Short-Term Psychodynamic Psychotherapy (STPP) for a Severely Performance Anxious Musician: A Case Report

Dianna T Kenny

doi:10.4172/2161-0487.1000272

Abstract

Most people experience performance anxiety (PA) at some time in a range of diverse endeavours. However, for those in careers related to the performing arts (music, theatre and dance), public speaking, or sport, it can be a career-limiting or career-ending experience. Little attention has been paid to performance anxiety, empirically, diagnostically, or therapeutically. This paper contributes to the theory proposed by Kenny that the underlying psychopathology of severe performance anxiety is an attachment rupture in early life that is unresponsive to cognitive behavioural therapies. Accordingly, a short-term psychodynamic psychotherapy (STPP) whose therapeutic focus is the resolution of attachment ruptures was undertaken with a young female musician who was in danger of failing her final year at a prestigious music school because she could no longer perform without breaking down. This paper describes the application of the triangle of conflict and the triangle of time/person in the resolution of the attachment ruptures of the three key attachment figures in the life of this young musician. This paper represents only the second detailed case report on the treatment of debilitating music performance anxiety using STPP. Given the successful outcome of both case reports, further investigation of this therapeutic approach for severe performance anxiety is warranted.

Highlights

The Extent of the ProblemPerformance anxiety is a very common source of psychological distress
In the DSM-IV [1] and DSM-IV-TR [2] performance anxiety is briefly discussed in a section on differential diagnosis in social phobia
The aim of this paper is to contribute to a better representation and understanding of the third proposed subtype of music performance anxiety (MPA) that I observe in my clinical practice, which constitutes the most debilitating form of the condition and to report on the efficacy of short-term psychodynamic psychotherapy (STPP)

Summary

Introduction

Performance anxiety is a very common source of psychological distress. Most people have experienced it at some time in any one of a range of diverse endeavours that include test-taking, mathematics, and sexual performance. For those in the performing arts (music, theatre and dance), public speaking, or sport, it can be a career-limiting or career-ending experience. Performance anxiety, stage fright, and shyness in social situations that involve unfamiliar people (a potentially hostile audience) are common and should not be diagnosed as Social Phobia unless the anxiety or avoidance leads to clinically significant impairment or marked distress. A diagnosis of Social Phobia should not be made in children unless the social anxiety is evident in peer settings and persists for at least 6 months [2]

Objectives

Methods

Findings

Conclusion