In last month’s column, I discussed beta blockers and their effects. As you know, these
drugs are widely used by musicians to lower their heart rate and blood pressure, and to
decrease other physiological symptoms of the fight/flight response. Like any other drug,
beta blockers have several side effects, including dependence and increased tolerance.
While these drugs may produce temporary relief, they do nothing to take away the inner
feeling of dread or improve your confidence. They do not solve the underlying causes of
nervousness, and they will never produce your best performances.

In the meantime, beta blockers will make focusing on the task at hand under pressure
even more difficult. It takes immense energy to concentrate intensely for extended
periods of time, like playing three rounds of auditions, the Ring Cycle, or gaining tenure
after winning an audition with an orchestra. Beta blockers will not increase your ability to
trust your talent and to go for it, while causing a false sense of security. Eventually, the
diminished returns and risks of taking the drugs will outweigh the potential benefits.

Dr. Richard Ginsburg at the Harvard Medical School wrote, “Some level of anxiety is
good for performance. It keeps you in your game. A beta blocker can take away some
edge, mellow you too much.” Adrenaline is an important hormone for maintaining a
sense of vitality, power, and well-being. Blocking it can cause fatigue, lethargy,
weakness, and depression.”

Many of my students and clients have asked me about using beta blockers before
important events. I never ask them not to use beta blockers, but ask them to consider
that they could perform much better without them.

If they want to wean themselves off beta blockers, I make sure they know that it will take
some time and an effective plan. I do not recommend quitting abruptly by going “cold
turkey”, especially if they have some important performance or auditions coming up
soon. The practical solution is to learn more effective and natural ways to deal with the
anxiety that often comes with performing classical music in front of an audience who
expect you to do well. Here are some ways that I recommend to you:

Making a Plan – First, make up your mind that over time, you’re going to learn how to
use your extra performance energy to achieve your peak performances under pressure,
rather than trying to suppress the energy with beta blockers. Set reasonable goals for
how long it may take, as well as tangible rewards for doing so.

Next, consult with your physician about your plan for gradually tapering off the drug.
You need to learn more about the drug and specifically how it affects you, your body
chemistry, and your mind. Tell your doctor about any and all other drugs that you’re
taking. Ask about the half-life of the beta blocker and how long it takes to metabolize out
of your system. Then find out if you can start taking half the usual dosage for two
weeks, and then possibly half of that as the next step, two weeks later.

At each step, you want to notify your doctor about any adverse reactions you are
experiencing. It may take two months or more before you notice any remaining
symptoms. Your body and mind need to relearn how to deal with stress and adrenaline
without beta blockers. Your heart may race at times, and your blood pressure might
skyrocket for a while, until you learn how to manage your anxiety by channeling the
extra energy into power, presence, and focus. That energy is what wins Olympic gold
medals and orchestral auditions. That’s how I train athletes and performers to thrive
under extreme pressure, when it really counts, without drugs.

Magnesium and complex carbs – There are several different things you may consider
to help you deal with anxiety. You might change your diet to include foods that are rich
in magnesium, such as spinach, almonds, halibut, and mackerel. Other foods that can
reduce anxiety are complex carbohydrates, salmon, olive oil, garlic, sunflower seeds,
dark chocolate, walnuts, bananas (very good an hour before you perform),
pomegranates, blueberries, raspberries, apples, strawberries, and pineapples. You can
also drink decaffeinated green tea, or chamomile tea. Try to reduce or eliminate
caffeine, alcohol, and carbonated or sugary drinks, and replace them with pomegranate
juice or vegetable juice, and lots of water.

Supplements and vitamins – There are also herbs that may reduce anxiety: Hawthorn,
indian coleus, passion flower, kava extract, St. John’s Wort, ashwagandha, inositol, 5-
HTP, bacopa monnieri, rhodiola rosea, and lavender. You might consider certain
vitamins or supplements like vitamin A, B, C, niacin, calcium, antioxidants (lycopene
and beta-carotene), and fish oil, as well as certain amino acids: GABA (Gamma
AminoButyric Acid), L-Arginine, Tryptophan, and L-Theanine. Please check with a
qualified health practitioner about dosage, proper use, and potential side effects before
using any of these substances.

Discussing anxiety – Teaching performers how to deal with their nerves and
performance anxiety is a new model of pedagogy. Many music, voice, and dance
teachers do not discuss this important topic with their students or offer them viable
solutions. Some teachers may need proper training in dealing with anxiety just as much

as their students. It is best to surround yourself with people and materials where you
can openly communicate about any anxiety felt.

Self-Talk – While beta blockers may help reduce the physical manifestations of
performance stress, no matter how much you take, they don’t produce any meaningful
mental or emotional changes. This means they don’t decrease negative thinking, mental
noise, doomsday thinking, or worrying, nor do they increase desire, motivation,
inspiration, resilience, courage, or mental toughness. Creating positive affirmations,
writing them down, and repeating them can have a strong effect on your confidence by
reprogramming your negative self-talk.

Preparation – Nothing takes the place of daily practice and proper preparation, which
are very real and practical solutions to managing one’s performance anxiety. If you
need to upgrade your technical skills, find a teacher you respect and follow their
guidance. Plan to practice, practice, practice, both physically and mentally every day.
There is no substitute or better way to build your confidence and sense of competence.
Strive for excellence, not perfection, daily in the practice room.

Natural remedies – In my opinion, the most natural remedies for dealing with
performance anxiety are the most effective. These include aerobic exercise, meditation,
prayer, mindfulness, zazen, positive affirmations, yoga, Chi Gong, breathing techniques,
T’ai Chi, cognitive-behavioral therapy, guided imagery, sufficient rest and sleep, neuro-
linguistic programming, Aikido, biofeedback, EFT, systematic desensitization, self-
hypnosis, mental rehearsal, autogenic training, the Silva Method, and my personal and
professional favorite, the Centering Process. I recommend that performers master the
Centering Process to control and channel performance energy without taking beta
blockers. It’s the main strategy that I’ve taught to hundreds of clients and students at
Juilliard, the New World Symphony, and the Colburn School.

Let’s get real. Performance pressure will never go away. You can just learn better ways
to handle it. Some methods are more beneficial (and less harmful) than others. My
belief is that beta blockers will prevent you from achieving your full potential as a
musician. If you’re interested in doing your absolute best, I suggest that you pursue
extra energy and excellence, not the comfort and relaxed state that you may get
through drugs. I always recommend to those clients who wish to feel comfortable and
relaxed, “Either go lay on the beach in Hawaii or choose to learn how to use your
performance energy to do your best when it counts.”

To learn more about my Centering exercises, please visit my website
( to find the comprehensive