Music performance anxiety: A clinical outcome study into the effects of cognitive hypnotherapy and eye movement desensitisation and reprocessing in advanced pianists

Abstract

Numerous investigations into music performance anxiety have focused on the conscious mind. However, little research has focused on implicit processes for alleviation of this condition. Cognitive hypnotherapy (CH) and eye movement desensitisation and reprocessing (EMDR), therapies which target implicit processes, were investigated in an intervention study with advanced pianists (n = 46). Participants were of mixed gender aged 18-26 years (three over 30) and were randomly assigned to a therapy or control group. The therapy groups received two interventions of either CH or EMDR during a two-week period between two concerts. Quantitative data were collected through performance assessment, the Spielberger State-Trait Anxiety Inventory and a self-report questionnaire (SRQ). The SRQ and a log of performance experience also allowed for qualitative assessment. Results showed that both therapy groups (but not the control) experienced a significant reduction in state anxiety post therapy and a significant improvement in performance. Trait anxiety decreased significantly below baseline levels post intervention in the EMDR group. This is an important area for future research in music psychology and has broader implications in other fields. Keywords cognition, implicit processes, intervention, state anxiety, trait anxietyCognitive anxiety is a psychological problem, the causes of which can be deeply embedded in the unconscious mind (Alladin, 2010). It exerts a negative effect on human behaviour, including music performance; the research literature validates this extensively (Kenny, 2011 Kenny, & Cooksey, 2007). Music performance anxiety (MPA) is widespread, affecting musicians of any age, instrument, amateur and professional musicians alike (Kenny, 2011) and over 60% of performing musicians experience this sometime during their lifetime (Wesner, Noyes, & Davis, 1990). Females generally exhibit higher degrees of MPA than males (Osborne & Franklin, 2002;Wesner et al., 1990) and solo performance generates higher levels of MPA than ensemble (Brugués, 2011). Music performance anxiety has been widely investigated; however, the problem still persists (Chan, 2011;Huang, 2011;Plaut, 1998;Shoup, 1995;Sloboda & Juslin, 2001;Williamon, Aufegger, & Eiholzer, 2014;Xu, 2010). The components of anxietyPerformance anxiety lies within the broad domain of social anxiety, occurring when psychological discomfort in situation-dependent states leads to anxiety (Crozier & Alden, 2005). A model of anxiety proposed by Lang, Miller, and Levin (1988) demonstrated that the combination and interplay of three factors -cognitive, physiological and behavioural -appear to be responsible for anxiety. Lang et al. (1988) maintained that anxiety is the interaction of fearful thoughts, arousal of the autonomic nervous system, and overt behavioural responses to perceived threat. Cognitive anxiety was first categorised into a two-factor structure having both trait and state components (Cattell, 1956). Traits are developed in early life and reflect residues o...

Cognitive Hypnotherapy

“…They were tested in two concert performances pre-and post-intervention. Significant decreases in performance anxiety (the cognitive, physiological and behavioural aspects of performance) were found in both the therapy groups but not in the control group [66]. This research was extended when trait levels of anxiety (an individual's general anxiety level) were tested at 4 months and 1 year post-intervention.…”

“…However, the literature reports that no theory/therapeutic action is without flaws, and a number of issues have been identified with the CBT approach: the failure to consider experiences in the past in relation to the present in generating anxiety; the effective role that cognition plays on physiological symptoms in the body; the failure to recognise the role of the unconscious mind in overt behaviour; and the failure to recognise that human thought and action are socially embedded [46]. Further to this, evidence from the literature indicates that one of the main drawbacks with CBT is the number of sessions required to effect positive change (10 or more sessions in some cases) [47].…”

“…Practitioners of hypnosis often employ techniques used by CBT therapists [48]. However, the protocols and procedures adapted by hypnotherapists explore past and present negative experiences in relation to the presenting problem, together with DOI: http://dx.doi.org /10.5772/intechopen.91327 the effect of cognitions on physiological and behavioural outcomes [47]. It is argued that the addition of these protocols with the added impact of hypnosis incorporated with CBT is a means of enabling a quicker and stronger resolution to the clinical condition [22].…”

“…Using two groups, it was found that the hypnotherapy group but not the control group showed a significant reduction in MPA post-intervention, which was still evident 6 months later. At that time, there were no definitive protocols and procedure for the adoption of CH as an intervention for MPA but these have now been recently documented, giving guidelines and clear directives for the process of integration in this domain [47].…”

An investigation of relationships between Flow Theory and music performance anxiety

“…Music performance anxiety (MPA) describes "a particular state of arousal, which regularly occurs when musicians present themselves before an audience in performance situations" (Spahn, 2015, p. 129). The incidence of MPA in different fields is quite high, including orchestral musicians (Fishbein, Middlestadt, Ottati, Straus, & Ellis, 1988), student actors (Andrew et al, 1995), choral singers (Ryan & Andrews, 2009), pianists (Brooker, 2018), dancers (Walker & Nordin-Bates, 2010), and non-music majors (Roberson & Kenny, 2017).…”