Musicians' Health Collective

Musicians' Health Collective: Supporting the health of musicians (and normal people)

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"Composed" Reviewed: First Reactions and Insights

This week, the documentary, “Composed,” receives its formal premiere in New York City, with a panel of professionals to discuss the film afterwards, including the filmmaker, John Beder.  I had the opportunity to preview the film earlier this week and offer up my first insights as a reviewer prior to the public viewing.  Let me preface this by saying that I am a biased reviewer- I’ve been interested in this project since its inception, and as a professional musician who makes the bulk of my income from performances and auditions, the issues addressed in this documentary are absolutely pertinent to my daily life, and that of my colleagues and friends.  That being said, “Composed” started as an inquiry into performance anxiety and beta-blocker usage amongst classical musicians, and as a finished product, explores richer and more complex issues about the nature of performance, internal pressures, music education models, and more.  

The film opens with different musicians sharing why they love music and when they first remember classical music as a child.  With contributions from Eugene Izotov, Christoph Eschenbach, Brant Taylor, William Short, and others, there is a foundational understanding that classical music is a profound art form that we all care deeply about and that holds deep meaning for us.  From there, the narrative shifts to reveal that musicians often get profoundly nervous about performing because of the great responsibility the art demands, the great technical and musical challenges at hand, and the incredible competition for employment. Throughout the documentary, we observe a group of five young musicians take auditions, practice, and address their own personal struggles with performance anxiety.  Interwoven throughout that narrative is a commentary from a series of different professionals, from symphonic musicians to medical professionals, performance coaches and instructors in other disciplines.  Drawing insights from many of the highest level musicians in the field, as well as those in psychology yields a product with rich insights, not only about the complexity of performance anxiety, but also the challenging nature of performance, musical study, and practice.

The challenges of auditions are explained early in the film, not only the rigors of preparation, but also the day itself, from warmup room to the actual audition.  One interesting comment from Leonard Slatkin, music director of the Detroit Symphony Orchestra, really hit home.  “(Auditions) It’s fair, but is it right?” He was speaking in regards to the many substitute musicians who repeatedly take the DSO auditions, and never win, despite being a first call sub or playing one year contracts.  “They’re good enough to play in the symphony, but not good enough at taking auditions.”  Others discuss the few minutes of an audition, in which a candidate has no room to be nervous but simply must perform at optimal levels, despite overwhelming odds against them.  Although film crews are not permitted to actually film an audition, the documentary does follow some of the musicians’ trips, pre audition preparation, transportation, and immediate post audition responses.  As a side note, I have to applaud these musicians for being vulnerable about their experiences and willingness to have someone film their pre and post audition processes.


The middle portion of the documentary examines the sympathetic nervous system, the role of eustress and stress, as well as the role that beta blockers plays in affecting the nervous system.  Rarely discussed until recently, beta-blockers are often used to help manage the physiological consequences of stage fright.  The unanimous conclusion of those interviewed was that beta-blockers can help performers play their best, but will not help them perform better than they normally would.  Jennifer Montone, Principal horn of Philadelphia reiterates how a bedrock foundation of practice and strong mental preparation is most important, which was something echoed by many others throughout the film, including Dr. Noa Kageyama of the Bulletproof Musician.  

The remainder of the film examines different ways of changing the way we as a musical community handle performance anxiety, from changing the way we train in schools and conservatories, to creating a more open dialogue about performance issues.  One quote from Nathan Cole, associate concertmaster of the Los Angeles Philharmonic, stood out to me.  “I’m a performer, violinist, but I’m also a person.  Violin doesn’t define me.”  It can be so easy as a performer to tie audition or performance success with larger self-worth (or lack thereof).   Gerald Klickstein, music educator and author of “the Musician’s Way,” proposes a different model of education in which students have access to a much wider spectrum of teachers, not only their private instrumental instructor, but a sports/performance psychologist or coach, body awareness teacher, and more.  The film ends with different musicians offering their perspectives on how there is no one right way to tackle performance anxiety, and that opening the dialogue about these issues is the first step to addressing the issue in a greater way.


The film is a nuanced examination of the pressures and stresses of professional music-making, but also weaves in kernels of musical wisdom throughout for both musician and non-musician audiences.  Drawing interviews from other 60 musicians, totaling 120 hours of footage, John Beder managed to edit the interviews into a cohesive and engaging narrative.  Footage of orchestras, soloists, and chamber ensembles is interspersed throughout the film, maintaining the connection between the art form and the challenge at hand.  Despite the sheer volume of interviews, the documentary is just short of 80 minutes.  One look at the number of interviews reveals that there are many fantastic insights that simply didn’t make it into the film, and I wish there was a way to see more of those interviews.  I can fully appreciate the amount of editing and observation needed to whittle down 120 hours of material into 1.2 hours, and Beder surely has many other gems of insight that didn’t make it in there.  

I don’t have many criticisms for the film: there have been few attempts to document classical music from the perspective of a filmmaker that is also a musician, and even fewer ventures into performance anxiety.  This film has the power to connect the musical community over a shared experience, but also promote a greater dialogue about these issues and usage of the many resources that are available to the modern musician.  By and large, the film does not take a negative or condemning stance to beta-blocker usage, and I would’ve liked to hear from musicians for whom they do not work, or whom feel that they play worse with them.  I would have also been curious to hear more from musicians about when (if at all) they use them, whether they use them for auditions and performances, or exclusively auditions, or never.  Yet, it took immense courage to approach professional musicians and encourage them to talk about these issues, and even more courage for those who spoke openly about their own issues and remedies.  That, in itself, is a landmark achievement which is truly astonishing.  Although this is a film about musicians, it would have relevance to non musical audiences as well, as it reveals the complexity and pressures of the classical music art form.  With the wide range of interviewees as well as the profound insights about performance and music itself, every classical musician should see this.

The film premieres October 19th, 8 PM, and for more information, visit

Beta-Blockers, Performance Anxiety, and the Results of the Musicians' Health Survey with John Beder

In the last year, John Beder has not only interviewed many classical musicians about their experiences with performance anxiety and beta-blockers, but also drafted his search into a cohesive survey for ICSOM (The International Conference for Symphony Orchestra Musicians), which has not addressed musicians and performance anxiety in almost 30 years.  On Wednesday, almost a year after initially launching his Musicians' Health Survey and reviewing the data, John shared his findings at the 2016 ICSOM conference in Washington D.C.  

K: With those who were comfortable discussing their beta blocker usage, how did they impact their performances, auditions, or other circumstances?

J: Throughout the project many of the musicians we talked to about beta-blockers heard about them as the “easiest" and “quickest" way to address performance anxiety. Fast and easy of course sounds perfect when so much time is already consumed by all the other demands of the profession. While we spoke with many people who had positive things to say about the use of beta blockers, many of the musicians we spoke to about beta blockers had a nuanced view of their application. They spoke about them as complimenting a diversity of methods for addressing performance anxiety, rather than using beta blockers to get around more traditional methods of performance preparation.

Many had spent a significant amount of time studying how to perform more confidently on stage, beyond the technical and musical demands of performing. Ultimately, beta blockers are not for everyone, and are certainly not a replacement for preparation or some sort of panacea for performance anxiety. This, I think, is the most important take away from any discussion around beta-blockers: that they are a part of a larger conversation about performance skills which is missing from many of our music education programs.

K: For those who don't use them, how do they manage their performance anxiety?

J: Many of the musicians we spoke to who had not tried beta blockers also invested a significant amount of time figuring out how to address performance anxiety. Many used mindfulness techniques and meditation, while others borrowed from sports psychology with things like heart monitors, biofeedback machines, and breathing exercises. We try to talk about as many of these as possible in the film in addition to beta blockers but with the impressive quantity of approaches we only had time to focus on a few of the most practiced. It’s interesting to note as well that the conversations never started with “I don’t get nervous” since every single person we talked to expressed experiences and instances of performance anxiety. 

K: Tell me about the Musicians' Health Survey that you launched a year ago and your findings since then.

J:  It’s been a year now since we distributed the study (2015 Musicians’ Health Survey) to ICSOM and it has been wonderful to see participation from orchestras around the country. A total of 447 musicians responded and some of the results are being shared at this year’s ICSOM conference in Washington DC. Professor Williamon with the Royal College of Music in London is still working on the formal analysis but much of what we learned will be discussed and presented at this year’s conference. 

Some interesting initial data I can share about the survey is that in 1987 women made up 34% of the respondents whereas our study reported 48% women to 52% men. Today’s classical musician also reported better than average health and there was major increase in physical exercise as a method to address performance anxiety. In 1987 61% of musicians reported regular exercise and in 2015, 68% reported regular exercise. As a means for addressing performance anxiety, however, exercise was used by 17% in 1987 and 74% in 2015, a striking increase. 

With regard to beta-blockers, the study shows that 72% of ICSOM musicians have tried using beta blockers for performance anxiety. Out of that group, 90% said they would consider using them for auditions, 74% would consider them for solo or featured performances, and 36% would consider them for orchestra performances. By comparison, in 1987 a reported 27% of ICSOM musicians had tried beta-blockers, representing a significant uptick (45%) over the last 28 years. Also in 1987 of those who’d tried beta-blockers 72% said they would use them for auditions while only 4% would use them for orchestra performances compared to today’s 36%.

Some other popular methods musicians reported trying included more experience (87%), eating bananas (54%), meditation (49%), and performance psychology (44%).

K: How do the survey and your findings factor into your work with the documentary and your work in Musicians' performance health?

J: The 2015 Musicians’ Health Survey is really just the start of a bigger conversation we hope to have with our film Composed. We can’t encourage musicians enough to explore performance skills outside of the notes on the page. Musicians are too often left feeling isolated in their struggle with performance anxiety despite the fact that 98% of ICSOM musicians report having experienced it at some point. The statistics here and ones to follow will likely prompt conversations about the beta blockers alone but our goal is not to adjudicate on the use of beta blockers, rather to promote an environment where talking about performance anxiety is accepted and encouraged as part of what it means to be a performer.

*In Fishbein et al. (1987) Senza Sordino

K: Thanks- I look forward to hearing more about this survey and new findings as the documentary moves towards completion!

Composed will begin a US tour starting October 2016. For more information please visit or email

Talking about Sweat Glands

I realize that a good portion of the country is covered in snow, including places I've formally lived like Boston and upstate New York.  Yet, it seemed like a good time to talk about...sweat, specifically sweat glands.  Nothing says a good winter read like talking about sweat glands, right?

We have two different types of sweat glands: eccrine glands and apocrine glands.

Apocrine sweat glands, found in limited locations of the body, are heavily influenced by stress and adrenaline.

Apocrine sweat glands, found in limited locations of the body, are heavily influenced by stress and adrenaline.

Eccrine glands are found all over the body and are our body's primary cooling mechanism.  When your body gets overheated, whether from vigorous movement, a hot yoga class, or warm weather, those glands secrete a compound of water/sodium chloride on the skin.  The fancy name for this process is thermoregulation. 

The apocrine glands, however, are just located in a few areas of the body, including the armpits, groin, and scalp, for starters, and these are our "smelly sweat" areas.  (That's a very technical term for the secretion of sialomucin, or sialic acid.  Don't ask me any chemistry's definitely not my field of expertise!)  These glands are more sensitive to adrenaline and rather than secreting odorless water/sodium chloride, instead secrete a combination of proteins, lipids, water, sodium chloride, and gain their odor upon contact with bacteria which "eat" the molecules, causing a change in odor.  This type of sweating is a direct response to stress, whether that be public speaking, anxiety, performance, auditions, etc.

Eccrine Sweat Glands look a bit different from apocrine glands, and are located all over the body.

Eccrine Sweat Glands look a bit different from apocrine glands, and are located all over the body.

Now a good question would be, why do I care about this when I'm freezing in 5 feet of snow?

Well, the apocrine glands are a part of our fight/flight autonomic nervous system response, and are affected during performances, auditions, etc., which you know from experience.  We've probably all experienced the anxiety perspiration phenomenon, whether in publicly speaking, performing, or auditioning.  More importantly, beta-blockers affect aprocrine production by decreasing the overall stress response on the body.  If someone has hyperhidrosis, or excessive sweating, beta-blockers can be prescribed to treat that (assuming they don't have asthma or blood vessel issues).  While the chemical binding process is a bit more complicated than I can certainly explain, your stage fright symptoms are a big part of the way your body responds to adrenaline, which affects your apocrine sweat glands, which can affect your ability to play your instrument.  Obviously excess perspiration is a big problem, especially when handling an instrument, especially a string instrument.

Your bikram class isn't really "sweating out toxins.:

Your bikram class isn't really "sweating out toxins.:

So here's the second part: how often have you heard the slogan "Sweat out your toxins with hot yoga/saunas/hot tubs, etc?"  When people talk in fitness land about hot yoga and sweating out toxins, that's not how it works.  Sweating and moving has benefits- removing toxins just isn't one of them.  As I mentioned above, perspiration isn't composed of toxins- if it's secreted by your eccrine glands, it's a combination of water and sodium.  You don't have 6 beers on a friday night and then at Saturday morning bikram, sweat it all out through your pores.  That doesn't mean that sweating isn't good for you or that a post-alcohol sweat fest won't be smelly, but really, your kidneys' and liver's job is handling toxins.  So drink water (lots of it!), especially if you're going to be sweating, and know that your kidneys and liver will be handling the aftermath of your alcohol/junk food/sugar choices, not your sweat glands.

Talking with John Beder about Beta-Blockers and "Composed"

As some of you may know, John Beder, a classically trained percussionist, is beginning a documentary project on the use of beta-blockers in classical music, focusing on auditions.  I think this is a fascinating project, not only reflecting how classical music may have changed in the last 50 years, but also how performers view perfection and the attempt to achieve audition perfection.   I asked him a few questions in the midst of his kickstarter launch to fund the documentary, "Composed."

K: What's your background in classical music and where did you grow up/study/etc? 

JB: My formal introduction to music started at the Boston Arts Academy where I’d transferred for my sophomore year of High School. It was Boston’s first public arts high school and the only option as far as I was concerned. I wasn’t planning on pursuing Classical Music at first but my instructor at the time forced me to audition for the Greater Boston Youth Symphony Orchestra (GBYSO) now known as BYSO. I somehow got in, was way over my head, but managed to keep up and found a serious passion for classical music. I continued down that path and attended Boston University where I was a percussion performance major. During my undergrad I also did a study abroad program at the Royal College of Music in London and participated in the Round Top Festival.

K: What's your interest in creating this documentary and what do you hope to show through the filming of the documentary? 

JB: My interest in this documentary comes from my own personal experience with beta blockers back when I was actively auditioning for festivals and regularly finding myself in stressful situations. I never really took much time thinking about why my love and passion for music had turned into fear and anxiety, but before I really gave it much thought I had already left to pursue film. With "Composed," I hope to elevate that conversation surrounding performance anxiety while also paying homage to what classical musician go through to pursue their dream. People experience anxiety on a regular basis it seems but don’t really enjoy talking about it. This film, I’m hoping, will open up that conversation for not only musicians but other people struggling with anxiety while pursuing their passion. That said I’m in the early stages of filming and am still discovering the path this film will take in its final form.

K: Who have you interviewed thus far? Have there been any surprises in terms of interviewing musicians? Have there been refusals?

JB: So far I’ve interviewed some great people and am always surprised with each interview. Everyone has something interesting to say about the topic and many times I’ve felt a sense of sadness that I didn’t have these conversations during my own struggles with performance anxiety. Here is the list of participants so far.

Diane Nichols, LICSW formerly of the Juilliard School Night Division
Dr. Noa Kageyama, Ph.D The Juilliard School (AKA. Bulletproof Musician)
Matt Decker, Assistant Principal Percussion North Carolina Symphony
Brent Edmondson, Principal Bass Lancaster Symphony
Max Michael Jacob, Freeland Bass, NYC
Tim Genis, Principal Timpani Boston Symphony

Others who’ve recently signed on include

Teddy Abrams, Music Director Louisville Orchestra
Emi Ferguson, Flute Soloist, faculty with The Juilliard School
Zoya Tsvetkova, Violinist Rhode Island Philharmonic, Vermont Symphony

As far as refusals are concerned I’ve had quiet a few. Some big names and others just acquaintances or former colleagues but though some are just not comfortable in front of the camera, many are hesitant to make any statements one way or another about the topic. 

K: Why is your documentary important and relevant to musicians today?

JB: Musicians in general though seem to express some sincere relief at the idea of talking about their struggle with performance anxiety and raising this discussion to a bigger platform. There are tons of people out there who want to talk about this subject and just don’t realize they can with this project. Many of my participants spend time thanking me for choosing the subject, while I’m simultaneously thanking them for participating in a subject that can be extremely personal. 

K: Lastly, how can people support your work and find you on the internet?

JB: If there are musicians or professional health experts out there wanting to participate, they can do so by backing my Kickstarter project or by contacting me directly at I still need participants and would love to talk to anyone willing to talk on camera. The Kickstarter project is mainly to help with travel costs that I severely underestimated for the film. Most of the funding comes from myself, but offsetting some necessary costs will make this project take shape a lot faster and allow for more voices to be heard. 

*Fact: as of 2/1/2015, the project is almost half funded, so let's spread the word!*

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