ORevery year the Sanremo Festival transforms the Ariston Theater into a living laboratory of performance anxiety. Lights, live television, millions of viewers, real-time comments on social media: the stage becomes a very powerful emotional amplifier. Yet, what happens to a singer in the minutes before going on stage is not so different from what happens to anyone before an important meeting, an interview, a decision that can change our trajectory. The so-called music performance anxiety is widely studied. Research shows that between 16.5% and 60% of professional musicians experience significant levels of performance anxiety, depending on the criteria used (Source: Kenny, 2011; Spahn et al., 2022, Psychological Medicine). This is therefore not an exception, but a widespread condition. But what really happens inside us? We talked about it with doctor Elisa Stefanati, Psychologist and psychotherapist at the Aesthe medical clinic in Ferrara.
What happens in the brain before going on stage
«In the minutes before entering the scene, the body enters into neurobiological activation», explains doctor Elisa Stefanati. «The amygdala, our threat radar, turns on. Adrenaline and cortisol increase. The heartbeat accelerateshands sweat, breathing becomes shorter. It is not a deficit of the system. It’s the system that activates.”
This mechanism is well documented in studies of social stress. The Trier Social Stress Test (TSST)one of the most used protocols to study the stress response, demonstrates how simple exposure to a situation of public scrutiny causes a significant increase in cortisol (Kirschbaum et al., 1993; Allen et al., 2017, Frontiers in Psychology).
Dr. Stefanati introduces a fundamental distinction:
- Eustress: functional activation, energy that prepares for action
- Distress: activation that exceeds the tolerance threshold and blocks
«From the point of view of the EMDR approach», he continues, «the difference is made by access to adaptive memory networks: if the activation is connected to memories of competence and mastery, it becomes a propulsive drive; if, however, it is connected to memories of humiliation, failure or criticism, the anxiety takes on deeper and more destabilizing meanings. It’s not the stage itself that generates panic. It is the implicit memory that is reactivated.”
The Ariston stage and the stages of our lives
The stage is not just physical. It’s relational. «From a systemic-relational perspective», explains the psychologist, «each performance is an exposure to the gaze of the other. And that gaze, in our history, may have been encouraging, demanding, judging, humiliating or unpredictable.”
When an artist enters the Ariston, he doesn’t just bring the song with him. Bring your own relationship history. Likewise, when we walk into a meeting, we don’t just bring a presentation: we bring our own internalized experiences of approval or criticism.
Research on social phobia and evaluation anxiety (Clark & Wells, 1995; Rapee & Heimberg, 1997) show how the fear of judgment is closely linked to the internal representation of oneself and previous experiences of rejection or humiliation. The mechanism is always the same: exposure and potential judgment.
Because some get stuck and others transform anxiety into performance
Many singers say they are afraid even after years of career. The total absence of anxiety is not an indication of competence. «Often», Stefanati underlines, «it is a sign of disconnection. And disconnection is always a defense mechanism.” The real difference is not between those who are afraid and those who aren’t. It is among those who interpret the activation as: “I am about to fail and this means that I am not worth enough” or “I am about to do something important, I prepare myself and put energy into it”.
The research on cognitive reappraisal (cognitive reappraisal) confirms that how we interpret activation influences performance. A study of Alison Wood Brooks (2014) has shown that telling yourself “I’m excited” instead of “I’m anxious” improves performance on public speaking tasks.
According to the psychologist, three main factors come into play:
1. The internal narrative
Thoughts like “I am not enough”, “They will expose me”, “If I make a mistake it’s over” they are often echoes of early experiences in which personal value was conditioned on performance.
2. Trained emotional regulation
“The artists learn centering rituals: breathing, visualizations, micro-movements, body anchors. All techniques that can be learned.”
Research in the sports and performance fields shows that Pre-performance routines improve concentration and emotional stability (Cotterill, 2010).
3. The stress tolerance threshold
«Who can stay inside the activation without avoiding it progressively widens its window of tolerance. It’s not just personality. It’s emotional training».
What we can concretely learn from artists
Dr. Stefanati suggests practical tools that can be transferred into daily life:
1. Normalize activation
«Tell yourself: my body is preparing me». Reframe anxiety as energy.
2. Shift focus from judgment to presence
«When the mind anticipates failure, the body goes into alarm. Bring your attention back to your senses: feet on the ground, slow breathing, voice.”
Research shows that reducing excessive self-monitoring improves social performance (Clark & Wells, 1995).
3. Work on the memories that fuel the distress
«If the anxiety is disproportionate to the situation, it often does not only concern the present. Refer to previous experiences of judgment or humiliation. It is necessary to pay attention to these signals.” EMDR, supported by numerous clinical studies for the treatment of trauma and disturbing memories (Shapiro, 2017), can help rework experiences that make any exposure an identity threat.
4. Separate performance and personal value
«Failing at something is not the same as being a failure. But for many people this distinction is not emotionally integrated”, adds Stefanati.
Anxiety as a signal: what is it telling us?
The fear of exposing oneself is often talked about need for recognition and fear of exclusion. From an evolutionary point of view, being judged negatively by the group meant risking exclusion, and therefore survival. Today social media amplifies this mechanism. A small uncertainty can go viral. But, as the psychologist points out, «the ruthless power of social media does not create fear of judgement. It amplifies it.”
Sanremo and performance anxiety teach us that activation is not the enemy. The enemy is thereattack on one’s own value. When the activation becomes: “If I make a mistake, I am worthless”, then distress takes over. But when it becomes: “I’m doing something that matters to me,” then it turns into eustress. A song is sung on the Ariston stage. On the stage of life we stage our identity. The real challenge is not to eliminate anxiety. It’s going up anyway. With a beating heart. With a voice that perhaps trembles. But with the awareness that our value does not depend on a perfect note.
Because courage is not the absence of fear. It is the presence of meaning. It’s being able to try, to stay, despite the fear.
