Photo credit: Bed Rock Productions

At the 2015 ICSOM Conference in Philadelphia we presented an online questionnaire to be distributed amongst ICSOM delegates and their respective orchestras called the 2015 Musicians’ Health Survey*. This would be the first time since 1987 that ICSOM musicians would take part in a survey regarding performance anxiety, and after 28 years enough time had passed that it was important to check in again.

I should mention how the updated survey came to be. In 2014 we started work on a film called Composed, a documentary about how classical musicians experience and address performance anxiety. The film is now complete and touring, with a wider release online planned for next winter. It was during initial research for this film that we came upon the 1987 ICSOM Medical Questionnaire**. This survey is often referenced when the subject of beta blockers arises. At that time, 27% of ICSOM musicians reported using beta blockers as treatment for stage fright. The study also asked questions regarding alternative treatments for performance anxiety and was concluded with the need for continued training and research in this field. Since then studies have been done in other parts of the world, but none as a follow-up to the ICSOM Questionnaire here in the US.

By the time the 2015 ICSOM Conference arrived, we had worked with mental health professionals from the US, UK, and Australia to create an updated survey that would be distributed in the fall and analyzed in the UK by the Royal College of Music’s Centre for Performance Science. In November 2015 we closed the survey, then handed the results over to Professor Aaron Williamon of the Royal College of Music and his team for analysis.

Here now I am happy to present some of the key results of the 2015 Musician’ Health Survey.
The total number of participants was 447 and is broken up below by instrument and gender.

Women make up 48% of the sample (214/447), compared with 36% reported in 1987.
We also asked musicians to identify their role in the orchestra (i.e., Principal vs. Section)

Before asking questions focused on performance issues we asked musicians to rate their general health as well as how often they report exercising regularly (68%) which was up from 1987 (61%).
Regarding performance anxiety we found that 98% of participants had at one time or another experienced performance anxiety. The question was How old were you when you first experienced performance anxiety? Ages 11–15 was when most participants first experienced performance anxiety (32%), followed by ages 16–20 (27%) and ages 5–10 (15%). 11 people (2%) responded that they had never experienced performance anxiety.

Another related question was: If you experience performance anxiety, do you believe it negatively affects your performance quality? With 60.6% responding yes, 22.2% maybe, and 17.2% responding no. In the 1987 article they made clear that ‘stage fright’ was a significant issue and it appears this is still the case: “Fully 76% of musicians performing with the 48 ICSOM orchestras reported at least one medical problem which was severe in terms of its effect on performance. Stage fright was the most prevalent medical problem.”

Percentage of respondents who had used the particular technique for managing performance anxiety.

With regard to beta blockers (e.g., propranolol), the survey shows that 70% of ICSOM musicians have tried using beta blockers for performance anxiety. Out of that group, 90% said they would consider using them for auditions, 74% would consider them for solo or featured performances, and 36% would consider them for orchestra performances. By comparison, in 1987 a reported 27% of ICSOM musicians had tried beta blockers. Also in 1987 of those who’d tried beta-blockers 72% said they would use them for auditions while only 4% would use them for orchestra performances compared to today’s 36%.

Additionally, when asked about their current usage of beta blockers, with 424 responses, 36% of respondents said that they had tried beta blockers but were not currently using them, 31% said they were currently using them, 31% said they did not use beta blockers, and 2% said they were considering using beta blockers but had never tried them.

With regards to alternative methods to address performance anxiety, there were a few categories that also showed increases in usage. 74% of respondents used physical exercise to address performance anxiety up from 17% in 1987. Additional increases were found in massage (37%) up from 4%, yoga (33%) up from 9%, and Alexander technique (30%) up from 4%. Experience was the method used by most respondents at 87% and was also found to be one of the most effective means of addressing performance anxiety with 36% of respondents believing it was somewhat effective and 44% believing it to be very effective.

In our last questions about the issue of performance anxiety we presented the question: When do you think musicians should be educated about the strategies which address performance anxiety? Participants could choose multiple answers that included Initial introduction to music (9%), High school years (29%), Higher education (46%), Post-graduate education (23%), Professional settings (21%), During all stages (37%), It should not be discussed in these settings (2%), and other (4%).

Thirty years ago it was clear to researchers that additional resources and training were necessary to the success of ICSOM’s musician community: “Given the proportion of professional musicians reporting medical problems severe enough to affect performance, there can be little doubt that music medicine is a field which deserves serious attention from health professionals. There is an urgent need for techniques to treat and prevent a variety of occupation-related medical problems. Information on these problems should be disseminated to musicians and their physicians, teachers, and other concerned professionals. ICSOM has done much to open up the issue of music medicine. Clearly, the magnitude of the problem warrants continued work in the field.” Today we have a plethora of resources available for musicians to seek, but the community at large still finds this a difficult topic to discuss openly. Our hope is that this information and other resources become commonplace in both our training and professional lives.

Our sincere thanks to the ICSOM Governing Board, delegates, and member orchestras for taking part in this survey. Their participation helps inform this current and future generation of musicians looking forward to improved performance resources and experiences.

Note: The Author is the director and producer of Composed. Learn more at composeddocumentary.com.

*The survey contains questions from the original 1987 ICSOM Survey, Prof. Dianna Kenny’s The Psychology of Music Performance Anxiety, consultants and our administrators. Consultants for the 2015 Musicians’ Health Survey include Professor Aaron Williamon, Dr. Noa Kageyama, Professor Dianna Kenny Ph.D, Dr. Julie Jaffee Nagel, and Dr. Molly Gebrian.

**Fishbein et al., “Medical Problems Among ICSOM Musicians: Overview of a National Survey,” Senza Sordino Volume 25, No. 6 (August 1987),
http://www.icsom.org/senza/issues/senza256.pdf.