Fighting Back Against Fight or Flight
Should you "calm down" or just embrace the adrenaline rush?
When Noa Kageyama was seven years old, he attended a summer music program at Ithaca College, and like most music camps, this one culminated in a recital. Kageyama, who was raised in central Ohio, had begun playing violin at age two. At five, he'd traveled to Japan to study with Shinichi Suzuki, creator of the famed Suzuki method of music instruction. By six, he'd played his violin on television. So by the time he was seven, Kageyama was a seasoned performer. As he stood waiting to go on stage, he felt relaxed and at ease. What could possibly go wrong?
Then, a few moments before his turn, a young female violinist took the stage and had a meltdown. She kept stopping and starting, as if she were forgetting the song. The distress on her face was obvious, and watching from a few feet away, Kageyama experienced an epiphany-one that would change the course of his life. "The whole concept that something bad could happen on stage popped into my awareness. I didn't know that could happen, because I'd never seen that before," he says. As he waited to play, Kageyama began to feel this strange mix of feelings, a kind of apprehensiveness that was so unfamiliar he didn't even know what to call it.
Despite this nascent anxiety, Kageyama performed just fine at the Ithaca recital. Afterward, he kept practicing the violin every day. As a teenager, he played with adult symphonies, won fellowships, and studied with world-famous violinists. During his senior year of high school, each weekend he would fly from Ohio to New York City, to participate in a precollege program at the Juilliard School. Along the way, he never experienced a full-blown panic while performing.
Still, he did experience subtle signs of anxiety. Sometimes his hands would sweat excessively. Sometimes his mind would wander. "There was this frustration over why I couldn't consistently play the way I was capable of playing, even if I was prepared," he says. Although his performance anxiety was not particularly noticeable to observers, he began to see it as an unpredictable, pernicious tax that unjustly subtracted from the expected return on the time he'd spent practicing.
In 1999, as a twenty-three-year-old a graduate student at Juilliard, Kageyama signed up for an elective class called "Performance Enhancement for Musicians," taught by a sports psychologist who'd previously worked with Olympic athletes. The course taught him that backstage jitters are an unavoidable part of a musician's life, and that even if you can't entirely eliminate them, you can systematically develop skills to perform well despite them. "It was such an eye-opener," Kageyama says. "It's not a crapshoot out there. There are things I could do to get better at this."
The course had an unintended consequence: It led him to quit playing violin altogether. As an undergrad, Kageyama had majored in psychology, and the more the young violinist considered what really interested him, the more he realized he wanted to teach people the skills he'd learned in the Juilliard course, rather than play music himself. So after graduating from Juilliard's master's program, he moved to Indiana University to pursue a PhD in psychology. Today his violin sits in a case that is rarely opened.
Instead, at 11 a.m. on a September morning, Professor Kageyama stands in Room 102 at Juilliard, teaching a new version of the course that changed his life. Kageyama is thin and soft spoken, with close-trimmed black hair. Around him in a circle of chairs are twenty grad students, instrument cases-violas, cellos, flutes, bassoons-at their feet. The previous week, in the semester's first class, he'd made the students take their instruments, one by one, to the front of the room while he fiddled with a video recorder set up on a tripod. (He didn't actually record the performances. He used the camera, and told students he would send the videos to Juilliard's dean, to increase their stress levels.) He told each student to play for sixty seconds, but then actually set a timer for ninety seconds, to flummox them. He wanted to see them play under pressure.
In this week's class, he alternates between lecture and discussion, focusing on how adrenaline and the body's physiological fight-or-flight response can have particularly detrimental effects on musicians. Pianists' fingers will go cold; shallow breathing and dry mouth can wreak havoc on musicians playing wind instruments. To help these students learn to cope better with these phenomena, Kageyama leads them through a relaxation exercise called centering, and then schedules appointments with each student to go over their individual results from an 84-question Performance Skill Inventory, which highlights each musician's particular strengths and weaknesses in dealing with performance anxiety.
As Kageyama and I exit the classroom and walk uptown to a Chinese restaurant, he tells me his plans for next week's class: He's going to make the musicians do calisthenics until their hearts are racing and their bodies are sweaty, and then have them play their instrument. "It's distracting when your heart is pounding," he says, but if you practice playing while feeling that sensation, it can become a little less unnerving. "It's the same thing you need in an audition-to see past what your body is saying, and to focus on the task at hand."
Kageyama compares a musician facing an audition to a rocket that's poised on the launch pad, experiencing the ticktock of the countdown. Rather than experience this countdown passively, he wants students to practice specific steps to get them ready to launch. The ultimate goal of his fifteen-week course, he says, is "to ensure that, in those last few seconds, you're set up as best you can to be successful."
In helping humans perform, psychology is the software, but biology is the hardware. Much of what performance psychologists like Noa Kageyama do is help people control and adjust to the chemical processes happening inside their bodies-and the emotional responses they create-when they're getting ready to perform.
These processes primarily involve the hormone adrenaline and the emotion of anxiety. Finding ways to control this biological and emotional response is the first step in making better use of the countdown period Kagayama describes.
Doctors first identified the adrenals, the small organs attached to the top of the kidneys, in the sixteenth century, but it took anatomists three hundred years to figure out what purpose they served. By the mid-1800s, doctors began seeing a pattern in patients with tumors on these organs: When the adrenals weren't working well, patients suffered from low blood pressure, fatigue, and fainting. In the 1890s, doctors began injecting adrenaline, which they extracted from adrenals, into animals (and a few humans) and observing how this mysterious substance resulted in instantaneous jumps in blood pressure, heart rate, and respiration.
In one 1903 experiment reported by the New York Times, a researcher used anesthetics to stop a dog's heartbeat, rendering it lifeless for fifteen minutes, and then revived the animal with a shot of adrenaline. Afterward, the researcher was besieged with letters asking if he could use the hormone to perform Lazarus-like revivals of people who'd been dead for years.
Although adrenaline isn't that miraculous, scientists immediately marveled at its adaptive utility. "When a person is, say, running form a ferocious dog, [adrenaline] changes and integrates the function of organs in favorable ways," writes Harvard Medical School professor Brian B. Hoffman in Adrenaline, his fascinating history of the hormone. "It increases the output of the heart in order to pump more oxygen-rich blood full of nutrients to the rest of the body; increases blood flow to the muscles and away from other organs where it is not immediately needed, such as the intestines; opens the lungs to breathe in more oxygen; and cuts blood flow to the skin to limit bleeding in case of injury." By the 1920s, the Harvard physiologist Walter Cannon had coined a name for the distinctive set of reactions this system creates in response to stress: "fight or flight."
Stage fright is just one peculiar manifestation of fight or flight, but it's such a familiar and widespread phenomenon that it's been deeply researched. That makes it particularly useful in trying to understand what works and what doesn't in trying to manage adrenaline and anxiety.
Although most of us are not concert musicians, a surprising amount of the research done on stage fright focuses on this profession. That's mostly because performing as a concert musician is really hard, especially when compared with giving a TED Talk or a boardroom presentation, or appearing on television. "With public speaking, there's a lot of wiggle room. The audience doesn't know what you're supposed to say," Kageyama says. "There's a lot of improvisation going on in a presentation, but in music, everybody knows what note is supposed to come next, and how it's supposed to sound." There's also insane competition: A big-city symphony may audition two hundred musicians for the single opening.
If you dive deeply into research on stage fright, the most striking aspect is the pervasiveness of the problem. In Playing Scared: A History and Memoir of Stage Fright, the journalist and amateur pianist Sara Solovitch tallies up the musicians (including Paul McCartney, Vladimir Horowitz, Ella Fitzgerald, Luciano Pavarotti, Rod Stewart, Bette Midler, and Barbra Streisand) who've struggled with severe onstage anxiety. Solovitch describes stage fright as "both utterly mysterious, an act of mutiny by the mind against the body, and ludicrously commonplace, as ordinary as the common cold."She goes on to list the techniques-including hypnosis, meditation, yoga, cognitive behavior therapy, psychopharmaceuticals, exposure therapy, eye movement therapy, and various breathing exercises-she sampled to overcome her fears and perform a piano recital.
Some performers develop creative techniques for dealing with the affliction. Carly Simon is an extreme and oft-noted example. In 1981, during a concert in Pittsburgh, Simon suffered an onstage anxiety attack so profound that she asked audience members to climb on stage to rub her arms to help calm her down, allowing her to finish the show. (She describes the incident in detail in her 2015 memoir, Boys in the Trees.) The episode caused her to cancel a tour, and she didn't sing again in public for seven years. "It's terribly paradoxical, because I do enjoy [performing]. But when the anxiety comes on, the adrenaline is so strong it topples me," she recalled later. Over time, Simon began instructing theaters to turn on the houselights, to reduce the spotlight's focus on her. She would focus obsessively on a single spectator in the front rows, intending to make this fan feel embarrassed by the attention, pushing that emotion away from herself. In the 1990s, she began bringing a couch on stage so she could sing lying down. When she learned that physical pain could reduce her emotional anxiety, she began jabbing her hand with pins while on stage, or asking to be spanked before the show began. John Lahr, writing in the New Yorker, recounts how at a 1996 birthday performance for President Clinton, the curtain very nearly went up while Simon was being spanked on stage by the entire horn section of her band.
Alas, Simon's prescription notwithstanding, there is no academic research suggesting that pre-performance spanking can help large numbers of people beat back pre-performance jitters. But there is surprising research that suggests that the most common advice that's given to people who are nervous before a performance-to try to relax and calm down-usually does more harm than good.
As a freshman at Princeton, Alison Wood Brooks auditioned for a coed a cappella singing group called the Princeton Roaring 20. Gaining a spot in the group is hypercompetitive: Each year, approximately a hundred students try out for the three or four spots left open by graduating seniors. Although she had no formal singing experience-she'd played oboe and piano in high school-Brooks had a splendid voice. So on a fall evening, she confidently walked into the audition room and sang "Beautiful" by Christina Aguilera. "It was exactly like something out of Pitch Perfect," she says. A few nights later, Brooks was invited the join the group.
Once she did, she became one of the judges at future auditions. During her sophomore, junior, and senior years, as Brooks watched several hundred candidates go through the tryout ordeal, she began to notice two distinct types of behavior. One group of singers would be visibly nervous before they sang. Their voices or their bodies might tremble slightly. Some might even apologize before they started singing: "I'm sorry. I'm really nervous." A second group of singers acted differently. They seemed more positively energized and less uncomfortable. They tended to smile and talk about being excited rather than anxious. "I really appreciate the opportunity," they'd say sincerely.
As Brooks watched the divergent behavior, she noticed a trend in how they performed. "The people who seemed to do well in the audition reframed their anxiety as excitement, or channeled it in a positive direction," she says. The visibly nervous singers generally didn't sing as well.
After graduating from Princeton, Brooks entered a doctoral program at the University of Pennsylvania's Wharton School. In the evenings she began watching American Idol, and as she watched the early-season auditions, she observed behavior that mirrored what she saw at the Roaring 20 auditions. Contestants who talked about being nervous during preaudition interviews with Ryan Seacrest tended to do poorly in front of the judges, while people who expressed excitement often performed better.
As a grad student, Brooks became interested in how different emotions affect people's performance in various kinds of tasks. Her primary interest: anxiety. "Researchers have been interested in and aware of anxiety issues, at least at a clinical level, for a very long time, but what we don't know a lot about is the anxiety that normal people feel every day," she says. Brooks is talking about the difference between "trait" anxiety, the individual quality that may make someone susceptible to an anxiety disorder that requires medicine or treatment, and "state" anxiety, which describes how well-balanced people with no particular susceptibility to anxiety react to a stressful situation.
As a doctoral student, Brooks coauthored papers that examined how people negotiate while feeling anxious (they generally do poorly), and how people who are anxious become overly dependent on advisers or experts when making decisions. Her research utilizes unique methods to make people feel anxious: In one set of experiments, she had subjects listen to the music from Psycho and watch clips of horror movies before they engaged in tasks.
For her dissertation, she set up a scientific experiment to test out the phenomenon she first noticed while judging auditions for the Princeton Roaring 20. First she tried to understand how frequently people think that "calming down" is the best way to deal with a performance situation. She surveyed two hundred people about what they'd tell a nervous coworker who's about to give a big speech. More than 90 percent of participants would tell the friend to "try to relax and calm down," while just under 8 percent would advise to "try to be excited instead of anxious." In her dissertation, she references the British wartime poster with the motto "Keep Calm and Carry On." For people facing stressful situations, this is the ubiquitous advice.