Music Performance Anxiety

344 Pages·2016·4.02 MB·English

Music Performance Anxiety:
An Investigation into the Efficacy of
Cognitive Hypnotherapy and Eye Movement
Desensitisation and Reprocessing when
applied to Grade 8 Pianists

Mary Elizabeth Brooker

Submitted in accordance with the requirements for the
degree of
Doctor of Philosophy

The University of Leeds
School of Music

March 2015
ii

The candidate confirms that the work submitted is her own and that appropriate credit has
been given where reference has been made to the work of others.

This copy has been supplied on the understanding that it is copyright material and that no
quotation from the thesis may be published without proper acknowledgement.

The right of Mary Elizabeth Brooker to be identified as Author of this work has been asserted
by her in accordance with the Copyright, Designs and Patents Act 1988.

© 2015 The University of Leeds and Mary Elizabeth Brooker
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Acknowledgements

I thank my supervisors Dr. Luke Windsor and Dr. Karen Burland for their help and guidance
during the writing of this thesis; and many thanks to all the wonderful musicians who took
part and made this research possible.
I wish to express my appreciation to Professor Nicola Dibben at the University of Sheffield
and Nico de Villiers at Leeds College of Music, who encouraged students in participating in
this research.
Last but not least, grateful thanks to my long-suffering husband John who has given
encouragement and support when the road was not always smooth.

I dedicate this PhD thesis to my late parents Muriel and Philip Evans who inspired me during
their lifetime to follow my dream. They would have been thrilled with the completion of this
work.
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Abstract
Music performance anxiety: an investigative study into the efficacy of cognitive
hypnotherapy and eye movement desensitisation and reprocessing when applied to
Grade 8 pianists
Music performance anxiety (MPA) is widespread and has a detrimental effect on performance
affecting amateur and professional musicians alike (Kenny, 2011; Wilson, 2002). Previous
approaches for alleviation have focused on the conscious mind; however this research targets
both the conscious and unconscious mind through two psychotherapies - cognitive
hypnotherapy (CH) and eye movement desensitisation and reprocessing (EMDR). The
efficacy of the therapies was investigated with 52 Grade 8 pianists at the Universities of Leeds
and Sheffield and at Leeds College of Music, initially a pilot study of 6 followed by 46 in a
further study. A multimodal design was adopted using four different measurements: the
State-Trait Anxiety Inventory (Spielberger, 1983); a self-report questionnaire (SRQ) testing
subjective anxiety; assessments of performance; and subjective perceptions of therapies pre-
and post-treatment. To further support the quantitative data, qualitative investigations were
conducted through the SRQ and an evaluative log of performance experiences post-research.
During the research period participants were randomly assigned to a therapy or control group;
the therapy groups received two interventions during a two-week period between two
concerts. A significant improvement in performance was found in the therapy groups post-
intervention, but not in the control; subjective levels of MPA also decreased significantly in
the CH and EMDR groups. Both therapy groups demonstrated a significant reduction in state
anxiety which was not evident in the control group, and trait anxiety decreased significantly
below baseline levels in the therapy groups. Longitudinal testing of trait levels of anxiety at
four months, one year and two years post-intervention demonstrated that significant decreases
from baseline were still maintained. This finding, using a large sample, has not been
previously reported and has important implications for educators, performers and future
research.
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Table of Contents
Page
Acknowledgements iii
Abstract iv

Chapter 1 Introduction 1
1.1 Conceptualisation of the study 1
1.2 Organisation of the chapters 2
Chapter 2 Exploring Anxiety 5
2.1 Cognitive anxiety 5
2.1.1 Trait anxiety 6
2.1.2 State anxiety 7
2.2 The role of cognition in exacerbating anxiety 8
2.3 The cognitive/emotional paradigm 9
2.4 The role of implicit and explicit memory as a contributor to anxiety 12
2.5 Psychotherapy and memories 14
2.6 Summary 15
Chapter 3 Music Performance Anxiety 17
3.1 What is the current understanding of the problem? 17
3.1.1 Cognitive arousal and performance 18
3.2 Aspects that affect performance 20
3.2.1 Trait anxiety 20
3.2.2 Solo performance 20
3.2.3 Performance strategies 21
3.3 Therapies: Key findings 22
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3.3.1 Behavioural therapy 22
3.3.2 Cognitive therapy 23
3.3.3 Comparisons of cognitive and behavioural therapy 24
3.3.4 Cognitive behavioural therapy: CBT 25
3.3.5 Evaluations of CBT 27
3.4 Innovative therapies currently adopted for MPA 28
3.4.1 Physiological therapies 29
3.4.2 Meditative therapies: Meditation and yoga 30
3.4.3 CH and EMDR: The therapies adopted in the current study 32
3.5 Outcome of studies: Effectiveness 35
3.5.1 The case for psychodynamic therapies 36
3.6 Neuroscience 37
3.7 Summary 38
Chapter 4 Cognitive Hypnotherapy 39
4.1 Introduction 39
4.2 The background of CBT 40
4.2.1 Cognitive therapy 40
4.2.2 Behavioural therapy 42
4.3 Cognitive behavioural therapy (CBT) 43
4.4 CBT as a treatment for anxiety and related psychological conditions 46
4.5 Hypnosis 48
4.6 Assimilating hypnotic techniques with CBT: Rationale for integration 51
4.7 Cognitive hypnotherapy (CH): Treatments 54
4.8 Conclusion 59
Chapter 5 Eye Movement Desensitisation and Reprocessing 61
5.1 Introduction 61
5.2 The background of EMDR 61
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5.3 Theory 63
5.4 Protocols used in treatment 64
5.5 Treatment using the Adaptive Information Processing Model 65
5.6 Bilateral eye movements 67
5.7 Controlled research 68
5.7.1 Research with humans 68
5.7.2 Research with animals 69
5.7.3 The human/animal connection 70
5.8 Disparate memories 71
5. 9 Desensitisation of the traumatic memory and the effect on trauma 72
5.10 Clinical studies 73
5.10.1 Category ‘A’ traumatic experiences 74
5.10.2 ‘t’ trauma (small trauma) 75
5.10.3 Long-term effects of EMDR 76
5.11 EMDR treatment of performance anxiety 76
5.12 Comparisons of EMDR with CBT and CH 78
5.13 Conclusion: The future of EMDR 79
Chapter 6 Summary 81
6.1 Outcomes from the literature review: Discussion of arguments 81
6.2 Aims of the current study 82
6.3 Hypnotheses 83
6.4 General approach 83
Chapter 7 Pilot Study 85
7.1 Introduction 85
7.1.1 Aims 86
7.1.2 Participants 86
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7.1.3 Documentation 87
7.2 Methodology: Materials and equipment 87
7.2.1 State-Trait Anxiety Inventory (STAI) 87
7.2.2 Physiological measurements 87
7.2.3 Interview and self-report questionnaires 88
7.2.4 Somatic symptoms 88
7.2.5 Behavioural symptoms in performance 89
7.3 Procedure 89
7.3.1 The design of the study 89
7.3.2 Completion of STAI and physiological measurements 89
7.3.3 The performance procedure 90
7.3.4 Treatment 90
7.3.5 Self-report questionnaire 91
7.3.6 The interview: Pre-treatment/post-treatment 91
7.4 Summary 92
Chapter 8 Pilot Study Results 93
8.1 State anxiety/group assessment 93
8.2 Physiological tests 94
8.2.1 Blood pressure measurements 94
8.2.2 Somatic symptoms of anxiety 96
8.3 Behavioural symptoms of anxiety: Notational errors in performance 97
8.3.1 Analysis of assessors’ reports 98
8.3.2 Triangulation of the three measures of anxiety 98
8.4 Longitudinal findings 100
8.4.1 Experiences of performance post-intervention 100
8.4.2 Longitudinal: Trait anxiety 101
8.4.3 Summary of longitudinal findings 101
8.5 Summary 104
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Chapter 9 Pilot Study Discussion and Conclusion 105
9.1 Aspects of MPA affecting performance 105
9.1.1 Cognitive 105
9.1.2 Physiological 107
9.1.3 Behavioural 107
9.1.4 Trait longitudinal 108
9.2 Limitations of the study 108
9.3 The main study 109
9.4 Conclusion 109
Chapter 10 Main Study 111
10.1 Introduction and aims 111
10.1.1 A larger sample of 46 participants 111
10.1.2 Participants’ ratings of therapies pre- and post-therapy 111
10.1.3 Assessment of gender differences in cognitive anxiety 112
10.1.4 Assessment of trait anxiety at all stages of the current research 112
10.1.5 Assessing the relationship of trait and state anxiety 112
10.1.6 Assessment of performance 112
10.1.7 Longitudinal assessment of trait anxiety 113
10.1.8 Longitudinal qualitative information of performance experience 113
10.2 Method 113
10.2.1 Purpose 113
10.2.2 The research design 114
10.2.3 Participants 115
10.3 Structure of recruitment 115
10.3.1 Tranche 1: 21 participants 115
10.3.2 Tranche 2: 25 participants 115
10.4 Data collection tools: Materials and equipment 117
10.4.1 Perception of therapies 117
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10.4.2 State-Trait Anxiety Inventory: Objective measurements of anxiety 117
10.4.3 Physiological measurements 117
10.4.4 Self-report questionnaire (SRQ): Subjective measurements of anxiety 118
10.4.5 Quality of performance (behavioural aspects) 118
10.4.6 Longitudinal trait: STAI Y-2 119
10.4.7 Longitudinal evaluation: Log of experiences post-research (LEPR) 120
10.5 Procedure 120
10.5.1 The design of the study and performance procedure 120
10.6 Categories of assessment 121
10.6.1 Performance 121
10.6.2 STAI Questionnaire: Y-1 and Y-2 122
10.6.3 Self-report questionnaire (SRQ) 122
10.6.4 Treatment 123
10.6.5 Longitudinal investigations: STAI Y-2 124
10.6.6 Longitudinal evaluation of performance experience 124
10.7 Summary 125
Chapter 11 Results 127
11.1 Introduction 127
11.2 Cognitive anxiety 127
11.3 Gender differences 128
11.4 State anxiety/group assessment: Objective anxiety 128
11.5 Trait anxiety/group assessment: Objective anxiety 129
11.6 Self-report questionnaires: subjective anxiety 132
11.7 Somatic symptoms taken from the self-report questionnaires 133
11.8 Assessment of performance 136
11.9 Perception of therapies 137
11.10 Trait anxiety longitudinal findings 138
11.10.1 Trait anxiety longitudinal results: Four months post-intervention 138