Book Review, Alice G. Brandfonbrener, M.D.
The first self-help book for dealing with performance anxiety and related issues of which I am aware was Eloise Ristad’s "A Soprano on Her Head" (1982, Real People Press, Moab, Utah). Since then there have been at least a dozen or more such books by authors who are performers, therapists or, occasionally, both. They offer solutions from their own perspective but they do not differ substantially in their underlying messages; emphasize the positive, cast out the negative. Although they are all written for popular consumption, these books differ in style and in the details or the relative importance placed on their suggested techniques, such as visualization, breathing, relaxation techniques, and consciously substituting positive thoughts about one’s own performance potential while minimizing the customary self-flagellation. All are notable for their sincerity and conviction that success awaits the suffering performer/reader if only they will follow the advice offered in their particular book.
The good news is the optimism is likely realistic for many of the hopeful consumers of each and every one of the books that I have read on the subject. The bad news is that most of these books fall short on recognizing the frequent complexity of the underlying problems behind the symptoms of performance anxiety. In my own clinical experience, many people with incapacitating performance anxiety seem to have relatively isolated pathology: the psychological problem appears limited to their performance. However, in many other individuals, the problems derive from an assortment of unconscious issues and conflicts which cannot be resolved until the patient becomes aware, ie. conscious, of them. Thus, while self-help formulas may help, they won’t do the whole job. Psychotherapy may also be necessary to resolve the anxiety.
Nancy Shainberg, the author of "Getting Out of Your Own Way" is a clinical social worker with a practice that includes a variety of performers, and she is also a competitive equestrian. She writes a very direct and clear book, much of it in a Q and rhetorical A style that is very readable without being condescending. Also reader friendly are the frequent bold face paragraph headings, and the absence of any threatening jargon or psychobabble. She herself acknowledges how much time she must devote in the book to dealing with the negative rather than the positive, and she clearly knows the issues that strike to the heart of the many examples of problems in the patients she cites, both athletes and musicians. The examples are well chosen to illustrate and clarity her theses.
Having been in performing arts medicine for a long time, I too, have many thoughts about the etiologies and frequency of disabling performance anxiety among otherwise well qualified performing artists. I was particularly interested in her chapters on "Imperfection" and "Over-coming Negativity". She emphasizes that, given the vulnerability of all who are human, shooting for perfection in performance is a prescription for failure. I am convinced that a great many of the problems we clinicians see among performing artists, are the product of an inordinate obsession with perfection, note perfection in particular. Among many teachers and schools there is so much more emphasis on mistakes than on artistry, on what is bad rather than on what is good in the playing of their students. How can this, except in the most callous individual, not paralyze the poor performer with fear while waiting for the almost inevitable mistake? Ms. Shainberg doesn’t come down as critically as I just have on the educational system but she certainly recognizes its product. The problem is that it is difficult to break behavior patterns once they are well established, especially if this was in early childhood, so that once again the emphasis needs to be on prevention.
There is a chapter on "Parents" in which she recognizes the potential impact of early and current parental attitudes, particularly those that have been hypercritical. On the other hand she advocates moving away from this baggage and takes the refreshing stance that the performers ought to stop blaming their problems on historical conflicts with their parents or whomever, especially when such blame is clearly displaced or misplaced from their own hang-ups. However, to her considerable credit she says something else even more important. " Despite the new experience having nothing to do with the past, we find ourselves…becoming very upset because of those previous experiences of being made to feel like an idiot….our body still hears the same message from the past. Once we can see and know the core place and what the real trauma we’re carrying is all about, make some room for the pain that it lived, we can then separate our new experience for what it is…Discovering and experiencing the core place frees us to act consciously." (p. 96). In other words problems stemming from the unconscious can be properly disposed of only after they are made conscious and we recognize their origins.
The final chapter "Practical Techniques" is a logical way to conclude the book and the suggestions, while not earthshaking, are sensible. It was interesting to see her take issue with"visualization" as a tool for dealing with performance anxiety, saying that she prefers "sensorization". That is, different people respond to different stimuli. For some visualization is adequate but Ms. Shainberg proposes a more complete sensory experience, a kinesthetic one, as she refers to it, that includes sounds and feelings as well as visual images. The recommendation for visualizing has become something of a buzz word and it was good to find someone not falling into that trap and looking for a more totally involving approach.
The real test of a good book, like a good present, is whether you would like it for yourself. I both admired and enjoyed Ms. Shainberg’s book and will add it high on my list of recommended reading for the frequent performer who is seeking relief.
Alice G. Brandfonbrener, M.D.