Wednesday, May 25, 2005


Performing in front of any audience usually makes one nervous. As a rule of thumb, the more sensitive a person is, the more his/her nerves can affect the performance.

Some people thrive on the rush of adrenaline, and they do better in these situations than normally. Others can be absolutely petrified by fear or they panic on the stage. Interestingly, the physical manifestations can be very different. Someone speaking may stutter or have an uncontrollably tight voice. An instrumentalist often worries most about memorizing a piece. The adrenaline can increase the fear factor in this area: the individual loses control and everything seems to fall apart. Physical symptoms may include overall shaking, or this happens unilaterally. Among string players, there are those whose bow shakes, especially on long slow notes, or others whose vibrato becomes far faster than they intended. Sounding hysterical in a slow passage is many players’ worst nightmare.

In order to combat the fear, musicians and other performers have often turned to alcohol, which in moderation can have a relaxing effect. But with larger amounts one loses control, just like driving a car. John Barbirolli was said to be only able to conduct well when drunk and was rather helpless when sober. I’ve known a number of alcoholic conductors. Perhaps that profession isn’t critical with accuracy as one isn’t heard. During the decades when hard drugs, such as cocaine and heroin, were widely available, artists were some of their most eager advocates. I’ve known many instrumental soloists who can only play after smoking a joint or two and are able make beautiful music in this altered state.

Today’s prescription drugs offer help in many areas. For those why are simply very anxious, Valium®, Xanax® or another benzodiazepine may do the trick. Most of us, however, turn to beta-blockers, which compete with adrenaline at the beta-adrenergic receptors, and are often able to block the physical manifestations of sudden nervousness.

Years ago, I was lucky to have been friends with an eye surgeon, who had previously specialized in pharmacology and was one of the first people to do research on propranolol (Inderal®) in this country. He taught me how differently this drug acts on the body, depending on the dosage. When taken for high blood pressure, up to 640 mg per day is necessary, and in treating schizophrenia, the dosage can be even many times higher; but in order to control shakiness, only a fraction is needed. Actually, a higher dosage will affect one’s fine motor skills and interfere with blood flow to fingers. This doctor took 10-20 mg before performing eye surgery: that was enough to counter the shakiness but it wasn’t too much to affect his performance; both important factors when he had to perform such extremely delicate operations. Personally, although I don’t believe in having to take drugs, I was greatly helped by just 5 mg during the many years I had to be on prednisone for a connective tissue problem.

It is quite easy to hear when a string player has taken propranolol, especially if he/she isn’t used to doing so regularly. This is most evident during auditions. Vibrato becomes slower and wider than normal and pitch accuracy suffers. I would advise that nobody take a beta blocker without first getting used to it, and knowing what its effects are going to be. There are, of course, numerous other drugs in this class, but from personal experience, most of them are better in lowering one’s blood pressure, and perhaps slowing one’s heart rate down, than preventing shakiness. But with the help of a willing doctor one can experiment, if this is the route one needs to take. Of course, in my opinion, it would be best if one could do without drugs.

With students the above remedies are out of question. We cannot fill preteens or teens with anti-anxiety agents or other drugs, or make them drink, which is against the law. Having had terrible stage fright as a youngster, I know how unpleasant playing in public can be. However, practice helps, and the more the student gets to play, the easier it will become. If memorizing is the main problem, let the student leave the music in front of him/her as security. After enough times, it need not be there any longer. Meditation and relaxation techniques do help. In this society though, it is hard to picture a young person, whose life is a constant pressure cooker, to find the time and understand the need for this. I was taught to picture people in the audience as heads of cabbage. This sounds like a wonderful idea; unfortunately this wisdom is easier said than done.