Walk backstage at any concert hall, locker room, or conference green room and you will hear the same quiet rituals. A violinist rolling her shoulders in tiny circles. A striker staring at an invisible spot on the wall. A CEO breathing through pursed lips as if cooling hot tea. They are all doing the same thing in different costumes, tuning a nervous system that wants to sprint while the task ahead requires precision.
Performance anxiety is rarely a thinking problem. It is a body problem that shows up in the worst moments, narrowing vision, quickening breath, and hijacking fine motor control. Brainspotting is a therapy designed for that layer of experience. It attends to where anxious energy lives in the body and how the eyes and brain coordinate around threat and safety. When used skillfully, it helps performers walk the narrow path from stage fright to flow, not by pushing harder, but by processing the survival responses that gum up smooth execution.
What brainspotting actually is
Brainspotting began with a simple clinical observation in 2003 by David Grand, PhD. While working with trauma and high performance clients, he noticed that certain eye positions seemed to reliably connect people to the core of an experience. If the person’s gaze held there, their body began to do meaningful work, tremors releasing in waves and images or sensations resolving without a lot of talking. The shorthand phrase became, where you look affects how you feel.
It is not hypnosis and not a cognitive exercise. Brainspotting is a focused, relational, body based therapy that uses eye position and mindful awareness to access and process subcortical material. Practitioners often use a pointer or the client’s hand to locate a precise angle of gaze that amplifies either activation or relief, then maintain that position while tracking breath, muscle tone, and micro movements. The therapist’s attunement matters. The frame is often called dual attunement, a mix of external attunement to the person and internal attunement to the client’s felt sense. Some clinicians add bilateral sound for gentle rhythmic support, though it is optional.
On the research side, brainspotting has a growing but still developing evidence base. Case series and pilot studies suggest benefit for trauma symptoms, anxiety, and performance blocks, and many clinicians have applied it in trauma therapy and anxiety therapy with positive clinical outcomes. Large randomized trials are limited so far. That does not make it magical or suspect. It makes it a promising tool that should be applied thoughtfully, monitored for results, and combined with well tested strategies when needed.
Why stage fright feels bigger than you
Performance anxiety rides on the physics of survival. The amygdala and midbrain track danger faster than the cortex can produce a rational thought. Your vagus nerve, adrenal system, and motor cortex reorganize you for a different task set than what performance requires. Heart rate climbs, pupils dilate, muscles prime for gross movement. On a soccer field that surge can be helpful. At the piano or podium it usually is not.
Two other brain features matter here. The first is implicit memory. The body stores experiences that did not get fully processed, then tags similar situations with a threat label in the background. The second is procedural learning. We practice a skill until it runs on motor programs. Under stress, the brain can yank back control and start micromanaging, the mental equivalent of grabbing the steering wheel on black ice. This is where hands shake, notes slip, and words tangle.
Brainspotting works at the intersection of these forces. By locating a gaze angle tied to the body’s threat map, then maintaining presence and support, the nervous system can complete cycles it froze mid step. When the stuck energy releases, the procedural system is free to run again without interference. Flow becomes possible because the threat signal drops, not because the performer forced confidence.
A day in the room
I will share a composite of several clients. Call her Maya, a 32 year old violist who started freezing on exposed entrances. Her coach tried mental rehearsal and breathing drills. She practiced more. She swapped caffeine for chamomile. Nothing moved the needle.
During brainspotting, Maya stood with her instrument in hand while we explored memory threads. The moment that gripped her was not a concert. It was an audition at 16 where she missed a cue and watched the panel whisper as she played. Her chest tightened as she described it. Her eyes naturally drifted up and to the right. We tested small shifts left and down, tracking where her body stirred. At a certain point her throat clenched and her knees bent. That was her brainspot.
We stayed there. I asked her to notice what rose and fell, to be curious without pushing. Small tremors moved through her forearms. Heat spread up her neck. After a few minutes the shaking changed to a deep sigh, then a wave of sadness. She was not re narrating the event, she was letting her body complete what it could not finish then. The whole cycle took 12 minutes. When she looked away from the spot, she felt lighter and oddly tired. Her self rated distress had gone from 8 out of 10 to 3.
We repeated this process over six sessions. In week three she brought her instrument and played through the problem passage while holding the gaze location. Her bow hand steadied. At her next orchestra rehearsal she felt anticipatory nerves, but the freeze did not arrive. By week eight, her baseline anxiety before performances hovered around a 2. She kept her warmup and sleep routines and stopped fighting her body.
You can find the same arc with athletes and public speakers. A starting pitcher carries one disastrous outing in his chest for years. A venture founder loses her voice at a crucial investor meeting and never speaks the same way again. Brainspotting does not erase caution or eliminate the stakes. It quiets the inappropriate danger response so the nervous system can recalibrate to the task.
How a session usually flows
When used for performance anxiety, a session has a rhythm. It is not rigid, but most clients recognize the shape after the first meeting.
- Preparation and resourcing. The therapist and client build safety in simple, practical ways. This can include anchoring to a pleasant sensation, locating a grounding eye position that feels neutral or good, and agreeing on stop signals. Finding the spot. Using a pointer or fingertip, the therapist helps the client discover an eye position that heightens either the performance block or a sense of relief. Body cues, not words, guide this search. Staying with the process. The client holds their gaze on the spot while tracking sensations. The therapist offers attuned presence, brief check ins, and permission to follow whatever rises, whether that is heat, tears, memories, or impulses to move. Unwinding and pendulation. The system often cycles through waves of activation and settling. The therapist supports gentle oscillation, avoiding overwhelm while allowing genuine release. Integration and testing. The client looks away from the spot, notices differences, and sometimes practices a small part of the performance task to embed the shift.
Sessions can last 50 to 90 minutes. For some clients, two hour blocks are useful, especially in an intensive therapy format designed to move through deeper layers without long gaps between sessions. Intensive therapy can condense what might take months into a focused week, though not every person or schedule benefits from that tempo.
From fear to flow
Flow is not only a psychological state. It is a neurophysiological balance between challenge and capacity with just enough arousal to focus and not so much that control fragments. In performance anxiety, the thermostat is miscalibrated. Brainspotting helps recalibrate by metabolizing the old threat tags and expanding the system’s tolerance window.
You can feel the difference. Before, the performer scans the audience for danger and strangles their breath. After processing, attention lands on the task. Breath synchronizes to the action. Micro corrections happen without a committee meeting in the frontal lobes. Mistakes, when they occur, do not rupture the system. The musician keeps tempo after a missed note. The pitcher resets after a ball. The speaker recovers a lost clause and keeps pace with the audience.
Many clients ask if this is only about removing fear. The answer is more nuanced. Some performers thrive on a line of electricity. The goal is not serenity. It is availability. You want full access to your technical skill and creative responsiveness while keeping a healthy respect for the stakes. The nervous system can do that when it is not dragging an old injury into the present.
Where brainspotting fits among other therapies
No single method owns performance anxiety. Cognitive behavioral strategies teach helpful skills: reframing catastrophic thoughts, optimizing exposure, building pre performance routines. EMDR also uses eye position, but its structure and focus differ. Somatic therapies like Somatic Experiencing and breath training target physiological regulation directly. Psychiatry addresses medical contributors, including depression or panic that may need medication.
Use judgment based on the person and the pattern. Here are simple guidelines I share with clients deciding how to proceed.
- Choose brainspotting first when the fear feels irrational or body based, when you sense a specific event sitting in the background, or when symptoms spike in a particular posture, gaze direction, or environment. Layer cognitive or skills based work when your thoughts spiral into predictable distortions, when you avoid practice or logistics, or when your routine needs better scaffolding. Consider EMDR when a clear traumatic memory dominates and you want a more protocol driven approach that also targets memory reconsolidation. Aim for a hybrid when schedule or stakes demand speed. For example, a two week window before opening night might pair three brainspotting sessions with daily mental rehearsal and brief exposures. Work with medical and psychiatric care when baseline depression, insomnia, or panic undercut progress. In some cases, a short course of medication stabilizes the platform so therapy can do its job.
Therapies can be complementary. I have treated performers who processed the old audition disaster with brainspotting and then used cognitive routines to shape healthy pre show habits. Conversely, some clients do months of anxiety therapy and realize a stubborn somatic knot is still unaddressed. Brainspotting can help there.
What about depression and burnout
Performance anxiety and depression often travel together. The grind of preparing while dreading the spotlight erodes mood. Repeated freezes can feel humiliating and lonely. For some clients, this turns into true depressive symptoms: sleep disruption, appetite changes, and loss of pleasure outside performance.
In those cases, brainspotting is not a standalone depression therapy, but it can help lift one of the anchors. When the body stops bracing, energy returns. Joy is easier to find when you are not spending hours per day containing fear. I have seen musicians who described their practice as gray return to curious exploration after processing the old audition or teacher shaming moment that lived in their throat. If depression remains prominent, widen the treatment plan. Talk therapy, social rhythm work, targeted exercise, and medical evaluation all have a place.
Practical applications in the wild
Clients often ask how to bring elements of brainspotting into their training and performance without trying to treat themselves. You can borrow the principles safely.
Visual anchoring is a simple example. Notice that your body feels more stable when your eyes rest on a particular angle or horizon line. Before you start, let your gaze settle there for 10 to 20 seconds and feel your feet. This is not full processing. It is a way to cue your system toward a resource state.
Bilateral rhythm can also help. Gentle alternating sound is one method, but you can also sway or tap in a slow left right pattern. I teach speakers to shift their weight in tiny arcs during pauses, which keeps the system from locking. Musicians can use alternating finger taps between sections they know and the ones that challenge them most, reinforcing the transition between calm and effort.
Breath pacing is the other simple lever. Four to six breaths per minute, with a soft exhale that lasts a beat longer than the inhale, nudges the vagus nerve toward parasympathetic balance. Practice this during rehearsal so it is native during performance. Trying a new breath pattern on stage is like breaking in new shoes during a marathon.
If you sense strong memories or emotion rising, respect that boundary. Save deeper work for therapy. Self regulation should feel steadying, not flood you.
Working with complex stories
Not every performance block is a neat knot tied at a single event. Some performers grow up in families or systems that criticized effort constantly. Others carry trauma outside the performance domain that shows up in their body under stress. Dissociation, chronic pain, or substance use complicate the picture.
Brainspotting is still useful, but the arc tends to be slower. More resourcing is needed. The window of tolerance, a zone where the nervous system can process without flooding or going numb, must be expanded first. That might mean several sessions devoted to finding safe eye positions, practicing brief dips into activation, and building trust. Intensive therapy can help when scheduling or geography makes regular weekly work hard, but for clients with complex trauma, a slower cadence with steady support is often wiser.
I am cautious with certain profiles. Active psychosis, unstable medical conditions, or substance withdrawal are not settings for this kind of deep attunement work. Stabilization first, then processing when the foundation can hold it.
Measuring whether it is working
The body is honest. If brainspotting is helping, you will feel and measure change. We set anchors at the start, both subjective and objective, and we track them across sessions.
Subjectively, we use distress ratings before, during, and after working a spot. Good sessions often start high, wobble in the middle, and settle lower by the end. Between sessions, we watch anticipation levels the night before a performance and the first 60 seconds on stage. Objectively, we watch film. Athletes look at their pre pitch routine, hand fidgets, and tempo. Musicians listen to tone stability in the first phrase. Speakers track pace, pause length, and filler words.
Where available, physiological markers add depth. Heart rate variability is a clean metric for many clients. Even simple wearables can show a trend toward better vagal tone over a month of work. Sleep improves. Recovery feels different. The point is not perfection, it is trajectory. Two steps forward and one step back still lands you in front.
Inside a short intensive
For performers with a deadline, a brief intensive format can stack the deck. A common design is three to five sessions in one week, each 90 to 120 minutes, with gentle practice between. The first day builds resourcing and maps triggers. The middle days work on the core spots, often alternating activation and relief to avoid fatigue. The final day integrates testing, sometimes with a mock performance.
These short sprints are not for everyone. They can be potent and tiring. If a client has a dense trauma history or limited time for sleep and recovery, I prefer a more traditional schedule. But for a performer who has a narrow band problem, good support, and a clock ticking toward opening day, they can be a lifeline.
Choosing the right clinician
A good fit matters more than a fancy office. When selecting a brainspotting provider, look for formal training in the method and a foundation in trauma therapy. Ask about work with performers. You want someone comfortable letting silence do its work and skilled at noticing micro cues in the body.
In the first meeting, notice your own system. Do you feel seen, not pushed? Can you say no without explanation? Do you understand the plan for resourcing before deep processing begins? The method is gentle by design, but depth work can stir strong waves. Attunement is the safety net.
I also encourage coordination with coaches or teachers, with consent. Your therapist does not need to know the intricacies of your embouchure or backhand, but if they understand the context in which symptoms show up, they can help you build field ready rituals that line up with your craft.
Small details that make a big difference
In practice, a handful of concrete decisions improve outcomes.
Sleep beats supplements. A rested nervous system processes more efficiently. Clients who add even 45 minutes of sleep on average during an active phase of therapy tend to report faster shifts and fewer rebound spikes after hard sessions.
Hydration and glucose matter. Dry mouth and low blood sugar mimic anxiety and can send sessions sideways. Bring water and a small snack. Musicians who nibble half a banana before woodshedding a tough passage often notice fewer shakes.
Stop while it is working. Many performers want to wring every drop of change out of a good session. In my experience, it is better to end at stable calm plus one. Leave the system https://www.drkatrinakwan.com/contact with capacity. Integration is quieter and more durable.
Train where you will perform. If you speak under white LED lights, do at least one therapy session in similar lighting. If your trigger lives in the wing just before you step on stage, process a spot while standing there if logistics and privacy allow. The brain loves context. It will generalize, but it does so faster with environmental matches.
Share the plan with your inner circle. Telling a partner or section leader you are working on this takes pressure off. You are less likely to hide spikes, which reduces the secondary shame loop that often drives avoidance.
The long game
There is a moment I watch for in this work. A client walks into the room on a day with a real test ahead, and their breathing is calm without effort. They tell me about the stakes, but their shoulders stay low. They do not make a speech about courage. They do not ask for new hacks. They trust their training, and when I ask about the old memory that used to own them, they look surprised and say, it feels far away.
That is the goal. Not a trick to paper over fear for one night, but a measurable shift in how the nervous system tags the performance environment. Brainspotting is not the only road there. It is a good road for many, especially when anxiety lives in the body more than in thoughts. When paired with smart practice, healthy routine, and support that knows your craft, it can move a performer from stage fright to the easy, alive focus that we call flow.
Phone: 650-387-2578
Website: https://www.drkatrinakwan.com/
Hours:
Sunday: Closed
Monday: 9:00 AM - 6:30 PM
Tuesday: 9:00 AM - 4:30 PM
Wednesday: 9:00 AM - 4:30 PM
Thursday: 9:00 AM - 4:00 PM
Friday: Closed
Saturday: Closed
Map/listing URL: https://maps.app.goo.gl/WRgYvvbdvkT2C1my8
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Dr. Katrina Kwan, Licensed Psychologist provides online therapy for adults who want support that goes deeper than talk-only work.
The site presents Brainspotting, trauma therapy, somatic therapies, nervous system regulation work, Accelerated Resourcing, the Safe and Sound Protocol, and intensive therapy as core offerings.
This virtual practice serves adults across Washington, Utah, and Florida, making it easier to access care without commuting to an office.
The practice appears especially relevant for adults navigating trauma, anxiety, depression, overwhelm, nervous system dysregulation, and some neurological or health-related concerns.
The overall approach is body-aware and regulation-focused, with an emphasis on helping clients build safety, self-understanding, and steadier functioning over time.
Weekly or bi-weekly 50-minute sessions are available, and the investment page also lists intensive therapy for people who want a more concentrated format.
To ask about fit or scheduling, call 650-387-2578 or visit https://www.drkatrinakwan.com/.
For a public profile reference with hours, see https://maps.app.goo.gl/WRgYvvbdvkT2C1my8.
Popular Questions About Dr. Katrina Kwan, Licensed Psychologist
What services does Dr. Katrina Kwan offer?
The official site lists Brainspotting, trauma therapy, anxiety therapy, depression therapy, nervous system regulation therapy, somatic therapies, Accelerated Resourcing, the Safe and Sound Protocol, and intensive therapy.Is this an online or in-person practice?
The site presents the practice as online therapy, with location pages for Washington, Utah, and Florida rather than a published walk-in office address.Who does the practice work with?
The about page says Dr. Katrina Kwan provides mental health treatment for adults experiencing trauma, anxiety, depression, overwhelm, nervous system dysregulation, and related difficulties.What states are listed on the website?
The official site says services are offered online in Washington, Utah, and Florida.What therapy methods are mentioned on the site?
The site highlights Brainspotting, somatic therapies, Accelerated Resourcing, and the Safe and Sound Protocol, along with broader trauma-informed and nervous-system-focused care.Does the practice offer intensive therapy?
Yes. The site includes an intensive therapy page and describes 1-day and 2-day intensive options alongside ongoing weekly or bi-weekly sessions.What does the investment page list for standard sessions?
The investment page says individual sessions are $250 for 50 minutes.What public hours are listed?
The accessible public listing shows Monday 9:00 AM to 6:30 PM, Tuesday 9:00 AM to 4:30 PM, Wednesday 9:00 AM to 4:30 PM, Thursday 9:00 AM to 4:00 PM, and Friday through Sunday closed.How can I contact Dr. Katrina Kwan, Licensed Psychologist?
Call tel:+16503872578, visit https://www.drkatrinakwan.com/, and use the public profile at https://maps.app.goo.gl/WRgYvvbdvkT2C1my8.Landmarks Across the Online Service Area
Seattle Center — A major Seattle arts and events hub and a recognizable anchor for clients in the Puget Sound region. If Seattle Center is part of your regular area, this practice serves Washington adults online through https://www.drkatrinakwan.com/.Pike Place Market — One of Seattle’s best-known downtown landmarks and a practical point of reference for central Seattle coverage. People near Pike Place Market can access the same virtual therapy options without an office commute.
Riverfront Spokane — Downtown Spokane’s Riverfront Park is a strong Eastern Washington landmark for service-area copy. If you are based near Riverfront Spokane or the Spokane Falls area, online sessions are available across Washington.
Temple Square — A central Salt Lake City landmark and a helpful anchor for Utah coverage. If you live near Temple Square or downtown Salt Lake, the practice’s Utah telehealth service area may be a fit.
Utah State Capitol — Another widely recognized Salt Lake City reference point for clients in northern Utah. Adults near Capitol Hill and surrounding neighborhoods can reach the practice online through https://www.drkatrinakwan.com/.
Lake Eola Park — A well-known Downtown Orlando landmark and a practical Florida service-area anchor. Florida adults near Lake Eola or central Orlando can explore virtual therapy options through the website.
Tampa Riverwalk — A major downtown Tampa landmark that helps illustrate statewide Florida coverage beyond one metro alone. If you are near the Riverwalk or nearby Tampa neighborhoods, the practice’s online format keeps access simple.