EMDR for Performance Anxiety
You've prepared. You know the material better than anyone in the room. And still, right before the pitch, the deposition, the board meeting, or the big call, your heart pounds, your mind goes blank, and your body acts like you're in danger.
If that sounds familiar, you're not alone.
According to the National Institute of Mental Health, about 1 in 8 adults will struggle with social anxiety at some point in their lives, and fear of being judged while performing is one of its most common forms.
I'm Laura Malandrino, an EMDR-trained therapist in Hermosa Beach. I work with executive and business leaders in entertainment, technology, engineering, manufacturing, and law, as well as creatives across the South Bay, and one of the things I hear most often is:
“I know it's irrational. I just can't make it stop.”
That gap between what you know and what your body does is exactly where EMDR can help. Here's what the research says, and why it works differently from the tools you've probably already tried.
Why preparation and coaching don't always fix it
Most of what you'll read about performance anxiety, or hear from a mentor or coach, focuses on how you think. Reframe the moment, picture it going well, remind yourself you're prepared. A good presentation coach adds structure and practice on top of that. These tools can genuinely help. But they all rely on the thinking part of your brain to settle a reaction that kicks in faster than thought can catch it.
The heat in your face, the tight chest, the blank mind: that's your nervous system reacting to a meeting as if it were dangerous. At some point, being in the spotlight felt unsafe, and your body remembers. That's why logic alone doesn't undo it, and why imposter syndrome can follow people with long, successful track records.
I see this often in my work. Many of the people who come to me are senior executives and leaders. They're well respected by the people around them, but underneath, they're exhausted, anxious, and quietly wondering whether they've really earned it. Every meeting and presentation leaves them more drained than the last. As we talk, it turns out the dread started long before this job. For some, it goes back to childhood. For others, it's something from early in their career that stuck more than they realized: a boss who tore them apart in front of the team, a layoff, a deal that fell through, or a panic attack in the middle of a pitch.
Seeing that connection is often a relief on its own. But insight doesn't always make the dread stop, because the body is still reacting to what happened then. That's where EMDR comes in. As we work through those experiences, they lose their charge, and the confidence people already have in their content finally starts showing up in the room.
This is why so many high achievers feel stuck. They've done the insight work, hired the coach, and understand where the anxiety comes from. The body just hasn't caught up. (I wrote more about why talking doesn't always reach this in What Does EMDR Feel Like?)
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EMDR is best known as a trauma treatment, and the World Health Organization recommends it for PTSD. Researchers have also tested it on the kind of anxiety that shows up under pressure:
Executives and employees. In four workplace case studies published in an American Psychological Association journal, EMDR was used to work through a setback that had hurt each person's performance. Their performance was restored or improved.
Musicians. In a controlled study of advanced pianists, the group that received EMDR felt less anxious and performed better than a control group. In the full research, lower baseline anxiety was still measurable at four months, one year, and two years.
Athletes. A study of karate and taekwondo athletes found EMDR reduced competitive anxiety and improved physical performance.
Performance blocks. A case study followed an athlete stuck with a performance block for 11 years. The block was tied to earlier experiences, and EMDR with gradual exposure helped resolve it.
A dedicated protocol. Clinicians have developed an EMDR Performance Enhancement Psychology Protocol for performers, athletes, and professionals. It targets fear of failure, procrastination, self-defeating beliefs, and recovery from setbacks.
A note on the evidence: most of this research involves small studies, case reports, and specific groups like musicians and athletes. That's promising, not definitive. What makes it worth taking seriously is that different researchers, in different fields, keep finding the same pattern: less anxiety, better performance, and in at least one study, results that lasted years.
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Researchers separate two kinds of anxiety. State anxiety is what you feel in the moment, like the racing heart before you walk into the room. Trait anxiety is your baseline: how anxious you tend to be in general.
Many quick fixes work on state anxiety. A breathing technique before a presentation can help, but the calm wears off, and you need it again next time. The pianist study measured both kinds, and baseline anxiety in the EMDR group dropped and stayed lower. In plain terms, the nervous system's default setting seemed to shift.
That matters because your baseline feeds the spikes. The higher it sits, the harder the pressure hits. Lower the baseline, and the spikes get smaller.
The goal isn't zero nerves. Some activation sharpens you. The goal is nerves that help you perform instead of hijacking you.
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EMDR follows a clear structure, adapted to what you bring in. For performance anxiety, the work usually covers three time frames:
The past: the moments that taught your nervous system that performing is dangerous. A public mistake, a harsh boss or teacher, a pitch that fell apart. Often these aren't dramatic. They just stuck.
The present: what sets off the reaction now, like a certain room, a certain kind of person, or the minutes before you speak.
The future: picturing your next high-stakes moment while your body stays steady.
Throughout, you hold a memory or image in mind during short sets of bilateral stimulation, such as the gentle handheld tappers I use in my office. You stay awake, alert, and in control the whole time, and you don't have to describe every detail. If you're curious what that's actually like, I walk through a session in What Does EMDR Feel Like? [link]
The memory doesn't disappear. What changes is its charge. Beliefs like "I'll be exposed" or "I can't handle pressure" loosen, and something more accurate takes their place: "I've prepared, and I can handle this."
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It depends on what's underneath. When the anxiety traces back to one clear experience, like a pitch that went badly, relief can come fairly quickly. When it's tied to years of pressure or criticism, the work takes longer. Every person is different, but for focused performance anxiety, many clients need around 6 to 10 sessions, and often notice a shift well before the end.
We also don't start with the hard material. First, we build steadiness, so you feel grounded before any memory work begins.
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EMDR for performance anxiety may be a good fit if:
• You freeze, blank, or overprepare before high-stakes moments, even though you're skilled and experienced
• One bad experience, like a failed pitch or a public mistake, still replays in your head
• You've tried breathing techniques, coaching, or talk therapy, and your body still reacts
• You live with imposter syndrome or a fear of failure that doesn't match your track record
• Procrastination or perfectionism seems to protect you from a fear you can't quite name
If your anxiety shows up well beyond work, like panic attacks in everyday situations, it's worth talking that through first. A consultation is a good place to sort out what will help most.
You don't have to keep white-knuckling your way through the moments that matter most. I offer EMDR in person at my office in Hermosa Beach, and a free 15-minute consultation is a simple way to see if it's a fit.
Laura Malandrino, APCC · Registered Associate Professional Clinical Counselor #15514 · Supervised by Robert Northcutt, LMFT #51430 · Employed by Lisa Chen & Associates Therapy
References
1. World Health Organization (2013). Guidelines for the management of conditions specifically related to stress. Geneva: WHO.
2. Foster, S., & Lendl, J. (1996). Eye movement desensitization and reprocessing: Four case studies of a new tool for executive coaching and restoring employee performance after setbacks. Consulting Psychology Journal: Practice and Research, 48(3), 155–161.
3. Brooker, E. [VERIFY: add year]. Music performance anxiety: A clinical outcome study into the effects of cognitive hypnotherapy and eye movement desensitisation and reprocessing in advanced pianists. Psychology of Music.
4. Brooker, M. E. (2015). Music performance anxiety: An investigation into the efficacy of cognitive hypnotherapy and eye movement desensitisation and reprocessing when applied to grade 8 pianists. PhD thesis, University of Leeds.
5. Abdi, M. S., Vatankhah, H., & Razavi, M. S. (2019). The effect of eye movement desensitization and reprocessing (EMDR) on anxiety and physical performance in athletes. RBS, 17(1), 151–158.
6. Bennett, J., Bickley, J., Vernon, T., Olusoga, P., & Maynard, I. (2017). Preliminary evidence for the treatment of performance blocks in sport: The efficacy of EMDR with graded exposure. Journal of EMDR Practice and Research, 11(2), 96–110.
7. Lendl, J., & Foster, S. (2009). EMDR performance enhancement psychology protocol. In M. Luber (Ed.), EMDR Scripted Protocols: Basics and Special Situations (pp. 377–396). New York: Springer Publishing.
8. National Institute of Mental Health. Social Anxiety Disorder. NIMH Statistics.
