This is the 1st of a series of case studies used to demonstrate what happens during a mental health counseling session with artists and creative individuals. All clients are an amalgamation of similar cases to protect client's confidentiality.
Case Study: Stella
I could hear the music being exuded from her hands even though there was no instrument in the room. It was the pace of her breath, the tapping of her fingers on her lap, and the energy of her foot keeping the tempo on the floor that gave off the illusion of sound. This piano-playing simulation exercise, our fourth in a span of about 10 weeks, was a way to help Stella address her performing anxiety. The goal was to recreate the playing conditions she encounters when she performs her solo and ensemble pieces, without needing to lug a piano into the office! She was asked to close her eyes and visualize the room, smell the generations-old wooden instrument, and to imagine the muffled chatter of audience members gathering. She was prompted to let her body become anxious and to feel every loud thump of her heart beating as she prepared to confront the core threats underlying her performance anxiety: perception of worthlessness as an artist, dread of mistaken career path, questioning of ability to “stay” in the music.
Stella's urgency to manage her performance anxiety reflected her desperation to successfully fill the shoes of the professional musician. Every show that did not match her potential, whether due to the way anxiety impaired her technique or made her feel emotionally detached, kept her one step away from being fully immersed in the creative moment. It kept her from becoming the artist she saw in herself. As her conscious brain was flooded with exaggerated self-critiques (“I'm messing up the tempo”, “my fingers are too stiff”, “I sounded better during practice”), her subconscious brain – her “art brain” as she liked to call it – would get buried whereby robbing her of the creative moment's full immersion and flow-like state. For her improvisational performances in particular, she heavily relied on raw and unfiltered emotions to produce authentic, honest and imaginative music. Yet, the more she struggled to access this space, the less she felt like a true artist, and more like an imposter with nothing interesting to say. “Who am I to deserve to be on this stage? I'm just some damaged kid from a non-sophisticated, art-illiterate family.” In a circular path, her fragile sense of her artist-Self damaged her confidence and triggered an anxious response, which then impaired her performance only to reinforce the belief that she is just not that good.
In our experiential performance simulations, we urged the body to ride along with the anxiety. Rather than try to control it through the use of “staying calm” affirmations and breathing regulation exercises, we thought of the body as a vehicle for creative expression. Did the head want to manically shake? Go with it. Did the shoulders want to tense up? Well, let's keep in mind how chronic tension can cause muscle strain that impairs playing ability, but within reason, go with it. Did they eyes want to stay shut the entire time? Go with it. Stella knew she would not keep these habits during the actual performances but that they were a way to explore where her creative subconscious wanted to go. Sessions also incorporated discussion on artistic self-centeredness. This kind of benign selfishness encouraged her to think about her creative needs in stark contrast to the audience's. The audience may want to be impressed but her goal might be to improve a particular skill. The audience may prefer classical styles whereas she may be craving contemporary and modern aesthetics. Empowered by the conscious articulation of her preferences, she would come to enjoy the musical moment she has given life to. The goal was to strengthen her identity and integrity as an artist and to weaken the knee-jerk,insecurity-bred anxiety response.
Finally, we made our way to the “magic” of art-making. The concept of flow, coined by creativity researcher Mihalyi Csikszentmihalyi, has nearly become a household word and is very familiar to artists and creative people. Stella's anxiety interfered with her ability to get to that space of full immersion, one in which nothing exists beyond the moment of pressing her fingers on the piano keys. In order to get her there we had to enter new territory. To be present, we had to look into the past. For Stella to be truly moved by the moment, unaffected by anxiety's constraints, she would have to reconcile the inherent value in music-making, in which it exists for its own sake, with the presence of an evaluative audience surrounding her. More specifically, she would have to confront her own feelings about being the center of attention when most of her past experiences created and affirmed the belief that seeking attention is a flawed attribute (yet, when the attention is there it had better be positive). Memories of being reprimanded for improvising in childhood music classes, of her father commenting on her being “too talkative” in social settings, and of being shunned by envious peers, snowballed during one of our sessions. The goal was to become mindful of how all these experiences shaped her relationship to performing, and to make a conscious choice about redefining it. It was not about her attention-seeking; it was about using the attention to communicate with listeners. It was not about her performing; it was about contributing to the abstract concept of art. It was not about what came after; it was about the moment.
Stella's experiences are common among performers such as actors, dancers, singers, and musicians. More than that, it captures the essence of many of the internal problems confronted by artistically creative populations. Problems about the pressure of sharing art with others, and about making a creative mark in spite of (or very often because of) emotional turmoil. When artistic clients want a therapist who “gets them” I understand that they are looking for some expertise on creativity, experiences (whether firsthand or vicarious), with people in the arts and entertainment world, but most importantly that are looking for someone who values and appreciates their undeniable need for creative expression.
I could hear the music being exuded from her hands even though there was no instrument in the room. It was the pace of her breath, the tapping of her fingers on her lap, and the energy of her foot keeping the tempo on the floor that gave off the illusion of sound. This piano-playing simulation exercise, our fourth in a span of about 10 weeks, was a way to help Stella address her performing anxiety. The goal was to recreate the playing conditions she encounters when she performs her solo and ensemble pieces, without needing to lug a piano into the office! She was asked to close her eyes and visualize the room, smell the generations-old wooden instrument, and to imagine the muffled chatter of audience members gathering. She was prompted to let her body become anxious and to feel every loud thump of her heart beating as she prepared to confront the core threats underlying her performance anxiety: perception of worthlessness as an artist, dread of mistaken career path, questioning of ability to “stay” in the music.
Stella's urgency to manage her performance anxiety reflected her desperation to successfully fill the shoes of the professional musician. Every show that did not match her potential, whether due to the way anxiety impaired her technique or made her feel emotionally detached, kept her one step away from being fully immersed in the creative moment. It kept her from becoming the artist she saw in herself. As her conscious brain was flooded with exaggerated self-critiques (“I'm messing up the tempo”, “my fingers are too stiff”, “I sounded better during practice”), her subconscious brain – her “art brain” as she liked to call it – would get buried whereby robbing her of the creative moment's full immersion and flow-like state. For her improvisational performances in particular, she heavily relied on raw and unfiltered emotions to produce authentic, honest and imaginative music. Yet, the more she struggled to access this space, the less she felt like a true artist, and more like an imposter with nothing interesting to say. “Who am I to deserve to be on this stage? I'm just some damaged kid from a non-sophisticated, art-illiterate family.” In a circular path, her fragile sense of her artist-Self damaged her confidence and triggered an anxious response, which then impaired her performance only to reinforce the belief that she is just not that good.
In our experiential performance simulations, we urged the body to ride along with the anxiety. Rather than try to control it through the use of “staying calm” affirmations and breathing regulation exercises, we thought of the body as a vehicle for creative expression. Did the head want to manically shake? Go with it. Did the shoulders want to tense up? Well, let's keep in mind how chronic tension can cause muscle strain that impairs playing ability, but within reason, go with it. Did they eyes want to stay shut the entire time? Go with it. Stella knew she would not keep these habits during the actual performances but that they were a way to explore where her creative subconscious wanted to go. Sessions also incorporated discussion on artistic self-centeredness. This kind of benign selfishness encouraged her to think about her creative needs in stark contrast to the audience's. The audience may want to be impressed but her goal might be to improve a particular skill. The audience may prefer classical styles whereas she may be craving contemporary and modern aesthetics. Empowered by the conscious articulation of her preferences, she would come to enjoy the musical moment she has given life to. The goal was to strengthen her identity and integrity as an artist and to weaken the knee-jerk,insecurity-bred anxiety response.
Finally, we made our way to the “magic” of art-making. The concept of flow, coined by creativity researcher Mihalyi Csikszentmihalyi, has nearly become a household word and is very familiar to artists and creative people. Stella's anxiety interfered with her ability to get to that space of full immersion, one in which nothing exists beyond the moment of pressing her fingers on the piano keys. In order to get her there we had to enter new territory. To be present, we had to look into the past. For Stella to be truly moved by the moment, unaffected by anxiety's constraints, she would have to reconcile the inherent value in music-making, in which it exists for its own sake, with the presence of an evaluative audience surrounding her. More specifically, she would have to confront her own feelings about being the center of attention when most of her past experiences created and affirmed the belief that seeking attention is a flawed attribute (yet, when the attention is there it had better be positive). Memories of being reprimanded for improvising in childhood music classes, of her father commenting on her being “too talkative” in social settings, and of being shunned by envious peers, snowballed during one of our sessions. The goal was to become mindful of how all these experiences shaped her relationship to performing, and to make a conscious choice about redefining it. It was not about her attention-seeking; it was about using the attention to communicate with listeners. It was not about her performing; it was about contributing to the abstract concept of art. It was not about what came after; it was about the moment.
Stella's experiences are common among performers such as actors, dancers, singers, and musicians. More than that, it captures the essence of many of the internal problems confronted by artistically creative populations. Problems about the pressure of sharing art with others, and about making a creative mark in spite of (or very often because of) emotional turmoil. When artistic clients want a therapist who “gets them” I understand that they are looking for some expertise on creativity, experiences (whether firsthand or vicarious), with people in the arts and entertainment world, but most importantly that are looking for someone who values and appreciates their undeniable need for creative expression.
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