Performance Anxiety

Performance anxiety is a disruptive level of anxiety that can develop in any situation where you have to perform some type of activity. Performance anxiety occurs in both public contexts (such as sports, acting, music or other artistic presentations, and public speaking) and private contexts (such as test taking and sexual intimacy). 

Regardless of whether the activity is public or private, the pattern of behavior involved in performance anxiety is typically the same.  First, you start to worry about all the things that could go wrong. Then you get anxious and the anxiety gets in the way of you performing successfully.  Ultimately, a vicious circle develops where worrying about your performance makes performance more difficult and eventually the performance anxiety becomes a problem in itself.  If you try not to worry, you may still be in the wrong frame of mind since you are still thinking instead of just experiencing the activity. This is called a self-fulfilling prophecy.  In order to get rid of performance anxiety you have to get out of this self-fulfilling prophecy.

An example of a common area for performance anxiety is sexual performance anxiety.  In thinking about sexual activity, you may worry about all the things that can go wrong.  Sexual activity then becomes a source of anxiety and this performance anxiety results in lowered self-esteem, avoidance of sexual encounters, relationship problems and sexual dysfunction. Typically, the performance anxiety produces so much preoccupation with the anxiety itself that you become less involved in the sexual interaction, bringing about the very failure that is feared.

Fears of sexual performance in men often center around not getting an erection, losing an erection, early ejaculation and not climaxing while in women sexual concerns center around vaginal lubrication, female climaxing, and intimacy. Fears can also reflect anxiety about levels of passion, tenderness, intimacy and sensitivity you have for yourself and your partner.

An experienced therapist can help you to develop coping skills to manage anxiety and overcome performance anxiety.  You will need to understand and adjust your thoughts and beliefs that help create the anxiety, learn and practice specific behavioral social skills to increase confidence, and then gradually practice these skills in real situations.  Treatment approaches for performance anxiety typically include traditional individual psychotherapy, reality therapy, , cognitive therapy, and behavior therapy. Relaxation and stress relief techniques are frequently an accompaniment to other therapeutic approaches. 

Medication may be used in conjunction with the above treatment approaches.  While the medication does not solve the whole problem, it may help reduce anxiety to a level that allows you to better benefit from therapy.

While I choose not to use hypnotherapy in my practice, hypnotherapy (using systematic desensitization and relaxation) can be an effective treatment tool for performance anxiety. If you go the hypnotherapy route, make sure the therapist is a trained and certified clinical hypnotherapist.

For more information about performance anxiety, please click on the linked websites listed below.

"If you really want help dealing with your feelings and emotions, changing your behavior, and improving your life, I will be happy to help you.  I am available almost any time and any place.  You can call me directly and there is no cost or obligation for the initial telephone consultation.  Or you can reach me by email.  I look forward to the possibility of helping you to improve your life."   Dr. Vince Berger