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Gerald Klickstein on Music Performance Anxiety

On the future of mental health

Eric Maisel
Source: Eric Maisel

The following interview is part of a “future of mental health” interview series that will be running for 100+ days. This series presents different points of view about what helps a person in distress. I’ve aimed to be ecumenical and included many points of view different from my own. I hope you enjoy it. As with every service and resource in the mental health field, please do your due diligence. If you’d like to learn more about these philosophies, services, and organizations mentioned, follow the links provided.


Interview with Gerald Klickstein

EM: What do you most want to say to mental health professionals who treat musicians for performance anxiety?

GK: For starters, the prevailing view of music performance anxiety as, let me paraphrase, “inappropriate or unexpected given a person's training,” strikes me as dubious.

When therapists encounter music school graduates who wrestle with stage nerves, if they have that definition in mind, they might assume that the musicians possess sufficient task mastery to perform confidently; hence, the anxiety must spring from psychological causes. I’ve taught conservatory-level musicians for 35 years, and I’ve found that such an assumption is almost never correct.

In truth, music performance training, even at top schools, is almost always incomplete, and anxious graduates typically deal with existential problems as much as with psychological ones.

EM: What sorts of training deficits and existential problems are you referring to?

GK: Let me begin with the training. Conservatory music students apprentice with individual instructors, typically active or retired performers, who are charged with teaching students how to practice, memorize and perform effectively. There is no standard model of how teachers might carry out those responsibilities and, of course, variation exists in the content that teachers cover and the diligence with which young musicians study.

If we consider practice and memorization, teachers may possess procedural but not declarative knowledge of those subjects and teach them haphazardly. Consequently, many of their students will practice using superficial repetition strategies that yield automated learning. By comparison, expert performance educators emphasize deep learning methods that empower students to excel on stage, but, even then, not all students will acquire optimal learning habits.

And that leads me to the main existential problem I mentioned: If musicians primarily rely on automated learning – aka “muscle memory” – then they will also depend on automated recall. Yet automated recall is easily corrupted by stress.

As a result, such musicians can only perform satisfactorily if they can get themselves into a sort of groove in which their automated reflexes run smoothly. They may report, for instance, that they play or sing effortlessly in practice but struggle on stage. Needless to say, performing can be adrenaline-charged and stressful, so such musicians can never know whether they’ll be in their groove when they step under the lights.

If musicians are expected to perform accurately but cannot know whether they will, then I’d say that anxiety is an appropriate response and they are faced with an existential predicament: Their practice habits actually produce performance anxiety.

EM: How might mental health professionals apply that information?

GK: First, let me say that I don’t mean to oversimplify. We all know that anxiety can stem from myriad causes. But given our space constraints, I’m zeroing in on task mastery because that is one of my specialties as a music educator and performance coach.

I think that mental health professionals can use this information to better screen musician clients who present with performance anxiety and then make recommendations accordingly. For example, therapists can inquire about the practice and memorization strategies the musicians use and the difficulty level of the repertoire they perform.

They can ask about clients’ training and whether it included deep learning methods, performance simulations, and the use of simple repertoire to acquire memorization and mental focusing abilities. They can become aware of and refer musicians to educators who teach practice and performance skills.

In my own work with anxious musicians, I’ve seen them benefit from a collaborative approach in which I, a therapist, and an instructor of Alexander technique work in concert. I’ve also found that even when musicians face hurdles such as elevated trait anxiety, as they lower the task difficulty of the music they learn and build up practice and performance skills, then the interference caused by their psychological issues greatly diminishes.

EM: Given that the anxious musicians you’ve coached displayed correctable training deficits, do you think it’s reasonable to label music performance anxiety as a disorder or form of social phobia?

GK: I have to admit that I bristle at those terms. Carol Dweck’s research on growth versus fixed mindsets proves how damaging it can be to use such labels with young people who are striving to achieve.

I find it especially disheartening to hear of music students being treated for performance anxiety with daily anti-anxiety medications.

That’s not to say that medication is never appropriate for people whose sole complaint is performance anxiety. As I wrote in my article, “Musicians and Beta-Blockers,” occasional low-dose beta-blocker use can make sense at professional auditions and for amateurs who perform rarely.

My core message is that musicians with inadequate practice and performance skills will almost inevitably experience problems with performance anxiety. Interventions that ignore that fact are mere Band-Aids or worse.

EM: You’ve written a highly successful book, now in its 12th printing, titled The Musician’s Way: A Guide to Practice, Performance, and Wellness (Oxford 2009): How does your text address the acquisition of practice and performance skills?

GK: The text is geared to undergraduate music students but suits younger and older musicians as well. It applies research in human learning, performance psychology and other topics to map out inclusive pathways to musical and professional success. Your readers can learn more on the companion site and blog that I publish at


Gerald Klickstein (@klickstein) is a veteran educator and guitarist who has served on the faculties of the University of North Carolina School of the Arts, the University of Texas at San Antonio and Michigan State University. Currently Director of the Music Entrepreneurship and Career Center at the Peabody Conservatory of The Johns Hopkins University, he presents lectures and workshops nationwide for music students and teachers.


Eric Maisel, Ph.D., is the author of 40+ books, among them The Future of Mental Health, Rethinking Depression, Mastering Creative Anxiety, Life Purpose Boot Camp and The Van Gogh Blues. Write Dr. Maisel at, visit him at, and learn more about the future of mental health movement at

To learn more about and/or to purchase The Future of Mental Health visit here

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