For performance anxiety, try the ‘four-pronged approach’

I know anxiety. I’ve known it for so long it’s like an old piece of furniture in the lounge room of my life. It’s like a hard, small rickety chair that you sit uncomfortably on the edge of, never able to relax fully on as you wait for it to collapse beneath you.

But time has allowed me to appreciate its place: it has positives, like urging me to never rest on my laurels and I’ve become more casual around its fragility: “Hey chair, if you’re going to break, break. I’m not tip-toeing around you any more.”

Avoidance doesn’t help anxiety, but there are effective strategies that do work.Credit:Stocksy

Time, treating my body better, having a kid and being in a relationship where I feel accepted for all parts of me, including the rickety breakable bits, have allowed me to be more comfortable with the uncomfortable feelings of anxiety; that chair I once tried to paint and hide away.

Learning self compassion and meditation, a skill I don’t practise formally but drop in to at times, like when I’m on the edge of that chair, have also helped.

But, there is one type of anxiety I haven’t managed to harness in my 38 years.

I am among the one in six who experience social anxiety at some point in their lifetime. One of the most common forms of social anxiety is performance anxiety, which is what I, too, have struggled with.

It has led me to avoid public speaking events, pull out of them or crumble in the middle of them. The last time I spoke at a conference, two years ago, I had a panic attack 10 minutes before going on stage; my heart leapt in my chest violently and I felt so dizzy my vision blurred.

I managed to bumble my way through it, so stiff from panic that it was as joyless to watch as it was to execute.

So much for exposure therapy, I thought, making a mental note to never do that again.

But the problem I have found with anxiety is that avoidance only feeds the fear and your world shrinks in proportion to it.

When I was asked to interview Dr Michael Mosley in front of 1300 people at the Happiness and Its Causes conference two weeks ago, I decided it was time to deal with the demon that so many of us face.

There are such effective strategies for dealing with anxiety … and it's possible to turn things around in weeks.

Clinical psychologist, Dr Jodie Lowinger is the founder of the Sydney Anxiety Clinic and coaching clinic  Mind Strength. “Performance anxiety is so prevalent in the modern day. It’s one of the most common things I work with,” she says.

Anxiety is “core to our survival” as it underpins our fight or flight response, helping us escape danger, Lowinger explains, but when it causes prolonged fear, suffering or avoidance it becomes problematic in people’s lives.

It is “probably reflective” of two different kinds of fear: Fear of failure – “of not being good enough” – and fear of being judged in a negative way.

She calls anxiety a “double-edged sword” that some are more susceptible to than others. “I often see people with an analytical mind and depth of feeling which leads those individuals to really awesome stuff, but it also makes them more predisposed to anxiety.”

Luckily, she says there are effective strategies for dealing with anxiety.

I tell her that I’ve been chatting to others about their techniques for dealing with it.

One friend solemnly advised me to clench my butt. “It’s a trick performers use when they’re nervous,” she told me. “It brings the blood and attention down from your head.”

The writer onstage with Dr Michael Mosley.

Another suggested beta blockers (blood pressure medication that can calm the body’s physical response to anxiety) and remembering that those watching “want you to be great” and besides “everyone’s mainly thinking about themselves and don’t really care about your performance at the end of the day”.

This is true, although I’ve found that rationalising the irrational (anxiety) is an uphill battle when you’re in the midst of it.

Lowinger says that butt-clenching might give you “glutes of steel” but is a safety behaviour.

“It’s a distraction technique,” she explains. “It might help in the short-term but it won’t help in the long-term.”

Beta blockers are the same. “‘Safety behaviours’ [are] where people only think they’re okay because of something else they are doing (similar to checking or reassurance seeking) and it undermines their ability to learn they would have been okay anyway,” Lowinger says, adding: “At a general level I’m not anti medication however beta blockers might be considered similar to strategies for numbing the symptoms in the present moment rather than treating the anxiety per se.

“There are many cases where psychological intervention alongside mind-body strategies such as exercise and meditation have extremely successful results without any medication.”

Instead, she says an effective evidence-based strategy is the “four-pronged” approach:

I ended up taking a four-pronged approach of my own: I butt-clenched, I took a beta blocker, a slowed my breathing and I focused on what I valued, which in this case was the courage to embrace challenge. The experience was, dare I say it, enjoyable but I now know beta blockers and butt clenching aren't necessary. I just wish I'd spoken with a professional sooner.

“The key is not to suffer in silence,” Lowinger urges. “There are such effective strategies for dealing with anxiety … and it's possible to turn things around in weeks.”

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