The Musician and the Psyche - a student-initiated seminar on musicians and mental health

The students' health and well-being survey (SHoT), NMH's Learning Environment Survey and CEMPE's own student survey conducted in January 2021, have all pointed out that music students lack more knowledge about and focus on mental health in music education. Being a musician is a high-performance profession where you continuously receive an external assessment of your performance. This applies both during your studies and in working life. In addition, it can be difficult, especially for young musicians, to distinguish between assessment of the artistic performance itself and the assessment of oneself as a person. Musicians can therefore be extra vulnerable during their studies and phase of establishing oneself.

These are challenges that the student partners of CEMPE, Ole Martin Solberg and Susanna Yttri Solsrud, believe the students and NMH as an institution should talk more about.

- It's about feeling good, about self-care, getting to know your own needs and taking them into account in a demanding everyday life, and helping to build a healthy performance culture, say the committed student partners.

During the seminar, we received several contributions from researchers who look into the mental health of musicians. First up was Jonas Vaag, psychologist specialist and associate professor in social and organizational psychology at Nord University and NTNU. In recent years, Vaag has been part of a research group that has investigated various aspects of musicians' mental health, including through a survey of 1,607 Norwegian musicians combined with qualitative in-depth interviews.

Do musicians have a more sensitive personality?

Parts of the results Vaag presented were gloomy reading. Musicians have a significantly higher incidence of anxiety, depression and sleep difficulties, and they also seek mental health care more often.

- Is it because musicians are wired differently? asked Jonas Vaag rhetorically. Do musicians have a different personality to the general population?

The answer doesn't seem to lie there. Based on personality tests of musicians compared to the rest of the workforce, there are no major differences in traits that are relevant to mental health. It is therefore difficult to say that musicians struggle with anxiety, depression and sleep difficulties because they have a more neurotic personality.

The gap between requirements and resources

Jonas Vaag and his colleagues believes it is important to focus on the gap between the demands that are placed on the musicians and the resources they feel they have.

- When the demands seem greater than the resources you have at your disposal, it is common to experience mental illness, the researcher said.

External demands can, for example, be about a large and unpredictable workload, unfavorable working hours and a high degree of family-work conflict. These are challenges that are reported more often by musicians compared to the rest of the population. Resources are about the internal resources which each and every individual possesses, and about the joy they themselves experience from performing their work.

- If a musician does not feel competent enough in relation to the tasks to be done, this can be experienced as very demanding over time.

Resources can also be about motivation, recognition and perceived support from colleagues.

The importance of managing your own everyday life
Vaag emphasized that it is important not only to focus on the challenging aspects of being a musician. There are also many areas where musicians report higher satisfaction than the rest of the population. Among other things, this is about the opportunity to manage one's own everyday life, about dedication to music and the satisfaction and meaning many musicians experience through performing music.

Openness is a key

Vaag ended his presentation by pointing out the need for more knowledge and more research into the mental health of musicians. We also need to look at how the music profession can be made more sustainable through better framework conditions and structures, as well as greater recognition through, among other things, increased fees.

- It is important to be open about these topics and the challenging aspects of the music profession. It is important to acknowledge that this exists, that it is normal and something that must be put on the agenda.

Openness was also emphasized as essential by Damla Tahirbegi, PhD research fellow at NMH. She gave the audience an insight into research done on music students and performance anxiety.

But what exactly is performance anxiety? In the research literature, it is often defined as a persistent concern for or a real impairment of the ability to perform in a stressful situation. Performance anxiety will vary depending on factors concerning the musician's personality, characteristics of the situation and characteristics of the task. An exam concert can therefore be experienced as more stressful than a Christmas concert for the family, and especially if the piece you are going to play is excessively demanding. It will also vary from person to person how sensitive you are to stress.

Tahirbegi, who has investigated how music students deal with performance anxiety, found that such symptoms can appear weeks and months before a performance situation. Some of those she spoke to had insomnia, concentration difficulties and stomach aches for a long time beforehand.

- To experience these high levels of anxiety, is quite a tiring state of mind to be operating in, the fellow said.

You are not alone

If you experience performance anxiety, however, you're in good company. Tahirbegi referred to studies which show that a great quantity of music students experiences this. However, it is highly individual how the problems manifest. Some experience strong physical reactions, such as sweaty hands, tremors in the bow arm, dry mouth or shortness of breath. In addition to physical reactions, it is common to feel negative thoughts about yourself, an anxiety about getting nervous and catastrophic thoughts about what will happen if a concert does not turn out as you want it to.

Strategies for dealing with the nervousness

The students Tahirbegi interviewed, reported different strategies when dealing with the unwanted reactions they experienced in connection to performance situations. Many used strategies of memorization to face the fear of playing by heart, others intensified their practice to make sure they were well enough prepared. There were also many who used breathing techniques, "grounding", or used visualization to create a safe atmosphere in a situation they actually experienced as threatening.

In addition, it was of great help that there was an openness regarding challenging aspects when high achievements was demanded in certain situations, both with their teacher and among fellow students. Students who experienced such openness also more often sought external help when needed.

– Therefore, talking about it can make a real difference, like you are doing here at this seminar, concluded Tahirbegi.

How can music be a health resource in your life as a musician and in a world together with others? This central question was asked by Karette Stensæth, professor of music therapy and head of CREMAH (Centre for Research in Music and Health) in the opening lecture Friday 23 April.

- As musicians, you have unique access to music and exploring music as a health resource in your own life, says Stensæth.

Health can be understood in so many different ways. The WHO has defined it as a state of complete physical, mental and social well-being, but who walks around in such a state? Instead, we can look to the origin of the term in Norwegian, from the Old Norse “heill”, which means whole or unharmed. In Latin, health is salus, which is also the word for salvation. In Greek, the word for health is an ethical way of living, in harmony between body, soul, society and nature. Stensæth believes that these understandings take up the complexity inherent in being human.

Music as a source of psychological resilience

Music can be an important resource that creates the resilience we need to endure the pain of life we all face. Stensæth refers to Professor Even Ruud, who believes music in many ways is a type of vaccination, a cultural immunogen.

- Music can help to strengthen our vitality, give us the power to act, give us belonging to a community and create meaning in life, which is the big life project for all of us, Stensæth continued.

CREMAH has carried out a study on how music teachers, music therapists, musicians and music researchers use music in their own lives as a health resource. Among the 497 respondents from the Nordic countries, there was a high degree of agreement that music helped them maintain good mental health. It was particularly prominent that many have had affective experiences linked to music, that music contributed to an experience of belonging and helped the respondents to regulate mood and emotions.

Keep your curiosity and the desire to explore

Stensæth suggested that we also can understand music as a metaphorical mask; that we sometimes need to put on masks to test out something else - another identity, another existence. She went on to talk about the importance of play and exploration and borrowed the following quote from Mikhail Bakhtin:

- I go out into the world in order to come back with a self.

However, what you come back with is never a finished self or a complete and clear identity. Everything is unfinished and changeable, the professor claimed. It is the process itself, the exploration and playing that is the point.

- If you stiffen, you fade, and then you also lose vitality. In the worst case, we die. That is why it is so important to keep doing the research on these topics.

Stensæth therefore ended her lecture with a call to tease oneself and the music more often, in order to create a balance in the accounts:

- It is serious if everything becomes serious.

The seminar presented a broad area of knowledge and experience where researchers, students and professional practitioners contributed alternately with lectures and panel discussions. What was striking, and in many ways surprising, was the impression the exchange of experiences in the conversations made. Listening to performers who have had successful long careers is presumably a form of learning that can be successfully utilized to a greater extent in higher education.

It has long been recognized that sport has come further than the art field when it comes to developing mental techniques as part of the training strategy. Many musicians have been inspired by research and practice in the area, and a conversation between Kjetil André Aamodt and Arve Tellefsen showed that there is a lot of common thinking in their respective environments.

Both expressed, for example, that it is important to have a certain orientation to reality when you are at the start of an international career. When Aamodt entered the top sport in Norway, the alpine team thought they were tough guys who trained a lot, he said. But when they trained with the skaters, they realized that they weren't training as hard as they thought. Arve Tellefsen had a similar moment of eureka when he went on a summer course in the USA shortly after his successful debut in Oslo. On the course he met 70 young violinists from all over the world. - Around 60 of them were better than me, he said.

Good values, good attitudes

A performance culture is fragile and can quickly be destroyed, emphasized Kjetil André Aamodt. It must be protected and cared for, not least by wise coaches and managers. For Aamodt, a good performance culture is a culture where you make each other better, where you get better from training together.

We didn't talk about each other in the corridors, we talked to each other. We were inspired by each other's results and if someone did well, we bragged about each other, congratulated each other and then we rather asked the person who won, "what did you think then, what worked?" And in this way we share experiences and became wiser together and also: The top ones should take care of the new members of the team. Also to learn oneself. The new ones are often young and hungry and in the greatest development. If you have already reached the top, you must work not to stagnate, and then fresh talents can contribute with new inspiration and new ways of training.

- In classical music, it is not always the same experience of being in a team, but in chamber music there is no doubt that it is the same thing that applies, to play well with each other, Tellefsen pointed out

- You have to make others better, because then they make you better, said Tellefsen, not only with regard to the musical interaction, but also to strengthen the environment, where the individual performer influences the development of others.

Good advice, good habits

- Focus on what you can do something about, was an advice from both of them. - Don't blame the weather, equipment, people around you, said Aamodt.

If the acoustics in a room are bad, it is my task to adapt my playing to the acoustics. It is important to be honest about one's own achievements, and not to blame other circumstances, which Tellefsen feels has been important for his own development.

One of the audience wanted to know more about how to prepare coming to factors which you have no control. Aamodt's blunt answer was "you have to try to get control of them too, or alternatively prepare for what to do if they occur."

Haraldsen elaborated on this by pointing out that it is possible to work with strategies to deal with unforeseen things.

Mental preparation is just as important as physical preparation

As a musician, Arve Tellefsen has placed great emphasis on mental preparation ahead of performance situations. For example, he uses visualizations. to imagining situations and events in advance.

First I use to imagine that everything is going perfectly. Then I imagine everything going to hell. And then I examine what is the difference in the two versions and correct the errors that I envisioned in the other version. So I also use visualization to imagine negative things that I want to work on, Tellefsen told.

Playing through entire works in the mind, both in the form of excellent and poor performances, is something that prepares a performer for everything that can happen along the way. It also exercise the ability to be able to get back into the music. If a gig doesn't go that well, look at it as a great learning opportunity, he said. Find out what went wrong! You always have a second chance, a new concert.

Finding out what suits you best

Another piece of advice was finding the right amount of practice. Most is not necessarily best. Five hours a day is suitable for him, not twelve, as in the first overzealous years of study.

But the point Tellefsen emphasized the most, was to maintain the curiosity. It is both talk and attitude and technique, as he sees it:

- What the teacher has said is one thing, but you have to be on the offensive. Do things in new ways. Discover new sounds, new ways of playing. Tell yourself this is fun. Smile when you play. Make it pleasurable.

Nerves and resistance

The public is most familiar with the successes, the frontside of the medal. But even the very best feel they fail more than they succeed, a perspective Kjetil André Aamodt presented with weight, he who has more medals from international championships than any other alpine skier. - You lose more than you win. I did 500 ski races at the highest level, but only managed to win 30 of them. I got really nervous every time, struggled to find the right level of excitement.

For Aamodt, the solution lay in changing the focus from the performance to the task itself, what had to be done. He said that he could then be satisfied with a 4th place, because the focus during the race had been very good.

Tellefsen is also well aware of the nervousness, but feels that the nerves help him:

- I have to be nervous before a concert to give my best. If I'm not nervous beforehand, I'll be nervous then, said Arve Tellefsen. Furthermore, he says that there is a lot in making mistakes as well. Not only should one learn from it, but it creates something of its own. - The perfect and brilliant do not particularly interest me. Misplay is underrated.

This led the conversation into the fact that artistic practice is closely related to credibility, which is the opposite of artificiality, and not least humanity, which is always a long way from perfection. Tellefsen emphasized his point by referring to concerts where the performers clearly fight with themselves and their own nerves, and that such experiences can be among the greatest.

Heidi Marian Haraldsen has a PhD in performance psychology, with a thesis on elite environments in ballet, classical music and cross-country skiing. In her lecture on "performance cultures in performing music environments", she presented various theories in the area. Two extremes can be said to be a hardening-theory, where the idea is that talent gains strength by being exposed to opposition and challenges, and a more holistic theory, which says that you have to feel good to do well. The latter may contradict the notion of a personally experienced and generated material that is translated into an artistic process, but may still have something to offer as inspiration to perform without disturbing thoughts and tensions.

- You probably won't become a worse performer by prioritizing having a good time outside of music, it's rather the opposite", Haraldsen pointed out and encouraged to challenge the ideal performer.

Performance = potential – disturbances

Haraldsen referred to a formula in performance psychology that states that "performance is potential minus disturbances". In order to achieve a greater tolerance for the pressure that always will be there in a performance culture, it is necessary - among other things - to strengthen concentration, self-confidence and motivation and to prevent anxiety, doubt and destructive self-criticism. The pressure must also be dealt with over time because it does not necessarily disappear over the years. Expectations might even rise and thus become a rising pressure.

Is there a peak in performance development, a point where our mental capacity is in danger of overrunning our real and physical capacity, Haraldsen asked. A point where success can tip over into collapse? That the pursuit of performance can contribute to developing risk-taking behavior is something that both the apparatus around the athletes, and the athletes themselves, must be aware of.

In this context, it was interesting that Haraldsen believes that ethics has received greater attention in the performing arts in general in recent years. This is an important aspect to be aware of for coaches and teachers in performance environments: it is an ever-present danger that artistic ideas as well as project managers may push a performer beyond what is healthy and acceptable.

Norms and uniqueness - some afterthoughts

Hierarchical and competitive systems with prizes and awards are well-known features of achievement-cultures. At the same time, one can ask to what extent such a way of thinking contradicts the notion of the artist as someone who has something of his own to contribute. Cultivating artistic individuality, both in higher music education and in music life in general, will perhaps help to reduce some of the pressure to perform and also make room for different types of artists?

Both in the panel discussion and in the research-based lectures, we heard that nervousness is completely normal and something that belongs to the profession. Studies show that between 50 and 94 per cent of music students struggle with performance anxiety. The increased focus that nerves bring can even help to raise the level of performance and create the nerve that characterizes a really good concert experience. Just knowing that might help - on the nerves?

Being a musician is a way of life, it is often said. For many, music is more than just a profession: it is part of their personality and identity. What does it actually mean and is there a limit? Towards the end of the seminar, a panel consisting of music students and musicians met for a nice and close conversation about how to live a good life both inside and outside the musician bubble.

The panel included Fride Nøstdahl Hjelle, pianist and student at NMH, Mathias Hagen, saxophonist and alumnus of NMH, and Ingrid Andsnes, pianist. The conversation was moderated by Ingfrid Breie Nyhus, pianist, composer and deputy chairman of CEMPE.

To structure your own dedication

In Jonas Vaag's presentation, we heard that there were some areas where musicians were more exposed than the rest of the population. In the panel discussion, the audience gained more insight into why this can happen. One reason is precisely the strong driving force: for many musicians, the dedication and motivation are at times that strong it becomes completely all-consuming. Ingfrid Breie Nyhus, pianist, composer and deputy chairman of CEMPE, tells about how she has had to structure this dedication in a different way than before:

- I am so happy to be a musician, I love it. When I'm inspired, I just want to get on with it, and that's the bubble we're talking about, Nyhus said. But then comes the rest of life, with children and partner and obligations, and you can no longer work on weekends and holidays and all the things you like to do as a musician.

Ingrid Andsnes has also experienced how the inner motivation can lead to allowing oneself to be completely engulfed by the "musician bubble".

- I went exhaustingly too far myself, and I thought I just had to keep working, but that was not a good option. We all need input and inspiration, and I feel that is what I get outside of the musician bubble. There you can have some time off and clear your head. It is important with this balance, to be human in the whole thing.

Musicians do not write hours and are not protected by working time regulations. Since the boundaries are so vague, it becomes an important for all to define their own boundaries. Mathias Hagen, saxophonist and former student at NMH believes this can also help others to set their own limits:

- If you set those limits yourself regarding when it is okay to work, then it will also be easier for others to speak up, says Hagen.

Combine music with the rest of life

Hagen believes it is important to be aware that the way one handles one's musical life acts as a role model for others:

- Many musicians have a way of life that is not very sustainable, and the young people who see, it will to a greater or lesser extent follow that way of doing things and it is not always very good.

One point, Hagen points out, is precisely that the boundaries between private life and work life are so diffuse. This has made it important for him to find a good structure for self-care.

-... It is important to recognize for yourself that I am not just a musician, I am more than the music, and there are other sides that are also valuable in life and for me, says Hagen.

How to live with the nerves?

Nyhus invited the panel to reflect on how to live with the nerves that often accompany a musician's life. Andsnes talked about the challenge of distinguishing between the musician and the private person Ingrid, something the other panel participants could recognise.

- It is difficult for the body, for the nervous system, to distinguish between work and leisure. My body doesn't take time off, even if I don't sit and practice when I have a concert in a week. I find it terribly difficult to separate.

For Nyhus, a solution has been to distinguish between self-esteem and self-confidence, i.e. between a more general self-esteem and value as a person, and self-confidence that was more dependent on how she performed as a musician:

- You can have a good self-esteem as an individual regardless of your self-confidence as a musician, Nyhus pointed out

Fride Nøstdahl Hjelle, jazz pianist and student at NMH, believes that becoming aware of these two things is a good start.

- It helps to become aware of what I actually do: now I connect what I performed at the concert with what I think about myself as a person.

The experienced musicians in the panel still feel the nerves, but have gradually learned to live with them and recognize that the nerves are there to help them perform better. And, as Andsnes points out, it helps to do it over and over again and to experience that life goes on even if a concert "goes terribly bad".

Taking back the power of definition

Nerves are often associated with an outsider's view - a feeling that there is someone else who is evaluating you and who should like what you do. During the panel discussion the day before, Kjetil-Andre Aamodt told how focusing on the task rather than the result removed much of the nervousness for him.

Also in artistic expression, this can be a strategy to meet the critic's ghost that often knocks.

- For me, art is about what it means to be human and then humanity must also have a large place in my practice. It has taken away a lot of the nervousness for me – now it's much more about whether I achieve what I want artistically, and not whether I succeed or fail in the eyes of others, Nyhus said.

If the eye of the needle of how to become a successful musician is too narrow, there is also a danger that we will lose many important voices along the way, Hagen pointed out.

- There are many ways to be a musician, and we need many different types of musicians who are good at and interested in many different fields. From time to time, the paths one envisions in professional life are too narrow.

And it's no wonder, because as Hjelle points out, it's difficult as a music student to gain insight into what it really means to live as a musician:

- We only see people we look up to playing concerts and doing tours - we don't get to see the everyday life, how they work and everything else they do in a musician's profession and which might not be seen as an ideal either.

And even if a musician has what is often seen as a great career, it is not certain that our role models live a life that suits them.

- Seeing a great musician on stage can be magical, but does the person live a life off stage that I would like? People are different, they thrive with different degrees of stability and security, said Hagen.

Use every opportunity to celebrate

Just as Kjetil André Aamodt's wonderful career mainly consisted of races he did not win, a musician also has to deal with many rejections along the way.

- If there's one thing that's certain, it's that as a musician you get rejected. For each and every thing that goes one's way, there are many more rejections, Andsnes said.

But how do you handle that? Andsnes has not found a good recipe herself, but feels that it helps to think about it as an interaction. The reason you get turned down by a festival could be that they were looking for something else this year, and not that you weren't a good enough musician.

Nyhus feels that this can go in waves, and that it tends to be quiet after a period of playing on many stages. Her advice, however, is to remember that this is something all musicians experience, and not least, to remember to celebrate everything you achieve:

- It's important to remember that this is a collective experience, and I think that you should celebrate every "yes" you get properly.

And from a distance, the rejections are small, even if they are experienced as very large when they happen, comments Hagen.

- And I think that if you manage to be happy with everything, then a lot bounces off.

The only way to completely avoid rejection is to never dare, never to put yourself forward, and there is no alternative, Hjelle points out:

- Vulnerability sounds like a weakness, but it is the exact opposite. Daring to be vulnerable is the main component of being brave. And even if you get a rejection then you can celebrate that you dared, that you threw yourself into it.

The importance of talking more about it

Does talking about it actually help? The participants in the panel agree that, yes, there is great value in being able to share your experiences and concerns with other musicians and fellow students.

- It is terribly important to talk about it, that all performance situations are a big challenge. When I have been open about the nerves and how it affects my everyday life, it has actually become much easier. I think we need to talk more about what goes on inside, concludes Ingrid Andsnes.