventory (STAI) questionnaire (15) before and after performance (subjects 2, 3, 6, 8, and 9).

180 C. Spahn et al.

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Figure 8. Values for state anxiety and blood pressure (subjects 1, 2, 3, 6, and 8).

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SuccesfulPerformingTest performancesVideo-feedback

Self-reflexionPsychoanalytic oriented

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Imagination exercicesMental techniques

Exposition trainingTraining plans

Figure 9. Freiburg treatment model of MPA (27). Inside the bounding-box MPA is visualized as a learning spiral of fear of performance. Outside the bounding-box there are different therapeutic elements integrating psychoanalytic, behavioural, and body-oriented approaches.

who—with the exception of one female singer—declared they could cope well with the requirements of a stage appearance and declared they already had ample stage experience.

Several other studies present much less evidence that MPA is associated with excessive physiological arousal. Abel and Larkin (18) showed that blood pressure and heart rate increased prior to playing


in public, but that responses were not signifi cantly correlated with MPA. Craske and Craig (19) as well as Fredrikson and Gunnarsson (20) came to similar results.

In our study with opera singers we also compared systolic blood pressure with anxiety values. Altogether, these fi ndings suggest the following: physiological arousal may be a necessary condition for MPA, but it is not a suffi cient explanation. Other factors are involved which relate to perceptions of physio-logical arousal as well as to the cognitive responses to performing. The most parsimonious explanation could be that performers experience the same feel-ings of physiological arousal, but while one fi nds these feelings energizing, another perceives them as signs of impending disaster. These results would be consistent with the two signal paths of MPA described earlier.

Pedagogical and treatment approaches on MPA

All previous clinical trials on MPA therapy demon-strated how cognitive therapies, as well as training and exposing oneself to the performance situation, are more effective than pharmaceuticals or placebo (21–24).

Until now, however, there are no study results on the effectiveness of a particular psychotherapeutical approach or of a combined therapy (25).

Interventional studies on specifi c treatment for singers are not yet available. Nevertheless, there is an upcoming interest in the psychological side of pedagogical and treatment approaches for singers. Barr recently stated in an article published in the LPV Forum that the ideal warm-up is built upon sound physiological foundations and also uses a psychological approach to prepare the singer on the emotional side (26).

In accordance with the complex aetiological model of MPA, we propose at our Freiburg Institute for Musician Medicine a multimodal approach to treatment, consisting of different psychotherapeu-tical and body-oriented treatment approaches (27).

Figure 9 gives an overview of our Freiburg treatment model of MPA. It can be visualized as a learning spiral integrating elements of a psychoana-lytic approach and different other body-oriented techniques.

In the area of thoughts and feelings, there are possible cognitive approaches. These approaches use imagination exercises to train positive thoughts and feelings during the imagined performance. Of similar importance is the psychoanalytic approach with psychotherapeutical refurbishment of deep-lying fears, unconscious confl icts and motives, which

come to the surface in a performance situation. Avoidance behaviour is a consequence of such fears, but it can be tackled by structuring, in the form of training plans and training diaries. This comprises also the real experience of exposing oneself to a performance situation.

The level of bodily reactions can be positively infl uenced by means of autogenous training, mental techniques, and breathing exercises. This includes also body fi tness and a positive body perception. Body-oriented approaches such as the Feldenkrais method, Alexander technique, and breathing therapy improve the body perception experienced when singing and the control of body language during the stage appearance, and also have a positive effect on self-esteem. A good cooperation with singing peda-gogics is of decisive importance here.

Also medicaments can lead to positive effects on body and psyche. From our point of view, pharma-ceutical therapy is only recommended in cases of a diagnosis with unambiguous indication. The range of medicaments is very limited due to their side-effects that are damaging for the voice. In our expe-rience, singers themselves are very cautious about taking pharmaceuticals. An important factor is to train the stage appearance under convenient circum-stances. Test performances with video feedback allow singers to perceive themselves from the out-side, work at their performance, and thus gain some self-confi dence.

The acquired techniques are applied on stage with therapeutical assistance during training sessions for stage presence. Afterwards, the musicians can put the acquired techniques into practice on their own.

The therapeutical approaches shown are sup-posed to be carried out in different phases. We dis-tinguish between three phases: the preparation phase, the stage appearance itself, and the wrap-up phase. The psychological, mental, and basal body-oriented preparation should take place in the weeks prior to the performance itself. The hours and minutes lead-ing up to the performance are discussed and planned in every detail. In this connection, factors such as nutrition, movement, and clothing play an important role. Ideally, during the performance there should be total and exclusive focus on the singing and the per-formance itself. So-called ‘ emergency measures ’ are prepared individually for any kind of trouble: these measures include the ‘ thought stop ’ in case of cata-strophizing, calling up a positive body feeling in case of a lacking presence, own inner imagination pic-tures, contact with the audience, etc. The wrap-up phase is extremely important, as the pre-conditions for the next performance are created during this phase. The singer learns that heightened adrenaline concentration has to be metabolized. This can lead

182 C. Spahn et al.

to feeling ‘ high ’ or suddenly exhausted. Sometimes, mildly depressive reactions can occur after a perfor-mance. In opera everyday life, the three phases are drastically shortened and often overlap. The singer thus needs a considerable amount of discipline and attention in order to adapt positively to these rou-tines and requirements. An assessment of the perfor-mance should ideally take place only 1 or 2 days after the performance itself. In this context, it is particu-larly important to become conscious of the perfor-mance ’ s positive aspects, as from these grow the resources for further positive development.

Conclusions

In all its different forms MPA represents a profes-sional challenge for singers and instrumentalists. There are a number of different pedagogical and therapeutical measures used to optimize stage fright which focus on physiological or psychological factors of MPA. As expected, a fi rst analysis of singers during a performance on stage revealed an increase of heart rate and blood pressure values before and after the performance. However, it is still diffi cult to assess the clinical relevance of these heightened parameters.

Physiological and psychological values of MPA did not point in the same direction. This possibly suggests that performers experience the same feel-ings of physiological arousal, but while one fi nds these feelings energizing, another perceives them as signs of impending disaster. Further research is necessary in order to gain more knowledge on MPA and its treatment especially in singers.

Declaration of interest: The authors report no confl icts of interest. The authors alone are respon-sible for the content and writing of the paper.

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