Extract from Mammoth magazine No 18, Autumn 2018.

Sonia Lupien, Ph. D.
Director, Centre for Studies on Human Stress

Over the last three years, the Center for Studies on Human Stress has witnessed an important rise in the number of calls from parents and education professionals seeking information on performance anxiety. Parents and professors tell us that they have seen an increase in cases of performance anxiety in children and adolescents and they want to understand the role that stress plays in the development and/or the fostering of performance anxiety in youth.

Here is a summary of the scientific literature on the subject. However, it is important to note that performance anxiety is not a psychiatric condition in itself and very few studies actually exist on this subject. However, below is a summary of what scientists have learned over the last 10 years.

Differences between stress and anxiety

Most people know the kind of stress that can be generated by an upcoming exam or competition. Scientific papers even use these to study environmental stress. Researchers measure stress hormones in children, adolescents or young university students that have an upcoming exam and it has generally been shown that stress hormone levels increase significantly in this situation. However, being successful at an exam or a competition can be so important to someone that it generates extremely high levels of stress. This is what we call ‘performance anxiety’.

As mentionned in the previous article, stress and anxiety are two concepts that do not refer to the same thing. Stress occurs when an individual faces, here and now, a threat detected by the brain. When the brain detects a threat, it produces stress hormones which allow us to fight or escape from the threat. Anxiety is the anticipation of an imagined threat. However, the brain reacts the same way to a real or imagined threat – it produces stress hormones. This explains why anxious individuals tend to produce higher amounts of stress hormones, given that they constantly anticipate imaginary threats.

Performance anxiety

To this day, scientists suggest that performance anxiety develops when an ‘estimation problem’ of the brain occurs. This means that the child has a tendency to overestimate threats and risks associated with a situation and underestimate their capacity to fight them. This gives rise to harassing thoughts such as : ‘If I fail this test, I will fail my school year, I will have to drop out, I will never attend CEGEP, I will not have a job later, no family…’ Whoa! It is easy to see how in the longer-term, such imaginary threats can become overwhelming and cause anxiety! The problem with the important stress response generated by these catastrophic thoughts is that it diminishes performance! When performance drops because of the stress generated by this anxious state, it ‘confirms’ the child’s catastrophic thoughts about the situation. This creates what I call the ‘vicious cycle of stress and performance anxiety’. I describe what this cycle entails below.

Step 1 : A situation is stressful, our brain detects a threat

CAs I mentioned at the beginning of this article, most people know what kind of stress can be generated by an upcoming exam or competition. At this point, it is important to distinguish two types of stress : absolute stress and relative stress.

Absolute stress consists of a real threat for everyone. If someone enters a class and screams ‘fire!’, every student will have a very robust stress response and will run out of the school. And that is perfectly fine. However, there are not many absolute stressors nowadays as we live in far safer times than our ancestors who hunted mammoths !

Today, we are primarily surrounded by ‘relative stressors’, This means we produce a physiological stress response (stress hormone secretion) if we interpret a situation as having one or more of the four characteristics of stress that you know well:

– Novelty
– Unpredictability
– Threat to ego
– Sense of low control

Step 2: Constant stress modifies our way of interpreting a threat

Every time our brain detects an absolute or relative stressor, it will produce stress hormones that rapidly access the brain. As long as it is an acute stressor (here and now), our biological system will work admirably well. Problems occur when stress becomes chronic. When stress hormones are produced repeatedly and chronically, they modify our ability to discriminate between threatening and nonthreatening information and in the long term, what can happen is that ‘everything becomes threatening’… It is at this moment in time that individuals begin to anticipate imaginary threats when there are none!

This is what we call anxiety. The brain turns into ‘super-threat detection’ mode and so, catastrophic thoughts are generated when we are faced with situations that are, in sum, nonthreatening. It is important to differentiate between three types of anxiety:

-State anxiety: We can all be in an ‘anxious state’. For example, before an important exam, it is normal to feel anxious. This anxious state is temporary and generally disappears when the particular stressful situation is over

-Trait anxiety: We can also have an ‘anxious personality’. Individuals who have an anxious personality have a tendency to worry about little things or they desire to have complete control over every aspect of their lives.

-Anxiety disorders :

Anxiety, when uncontrolled, can develop into a mental health condition called ‘anxiety disorder’. There are many types of anxiety disorders such as phobias, generalized anxiety disorder and social anxiety disorder.As mentioned previously, performance anxiety is not a mental health condition in itself, but it is a part of the broader category of ‘anxiety disorders’

When therapy becomes a necessity

Can we treat or control performance anxiety?

A child suffering from performance anxiety fears any form of evaluation in which he/she might fail, feel judged or criticized. When confronted with a threat, our biological system has two choices : to fight or flee the situation. A child with performance anxiety will systematically choose to flee, which we call avoidance. For example, the child could ask not to go to school or to their sports practice.

Research on anxiety disorders have shown that avoidance IS NOT the preferable option to choose when one suffers from an anxiety disorder. Children need to learn to fight their ‘inner mammoths’ so that their brains do not begin detecting threats when there are none (we invite you to read the next article which elaborates on avoidance).

Below, I describe a form of psychological therapy that was proven to treat anxiety disorders as well as 5 methods described in the scientific literature that have demonstrated their capacity to help young people deal with performance anxiety.

Seeing a psychologist can possibly be a very good approach to helping young people deal with performance anxiety. Scientific literature suggests choosing a psychologist that uses ‘cognitivebehavioural therapy’ (CBT). CBT is a form of therapy that teaches young people to better discriminate between threats that are real and those that are not. When they are better able to make this distinction, anxiety greatly decreases and may even disappear. Therefore, every time a terrible thought comes to mind, we teach the person to control this thought. CBT is very effective in treating anxiety disorders, but there is one condition to the success of this type of therapy: the patient must be 100% invested in the therapy and do the homework required by the psychologist. No diligence, no results !

In issue 16 of the Mammoth Magazine, we outline the procedures to follow to locate a psychologist near you who uses the cognitive-behavioural approach. Do not hesitate to read this issue if you want to find psychological help for your child.

Interpreting stress as a challenge

Stress is necessary for survival and small stress responses help to increase alertness and therefore, attention and memory. In fact, we do not say it very often but a little stress increases memory! It is only in the case of very high acute stress or chronic stress that memory is decreased. Therefore, the curve linking stress and performance is an inverted-U shape (see diagram below).

A little stress increases performance (left When therapy becomes a necessity side of the curve), while too much stress decreases performance (right side of the curve). When we see a situation as being a huge stressor, we can easily find ourselves on the right side of the curve with decreased performance. However, if instead of telling ourselves “this is a stressor”, we tell ourselves “this is a challenge”, we modify our interpretation of the situation and we can increase our performance thanks to the low stress response that is generated by perceiving the situation as a challenge. Since we have to deal with relative stressors in our everyday lives, our interpretation of the situation can change everything when it comes to the positive or negative effects of stress on our brains !

The motivation that is generated by the idea that the situation is a challenge (rather than a stressor) has to be intrinsic and not extrinsic. The motivation to face the challenge has to come from the child (intrinsic) and not from their parents, coaches or teachers (extrinsic). Research has shown that when motivation is extrinsic (for example, the child wants to perform well to please their parents), this generates such high levels of stress that brings the child to the right side of the stress/performance curve and so, his/her performance decreases and this makes them believe that they are not able to combat the stress. When the motivation is intrinsic (the child wants to perform on their own), this generates less stress which brings them to the left side of the stress/ performance curve and their performance increases.

Not trusting our inner voice when it screams out at a threat

The little voice we hear in our head (our of this we have a tendency to believe everything this voice says. However, this voice is only the reflection of thousands of thoughts that pass through our brain every second. We have to see this constant babbling as ‘brainwashing’. You do not believe all the dreams you have at night, and yet, you have your own voice in your dreams ! So why always believe what your ‘little inner hamster’ says ? In a great book called ‘Le piège du bonheur’ (“The Happiness Trap”), researchers suggest that we modify the voice in our head in order to reduce its impact on our lives.

Every time your inner voice tells you you are afraid because there is a threat, change that voice to ‘Dora the Explorer’ or ‘Bart Simpson’. You will notice that the impact of the little voice on your emotions will be less strong! And if this works for you, it will also work for your child.

Listening to music

When our inner voice annoys us too much, we listen to music ! In fact, scientific studies have shown that listening to music (and if the music has lyrics, it is even better), interferes with the inner voice and decreases its importance!

Moving

When we are stressed out, we mobilize energy. If we do not lose this energy, it affects our brain and our performance. It is when we feel anxious and that our little inner hamster starts turning that we have to put on our running shoes and go play outside!

There are over 100,000 ways to move and play sports but one we often forget, which is often enjoyed by children, is dancing! What do you think mammoth hunters of the prehistoric age use to do around the fire come nighttime? They danced. By doing so, they got rid of the energy mobilized during their mammoth hunts !

To conclude, my message to young girls and boys who are ‘super threat detectors’: if you are a little anxious near exam time, it is not after the school year that you should have a party and dance…it is before!