Alexandra Frost works with performing, visual artists and creatives, the people who train and support them, and their families, covering performance anxiety, mental skills for peak performance, career sustainability, general wellbeing and the identity and relationship demands of a creative life. She provides LGBTQIA+ affirming and neurodiversity-affirming care, and has close to 30 years’ clinical experience, beginning with Master’s research on musical performance anxiety in 1997. Alexandra later co-authored follow up research that was published in Medical Problems of Performing Artists in 2002.
What is performance anxiety, and why does it happen to capable performers?
Performance anxiety is defined as persisting, distressing apprehension about a performance, or actual impairment of performance skills, to a degree that doesn’t match your real ability, training or preparation (Salmon, 1990).
It happens because your brain misinterprets a meaningful, sometimes career defining moment, whether this be an audition, a university exam, or a higher stakes performance in a new venue as a threat to your safety and life. Your nervous system responds the exact same way it would if you came face to face with a lion in the woods and does everything necessary to try to protect you from danger.
Have you ever experienced shaking hands, a trembling voice, a racing heart, or a mind that goes blank when performing? These are very common symptoms and do not indicate that you lack competence as a performer. They are your body’s survival mechanisms and have the capacity to disrupt your trained performance execution through loss of memory and self doubt, extreme adrenalin, and a loss of focus that interrupts the state of flow,
These feelings show up because the performance matters to you and has significant meaning. What sets elite professionals apart is not the absence of this normal biological response, it is the fact that they have learned to channel that adrenalin to their advantage.
Is this only for performance anxiety?
No. It’s one of the most common reasons people first get in touch, but it’s rarely the whole picture.
This work covers the full experience of a creative life, including things such as improving the quality and enjoyment of performance, setting values based goals for your career, coping with burnout, dealing with the impact of touring on your relationship and mood and more.
Who is this for?
Musicians, singers, actors, dancers, visual artists and creatives of any discipline, from students through to touring professionals.
It also extends to the people around them: teachers, conductors, directors and crew, who carry their own version of the pressure, and to the partners and families navigating a performing life alongside someone else.
Is this an inclusive, LGBTQIA+ affirming space?
Yes. The arts community has a high proportion of LGBTQIA+ representation, and affirming practice isn’t an add-on here, it’s core to how I work. I bring significant experience working with LGBTQIA+ clients specifically, alongside a broader commitment to neurodiversity affirming and culturally responsive care. Being a performer or creative inherently means being vulnerable in front of others. You deserve a space where you can show up completely as yourself.
What does "improving performance" actually involve?
Mental skills training supports more than just the management of anxiety. Areas such as improving the flexibility of attention and concentration, managing internal and external distractions and building mindfulness skills that keeps you present are critical.
If you are likely to be easily pulled out of the moment through your own negative internal dialogue, or doubt yourself alot, confidence may be built through skill development that supports facing situations you may have avoided before. Peak performance doesn’t come from the absence of nerves. Instead it is a set of learnable skills for staying present when it counts.
What if my nerves are getting in the way of taking opportunities at all?
Avoidance is one of the most common contributors to the maintenance of performance anxiety and missing opportunities. If you have been known to turn down auditions, lessons, solo performances or exhibitions because the anticipated stress feels unbearable, or find it hard to let go of past mistakes, then over time it is easy for anxiety to build and generalise such that every performance feels high risk. This is workable territory as we know that structured exposure following the mastery of certain skills prepares you for mindful performance practice.
When we work on identifying why performing is important to you, you can combine this with your technical and mental preparation to make decisions that are driven by what actually matters to you rather than fear or potential comparison. Over time what seemed terrifying once becomes a challenge you can safely meet, well prepared for what is ahead while not buying into the potential catastrophes that could occur.
What happens when things go wrong?
Recovering from a rejection, a season that didn’t go to plan, or a mistake you can’t stop replaying is part of this work, as is the comedown after a performance or production, and rebuilding rest around an unpredictable schedule.
What about identity, when the work itself is unpredictable?
A quiet audition cycle, a stretch without work, or a sense of self that’s become tightly bound to your last performance — this is common in creative careers and worth addressing directly, not just riding out. The same applies to burnout: recognising when intensity has tipped into depletion, and rebuilding a way of working — and living — you can actually sustain, including through genre changes, injury, or stepping back from performing altogether.
How do you build a sustainable creative practice long-term?
Sustainability isn’t a side issue in creative careers — irregular schedules, unpredictable income and the emotional demands of the work make it easy for your craft to compete with the rest of your life rather than complement it. This work includes building routines and boundaries that let you keep doing what you love without it costing you everything else.
Do you support general mental health and wellbeing, not just performance-related issues?
Yes. Alongside performance-specific work, I support broader mental health and wellbeing — working from a preventative framework where possible, rather than waiting until things reach crisis point.
Does this go deeper than performance psychology if needed?
Yes. Where performance anxiety, creative blocks, or a loss of trust in your own ability are connected to something underneath — past trauma, relationship strain from a demanding career, or broader mental health — that’s within scope too.
Is neurodivergence part of this?
Yes. ADHD and autism are both overrepresented in the performing arts. If sensory sensitivities, rejection sensitivity, or the way your attention works have shaped your experience of performing, that’s built into how I work — not something separate to work around.
Why a Clinical Psychologist rather than a coach?
Because it means I can move between a focused, practical tool for the week before your audition and something deeper, without you needing to find a different practitioner if it turns out to be more than performance anxiety alone.
What kind of support is available?
- 1:1 sessions — for a specific audition or season, or something that’s been building for years
- Online courses (in development), including:
- Mini Course: Working with Performance Anxiety: Essential Skills for Performing Artists
- Signature Course: The Attuned Performer: Performance Psychology to Help You Perform to Your True Potential
- Workshops — for schools, conservatoires, companies and studios
- Attuned Collective — the multidisciplinary arts wellbeing community I founded
Is this just for performance anxiety, or does it go deeper if needed?
Both.
Being a registered Clinical Psychologist as well as a performer means I can work narrowly on a pre-audition protocol, or go deeper into identity, burnout, career transitions or trauma, without you needing a different practitioner if it turns out to be more than performance anxiety alone.
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