Searching for the unknown Phenomenon-oriented study of music performance anxiety within the boundaries of psychodynamic approach Inaugural-Dissertation zur Erlangung des akademischen Grades des Doctor scientiae musicae am Institut für Musiktherapie der Hochschule für Musik und Theater Hamburg Direktorin (kommissarisch): Prof. Eva-Maria Frank-Bleckwedel im Promotionsstudiengang Musiktherapie (alter Ordnung) am Institut für Musiktherapie der Hochschule für Musik und Theater Hamburg Vorsitz des Promotionsausschusses: Prof. Dr. Hans-Helmut Decker-Voigt Prof. h.c. der Kunstwissenschaften und Dr. h.c. Rostropovitch-Hochschule Orenburg/Russland eingereicht von Alice Pehk Hamburg 2012 Gutachter: 1. Prof. Dr. Hans-Helmut Decker-Voigt 2. Prof. Dr. med. Jörg Zimmermann © Alice Pehk 2012 ISBN 978-9949-30-669-5 1 ACKNOWLEDGEMENTS First of all I would like to express my deepest gratitude to Prof. Dr. Hans-Helmut Decker- Voigt for making it possible to work towards completing the thesis, for his charming academic brilliance that he shared with me and for his understanding and support along the way. I am very grateful to my second scientific advisor, Prof. Dr. med. Jörg Zimmermann for his assent to take the position of an advisor and for his encouragement to my work. I would like to thank the great professionals in the field of performance anxiety, Dianna Kenny, PhD from the University of Sidney and Prof. Julie Nagel, PhD, for kindly sharing their valuable knowledge and experience with me. I would also like to thank post humus the Grand (Old) Man of music therapy, a great colleague and friend Tony Wigram, who never declined any kind of support and encouraged me to take new challenges in the field. My main teachers in discovering the deepest areas of the BMGIM-method have been the BMGIM-therapists, primary trainers and researchers Torben Moe, PhD and Lars Ole Bonde, PhD from Denmark and Margareta Wärja, MA from Sweden. Thank you for the opportunity to dig so deep into the secret processes of music and consciousness that let me grow as a person as well as a psychodynamic music therapist. My acknowledgements go to four young musicians – Laura, Emma, Eric and Oliver (aliases) who were ready to explore their inner depths and who gave the opportunity for a larger audience to get acquainted with their unique internal processes and experiences to gain deeper knowledge of the phenomenon of Music Performance Anxiety. I wish to acknowledge Katrin Kullasepp, PhD from the Institute of Psychology of Tallinn University, Margus Pärtlas and Toomas Siitan from the Estonian Academy of Music, Aarne Saluveer and Marje Oja from the Georg Ots Tallinn School of Music for their great effort in supporting to complete the research study with Estonian music students. I would like to thank my great colleagues, music therapists Eve Lukk and Malle Luik, for the possibility to walk supportively next to each other on the way towards the PhD degree. My great gratitude goes to my dear friend and colleague, psychologist and family therapist Roman Timofejev for his great inspiration, solid suggestions and remarks, unconditional support, and for helping me not to astray from the road. I am very grateful to my good friend Maris Tomingas for her considerable contribution in shaping my thoughts into accurate English. I am highly thankful to my family for kindly supporting all my peregrinations on my personal and professional road. And finally, I would like to thank Estonian Cultural Endowment, Estonian World Council and Archimedes Foundation for allowing my thoughts flow by making the writing process of the thesis easier with essential financial support. 2 TABLE OF CONTENTS ACKNOWLEDGEMENTS ....................................................................................................... 2 INTRODUCTION ...................................................................................................................... 7 1. LITERATURE REVIEW AND THEORETICAL BACKGROUND ................................. 11 1.1. DEFINITIONS .......................................................................................................... 11 1.1.1. Social anxiety ..................................................................................................... 11 1.1.2. Performance anxiety ........................................................................................... 12 1.1.3. Music performance anxiety ................................................................................ 13 1.2. SYMPTOMS OF PERFORMANCE ANXIETY ......................................................... 14 1.3. THE DETERMINANTS AND AETIOLOGY OF PERFORMANCE ANXIETY ...... 15 1.4. RELATIONSHIP BETWEEN AROUSAL AND PERFORMANCE .......................... 19 1.5. TREATMENT OF MPA ............................................................................................... 20 1.5.1. Cognitive Behavioural Therapy ............................................................................. 21 1.5.2. Relaxation and breathing techniques ...................................................................... 22 1.5.3. Hypnotherapy ......................................................................................................... 23 1.5.4. Biofeedback ............................................................................................................ 24 1.5.5. Music Therapy ........................................................................................................ 24 1.5.6. Medical treatment ................................................................................................... 25 1.5.7. Combined interventions ......................................................................................... 25 1.6. PSYCHODYNAMIC APPROACH TO PERFORMANCE ANXIETY ...................... 26 1.6.1. Attachment style as one of the determinants of performance anxiety ................... 26 1.6.2. Death and anxiety ................................................................................................... 29 1.6.3. Perfectionism .......................................................................................................... 30 1.6.4. Potentials of The Bonny Method of Guided Imagery and Music (BMGIM) in dealing with MPA ............................................................................................................ 31 2. RESEARCH STUDY ON MUSIC PERFORMANCE ANXIETY OF MUSIC STUDENTS OF ESTONIAN MUSIC COLLEGES ............................................................... 36 2.1. INTRODUCTION ..................................................................................................... 36 2.2. QUANTITATIVE RESEARCH ................................................................................ 37 2.2.1. Method ............................................................................................................... 37 2.2.2. Results ................................................................................................................ 38 2.2.3. Discussion .......................................................................................................... 50 2.3. QUALITATIVE RESEARCH .................................................................................. 54 2.3.1. Method ................................................................................................................... 54 2.3.2. Outcome: General structure of performing experiences ........................................ 58 2.3.3. Discussion .............................................................................................................. 59 3 3. QUALITATIVE PSYCHODYNAMICALLY ORIENTED MUSIC THERAPY MULTIPLE CASE-STUDIES RESEARCH ON PHENOMENON OF MUSIC PERFORMANCE ANXIETY .................................................................................................. 62 3.1. INTRODUCTION ..................................................................................................... 62 3.2. METHOD .................................................................................................................. 63 3.2.1. Participants ............................................................................................................. 63 3.2.2. Therapy setting ....................................................................................................... 64 3.2.3. Data .................................................................................................................... 64 3.2.4. Ethical issues .......................................................................................................... 68 3.2.5. Therapist’s/researcher’s theoretical background and therapy methods ................. 69 3.2.6. Research method .................................................................................................... 71 3.3. CASE STUDY 1/ LAURA: A CAT THAT IS WALKING ON ITS OWN ................. 75 3.3.1. Background information ........................................................................................ 75 3.3.2. Objectives of the therapy ........................................................................................ 84 3.3.3. Therapy setting ....................................................................................................... 85 3.3.4. Music therapy process: data from therapy sessions ............................................... 85 3.3.5. Outcome ........................................................................................................... 106 3.3.6.