Living with performance anxiety

I’ve never been a natural performer.

And I mean that in the most general sense. As a child I wouldn’t even raise my hand in class even if no one else knew the answers and I did. And it wasn’t even so much out of any fear of being considered a nerd. It was that it felt like it would be a performance: I’d have to stand up to the glare of everyone’s eyes while I gave words to whatever I thought the answer was.

Far easier to just say nothing.

I did it in Sunday school, too. One teacher caught on to me and started calling on me specifically when questions went unanswered. I still recall one time he asked about St Luke’s profession and I happened to be the only one who knew he was a physician. I recall it because of how tense I felt in the moment. But he was nice about it, and would later tell my mum (also a Sunday school teacher) he thought I had more to offer if I could get over my shyness.

I didn’t until my final year in uni.

The hardest thing was always the feeling of performing. Of having to do an act I didn’t feel actually good at it yet being judged by how well I did it. And that actually became real in uni, because during our clinical years we had “long cases”: exams where you had to interview a patient and then present them to a couple of consultants who would then ask questions about it.

Oh, and if you failed long case, you failed, period, however well you did in the written exams.

No pressure.

That’s when I learned to actually lean into the performance of it. After all, that’s what actors did, right? They don’t complain that no one wants to see their real selves, they just enter into the role. And they’re not half-hearted or false about it either. No, they make it real, play it true in all the ways that really matter—true to the medium and the act, to the audience and the actor themselves. That’s what people respond to.

And also like an actor, it wasn’t like I had to be performing all the time, just for situations where I was expected to give a performance.

Now I just had to actually learn the acting part.

That’s where final year of med school came in. I think it was because the entire class was together for the first time in three years. The previous two years, we’d been doing our various medical postings with classes as part of that. Now we were all together in the same hall again, for one last set of classes. And it had struck me that if I didn’t find it in me to speak up in public among these people I’d spent all of medical school with, I never might.

So I started raising my hand to answer questions. Without being called first. Again and again, I raised my hands every chance I got, until some classmates complained I was hogging the mic. I knew then I’d broken through my fear, and I toned it down.

(That also taught me how useful it can be, when you’re struggling with a tendency, to deliberately overcompensate in the opposite direction, rather than try to stay “balanced” only to end up still leaning to your default.)

I would go on to volunteer with a nonprofit that worked with young people, talking to teens—one of the more unnerving audiences—every other weekend and eventually heading up the training arm for youth workers and schoolteachers. And even now, in the UK, I teaching medical students and junior doctors at work and volunteer for church Sunday school—full circle!

And each time I’m coming up, I turn on what I think of as my extrovert nitro. I think I got it from my dad, who’s an extrovert’s extrovert. It’s the part that comes alive when I’m in social situations and helps me give my best performance. Plus it helps when I’m able to trick myself into focusing on being in the moment and not thinking about the outcome.

That’s especially come in handy in the UK, where all the scripts I had mastered for navigating social settings from Nigeria just suddenly fell flat. It was like I’d spent my life learning lines for a performance I regularly gave and then I showed up one night for the same performance but the lines had been changed on me and director was telling me my tone was too loud and abrupt and direct.

For my first couple years here social situations honestly often left me feeling like I was drowning.

And like that wasn’t bad enough, I faced some of the worst exams of my life: the board exams required to practice as a medical doctor in the UK include something called OSCEs. Basically you go from one point to another, with a patient at most of these and two consultants observing and marking as you engage the patient.

We had this in Nigeria, too, and they featured greatly in my psychiatry residency exams. Here, though, I had to process the cultural differences on top of that. Saying 5-10 times more “please and thank you” than would be deemed necessary in Nigeria, lots of “I’m sorry to hear that” and a large dose of framing statements as questions so they didn’t seem too direct.

And all while giving the performance of my life.

Yeah, no pressure.

But in the process I’ve learned how helpful it can be to reframe this performance anxiety as an indication that I really care about what I’m doing—I wouldn’t be nervous otherwise. After all, the way our body reacts to anxiety is similar to how it reacts to excitement. Of course that’s harder to sometimes than others. Mostly it just feels like being afraid I’ll be judged unfairly, my future hanging on the opinion or whim of someone with no real knowledge of me or context for interpreting me.

More existentially, this has been one of the hardest aspects of living with faith and the Christian view of God. I find it interesting when people talk about faith as a comforting thing but I often feel like it’s like people talking about marriage as beautiful. Both are true, but you’d be rudely surprised if you imagined that’s all they were. Any comfort faith offers isn’t really possible without first wrestling with the inevitable intrusiveness a God entails.

In the Bible, there’s a psalm, the 139th, that begins with these words:

O Lord, you have searched me and known me!
You know when I sit down and when I rise up;
you discern my thoughts from afar.
You search out my path and my lying down
and are acquainted with all my ways.
Even before a word is on my tongue,
behold, O Lord, you know it altogether.
You hem me in, behind and before, and lay your hand upon me.

Psalm 139 (ESV)

To many Christians I know, these words are comforting and I get that. I’m convinced that’s because they’ve come to take for granted that the God in question has good intentions. Because if that’s in question, those words are anything but comforting. And even as a practising Christian I think if the idea of a God whose eyes are always on you doesn’t feel discomfiting at least sometimes, you either are one of those rare people who have the ability to truly trust in his love 100% of the time or you’re not really thinking it through.

And because performance is out of the question, my ability to find comfort in words like that of the psalm is entirely dependent on my ability to trust that the intentions of this God toward me are loving. I do, mostly, now, but some days are better than others.

In the meantime I’ve learned to not just live with this anxiety around social situations and performing, but even embrace it. Sure I still feel like every time I going to engage people I don’t know (and sometimes even those I do) I’m very liable to totally muck it up. But you gotta go do what you gotta do. 

Great performances aren’t born, after all: they’re made.

Published by Doc Ayomide

I’m a medical doctor with specialty training in psychiatry, and I love thinking and writing about what it means to be human.

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1 Comment

  1. Performance isn’t built in a day,but the passion we have in what we do,results to our great performances.

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