Read this editorial piece and more inside TPH’s 2017 Pony Issue HERE

BY ELENA PEREA MD, PHOTO BY AMY CORETZ

So you’re sitting at the in-gate, ready for your round. Your stomach is turning, you’re sweating, your heart is coming out of your chest, and suddenly you can’t breathe. In the more dramatic example, perhaps you vomit, black out or fall off. In the more common example, you ride into the ring, and proceed to have every bit of advice your trainer just gave you leave your head, eat every fence, miss every lead, and leave the ring feeling like you wasted an entry fee.

Not that I’m speaking from experience. No, I’ve never vomited off the side of my horse in the start box. STOP IT! (OK, I have.)

This is not an uncommon scenario. After all, who amongst us has not experienced the phenomenon of “butterflies in the stomach”? Anxiety is an evolutionary advantage, part of the body’s natural defense system: it is a normal response to a threat, often vague or internally perceived. It prepares us for things that might be dangerous, pumps epinephrine into our body from the adrenal gland, and gets us ready to fight (or flee) a bear.

When anxiety begins to impair functioning, however, we call it a disorder. Anxiety is the most common experience of mental illness in the world—according to the CDC, more than 10% of people will experience an anxiety disorder in any given year. There are many different kinds of anxiety: panic attacks, anxiety in crowds, and performance anxiety are just a few. As competitive equestrians, probably the most applicable to us is performance anxiety. Performance anxiety is as I described at the beginning of this piece: racing heart, sweating, shortness of breath, upset stomach, dry mouth, and shaking/trembling right before you plan to do something in front of an audience. In short, it keeps us from doing our best when there are $0.50 ribbons on the line (or sometimes real money)!

How do you combat performance anxiety? One way is to recognize from whence the anxiety is coming. Emotions are driven by thoughts, and in turn, they drive behavior. The thoughts underlying our emotions are often so routine that they go unnoticed—all we notice is the anxiety when it’s already there! These thoughts are called “automatic thoughts”—thoughts that occur without us even realizing that we have them. When thinking about performance anxiety, some possible examples of automatic thoughts that might occur are “I’m going to screw up,” or “I’m going to make a fool out of myself.” Automatic thoughts lead to feelings—anxiety, depression, hopelessness. Those feelings produce physical reactions (racing heart, sweating, nausea), and also affect our behavior (ability to perform). In turn, a negative performance might reinforce automatic thoughts.

Now that we understand where the anxiety comes from, how do we interrupt this vicious cycle? There are a few things you can do that may help. First, identify the unhelpful, automatic thought that is occurring and the feelings that thought is causing you to have. Acknowledge those feelings, and maybe even write down what you are afraid will happen. What evidence do you have that the thought is totally true? Next, write down some reasons that the thought is NOT true: you’ve been schooling a level above at home; your horse knows his job; you have never been fired by your trainer before after a bad round… I could go on, but I won’t. When you look at the two columns of evidence, for and against your unhelpful automatic thought, you should be able to see a way that the automatic thought is not entirely true. Using that information, write down a thought to replace your automatic thought from this more balanced and realistic perspective.When you have been through that exercise, you should be able to look back at your automatic thought (maybe a little disdainfully) and know that you can beat it. That should (and does) take your anxiety down several notches. This is a great exercise to do when you have the time out of the saddle.

When you have been through that exercise, you should be able to look back at your automatic thought (maybe a little disdainfully) and know that you can beat it. That should (and does) take your anxiety down several notches. This is a great exercise to do when you have the time out of the saddle.

Another tact, which can be used with the above psychological intervention, is to do as much exposure therapy as possible. That doesn’t mean you have to show every weekend if you don’t have the money—you can recreate the show environment at home. Think hard: what about a show environment makes you nervous? Is it riding against a clock? Is it the audience? Is it bright or unfamiliar obstacles? Practice riding in an environment as much like a show as you can make it. Invite work friends (the ones who always say it’s so cool that you ride horses, can we meet Dobbin some time?) to the barn and ride a course for them. Make a course and ride against the clock with a friend (note: I am not endorsing doing a course at mach 3 with your pants on fire). Paint the jumps at home (Lowes will sell you pre-mixed paint people returned for a couple bucks) or throw dirty turnout blankets over them. Make a Liverpool with a baby pool. (My redneck roots are showing here.) Practice like this, and I think you will find that when you get to your next show, it might be a little easier to avoid vomiting.Performance anxiety is extremely common, but you do not have to be held hostage by it. I’ve given you some ideas above to battle at home. I want you all to remember, though, that there are professionals who are happy to help you. Guided therapy may be necessary for the most severe cases, and even medication may have a role. Anxiety disorders are medical conditions that are treatable, and should not keep you from doing the thing that you love! I hope this has been helpful.

Performance anxiety is extremely common, but you do not have to be held hostage by it. I’ve given you some ideas above to battle at home. I want you all to remember, though, that there are professionals who are happy to help you. Guided therapy may be necessary for the most severe cases, and even medication may have a role. Anxiety disorders are medical conditions that are treatable, and should not keep you from doing the thing that you love! I hope this has been helpful.

Dr. Perea is a psychiatrist at Duke University Hospitals, and teaches medical students and young psychiatrists. She is an avid equestrian who events her OTTB in Area II and III.

Read this editorial piece and more inside TPH’s 2017 Pony Issue HERE