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Understanding Performance and Test Anxiety: How It Develops, What Maintains It, and How Therapy Can Help

Performance and test anxiety involve intense fear or worry about doing well in situations where you are being evaluated, such as exams, public speaking, sports, or work presentations. While some nerves can be motivating, performance anxiety becomes a problem when it interferes with preparation, performance, confidence, or overall wellbeing.

People with performance anxiety may experience self-doubt, physical symptoms, and avoidance behaviours that limit opportunities and personal growth. Understanding how performance anxiety develops and persists is an important step toward effective treatment.

What Is Performance and Test Anxiety?

Performance and test anxiety is characterized by:

• Intense worry before or during evaluation
• Physical symptoms such as rapid heartbeat, sweating, shaking, nausea, or tense muscles
• Overthinking or “freezing” during performance
• Avoidance of performance situations or last-minute preparation
• Persistent fear that one will fail or be judged negatively

The anxiety is real and distressing, but it is often maintained by patterns of thought, self-criticism, and avoidance rather than by actual lack of ability.

How Performance Anxiety Develops

Performance anxiety often develops from a combination of personal temperament, early experiences, and learned expectations. Contributing factors may include:

• Past experiences of failure, embarrassment, or criticism
• High expectations from self or caregivers
• Comparisons with others and perfectionistic tendencies
• Sensitivity to evaluation or heightened awareness of performance
• Experiences of shame or pressure to succeed

Over time, the nervous system learns to treat evaluation as threatening, triggering physical symptoms and negative self-talk even in situations where the risk of harm is low. Performance anxiety is often linked to social anxiety.

How Performance Anxiety Is Maintained

Performance anxiety is maintained by avoidance, over-preparation, and negative self-evaluation. Common patterns include:

• Avoiding challenging tasks or opportunities for performance
• Excessive rehearsal or overstudying that reinforces pressure
• Catastrophic thinking about potential mistakes or failure
• Harsh self-criticism that reduces confidence
• Physical tension and rumination that amplify anxiety

These behaviours prevent the nervous system from learning that performance situations are manageable and that mistakes are not catastrophic.

Therapeutic Approaches for Performance and Test Anxiety

Performance and test anxiety is highly treatable. Therapy focuses on reducing fear, increasing confidence, and improving coping strategies through cognitive, behavioural, and emotional work.

Cognitive Behavioural Therapy (CBT)

CBT helps clients understand how thoughts, feelings, and behaviours interact to maintain anxiety. Therapy involves identifying catastrophic thinking, challenging self-criticism, and practising adaptive coping strategies. Clients learn to prepare effectively while reducing overthinking and fear of negative evaluation.

Exposure-Based Approaches

Exposure therapy involves gradually engaging with feared performance situations. This may include practising public speaking in a safe setting, timed mock exams, or gradually increasing task difficulty. Exposure helps retrain the nervous system, teaching that anxiety can be tolerated and that feared outcomes rarely occur.

Schema Therapy

Performance anxiety can be linked to schemas such as unrelenting standards, defectiveness/shame, or social evaluation concerns. Schema therapy helps clients understand how these long-standing beliefs influence anxiety, updating emotional responses and building self-compassion and confidence.

Acceptance and Commitment Therapy (ACT)

ACT encourages clients to notice anxious thoughts and physical sensations without trying to control them, while taking action in alignment with values. By focusing on meaningful goals rather than feared evaluation, anxiety becomes less controlling, and clients can perform more freely.

Internal Family Systems (IFS)

IFS views performance anxiety as involving protective parts that aim to prevent failure or criticism. These may include a critical part that monitors performance, a fearful part that triggers anxiety, or an avoidant part that discourages taking risks. IFS therapy helps clients relate to these parts with curiosity and compassion, reducing internal pressure and allowing greater confidence to emerge.

Building Confidence and Freedom

Performance and test anxiety can feel limiting, but it is highly treatable. With evidence-based therapy, people can learn to manage physical sensations, quiet self-criticism, and approach performance situations with greater confidence. Gradual, supported practice allows nervous system retraining and helps individuals reclaim opportunities for growth and achievement.

If performance or test anxiety is affecting your life, therapy can help you perform at your best while feeling calmer and more confident. Reach out today!

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