Self-Consciousness and Performance Anxiety

Most of us have had the experience of hearing a recorded version of our own voice and thinking, “I don’t really sound like that.” In preparing the first two videos for my website and new YouTube channel, I’ve had to observe myself in a similarly unfamiliar way. As I’ve seen myself on camera — editing different takes, perceiving my discomfort, watching myself fumble because of anxiety — I’ve had to take a different look at how I appear to others. At the same time, this has brought me into closer contact with my own self-criticism; I’ve had to confront that savage inner voice in ways I don’t usually do.

That critical voice tells me things in ways that aren’t particularly useful, but there’s often an element of truth. Getting feedback from friends and site visitors has helped me to filter our the harshness and distill everyone’s observations (including my own) into something useful. The best reality check came from a client who viewed the first video on bipolar disorder and told me I didn’t seem at all like the person she’d known for so many years. She could see I was struggling; she commented on my anxiety. I think she meant that I didn’t seem at ease and lacked my usual self-confidence. To me, it feels a lot like playing the piano. If I’m alone, I can play my current piece almost perfectly, completely immersed in the music, almost without self-awareness; if you give me an audience, I’ll become self-conscious and start to fumble. I’m sure many of you have had similar experiences.

These situations involve the process of projection, where our own inner critic is projected outside into the audience. Artur Rubinstein, one of the greatest pianists of the 20th century, suffered from such severe performance anxiety that he would become physically ill before each concert and sometimes had to be forced onto the stage. The pianist father of one of my clients was so crippled by stage fright that he eventually abandoned his concert career and spent his life teaching instead. For some reason I don’t entirely understand, this process of projection seems to intensify the self-criticism. Maybe it’s because instead of one critical (internal) observer, you have thousands outside, each one of them just as critical as you are. In recording myself on camera, I’m no doubt inhibited by the fantasy of potential viewers watching me and finding fault. So maybe if I’m very careful and controlled, I can avoid doing that one thing or expressing myself in that one particular way that all of you out there will criticize!

For that reason, what comes across most to me as I watch myself on camera is my guardedness. I’m trying so hard not to make a mistake! As a result, I lack spontaneity or a sense of ease, and several of my personal qualities seem to be missing: my warmth, first of all. More than one friend has told me I need to smile more, the way I do in social interactions; but what exactly is there to smile about when discussing the extreme suffering behind major symptoms of depression and manic flight? In a similar vein, I have a lively sense of humor. I like to laugh a lot; even in sessions with clients, we’ll often laugh together about something we both find funny. How to convey that in a video for an audience of people who don’t know me? It’s hard to laugh “with” a camera, even if I could find something to laugh about in bipolar disorder. An actor-friend who has done a lot of work on television told me I need to address the camera as if I were speaking to somebody I know well, explaining my ideas to an intimate. Okay, I’ll work on that one.

A part of my anxiety also comes from not wanting to appear narcissistic, as if I think I have all the answers. It should be obvious from this website that I don’t believe in answers or solutions of the kind so many mental health professionals seem to offer. I also spent a lot of time in a professional community where it was too often personal charisma — the appearance of having it all together and knowing the answers — that made people want to connect with you. And yet, here I am, putting myself on video and promoting myself as an authority. Surely that is narcissistic behavior of some kind. What makes me think I have the right to put myself forward in this way?

I do think I have something of value to say, a point of view that’s different from most of what’s available in the mental health community at large and online. Video has become increasingly important for reaching an Internet audience, so as uncomfortable as it makes me feel, I’m committed to putting myself forward in this way. I expect that in time, I’ll get better and more relaxed with the process. If you haven’t seen it already, I’ve made a second effort, a piece about narcissism and ‘The Social Network’. You can view that video by clicking on the Vimeo link below.

I think this one is a little better. There’s even the hint of a smile at the very end!

Different Types of Depression

As I discussed in an earlier post, most people use the word “depression” to describe many separate and distinct experiences — grief, disappointment, mild forms of unhappiness, etc.  When I use the word here, I mean clinical depression, the sort of mental and emotional suffering that sends people into therapy or to their physician for prescription-based relief.  I’ve seen many depressed men and women over the years; from my experience, the roots of their suffering usually lie in three common areas.  I’d like to offer some thoughts about these types of depression and their origins.  I don’t view them as necessarily distinct; they often overlap and mingle in various ways.

1.  Post-Apocalyptic Rage:

Beginning with Freud, psychotherapists have noted the frequent connection between anger and depression; you may heard depression described as “anger turned inward.”  I’d take this a step further and say that explosive and violent rage often lies at the heart of certain severe forms of depression.  I use the phrase “post-apocalyptic” because, with many severely depressed clients, I have felt almost as if a nuclear bomb has gone off inside them, devastating their minds and laying them waste.  Such clients might make it to session but lie inert and mute on the couch; they might say they feel nothing, or describe their body as feeling numb, weighted down by a pressure that flattens all emotion.  In the room with these clients, I often feels as if meaning has been completely destroyed and the emotional realm is void.  Such clients might describe themselves as feeling no interest or motivation to do anything.  They often mention intense pressure around their eyes or face.

Re-creating the emotional events that led to this state of devastation takes time and patience.  The task is complicated by the fact that the rage is almost always unconscious:  the client has no idea that he or she has been raging.  Sometimes you might hear hints of it in the client’s material when he or she begins to speak; more often, you see it in dreams or simply feel it by intuition.  The landscape of the apocalypse often appears in the dreams of depressed people: bleak ghettoes, vast lifeless deserts or scorched terrain borrowed from movies such as The Terminator.  If you have a strong empathic link with your client, you may find feelings of rage rising inside you during the silence, for no reason you can understand.

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Art and the Dread of Experience

Over the years, I’ve worked with a number of artists — musicians, a choreographer, several writers — and dealt with various types of artistic inhibition such as writer’s block.  In our work together, my clients and I  struggled with issues that might be familiar to you:  perfectionism, grandiosity of the type described in my post on self-criticism, as well as the self-envy that may lie behind fear of success. With several of my clients, I came to understand another such difficulty in making art, where the original inspiration or emotional charge behind the work of art is killed off in the process of creation.

In an earlier post on anxiety attacks and disorders, I introduced the concept of mind as a container for emotional experience; I discussed how people with “insufficient mind” — that is, an inability to contain and manage their emotional experience — often feel terrified that strong feelings will overwhelm and annihilate them.  Several of the artists in my practice fit this description.  One of them was prone to anxiety attacks and states of disintegration; another led a very controlled life, without much human emotional involvement; a third showed symptoms of autism and often tried to shut out a world that stirred up such terrifying emotions.  These difficulties also affected their creative processes.

Over time, we came to think of the work of art — be it a choreographic work, a song or a piece of fiction — as a sort of container for their emotional experience.  It’s how I think about art in general:  great works of art contain and express profound emotional experiences; optimally, the shape of that container (the individual and unique painting, novel, symphony, etc.) bears an organic relationship to what is contained, adapting its shape to the needs of authentic emotional expression.  I hope that doesn’t sound too abstract; as a clinician, I have found it an incredibly helpful way to think about my artist-clients.  The artist works upon his or her “insights” and tries to create a uniquely powerful work of art that will convey powerful emotion (basic human truths) to an audience.

With several of my clients, they started off with a powerful feeling or insight but in the process of creating their work of art, deadened it.  The art they produced (in their own view, not mine) lacked “depth” or “dimension”:  dance works felt “constipated”, their performers trapped in choreography with constricted movement and little emotion; songs seemed simplistic and boring, without true feeling; characters appeared “flat” and “two-dimensional”.  In our culture, we frequently use these exact critical terms:  lack of depth, flat characters, two-dimensional stories, etc.  A vital artistic container has three dimensions and its own sort of life force; it has an interior and a surface or “skin” with which we, as audience, can interact.

Unsuccessful works of art have little dimension.  Rather than containing and conveying powerful emotion, they stifle it.  The artist who is terrified of intense emotion may mis-use his or her art form, employing it to flatten feelings instead of expressing them.  For that reason, the works of art they produce will leave an audience feeling “cold”, indifferent or bored.  In short, rather than conveying profound and intense human truths, such art works seek to deny them.

Recently, one of my clients (an aspiring and frustrated writer) brought in a dream that perfectly illustrated this process.  She was treading water in a pond along with some “cowboys”.  The pond felt like a whirlpool and they were all in danger of being sucked down into it.  The only way to save themselves — that is, to keep from drowning — was to tell one another non-stop stories while treading water.  At the same time, each of them had to hold onto a piece of raw meat that had been vacuum-sealed in plastic.

The cowboys are linked to the Wild West, a frightening way of life without the restraining influence of law and civilization.  Raw meat connects to raw emotion.  The dream shows how my client is terrified of her own raw emotional experience; in order to save herself from being overwhelmed by that experience, she resorts to “art” (telling stories) as a defense.  In the process, she shrink-wraps her experience and makes it safe, no longer raw and vital but hygienically processed, like something you might find in a supermarket meat case.

Finding Your Own Way:

I know that a number of visitors to this site are artists; I’d welcome your input on this subject.  What sort of artistic inhibitions have you struggled with?  Does this description in any way resonate with your own experience?  What about your view of other artists and their work?

As for the rest of us, we might begin with our relation to different art forms and how they affect us.  Think of a movie you found boring and ask yourself why.  Was it because the characters were flat, the story lacking in dimension?  Movies that portray extremely black-and-white characters often leave me cold because they strike me as a denial of a basic truth, that humans are a mixture of good and bad, each of us struggling with unavoidable ambivalence. What about novels you put aside and never finished?  Was it because they failed to engage your emotions?  Did they seem flat and lacking in dimension?

Many of us have artistic urges and never manage to fulfill them.  Maybe it’s because we lack time and self-discipline; maybe it’s because we don’t have the patience to master the needed skill.  Another possible explanation, suggested by this post, is that we grow bored with the process, bored with our own creations, and abandon them.  Sometimes people take up a “hobby”, an artistic endeavor that holds meaning, and in the process somehow render the experience meaningless to them; often it’s because they simply can’t sustain intense emotional involvement with themselves and their art form.

Existential Aloneness

During a recent session, my client Ellen was talking about how poorly she had done over our two-week Christmas break, in terms of looking after herself and using what she’d learned in treatment.  It worried her and she didn’t  understand why it should be so since she’d recently been taking much better care of herself.  Coming back to her first session after the holidays seemed immediately to make her feel better, less distracted by the fantasies and obsessive thoughts that had troubled her during the break. I had some ideas about why this should be so but didn’t at first mention them; I waited to see where this train of thought would take her.

Later in the session, Ellen mentioned that she’d had a “scare” earlier in the week.  She works as personal assistant to the boss of a medium-sized company; her boss had been away during the holidays and in his absence, some of his oversight duties had fallen onto her shoulders.  She took off a few days herself during that period but because her boss was away, she felt it would be irresponsible to take as many days as she would have liked; this made her feel resentful, to have to deprive herself in order to fulfill her duties.

On the first day after her boss returned from his vacation, it occurred to Ellen that she should probably consult the firm’s calendar (which she had failed to do for a week or so), to see whether there might be an upcoming due-date for one of the firm’s projects.  Sure enough, there was a project due that very day; she alerted the appropriate personnel and in the nick of time, they managed to complete the assignment for delivery.  It troubled her that she had “forgotten” all about the calendar and wondered why she should have remembered on that very day.

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Insufficient Mind in Anxiety Attacks and Disorders

This discussion may sound a little abstract at first but it’s crucial for understanding many psychological difficulties, especially in the realm of anxiety attacks and disorders.  It concerns the literal inability to tolerate one’s emotions. In an earlier post, I discussed how hatred can function as a kind of glue to hold the psyche together when a person is unconsciously terrified of falling into pieces under the pressure of intense experience; in my most recent post, I described the fear of psychic disintegration lying behind some anxiety symptoms and panic attacks.  If you haven’t done so already, it would help to read both those posts before this one.

In my psychotherapy practice, I find it useful to think of the mind as a sort of container for emotional experience.  Think of emotions and feelings as shapeless liquid and the mind as a vessel that holds and gives them form — that is, it makes sense of them and gives them meaning.  I know this sounds a little abstract; an example might help make it less so.  Say I’m watching a movie and I start to feel a sensation around my eyes and at the back of my throat.  There’s a tightness in my chest, too; my breathing becomes a little quivery.  My mind brings all those sensations together, and from past experience, I understand that I am feeling sad.  This isn’t a conscious process, of course, but I do believe it’s how we assign meaning to inchoate experience.

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