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Almost everybody knows and chuckles at the quote attributed to Sigmund Freud about a cigar, "When is a cigar more than a cigar?" And almost everybody realizes that that a cigar can be taken literally to represent rolled up tobacco leaves that one smokes. But a cigar also can signify much more. When a performer's efforts on stage go up in smoke due to performance anxiety, the issues that ignite stage fright must be considered seriously. This is no joke.
Ms. T. consulted me for her performance anxiety. At our initial sessions, she expressed worry about her technical security and memory slips when playing the violin in public. These were symptoms of which she was aware.
As I got to know her, it was clear to me that her stage fright was not due to lack of practice, limited talent, or not being smart (as she believed about herself). Nevertheless, she held fast to her convictions that something was wrong with her that smart people should be able to solve their own problems, and that only crazy people went to "shrinks". It did not take long to discover that her parents disapproved of her musical ambitions and told her smart people could solve their own problems. They maintained that crazy people consulted a therapist. Thus, making an appointment to see me was a defiant act as well as admitting to her long held conviction that she was not intelligent. My attempts to help her reconsider her entrenched negative feelings about herself were viewed as criticisms. She insisted she only wanted relief from her fear of technical and memory slips in public -the overt symptoms of her performance anxiety.
People come to see a therapist embracing a variety of thoughts and feelings about what it means to seek help. Some are embarrassed. Some fear depending on another person. Some wish to depend on another person. Some want to be told what to do. Some are bothered by various emotional and physical concerns such as insomnia, irritability, headaches, and muscle tension. (Of course, a doctor to rule out any underlying medical condition should evaluate all physical symptoms.) Some are in dysfunctional relationships. Such conditions and concerns can settle into anxiety and depression with accompanying symptoms that may be experienced both physically and psychologically. Usually a trigger, i.e., an event that feels humiliating or an anticipated performance or important test that generates anxiety tips the scale and leads to that first phone call requesting an appointment. Anything can be a trigger, and anything can be a symptom.
However, as became clear with Ms. T., her symptoms about memory and technique were more than symptoms. As I got to know her, we discovered that she had been suffering chronically on and off stage with her anxiety, she had very low self-esteem, she feared being close, she worked obsessively which interfered with her personal relationships, she got diminished pleasure from being with friends, and she did not "solve" her anxiety through persistent attempts at rational problem solving and reading self-help books.
Ms. T's symptoms, so clearly defined by her as technique and memory, were much more than discreet symptoms. They had multiple origins and served multiple purposes. The external reality of the stresses of performance held great meaning inside her mind. And so we embarked on a process that helped her discover and uncover the complexity of her performance anxiety that prevented her from enjoying a fulfilling career in her chosen field and satisfying relationships. We learned that she grew up in a household that was dominated by parental demands for perfection, as she now demanded from herself. Her father often traveled, and she believed her bad behavior had caused him to leave home. She felt competitive with her brother and with her mother, whom she saw as more successful. She did not feel supported in her decision to become a musician by either parent and was faced with either conforming to their wishes or defying them. Neither solution solved her anxiety. All of these issues became condensed into symptoms when she stepped on stage - or even anticipated doing so. Her performance anxiety symptoms debilitated her but more so protected her from deeper pain and disillusionments associated with her family and her growing-up years.
After working together to untangle some of the mental ghosts that haunted her, we were able to excavate some underlying issues and place them in a broader perspective. Some we even put to rest. Ms. T came to realize that she took her entire self onto the stage - complete with her childhood "laws" and her convictions that she was not competent. She also realized how angry she had been as a child, but felt she could not express it. Anger was a dangerous emotion. She felt that showing anger risked abandonment by the very people on whom she depended. As a performer, she felt she needed to produce a perfect performance to make the audience/parent love her and not leave her. It was no wonder to discover that walking on stage to perform was "dangerous" for her - or, by extension, walking into a therapist's office. She could not afford to "slip up" with the audience/parents watching. She was afraid of being overpowered by emotions during performance - where she would symbolically lose control of her body (technique) and mind (memory slips).
Our work focused on her attitudes vs. her aptitude for her work. Ms. T. developed a greater tolerance for ambiguity and contradictions. She realized that while her parents were strict and meant well, she did not have to internalize their values as her own - and feel guilty if she did not. She came to appreciate their and her limitations and strengths and was better able to think in the face of strong emotion. Ms. T. told me at one of her final sessions that, "you can better control your thoughts and actions although you may not be able to control what goes on around you". These realizations and this attitude allowed her to resume and pursue her career without debilitating performance anxiety. Sometimes a cigar is just a cigar. Sometimes it is much more.
Schafer, R. (1983) The Analytic Attitude. Basic Books. New York.
Julie Jaffee Nagel, Ph.D. is a psychologist-psychoanalyst in Ann Arbor, Michigan. She is a graduate of The Juilliard School with a major in piano performance and a minor in stage fright. She is also a graduate of the University of Michigan and the Michigan Psychoanalytic Institute. Nagel publishes and presents on the topics of performance anxiety and music and emotion. Visit her website at julienagel.net
