HealthActors and Performance Anxiety: Sometimes Helpful, Often Debilitating — But It Can...

Actors and Performance Anxiety: Sometimes Helpful, Often Debilitating — But It Can Be Treated

While an abundant amount of research has been conducted on anxiety and its effects on public speakers, musicians1 and dancers2, precious little research has been done about actors and anxiety. A review of the journal of Medical Problems of Performing Artists (from 2009 to 2014) reveals that only one of 164 research articles and editorials is related to actors3. A 2012 study of actors and other performers indicated that stage fright was a universal experience that cuts across all types of professional and amateur performers.

Acting With Anxiety Awareness

If performance anxiety is pervasive, why might people continually subject themselves to one nerve-wracking experience after another? This same study indicated that performers possessed self-awareness regarding anxiety, but chose to keep performing because it often fulfilled other emotional needs4.

Actors are keenly aware that the audience as well as the director and fellow actors may affect their performance in various ways. And they can often use that sense of frisson to deliver strong performances night after night. Yet at other times this awareness can blindside them with intense stage fright. Many develop strategies for blocking out their awareness of the audience; others develop ways to maintain awareness by prioritizing the material, lessening the role of the spectators, which can paradoxically lead to feelings of intense audience connection4.

Debilitating Performance Anxiety

Published in 2015, a study of actors in Australia may provide the most far-ranging and complete picture of the challenges to actors’ physical, psychological, and emotional health: 23.6 percent of male respondents and 28.1 percent of female respondents reported experiencing debilitating performance anxiety. Ironically and counterintuitively, the more professional training an actor has had corresponds with an increase in the likelihood of experiencing this type of anxiety.

In addition, because women are more likely to report having experienced performance anxiety, the ugly realities of age discrimination in the acting profession only serve to compound the problem. While work for both genders seems to peak around the ages of 30 to 32, the decline in opportunities for women is more marked, continuing for the remainder of their careers, while men often see more opportunities once they reach their 50s and 60s5.

How Actors Cope

Almost two-thirds of the study respondents reported adopting some form of preventative or coping mechanism to deal with the physical and psychological effects of being an actor: 44 percent use regular physical exercise or sports; 20.6 percent used counseling or psychotherapy; and 27.5 percent use the Alexander Technique, the Feldenkrais Method®, or yoga techniques.

Far riskier is the reliance on drugs and alcohol as more immediate relief to deal with “problems related to their work as a performer:” 36.7 percent reported drinking alcohol; 12.3 percent reported taking prescribed antidepressants such as Prozac or Paxil; 8.3 percent reported taking anti-anxiety drugs such as Xanax; and almost 7 percent reported using cocaine, ecstasy, or LSD5.

Even actors who reach the pinnacle of their craft and enjoy the attendant fame and adulation may struggle with performance anxiety. Relying on rest as the center of her beauty regimen, Marilyn Monroe found it increasingly difficult to get her much needed beauty sleep as her career was in its ascent, her anxiety rooted in a long and ongoing battle with stage fright. Matters turned worse when, following an intense bout of jet lag brought on by an overseas trip, the legendary actress fell into barbiturate use exacerbated by their easy availability6.

In a 2013 interview, Academy Award winner Al Pacino confronted his own method of dealing with pre-show anxieties when he stated, “If you feel as though you are presenting something to an audience that you feel good about, it takes a little bit of the edge off the fear. You want to communicate this play to them. Serving the play becomes the thing that bails you out of any real stage fright”7.

Proven Effective Therapies

It has long been common practice for performing art schools and dance companies to have an on-call psychologist ready to help performers navigate the demands of their craft. They may employ several proven effective interventions.

Cognitive-behavioral therapy (CBT) has proved to be effective for stage fright and other types of anxiety, focusing on identifying and changing negative patterns of thought and behavior.

Exposure therapy reduces the response to fear and anxiety by gradual exposure to a feared situation until the anxiety reaction decreases.

Biofeedback measures the body’s reaction to stressors and leads to a stronger sense of physical self-awareness and the development of relaxation techniques. In some cases, neurochemical-targeting medications can be prescribed, but this may be risky because medications can interfere with proper muscle functioning and be detrimental to performance 2.

It is perhaps the time-tested backstage pre-show rituals, however, that might just as well be an effective antidote to stage fright. From vocal warm-ups and group circles filled with chants and hugs, to lucky charms and specific food items, rituals and routines often have a soothing and calming effect, connecting performers to themselves, their talents, and an awaiting audience8.


1. Braden, A. M., Osborne, M. S., & Wilson, S. J. (2015). Psychological intervention reduces self-reported performance anxiety in high school music students. Frontiers In Psychology, 6, 1-9. doi:10.3389/fpsyg.2015.00195

2. Zar, R. (2014). Got Stage Fright?. Dance Magazine, 88(6), 54-55.

3. Anderson, L. M. (2011). Myself or someone like me: A review of the literature on the psychological well-being of child actors. Medical Problems of Performing Artists, 26(3), 146-149.

4. Simmonds, J. G., & Southcott, J. E. (2012). Stage Fright and Joy: Performers in relation to the troupe, audience, and beyond. International Journal Of Applied Psychoanalytic Studies, 9(4), 318-329. doi:10.1002/aps.327

5. Maxwell, Ian, Mark Seton, and Marianna Szabo. “The Australian actors’ wellbeing study: A preliminary report.” About Performance. No. 13. Centre for Performance Studies, 2015.

6. De Entrambasaguas, M. (2013). Insomnia and death of Marilyn Monroe. Sleep Medicine, 14 e116. doi:10.1016/j.sleep.2013.11.256

7. Johnston, A., & Percy, D. A. (2010). Stage fright tops the marquee. Phi Kappa Phi Forum, 90(3), 24.

8. Aylmer, O. (2015). Superstitious? Dance Magazine, 89(11), 46-47.

Clinical Psychology at Alliant International University

Cinzia Cottù Di Roccaforte earned a Doctoral Degree in Clinical Psychology from Alliant International University Los Angeles in 2019. She received a Bachelor of Arts in psychology from UCLA in 2011 and her Master of Arts in clinical psychology with emphasis in Marriage & Family Therapy from Pepperdine University in 2014. Dr. Roccaforte has been working with Dr. Alexander Bystritsky at the UCLA Anxiety Disorders Program. Dr. Roccaforte and Dr. Bystritsky also collaborated writing articles for


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