Tips for Defeating Stage Fright and Performance Anxiety

In previous articles, we laid down some pretty fascinating new science that has demonstrated prolonged laryngeal tension due to performance anxiety. We can manage the muscular and ligament tightening with laryngeal massage, and this should be part of the vocal athlete’s post-performance routine.

Where we need to dive deeper is in the preparatory work- the avoidance and control of performance anxiety.

How can I beat stage fright?

First, recognize that performance anxiety is extremely common and is due to autonomic nervous system (ANS) activation (“fight or flight”). Overactivity of the ANS creates voice symptoms, including difficulty with breath control, voice projection, pitch stability, and expression. Managing these symptoms requires tackling that reaction before it becomes habitual.

What strategies can help with stage fright?

There are a multitude of tools that may help an anxious performer. The Center for Vocal Health team has comprised a list that is a good starting point. One size will never fit all – experimentation is encouraged!


Warm up rituals – having a routine to warm up your voice is critical, even for non-singers. It puts the mind in a preparatory state and helps to provide a sense of control around the voice. Straw phonation is an effective, proven tool for vocal warm-up. Hydration, voice steaming, jumping jacks… everyone’s ritual is different and should be customized for you with your vocal coach and physician.

Power poses – it may seem unbelievable or even a little silly but it has been proven countless times that power poses create a sense of strength and mental well-being that translates into better performance. A wonderful TED talk on this by Amy Cuddy can be found here. Standing in a power pose for 1-2 minutes before performance “convinces you” of your strength – the fake it ‘til you make it approach. Poses include

o   What I call “Starfish” (arms above your head in a “V” and legs apart)

o   Standing with hands on hips (“Wonder Woman”)

o   Standing with a wide leg stance

o   Arms crossed behind your head with a wide leg-stance or, if sitting, with feet up on a table. 

Post-performance rituals – implement a cool down that includes laryngeal massage.

Medications – beta blockers, such as propranolol, have been used to control the racing heart that comes with stage fright. Voice effects might be similarly controlled. While studies are not conclusive, and a double-blinded placebo-controlled study actually indicated no benefit, there are some performers who do note improvement. This may be considered with your doctor.1 Medications may also be required to manage anxiety, ADHD, or other conditions that make stage fright more difficult to control. These may have voice side effects so, again, your laryngologist should be working with your psychiatrist for optimal control.


Preparation – You know what they say – “failing to prepare is preparing to fail.” Invest in your craft well before you hit the boards and you will find your anxiety significantly lowered.

Cognitive Behavioral Therapy vs. Coordination Voice Therapy vs. Traditional Voice Therapy 

These are three types of therapy that may help. Coordination Voice Therapy is holistic, encompassing behavioral aspects, physical and muscular contributors, and stress responses. There are many therapists that may perform this type of therapy and it is, in some ways, a combination of traditional voice therapy and cognitive behavior therapy (CBT). Coordination Voice Therapy has shown in studies to be more effective than traditional voice therapy at reducing complaints of symptoms. 2

In the absence of a local Coordination Voice Therapist, a combination of CBT and traditional voice therapy have been proven effective. 

Things to avoid

 Mood altering substances – it is extremely important to treat mood disorders, including anxiety and depression, with your physician. However, in the absence of a medical diagnosis, it is not wise to “mask” anxiety with drugs and alcohol. Not only will this affect your performance but it will not get to the root of the problem, making it more likely you’ll need these crutches every time you perform.

Ignoring it – this problem isn’t going away and you’re not fooling yourself. You know if you haven’t done anything to help your symptoms, which means that the next time you go to perform, your anxiety will be worse for having done nothing to mitigate it.

Management of performance anxiety is within your reach but requires a customized approach. Work with your laryngologist to find the best strategies for you. 



  1.       Cheryl L. Giddens, Kirk W. Barron, Keith F. Clark, and William D. Warde. Beta-Adrenergic Blockade and Voice: A Double-Blind, Placebo-Controlled Trial. Journal of Voice, Vol. 24, No. 4, pp. 477-489.
  2.       L. Demmink-Geertman and P. H. Dejonckere. Differential Effects of Voice Therapies on Neurovegetative Symptoms and Complaints. Journal of Voice, Vol. 24, No. 5, pp. 585-591.