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You can view the first installment of this debate here and the third installment here

Beta-Blockers (2)

Please stop that thread. There is no help for performance anxiety. One has to live with it or give up playing in public. But there are some other advises:
  • Stop ambitiousness which exceeds your playing abilities.
  • Try to be real about your playing quality.
  • Care more for easier pieces & play them better.
  • Stop consuming any alcohol or other drugs & watch the positive effect on your nerves.
Beta Blocker works well for persons suffering high blood pressure, but nor for playing the horn.

For those unconvincibles:
take Beta Blockers, drink cognac or champagne before the concert & some cups of espresso, eat as much of strong food as you can to make you strong, play continuously until the concert (minimum 2 hours practice & one hour warm up the day of the concert, regardess if there is a dress rehearsal the same day, play the most challenging & difficult concertos neglecting the other pieces as to easy, forget about the musical values completely, exaggerate all dynamic values specially in the double forte, etc.etc. attend all parties after the concerts & other parties - and shorten your playing life & real life.

Prof.Hans Pizka
Dear Hans, and hornlist,

I thought of not posting this to the list, but then changed my mind. It is worth mentioning, and if gets back to the person involved, perhaps the world of horn-playing will improve.

My experience with beta-blockers (that I know of) has been as playing 2nd horn to a betablocked-1st-horn in a concert which concluded with Beethoven's 7th symphony. I don't recall any high b's coming out of the bell of the betablocked-principal, who was also using an assistant rather ineffectively. This hornplayer basically muffed the entire thing, but had actually been doing the job during the rehearsals, with no pills. Going on the pill for that concert is beyond me.
(maybe they did their job: b-blockers? (groan...))

But the strangest thing was, we talked a bit after the concert, I was prepared to give some encouragement, but this person said: "...well it went pretty well, don't you think ?..." Didn't even notice, but the audience did. The betablocker may have even impaired judgement. Who knows, it may have been just a simple case of B7-bomb-out.

I had a lot of difficulty trying to match the volume level of that non-existant high part. After figuring out what was happening I just gave up and played as written.

This person did not consult a doctor, nor have experience taking them, nor even need them to get through nerves. I believe that they are useful for what they are for, and only for medical conditions should they be used. And if you use them under medical advice and they work, ask for a placebo instead, it might be cheaper :) (think about it, that's a joke!)

:) Finally, there are some people who honestly and truly need medication for this, and if they play wonderfully, then medical science has helped out the musical world, just like saving the life of a musician suffering a stroke, or a car accident, or...

Carl Ek
I've been reading everyone's comments on this subject and thought that it was about time to give my reaction. I love music, and I love playing the french horn. when presented the challange of performing in a public setting many people forget this very fundamental thing. You love music. You are creating music. Not everyone is perfect, and most of us are going to make mistakes of varying degrees. Enjoy what you are doing. Just like anything in life, music can be an aggravating, nerve wrecking, ulser producing job, or a creative outlet, a fun enjoyable experience, a way to release emotions.
so when people ask me how I didn't get nervous, I respond, I enjoy making music, no matter what the setting...
Bill Aiken
Regarding the use of Beta Blockers:

I don't have a positive or negative view on the use of beta blockers, otherwise known as Inderal. I just want to caution those who have never use them to keep this in mind. Many doctors do not realize that musicians don't need the usual medical dosage of Inderal for it to be effective. The normal dosage is between 80-100mg. A musician does not need this large a dose. 5-10mg is all one needs for the drug to be effective for performance anxiety. Make sure that if you are going to try beta blockers that you explain to your doctor that you do not need such large doses. Also make sure that if you are going to try them that you try them before the actual time that you need them!! They may have side-effects on your system that you are not prepared to handle out of the blue.

Warning over. :)

Karen McGale
I was on Beta blockers for an accelerated heart rate due to thyroid disease a couple of years ago. I play much better now than I did then and since I didn't know it was supposed to relax me before a concert, I never noticed that effect. If you are getting an effect on a sub-clinical dosage methinks it could be you would have the same effect with a sugar pill and the assurance of its success.

When I was in Drum Corps, there were several of my fellow performers who were always interested in recreational drugs. I was working at a Madison, WI veterinary clinic, actually living above the clinic. These poor souls thought I had access to some good stuff. To teach them a lesson, I took some chlorophyll tablets that we used to give dogs to freshen their breath and I gave them a fancy name and told the would be experimenters that they were equine muscle relaxants. I charged them a buck a pill and sat back to watch the show. About a quarter of the people said the pills were bogus, another 50% started acting pretty goofy and wanted more and another 25% said they were the best "high" they ever had. I ended up about 50 dollars richer (a lot in the late 70's) and about 20 people got "high" on doggie breath fresheners. When I told them the truth no one believed me or it was less embarrassing not to believe me. At least everyone in the back of the bus had fresh breath.

Annamarie Dittmar DVM
Just one more item regarding beta blockers: I have been told that those individuals who are asthamatic should not use these products. Always check with a physician.
M Hesse
Please stop that thread. There is no help for performance anxiety. One has to live with it or give up playing in public.
The post I made about beta blockers was not an advertisement for people to start using them. It was cautionary information only, because it appears that too many people are already using them without a doctor's consultation, or ready to arbitrarily start taking them, as well as other drugs. As I said before, this can be very dangerous or, in some cases, fatal.

In looking for other methods to get over performance anxiety, I am asking you to tell us without the sarcastic remarks please-how have you dealt with performance anxiety without resorting to drugs or alcohol?

There was the time when you first began playing horn in front of audiences.
Did you get nervous while playing in front of an audience?
If so, what did you do to get over it?
What do you tell your students when they are anxious about playing in front of an audience?
What is the single most important thing you could tell all other horn players in regards to performing in public?

Rachel Harvey
For those unconvincibles: take Beta Blockers, drink cognac or champagne before the concert & some cups of espresso, eat as much of strong food as you can to make you strong, play continuously until the concert (minimum 2 hours practice & one hour warm up the day of the concert, regardess if there is a dress rehearsal the same day, play the most challenging & difficult concertos neglecting the other pieces as to easy, forget about the musical values completely, exaggerate all dynamic values specially in the double forte, etc.etc. attend all parties after the concerts & other parties - and shorten your playing life & real life.
If your argument were reversed -

To be a legendary hornist, one should be born by immaculate conception, jump buildings in a single bound, have nerves and brains made of steel, eat nails, and if you could rise from the dead after you die, that would help to...

To make the analogy that persons who take medications for medical conditions are somehow weak, inferior or reckless in their personal disciplines is pure poppycock, professor.

Certainly bad practice habits or personal indulgences can create performance anxiety. But it can also be a medical or psychological condition - that can be treated. Do we not treat other physiological ailments with medications and/or counseling?

Yes, I agree with you in that the choice to be a hornist is a tough one and that the world owes NO favors when that choice is made. But before declaring a musician as inferior because of a treatable condition seems a bit cruel and smacks of a superiority complex.

As humans, I believe that we are inherently IMPERFECT. I will never be as good as my imagination, but I try. It is foolhearty to presume that MY way is the only way. So what? Some people have to take medications to perform. Some musicians even get stinkin' drunk - so what?

It is not for me to judge one's personal habits or personal ailments. If I enjoy listening to or making music with them - who cares?

Bruce Hembd
I would like to tell you about my experiences with beta blockers and tranquilizers:

While playing in a Mexican orchestra, my second horn player and myself were invited to perform Rosetti's 2 Horn Concerto in E Flat with the group. There were two performances scheduled and the two of us practiced daily for about a month or so until the parts were worked up perfectly. It was around this time that I heard about beta blockers, and obtained some propranolol over the counter (which was the way it was sold in Mexico City). The suggested dosage was 20 milligrams.

For the first performance, I decided not to take the Inderal (which is one brand name for propranolol). My recollection of that performance is that I was terrified out of my wits throughout, although there were no train wrecks. The audience reaction was favorable enough to convince us that we had done a good job. I decided to go ahead and take the Inderal for the second performance. I had never taken this drug before, and did not know about possible side effects. Four hours before we were supposed to play, I took 20 milligrams. 1/2 hour later, I had a bout of dizziness which passed, after which I felt like I was seeing things through a pane of glass. It was also somewhat difficult to concentrate or to breathe. When it was time to perform, we got on stage and ran through the Rosetti with no hitches. Mentally, I felt as though I had been freed from some kind of a 'bondage'-it seemed to be easier to perform. The only problem was that my emotions had somehow been shut off. Listening to the tape, I felt the performance was rather lifeless, even though it was note-perfect.

The second time I took Inderal was for a horn club gathering, also in Mexico City. Some of us had volunteered to play solos. I chose a solo piece by Malcolm Arnold but did not prepare it adequately. And, before the peformance, I took the Inderal again. The experience was completely different this time. Instead of being calm, cool, and collected, I was terrified out of my wits. Although I didn't shake, my left hand froze up so much that I could hardly move the levers on my horn. I also could not take a full breath for the extended passages the piece demanded. Of course, the performance was a complete flop.

After this, I abandoned the Inderal entirely for many years. At this time, it was difficult for me to understand why it seemingly worked for me at one performance, but not at another.

I know the answer now-it wasn't the Inderal that caused me to play well at one performance and badly at the other; it was the fact that I had thoroughly prepared for the first and hardly prepared at all for the second. This told me that Inderal did not keep me from being afraid; nor did it make me a good hornist.

In 1991, I was diagnosed with high blood pressure and migraine headaches, for which my doctor prescribed Inderal in a very high dosage (480 milligrams). Although the medication helped bring my blood pressure down, I did not find any substantial improvement in my horn playing, nor a lessening of personal anxiety. In fact, my hair fell out on the top of my head, leaving a bald spot, which I had to hide by combing the rest of my hair over it. And, I had more train wrecks during concerts than ever-due to not practicing my horn enough, since I was working full time in those days.

In 1995, my doctor proposed changing my medication from Inderal to Vasotec which is a calcium channel blocker. After just one week on the medication, I had a true allergic reaction to it which put me into the hospital. So, it was back on to the Inderal.

Over the years, my doctor has reduced the dosage of Inderal down to what I take it at present; 160 milligrams a day of long-acting Inderal, taken in 2 dosages. I have no discernable side-effects, since I have become accustomed to the medication.

However-I have taken several auditions during this time period. In every one of these auditions, I was not adequately prepared for what was offered. Because of this, I was naturally quite anxious during the preliminary rounds of the auditions; played badly, and was disqualified.

The only audition that I have passed in the last 12 years is the one I took to get into the Japanese orchestra I play in now. It was a non-screened audition, in front of a committee of 25 persons. For that audition, I prepared for 2 months; 4 hours a day. Because of this, I was not anxious about playing; I knew the music cold. It was the work of a moment to come out on the playing floor, sit down, blow a few notes, and do the audition with no problems.

For all of you who read this-Inderal has not, I repeat *NOT* made me a better horn player. And, I may have more confidence now than 12 years ago, but I still get anxious before big performances and I still get nervous at auditions.

That is why I do the personal routine I posted before in answer to Mike Emery's question about performance anxiety, despite the fact I do take Inderal regularly.

For those of you who may have missed it, I am reposting the statement I made about beta blockers at the bottom of the post in reply to Mike Emery's post about performance anxiety:

__________________________REPOST__________________________

 As far as taking Inderal (a beta-blocker) is concerned, it does prevent
the shakes, dry mouth, but does not prevent you from being scared.
 
Indeed, when taken daily, Inderal often counteracts some or all of the
energy you need to put the necessary sparkle into a performance.  I do
not believe that Inderal will ever, EVER make you a good horn player,
nor will it EVER make you fearless.
 
 ***Never take Inderal without a doctor's prescription.***
____________________________________________________________
Karen, I would like to give a friendly word of advice: I am sorry to say this, but neither you nor anyone else are qualified to recommend any kind of dosage of Inderal or any kind of prescription or non prescription medication over the Internet to anyone who may be reading your post. ***Not even a doctor will prescribe over email***

Indeed, what you call a small dosage of Inderal (20 milligrams) can cause a person with moderately low blood pressure to faint, have breathing problems, or other nasty side effects. It would be so easy for some high school kid who has been scared of playing in public to grab his dad's bottle of drugs and pop a few. For him, that may be fatal.

I am posting two bookmarks below. The first one is doctors' information about beta blockers. The second is a post from the harp list.

For Paul, I would also like to add a short note about diazepam (Valium, Xanax, Ativan) tranquilizer agents. I took Valium, Xanax, and Ativan, mostly for the stress I was enduring while working as a secretary for 12 years. In fact, I was taking Valium when I performed the Britten Serenade with an orchestra in early 1990. I remember that performance most clearly-it was absolutely terrifying. And, again I did not practice my horn as much after work, so my chops weren't built up enough. I thought that I would do okay in the concert, since the rehearsals seemed to be going well. But I was mistaken. Despite the tranquilizer, I still froze up during key portions of the work-such as that high C in the Dirge. In fact, I think the only thing I played well was the offstage horn solo-because I felt that now there was nothing to lose-and could relax and enjoy the concert (a little too late though).

Valium also made me irritable, cranky, and real nasty to my colleagues during rehearsals. I have totally alienated some people for life since 1986 because of my behavior while taking this drug. A performance of Mahler 9 done with Valium was not all I had hoped it to be. Although I thought it went well, after listening to the tape I judged my performance to be rather 'lifeless', despite being technically accurate.

I stopped taking Valium and Xanax a number of years back and do not miss them at all. Other side effects of tranquilizers for me included headaches (which I don't need more of!), short term memory loss, and sleeplessness (couldn't sleep without them).

I do not drink alcohol any more because I can't play the horn after having even one beer. I also know that prolonged alcohol use breaks down muscle tissue-and aren't our horn chops *muscle* tissue? I have to keep explaining to our Japanese musician colleagues why my husband and I do not drink, when we are partying with them after rehearsals.

Experiments with marijuana in the mid 70's showed me that this drug causes short-term memory loss in the extreme and completely interferes with concentration. In fact, I remember the day I decided to stop smoking it- After taking a couple of hits, I was walking across the lawn at the facility where we were doing opera performances, and completely forgot where I was headed and what I was supposed to be doing. That was the day I stopped smoking marijuana entirely. Not even the fact that some of my colleagues in the Mexican orchestra used marijuana daily, before and after rehearsals could change my mind about taking it again.

I hope that this post will be beneficial to everyone who is considering using any kind of drug for performance anxiety. I have learned, the hard way, that no anxiety-reducing agent is quite so good as being overly and thoroughly prepared on whatever music you will be playing and to be prepared for the environment in which you will be playing that music.

Rachel Harvey
It seems that this thread will not die. Last year at this time there was a truly heated debate over the pros and cons of using such medications.

To be sure there are people firmly entrenched in both camps, and each have valid points for their positions. Proponents of each camp are adament and will not change their minds.

For those who may be flirting with this issue,I would first talk to SEVERAL trusted physicians about WHY you are deciding this course. You may find out more information to make a truly informed decision. Remember, what works for one may very well not work for all.

I am not being judgemental, but offer prudent caution for you to solicit expert advise from medically qualified individuals. So, before we see another heated debate rage over this issue, let's have this issue die away.

Eldon Matlick
Because of several experiences I didn't choose to have, and wish I had avoided, I think I can comment on the effects upon performance of beta blockers and other mind altering experiences.

Ten or so years ago, a doctor perscribed for me a beta blocker for treatment of high blood pressure. During the time I used it, I coincidentally felt I was maturing as a musician, because it seemed to me that I had finally mastered the problem of nervous jitters. Whether or not I actually played better horn because of the pills, I will leave to others to say.

Eventually, the Doctor took me off the beta blockers because they managed to dull me down for hugh chunks of the day. The pre-solo jitters returned. But so too did a more normal life! I must say now, I have no regrets.

Another medical experience, beginning in 1994, produced a somewhat similar result in me. I came down with encephalitis. Apparently, I suffered extensive (but fortunately neither overwhelming nor permanent) damage to the brain, particularly in the temporal areas. Again I lost all instinctive sense of fear. I could climb ladders to the top, step out on a roof and nail shingles on the edge without batting an eye. I could also sit calmly for forty measures awaiting a solo and come in without a qualm. At least this -- as long as it lasted -- was a great plus.

During the past year or so, some mild sense of apprehension has returned. I have welcomed this return of natural apprehension as an indication of further recovery from my ailment and have been more than willing to live with it. Certainly, despite the incidental benefits, I would never recommend a little encephalitis injection as a satisfactory method of performance enhancement.

One last experience that I think is also relevent to the discussion. Last spring, I rehearsed and played first horn in a performance of Vittorio Giannini's Symphony# 3. The part, for me, was challenging. I really worked on it and as the concert approached, I was confident I was going to do a professional job. The day of the concert, however, I tried to relax by working outdoors on removal of rust spots on my car. The job included spraying paint, and cleaning off the chrome with a solvent. When I went on stage that particular night I experienced an eerie sense of calm and well being -- unlike anything I had ever felt before. Almost from the start, however, I realized that I was not playing with a full deck. On some occassions I wasn't even counting up to four correctly. My doctor informed me later that the solvent contained the same ingredient that glue sniffers inhale, often doing themselves permanent damage. He advised me to get a new car.

Somehow, I think there is something here for more than just me.

Lew Rubenstein

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