Beta Blockers for Performance Anxiety: What They Fix, and What They Don’t

Somewhere in the hour before a concert, a musician makes a decision. The propranolol is in the bag. It has been in the bag for months, sometimes years. Taking it means the hands stay steady and the passage comes out. Not taking it means finding out which version of yourself turns up tonight.

Most articles on this subject are written to talk you out of it. This one is not.

Beta blockers work. Adrenaline lands on receptors in your heart and your hands, the drug occupies the receptor first, and the tremor never arrives. Musicians who use them play more like they do at home, away from audiences’ eyes and ears. Some find they have more expressive room on stage than they have ever had, because the anxiety is gone and there is suddenly space to listen. These are valuable benefits, but there’s a hidden cost.

This article explores the nature of that cost, and why the cost happens to be the reason you started playing music in the first place.

What is the playing for?

Whether a beta blocker costs you anything at all depends entirely on what you think the performance is for. That question is older than the pharmacology, and I answered it this way in Soulforce:

The purpose of art is to bring us alive; to connect us with something bigger than our individual selves; to inspire, heal, and foster community. These are universal human needs whose fulfillment provides a necessary sense of meaning, purpose, and belonging. Without them, life becomes a dry, dusty bone.

The greatness of a work of art is in direct proportion to the degree it serves this higher purpose; the more it does so, the more it enriches the lives of those who behold it. By the same token, without the guiding light of this higher purpose, a work of art can become vulnerable to financial, social, technological, or political influences, and thereby risk losing its essential transformative power.

Read that last sentence again with a pill bottle in mind.

The pull on you in the hour before a concert is a perfectly reasonable one. Get through it. Get the notes right. Do not embarrass yourself in front of people whose opinion you care about. A beta blocker serves that pull beautifully.

The trouble is that the pull to take beta blockers is not totally in alignment with music’s true purpose. Optimize hard enough for getting the notes right and you can arrive at a performance that is technically clean and brings nobody to life, starting with you.

What it does not touch

A beta blocker does not reach the reason the adrenaline was released. Your body sent it because something in you read that room as dangerous. Block the receptor and the reading is unchanged. You have switched off the alarm bell without going to look at what set it off.

Let’s start with something you can check for yourself. There is nothing inherently dangerous about standing on a stage in a room full of people. I am sure you know musicians who are as free and comfortable up there as they are in the practice room. Same room, same lights, same audience, opposite experience.

The stage is not producing the fear. What the stage means to you is producing the fear.

Something real does sit underneath this. Being looked at by a group, with your standing among them riding on how you do, is genuinely stimulating for a human being. That is evolutionary wiring and everyone has it. Wiring is not a verdict, though. Whether that stimulation arrives as excitement or as terror depends on what the moment means to you, and meaning is learned.

This is why being told to calm down has never once worked on anybody. Telling yourself to calm down is like slapping the waves to get water to settle. Your emotions are downstream of the meaning you make of situations. If you want different emotions, choose different meanings.

The picture you hold to keep yourself safe

When I work with a musician on this, I do not treat the fear as a malfunction. I treat it as a part of them that has had some hard experiences, and standing in front of people reminds that part of those experiences, so it sends up a flare.

Here is what that part of you is doing that almost nobody notices. It is holding a picture of a potential disaster. The entry you miss. The judgmental face in the second row. The shame of cracking that one note. It holds the picture deliberately, as a safety strategy, and the logic runs like this: if I keep reminding myself of this, I can stop it from happening.

Attention does not work that way. Whatever you put your attention on shapes the rest of your experience. The picture you are holding in order to prevent the disaster is the very thing generating the fear, sometimes for days and weeks before the concert.

This is also why talking yourself out of it backfires, and why pushing it down backfires harder. Repressing an emotion, even through positive thinking, only makes it stronger, and then it comes out sideways.

Hold both

So we don’t push away the bad or cling to the good. Instead, we hold both.

What follows is a polarity meditation. You alternate your attention between the two sides of a situation, the current painful reality and the ideal alternative, anchoring each with a sentence of your own. It takes about two minutes and you can do it right now, wherever you are reading this.

First, find your sentence for the painful reality. The true one, not the tidy one. Something in the shape of: sometimes when I perform, I feel fear and shame, and I just want to run away and hide. Use your own words. It should be slightly uncomfortable to say.

Rate it 0 to 10. How much charge is on that sentence right now. Note the number.

Say it, out loud or silently, then stay with whatever happens in your body. Ten to twenty seconds. Do not fix anything. Notice thoughts, pictures, emotions, sensations, wherever they turn up.

Now the other pole: I would rather experience freedom, joy, and connection. Again, your words. Say it, stay with what happens, notice how it differs.

Back to the first. Back to the second. Several rounds.

Two things matter here. Stay with the same two sentences until the charge is actually gone, and do not go hunting for better phrasing the moment it gets uncomfortable, because that is the charge talking. Do not try to make the good pole win either. Positive thinking ignores what could go wrong, and the part of you holding the disaster picture knows perfectly well it is being ignored, so it grips harder. You are holding both. That is the entire mechanism.

Rate it again, 0 to 10.

Most people watch that number come down. Seven to five. Five to two. I have seen fear a musician carried for decades drop substantially in a single sitting, and I have seen it in myself.

I do not know exactly why this works. My best guess is that clinging to an outcome, or bracing against one, keeps sending a danger signal to a nervous system that is in no danger, and holding both poles stops the signal. That is a hypothesis. What I can tell you is what the number does, and you have just watched your own.

The hypothesis has deep roots. Taoism holds that life is best lived by taking account of the whole picture, accepting the positive and the negative, the yin and the yang of anything. Do that and something unexpected happens: you find greater freedom, fulfillment, and a sense of connection that makes you feel whole again.

That is an ideal state for living in general and for performing in particular. The polarity meditation is a quick, practical way of clearing what stands between you and it.

Once the number is down, ask yourself three questions. How do I feel about performing now? What is true about me as a performer now? What is true about the next performance I have coming up? Answer them from the space the exercise just cleared rather than from memory. That is where the change gets consolidated.

What the drug quietly assumes

Beta blockers work. They help you get the notes right, and on some nights that is exactly what you need. If the audition is tomorrow and there is no time to do anything else, take the beta blocker. Do what you have to do to get the job done.

Which brings us back to where we started. The drug serves the smaller pull perfectly, and it never claimed to do anything else. Nothing in it was designed to bring anybody alive.

Mask the fear, treat only the symptom, and you never find out what is actually true about who you are as a musician. That only shows up when you do the harder thing and face it.

There is a reason the old stories about dragons always include gold hidden in the lair. Mask the dragon, or pretend it is not there, and you never get the gold. The gold for musicians is what I call Soulforce: the feeling of your heart and soul pouring through your sound.

A smaller, practical problem comes with any symptom-based approach. Beta blockers give you an ease you have to remember to bring. You can leave the pills at home. The pharmacy can run out. Your ease belongs to something outside you.

The meditation you just did belongs to you. Clearing a charge, releasing a belief that was never true about who you actually are, is what makes you reliably free, reliably comfortable, reliably safe up there. From that place you get the notes right anyway, and you get to say something as well.

One last thing, and it is the whole method in a single line. Ask it about a technique, a belief, a mindset, or about why you play at all: does this make you tighter, or freer?

It makes a good north star, because music should be free.

If you want to do this work with your instrument in your hands, I run a free live class called the Musician’s Tension Reset Lab. Details at soulforcearts.com/lab-anxiety. Bring the instrument and a passage you already know.