Performance pressure never goes away — so how do we deal with it?

Winning on Stage

Volume 119, No. 8September, 2019

Dr. Don Greene

The most natural remedies for dealing with performance anxiety may be the most effective, including prayer, meditation and yoga. (photo by Milkos)

My column last month about beta blockers got lots of great feedback, and I want to give you some follow up. I wrote that beta blockers are widely used by musicians to lower their heart rate and blood pressure, and to decrease other physiological symptoms of the fight vs. flight response. Like any other drug, beta blockers have several side effects, including dependence and increased tolerance. While these drugs may produce temporary relief, they do nothing to take away the inner feeling of dread or improve your confidence. They do not solve the underlying causes of nervousness, and they will never produce your best performances.

In the meantime, beta blockers will make focusing on the task at hand under pressure even more difficult. It takes immense energy to concentrate intensely for extended periods of time, like playing three rounds of auditions, the Ring Cycle, or gaining tenure after winning an audition with an orchestra. Beta blockers will not increase your ability to trust your talent and to go for it, while causing a false sense of security. Eventually, the diminished returns and risks of taking the drugs will outweigh the potential benefits.

Dr. Richard Ginsburg at the Harvard Medical School wrote, “Some level of anxiety is good for performance. It keeps you in your game. A beta blocker can take away some edge, mellow you too much. Adrenaline is an important hormone for maintaining a sense of vitality, power, and well-being. Blocking it can cause fatigue, lethargy, weakness, and depression.”

Many of my students and clients have asked me about using beta blockers before important events. I never ask them not to use beta blockers, but ask them to consider that they could perform much better without them.

If they want to wean themselves off beta blockers, I make sure they know that it will take some time and an effective plan. I do not recommend quitting abruptly by going cold turkey, especially if they have some important performance or auditions coming up soon. The practical solution is to learn more effective and natural ways to deal with the anxiety that often comes with performing classical music in front of an audience who expect you to do well. Here are some ways that I recommend:

Make a plan

First, make up your mind that over time, you’re going to learn how to use your extra performance energy to achieve your peak performances under pressure, rather than trying to suppress the energy with beta blockers. Set reasonable goals for how long it may take, as well as tangible rewards for doing so.

Next, consult with your physician about gradually tapering off the drug. You need to learn more about the drug and specifically how it affects you, your body chemistry, and your mind. Tell your doctor about any and all other drugs that you’re taking. Ask about the half-life of the beta blocker and how long it takes to metabolize out of your system. Then find out if you can start taking half the usual dosage for two weeks, and then possibly half of that as the next step, two weeks later.

At each step, you want to notify your doctor about any adverse reactions you are experiencing. It may take two months or more before you notice any remaining symptoms. Your body and mind need to relearn how to deal with stress and adrenaline without beta blockers. Your heart may race at times, and your blood pressure might skyrocket for a while, until you learn how to manage your anxiety by channeling the extra energy into power, presence, and focus. That energy is what wins Olympic gold medals and orchestral auditions. That’s how I train athletes and performers to thrive under extreme pressure, when it really counts, without drugs.

Magnesium and complex carbs

There are several different things you may consider to help you deal with anxiety. You might change your diet to include foods that are rich in magnesium, such as spinach, almonds, halibut and mackerel. Other foods that can reduce anxiety are complex carbohydrates, salmon, olive oil, garlic, sunflower seeds, dark chocolate, walnuts, bananas (very good an hour before you perform), pomegranates, blueberries, raspberries, apples, strawberries and pineapples. You can also drink decaffeinated green tea or chamomile tea. Try to reduce or eliminate caffeine, alcohol and carbonated or sugary drinks, and replace them with pomegranate juice or vegetable juice, and lots of water.

Supplements and vitamins

There are also herbs that may reduce anxiety: hawthorn, indian coleus, passion flower, kava extract, St. John’s Wort, ashwagandha, inositol, 5-HTP, bacopa monnieri, rhodiola rosea, and lavender. You might consider certain vitamins or supplements like vitamin A, B, C, niacin, calcium, antioxidants (lycopene and beta-carotene), and fish oil, as well as certain amino acids: GABA (Gamma AminoButyric Acid), L-Arginine, Tryptophan, and L-Theanine. Please check with a qualified health practitioner about dosage, proper use, and potential side effects before using any of these substances.

Discussing anxiety

Teaching performers how to deal with their nerves and performance anxiety is a new model of pedagogy. Many music, voice, and dance teachers do not discuss this important topic with their students or offer them viable solutions. Some teachers may need proper training in dealing with anxiety just as much as their students. It is best to surround yourself with people and materials where you can openly communicate about any anxiety felt.


While beta blockers may help reduce the physical manifestations of performance stress, no matter how much you take, they don’t produce any meaningful mental or emotional changes. This means they don’t decrease negative thinking, mental noise, doomsday thinking, or worrying, nor do they increase desire, motivation, inspiration, resilience, courage, or mental toughness. Creating positive affirmations, writing them down, and repeating them can have a strong effect on your confidence by reprogramming your negative self-talk.


Nothing takes the place of daily practice and proper preparation, which are very real and practical solutions to managing one’s performance anxiety. If you need to upgrade your technical skills, find a teacher you respect and follow their guidance. Plan to practice, practice, practice, both physically and mentally, every day. There is no substitute or better way to build your confidence and sense of competence. Strive for excellence, not perfection, daily in the practice room.

Natural remedies

In my opinion, the most natural remedies for dealing with performance anxiety are the most effective. These include aerobic exercise, meditation, prayer, mindfulness, zazen, positive affirmations, yoga, Chi Gong, breathing techniques, T’ai Chi, cognitive-behavioral therapy, guided imagery, sufficient rest and sleep, neuro-linguistic programming, Aikido, biofeedback, EFT, systematic desensitization, self-hypnosis, mental rehearsal, autogenic training, the Silva Method, and my personal and professional favorite, the Centering Process. I recommend that performers master the Centering Process to control and channel performance energy without taking beta blockers. It’s the main strategy that I’ve taught to hundreds of clients and students at Juilliard, the New World Symphony and the Colburn School.

Let’s get real

Performance pressure will never go away. You can just learn better ways to handle it. Some methods are more beneficial (and less harmful) than others. My belief is that beta blockers will prevent you from achieving your full potential as a musician. If you’re interested in doing your absolute best, I suggest that you pursue extra energy and excellence, not the comfort and relaxed state that you may get through drugs. I always recommend to those clients who wish to feel comfortable and relaxed, “Either go lie on the beach in Hawaii or choose to learn how to use your performance energy to do your best when it counts.”

To learn more about my Centering exercises, please visit my websites (see below) and look for the courses.

Dr. Don Greene, a peak performance psychologist, has taught his comprehensive approach to peak performance mastery at Juilliard, Colburn School, New World Symphony, Los Angeles Opera Young Artists Program, Vail Ski School, Perlman Music Program, and the U.S. Olympic Training Center. During his 32-year career, he has coached more than 1,000 performers to win professional auditions and has guided countless solo performers to successful careers. Some of the performing artists with whom Dr. Greene has worked have won jobs with the Metropolitan Opera Orchestra, Concertgebouw Orchestra, New York Philharmonic, Chicago Symphony, San Francisco Opera, Montreal Symphony, Pittsburgh Symphony, National Symphony, Cincinnati Symphony, Pacific Northwest Ballet, and the Dance Theatre of Harlem, to name just a few. Of the Olympic track and field athletes he worked with up until and through the 2016 games in Rio, 14 won medals, including five gold. Dr. Greene has authored ten books including “Audition Success,” “Fight Your Fear & Win,” “Performance Success,” and most recently “College Prep for Musicians.” In 2017, Dr. Greene was named a TED Educator and collaborated with musician Dr. Annie Bosler to produce the TED-Ed talk “How to practice effectively…for just about anything.” The video went viral and received over 25 million views across Facebook and YouTube. For more information, visit, and