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Creative people of all backgrounds, including artists, musicians, dancers, writers, and more, have been the cornerstone of human connection, expression, and growth since the dawn of humanity.
For therapists, working with creative professionals is an extremely rewarding experience.
Artists of all kinds tend to have unique perspectives and are adept at thinking out of the box.
However, providing artist mental health support also comes with its own set of challenges, as the high level of anxiety and stress creative folks tend to experience can manifest in ways that look and feel different from non-artist clients.
In this article, we’ll explore working with creative professionals as a therapist offering artist mental health support, including advising on how to handle creative blocks, performance anxiety, toxic perfectionism, and identity struggles.
How to handle creative blocks
A creative block happens when an individual intends to work on a project but feels as though there is an invisible barrier keeping them from starting.
It can be an incredibly frustrating experience that may even contribute to depression and hopelessness.
Once somebody is struggling with a creative block, it can easily become a self-perpetuating cycle. The more difficulty they have starting the work, the more anxious they become about being unable to start it. This leads to a more intense creative block, and the hold the cycle has over them intensifies.
There is always an underlying root cause of the creative block, and the first step is to help the client identify what that root is.
Typically, this root is fear-based and often taps into anxiety about failure, fear of judgment, fear of not accomplishing the task to the best of their ability, or fear of not realizing their true artistic vision.
Additionally, there is typically a visceral, emotional reaction in addition to the feared thought. This might feel like tension, tightness, discomfort, panic, or a general sense of unease in the body.
The key to how to handle creative blocks is to help clients put words to their feared narrative ("name it to tame it"), and then create some distance from the thoughts using mindfulness techniques.
At the same time, we must help clients slowly move into the uncomfortable feelings in their bodies, rather than away from them.
Essentially, this is a form of exposure therapy.
It’s crucial to ease into this, and a helpful intervention is for clients to give themselves permission to work on the project without the intention of achieving a positive outcome.
Typically, when they can create momentum with their work, the block melts away, allowing them to enter the intuitive flow state.
What about performance anxiety
Performance anxiety is similar to creative blocks in some ways.
However, instead of being focused on the task itself, performance anxiety typically focuses on fears about being judged or perceived negatively by others.
The more individuals try to “perform well” to appease these fears, the more anxious they become and the harder it is to truly to maintain one's composure, leading to even more anxiety.
While performance anxiety (technically a form of social anxiety) is widespread, it can be particularly debilitating to creatives whose job it is to showcase their work in front of others.
Performance anxiety usually starts with a cognition where one worries about being judged negatively. This leads to an increase in physiological symptoms (e.g., fast heart rate, sweating, tightness in the chest, flushed cheeks), which then leads the performer to become hyperconscious of these responses (e.g., “Oh no, everybody can see my face blushing, this is horrible”), ending in more anxiety. It’s a vicious cycle!
Helping people overcome performance anxiety involves targeting and addressing each of these processes within the cycle.
A helpful acronym I created for this purpose is: PACE.
P: Pause and notice
Take a moment to observe the thoughts and feelings that show up non-judgmentally.
Clients should let go of any attempt to solve or attach meaning to their internal experience.
They can tell themselves, “I notice I’m having a thought that I will fail,” or “Here is a thought that people will judge me for having shaky hands.”
A: Allow and accept
Clients should open up to any sensations or feelings that arise. This is about letting go of any internal struggles and simply making space for discomfort
C: Connecting with values
Clients can remind themselves what they are here for.
What about this performance or presentation is valuable, enriching, and meaningful for them?
It’s about finding their “why” and using this to anchor themselves in the present moment.
E: Engage in the here-and-now
While continuing to observe and allow all thoughts and feelings, creatives with performance anxiety need to learn how to shift their attention externally, connecting with what is happening in the world around them, instead of all the “what if” fears their anxiety is trying to torment them with.
When to address perfectionism
Perfectionism is a personality trait that contributes to many different types of anxiety disorders, including generalized anxiety disorder, social anxiety, and obsessive-compulsive disorder.
It's different from having high standards, which can help creatives be detail-oriented and hardworking.
Perfectionism, on the other hand, is a myth that both engenders anxiety and leads to poorer outcomes.
As soon as somebody achieves what their mind says is “perfect”, the mind can always come up with something even better.
Furthermore, clients with perfectionism often feel immense dread and anxiety at the thought that there will be dire consequences if they don’t achieve perfection.
This includes fears of being rejected, not being a “good enough” person, or not being a worthy person.
Therapists may wonder when to address perfectionism with their clients. The answer is: as soon as it becomes apparent that perfectionism is interfering with the client's well-being, creative output, or quality of life.
The paradox of perfectionism is that when creatives operate from a place of fear in trying to achieve perfection to avoid a bad outcome, their sympathetic nervous system becomes activated (the sympathetic response). When this happens it can impede performance by keeping them out of the powerful “flow state” that occurs when we are present and engaged in our passions.
Helping creatives break the hold of perfectionism can be a long process, but it offers the opportunity for future empowerment and freedom.
Acceptance and Commitment Therapy (ACT) is an evidence-based treatment that is particularly helpful in allowing clients to break the bonds of perfectionist tendencies by teaching skills such as self-compassion, mindfulness, exposure and response prevention, and connection with one’s core values.
How to maintain artistic identity
It's common for creative professionals to struggle with concerns around how to maintain artistic identity.
This is due to several factors, including constantly being under the scrutiny of others, self-doubt or imposter syndrome, oppressive cultural or societal messages, and the struggle of trying to make a living in a capitalist society while staying true to one's authentic self.
One of the most helpful ways to empower clients struggling with identity concerns is to help them connect with their core values.
Connecting with values allows artists to make space for all the background noise of an anxious mind, and instead focus on what's most important to them in the present moment, helping them shape their identity by what they do, rather than what they think.
Every artist and creative will have a different set of values. However, some common ones include: creating inspiration, advocating for something important, connecting with emotions, communicating ideas, sharing stories, creating purpose, connecting with or understanding spirituality, making a lasting difference in the world, and many more.
What about financial instability?
Financial instability can be a significant stressor and contributor to anxiety for clients who are creatives.
Stress from financial instability can both exacerbate underlying anxiety (e.g., worry, discomfort, somatic complaints) and it can become a specific source of anxiety itself.
Not knowing when the next paycheck will be or how much money they will make can be terrifying for anybody.
Creatives might even feel an added sense of guilt for worrying about money at all, a self-judgment about what their “true intentions” are.
Acknowledging financial instability and helping creative clients bring self-compassion to their experience can go a long way in easing this stress.
Reminding them that it’s okay to be stressed about finances and that they are not alone in this struggle can remove quite a bit of the shame surrounding it.
It’s also helpful to take a strengths-based approach, helping clients see that while their stress is valid, they likely have overcome incredible adversity in the past, a fact that is easy to forget during moments of struggle.
How to support the creative process
Offering clients a safe, private space to unpack their thoughts, feelings, and memories can go a long way in artist mental health support.
It's important to remember that creative individuals rarely want to be seen as a problem that needs to be “fixed.”
Rather, it’s essential to see them as already whole and complete.
Without trying to solve them, you can use mindfulness to bring a sense of compassionate curiosity to their stuck points.
More often than not, if you help them look closely enough in an open and mindful way, they will find inspiration for incredible growth and creativity sitting just underneath their suffering.
The rewards of working with creative professionals
Working with creative professionals in therapy offers mental health therapists the opportunity to witness and facilitate profound transformation in individuals who enrich our world through their artistry.
By understanding the unique challenges these clients face—from creative blocks and performance anxiety to perfectionism and identity struggles—therapists can provide targeted, effective artist mental health support that honors both the art and the artist.
The therapeutic approaches outlined in this article, including ACT-based interventions, exposure techniques, values clarification, and mindfulness practices, provide a solid foundation for supporting the creative process while addressing the anxiety, fear, and self-doubt that often accompany creative work.
Remember that your role is not to fix creative clients but to create space for them to discover their own pathways to healing, growth, and authentic artistic expression.
Sources
Callaghan, T., Greene, D., Shafran, R., Lunn, J., & Egan, S. J. (2024). The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis. Cognitive Behaviour Therapy, 53(2), 121-132.
Daker, R. J., Cortes, R. A., Lyons, I. M., & Green, A. E. (2020). Creativity anxiety: Evidence for anxiety that is specific to creative thinking, from STEM to the arts. Journal of Experimental Psychology: General, 149(1), 42–57.
Henriksen, D., Richardson, C., Gruber, N., & Mishra, P. (2022). The uncertainty of creativity: Opening possibilities and reducing restrictions through mindfulness. In Uncertainty: A catalyst for creativity, learning and development (pp. 103-124). Cham: Springer International Publishing.
Marchant-Haycox, S. E., & Wilson, G. D. (1992). Personality and stress in performing artists. Personality and individual differences, 13(10), 1061-1068.
Mor, S., Day, H.I., Flett, G.L. et al. Perfectionism, control, and components of performance anxiety in professional artists. Cogn Ther Res 19, 207–225 (1995).
Ong, Clarissa W., Barney, Jennifer L., Barrett, Tyson S., Lee, Eric B., Levin, Michael E., & Twohig, Michael P. "The Role of Psychological Inflexibility and Self-Compassion in Acceptance and Commitment Therapy for Clinical Perfectionism." Journal of Contextual Behavioral Science. 2019, pp 1-35. j.jcbs.2019.06.005
Viator, T. L., Levy, J. J., & Murphy, B. A. (2024). Exploring the Relations among Psychological Flexibility, Music Performance Anxiety, and Perceived Performance Quality with University Music Students. Music & Science, 7. (Original work published 2024)
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