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Coping with stage fright

Stage fright, or performance anxiety, is a feeling of dread and fear that comesover a performer before and/or during an appearance or performance in front of By Dr Sanchita
an audience. It occurs especial y, but not only, when performing for the first time, Farruque, BAPAM
though even wel -established performers can suffer.
It usual y starts on the day of the performance and may get worse as the show gets closer, but it can happen at any time, without warning. If your nerves take over, your performance could real y suffer. Here are some of the symptoms: • Dry mouth• Heart beats faster and can be felt in the chest• Breathing gets faster and heavier• Dizziness• A sick feeling (although actual vomiting is less common)• The urge to keep rushing to the loo You may also have some negative thoughts, being very worried about theperformance and feel as if you might not be able to cope with it, etc. This maybecome so persistent that you can’t think of anything else.
Some level of excitement is necessary to make a good performance, but when thisturns into stress, it can be a problem. The graph below shows how this can work.
The more the pressure of performance increases, the more the excitement goes up,but after a certain level, the performance level starts to drop as excitement turnsinto stress. This effect is driven by the acute stress hormone – adrenaline.
How excitement turns into stress
The many causes of stage fright can be grouped into certain types:• First time performing on stage, although it should be noted that it can strike even • Poor preparation – if you haven’t learnt your piece or lyrics properly.
• Nervous personality type – which might also have deeper psychological causes.
• The importance of the performance itself.
• Outside factors about the gig: the venue, difficulties with promoters and/or staff, poor acoustics, etc, that you have no control over.
How you can deal with stage fright
There are a few ways of trying to reduce stage fright, but it may never completely
go away and some people would say that a performer needs a certain amount of
‘nerves’ to perform wel . What this means is that, as long as the energy feels more
like excitement than dread, then it’s fine to have a little bit of anticipation.
However, because this can be very hard to judge, it’s not always possible to
control the excitement and stop yourself feeling afraid.
The triad of performance anxiety
FEAR You can change this by working on the negative thoughts Below are some strategies for reducing these feelings. First, we list non-medicalstrategies, fol owed by medical interventions: Ways of dealing with stage fright that don’t require medication
You can work on the physical/mental/technical aspects by:
• Preparing for your gig! Learn your parts/words, etc. and do this wel in
• Doing some less important performances to take the edge off the main • Distracting yourself with other activities. Anything that takes your mind off things wil do, but don’t get too engrossed in your displacement activity! • Managing the adrenaline with deep breathing. Use the bottom parts of your lungs (abdominal breathing) to slow down your heart rate and calm the nerves.
• Doing some physical exercise or warm-up as this helps to relax you. See the warm-up exercises factsheet ‘Don’t cramp your style’.
• Trying complementary therapies, such as massage, meditation, yoga, Tai Chi, Pilates and Alexander technique, to name but a few. These wil help to relax youphysical y and mental y.
• Eat foods that release serotonin (the ‘happy hormone’). Examples are bananas PAGE 2 OF 3
or dark chocolate (but watch out for the caffeine effect of chocolate, which cancreate more stress!) and keep hydrated (NOT with alcohol! – as this can impairyour performance).
• For dry mouths, drink water, gently bite your tongue (if you are about to get on stage and you have no water to hand) as this wil produce saliva in the mouth.
• Counsel ing –if none of the above seem to help, or if you have some deeper psychological concerns that would benefit from one of the talking therapies.
(Cognitive-Behavioural Therapy – CBT – is widely used for stage fright). Youshould look for a therapist who has experience in treating performance anxiety.
Medical ways of dealing with stage fright
The drugs that can be used to ameliorate the symptoms of performance anxiety
are available on prescription only. Even if you have a prescription, you must
fol ow the dosing instructions careful y at al times. Self-medicating is highly
The drugs used are:• Beta blockers. These slow the heart down, reduce the sweating and help to calm the nerves. These drugs are very serious and should only be used 1-2hours before a performance and at a dose that has been prescribed by yourdoctor. This dose – or amount of drug – wil depend on the individual, yourage, gender, size, etc. and so it is not possible for you to guess how much youcan safely take, by yourself.
• Tranquil isers. Again these are very serious drugs and need medical guidance when being used. These have the same side-effects as alcohol, in that they tendto make the individual rather clumsy and drowsy. Clearly this is not ideal forperformers.
The best line of action is to explore the non-medical ways of dealing with stagefright first, and to resort to medication only if these don’t seem to help on theirown.
Stage fright is something that can affect you, to varying degrees, when you haveto perform. There are many different causes of it and different ways to deal with BAPAM Factsheet 1
it. Being aware of it and open about it is a good start. The more you share your Don’t cramp your
fears, the less you wil suffer alone. Get yourself help that works for you and you should find that, as you perform more and more, the bad effects of stage frightget less and less stressful, reaching a level you wil be able to cope with.
BAPAM Factsheet 6
The drinks are on

Don’t forget – try to enjoy yourself!
British Association for Performing Arts Medicine
Totara Park House, 4th Floor, 34–36 Gray’s Inn Road, London WC1X 8HR
ADMIN 020 7404 5888
CLINIC LINE 0845 602 0235
FAX 020 7404 3222
BAPAM 2007. May be copied for non-commercial purposes provided the source is acknowledged.


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