Intensive Short-Term Dynamic Psychotherapy for Severe Music Performance Anxiety: Assessment, Process, and Outcome of Psychotherapy with a Professional Orchestral Musician

Abstract

This paper reports on the process and outcome of therapy using intensive short-term dynamic psychotherapy (ISTDP) with a professional musician who had suffered severe music performance anxiety over the course of his entire 30-year career. In this paper, we describe the nature of the therapy, the case history of the musician, the first assessment and trial therapy session, and the course and successful outcome of therapy. The patient underwent 10 sessions of ISTDP over a period of 4 months. This paper reports on the first 6 sessions, which were most relevant to the understanding and treatment of the patient’s severe music performance anxiety. This case study is the first reported application of ISTDP to a professional musician. We believe that this case study provides initial support that moderate to severe performance anxiety, in at least some cases, has its origins in unresolved complex emotions and defences arising from ruptures to early attachment relationships.

Sound Practice—improving occupational health and safety for professional orchestral musicians in Australia

“…Davanloo (1990, 2001, 2005) developed a technique to rapidly mobilize the unconscious therapeutic alliance, called the central dynamic sequence (Davanloo, 1987) in order to remove the major resistances to change, which are not effectively removed through interpretation alone. To date, one successful case study has been published (Kenny et al, 2014) and others are in preparation.…”

Acceptance and Commitment Therapy for the Treatment of Music Performance Anxiety: A Pilot Study with Student Vocalists

“…Lastly, participants with more severe MPA and co-morbid depression should also be included, in order to compare outcomes between ACT and Psycho-dynamically oriented therapy, a treatment that has already shown promise in treating more severe cases (Kenny et al, 2014, 2016; Kenny and Holmes, 2015; Kenny, 2016). Like CBT, ACT may be more effective in treating mild to moderate cases only.…”

“…CBT is a popular therapy involving cognitive restructuring and behavioral exposure that has been shown to effectively treat mild to moderate MPA (Clark and Agras, 1991; Osborne et al, 2007; Braden et al, 2015). Psycho-dynamically oriented therapy has also shown promise in treating more severe forms of MPA (Kenny et al, 2014, 2016; Kenny and Holmes, 2015; Kenny, 2016). …”

Exploring the Attachment Narrative of a Professional Musician with Severe Performance Anxiety: A Case Report

“…The aim of this paper was to illustrate the complex and multifaceted psychodynamics and therapeutic needs of musicians with insecure attachment and its possible relationship with how they express their music performance anxiety [39]. One of the key aspects from the musical point of view is the occurrence of physiological hyper-arousal in insecure attachment.…”