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Hello! I’m a freelance writer for stage and screen, a theatre producer and educator. I’ve been working in the performing arts for 20 years and have written over 80 commissioned scripts, but when I first started experiencing peri-menopausal symptoms I genuinely wondered if I’d ever be able to work again.��

It felt like, overnight, my brain had stopped being my brain. Not only had my ability to form coherent sentences ground to a halt but all the words, structures and stories that had previously been really easy to access, had been replaced with a ball of white-hot rage and anxiety.

This state of affairs was not at all conducive to being able to carry on working in a fast-paced creative freelance career.�� Panic set in.

After a bit of wailing, ranting, and a lot of walking the dog, I took a few calming breaths and then I started researching the impact of menopause on creative brains. A guest blog on the BAPAM website by the wonderful Sophie Tott was pivotal in helping me to realise that I was definitely NOT alone. From there, it was reasonable to think that a lot of my friends and colleagues must be in a very similar boat to mine. And so we all started to talk, honestly and openly, about the brain fog, the weird and distracting symptoms (itchy ears, anyone?), and the rage that lurks constantly just below (or above) the surface.

I soon realised that there isn’t a great deal available in terms of easy-to-find industry support for ‘writers who suddenly can’t write because their body is undergoing seismic hormonal shifts’ so, with a few other wonderful writers, I set up a WhatsApp group of peri-menopausal and menopausal writers.

In no time at all we had created one of the most supportive and creative communities I have ever been a part of.�� Our conversations, on a daily basis, range from anxiety about work, to amusing anecdotes about menopause-induced aphasia (not being able to find the right words) to discussions about nutritional supplements, music to listen to which boosts focus, good pyjamas to combat hot flushes, and much, much more.

There was just so much brilliant advice and supportiveness that I felt inspired to collect it, shape it, and turn it into a resource pack which other writers might find useful. was born.

This document soon turned into two documents: one for writers and one for those who work with and support writers who are experiencing menopausal symptoms. These documents are also a hope for more conversations leading to more understanding and support across the creative industries for affected writers.

Since creating these resources, I have been overwhelmed by the positive response and support from theatres, literary organisations, publishers, and BAPM. Everyone I’ve reached out to has responded so positively and it’s been incredibly encouraging to see the logos of supporters on the back page grow and grow (and it’s still growing – please get in touch via my website if you’d like to support these documents).

What started as a response to a moment of personal crisis has grown into a supportive community and from there to, hopefully, the start of a sector-wide conversation.

And the response to this project, as well as several others I am working on at the moment, inspired me to set up a new company . All of the work of my new company is driven by a desire to harness my new peri-menopausal energy (and yes a certain amount of rage) into activism and advocacy where I can to inject kindness and common sense into the arts.

The Writing the (r)Age resources will be launched at Sheffield Theatres on February 25th, with a panel of phenomenal and fascinating speakers, including BAPAM’s Lucy Heyman. You can book tickets for both the launch event and companion workshop (on having fun with accidental surrealism caused by aphasia) ��

To download the resources visit: ��

–

About the writer: Rachel Barnett-Jones – Writer, Producer and Sensible Creative

Rachel is a writer, educator and arts advocate. As the founder of, she is committed to dismantling the complexities of the professional arts to ensure that creatives are protected, informed, and respected.

Her work as an advocate is built on a career of world-class storytelling, with writing credits spanning television (Sky Kids’ Pip and Posy, S4C/ITV’s Tiny Buds), audio (Tonies, Lapland UK), and international theatre (Polka, Chichester Festival Theatre, York Theatre Royal).

By merging her creative practice with a tireless commitment to practical kindness, Rachel is working on a variety of projects which, she hopes, will make the arts a happier and healthier place to work.

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The �� and the Ģ��tv (BAPAM) have unveiled a new Guidance Note at the ABTT annual Christmas Party on the 5^th December, timed to coincide with panto season – an often intense and stressful period for backstage workers.

is the first dedicated guidance of its kind focusing on the physical health of backstage professionals in the theatre and live production sector.

ABTT CEO, Liz Sillett (centre) with Mig Walsh, GSA (left) and Claire Cordeaux (right) at the launch of Guidance Note W101 at Gillian Lynne Theatre on Friday 5th December

This extensive, evidence-based resource recognises the essential link between physical and mental well-being and arrives at a critical moment for the industry. Building upon the initial , introduced at the in June 2024, the guidance represents a long-awaited, in-depth framework designed to improve backstage workplace health and provide practical support for theatre professionals.

Backstage professionals—including lighting, sound, stage, rigging, AV, costume and wardrobe departments and automation technicians—often work in demanding environments with long hours, heavy equipment, and limited recovery time. With more than 70% of the workforce identifying as freelance, the sector faces unique challenges when it comes to managing health and safety.

This new Physical Wellbeing Guidance Note provides detailed, practical recommendations aimed at improving physical health outcomes and reducing the risk of occupational injury or chronic illness for backstage workers.

It also includes:

• A breakdown of the S.T.A.G.E. C.R.E.W. mnemonic:
  Sleep, Training & Technique, Appetite & Diet, Good Hygiene, Environment (risk assessments), Clinical Support, Rest & Recovery, Exercise & Warm-Up
• Real-life case studies exploring common physical health issues
• Managerial guidance on supporting staff health
• A self-assessment tool for individual workers to evaluate and improve their wellbeing

The guidance draws on the ABTT’s deep sector expertise and �����ʴ���’s four decades of clinical experience in the performing arts. It is designed to be accessible, free to download, and relevant to organisations of all sizes.

The Physical Wellbeing Guidance Note will form part of the ABTT Code of Practice for the Theatre Industry in the UK, recognised by the Health and Safety Executive (HSE) as an Established Standard, and will be referenced in the Technical Standards for Places of Entertainment.

It will be made freely available via the and integrated into the growing suite of , further supporting theatre venues and employers in meeting their responsibilities under the Health and Safety at Work etc. Act 1974.

“As the largest provider of clinical services to the UK’s performing arts sector, we are proud to announce this milestone partnership with the ABTT. This is a major step forward in recognising and supporting the physical health of backstage professionals – an area long overlooked. A vibrant, healthy workforce is essential to the future of live performance.”
Claire Cordeaux, CEO, Ģ��tv (BAPAM)

“The ABTT and BAPAM have worked in partnership since 2018, united by a shared commitment to improving health and welfare for the technical workforce. This new guidance is both timely and essential, providing clear, practical advice to support the wellbeing of those who bring live performance to life, and helping the industry embed healthy practices across all backstage roles”
Liz Sillett, CEO, Association of British Theatre Technicians (ABTT)

“I’m delighted to share this landmark document—the first to provide physical welfare guidance for backstage staff. My thanks to the ABTT for funding the project, to the clinicians at BAPAM for bringing it to life and to The Guildford School of Acting for supporting its development. This guidance is a vital addition to the ABTT’s technical standards and the growing series of welfare resources, helping to place health and wellbeing on equal footing with safety across our industry and I hope the sector can recognise the value of this guidance in improving health and wellbeing backstage.”
Mig Walsh, Senior Lecturer at Guildford School of Acting

Guidance Note W101: Improving the Physical Health of Backstage Staff can be downloaded on the ABTT Website for free here:

Notes for Editor:

About ABTT

The Association of British Theatre Technicians (ABTT) is a registered charity and membership organisation dedicated to raising technical standards across theatre and live performance. Founded in 1961 by a committed group of theatre technicians, the ABTT has become a trusted authority in the industry, providing expert technical advice, consultations, training, publications, and essential resources such as its Guidance Notes.

In addition to its technical leadership, the ABTT fosters collaboration and knowledge-sharing through a wide range of networking opportunities, including events, seminars, conferences, and its flagship annual ABTT Theatre Show.

Working in partnership with the National Theatre Safety Committee, the ABTT produces the Code of Practice for the Theatre Industry, which is formally recognised as an Established Standard under the Health and Safety Executive’s (HSE) Enforcement Management Model. The newly launched Guidance Note will now form part of this Code of Practice and will also be referenced in the Technical Standards for Places of Entertainment, reinforcing its role as a benchmark for health, safety, and best practice across the UK theatre sector.

For more information, please visit

About BAPAM

The Ģ��tv (BAPAM) is the medical charity for the performing arts, working with performers and industry professionals, from musicians and singers to dancers, actors, and circus performers as well as those who work behind the scenes.

The charity provides free, bespoke sector-specific care from expert clinicians in a range of disciplines, responding to requests for help with mental health, musculoskeletal care, vocal health, hearing concerns and some eye care and dental health issues. �����ʴ���’s wider network of more than 300 Ģ��tvs across the UK also offers support for health problems and injuries associated with work in the creative sector.

Established in 1984, BAPAM helps thousands of people each year to enjoy a healthy and sustainable career in the performing arts, and works across the sector with organisations including Help Musicians, the Musicians’ Union, Equity, PRS Members’ Fund, PPL, the Royal Society of Musicians, Actors’ Trust, Dance Professionals Fund, Equity Charitable Trust, Association of British Theatre Technicians, Healthy Conservatoires,��and the Royal Variety Charity.

For more information, visit

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ABOUT THE AUTHOR

Dr Kay Capaldi () is a BACP-registered integrative psychotherapist, researcher, and university lecturer with extensive experience supporting performers. She is listed in the BAPAM Directory and specialises in the self-relationship, negative self-treatment (NTS), and social anxiety—areas she continues to explore through both research and clinical practice.

Drawing on these insights, Dr Capaldi developed the Self-Relationship Training® programme, which helps people develop awareness of unhelpful patterns, cultivate self-compassion, and build a healthier, more supportive relationship with themselves.

In this guest blog for BAPAM, Dr Capaldi examines the links between performance anxiety, social anxiety, and the self-relationship, and explains how these insights have shaped the Self-Relationship Training® programme.

BAPAM readers are invited to join a pilot weekend of the programme in central/South West London—an opportunity to experience the approach first-hand, provide feedback, and help shape its future. The pilot will be offered at a reduced rate of £95, with a Pay-What-You-Can option available for those in the performing arts community who may need additional support.

Participants will be invited to share their feedback, which will directly inform the next stage of the programme’s development. The exact date is yet to be confirmed, with the pilot planned for early 2026.

This programme is suitable for anyone experiencing challenges in their self-relationship, such as self-criticism, low self-worth, or harsh self-judgement. Places are limited, and participants will be selected based on suitability criteria. If you are unsure whether this pilot is right for you, please contact Dr Capaldi for a confidential discussion.

To register your interest or find out more:
Email: kay@drkaycapaldi.com

Please note that the Self-Relationship Training® programme and pilot are organised independently of BAPAM.

Introduction: Typical Nerves or a Clinical Concern?

Performance anxiety – often referred to as stage fright – sits on a spectrum. Whether it is a clinical concern or simply part of the typical experience of performing depends on its intensity, frequency, and impact on everyday life.

For many performers, some level of anxiety is expected. It often shows up as nerves, butterflies, or physical changes such as increased heart rate, sweating, or trembling before or during performance. Usually situational and mild to moderate, this form of anxiety rarely prevents performance. In fact, it can be adaptive, sharpening focus and enhancing preparation.

However, performance anxiety can escalate into a clinical condition when nervousness becomes intense, persistent, and disruptive. In such cases, it may meet the criteria for a formal anxiety difficulty, most often classified as the performance-only subtype of Social Anxiety Disorder (SAD). Severe physical symptoms such as trembling, nausea, or panic attacks are common, and avoidance of auditions, performances, or evaluative situations may follow. While performance anxiety and SAD overlap, they are not identical. The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (known as the DSM-5) recognises a performance-only specifier for SAD, where anxiety is confined to public speaking or performance contexts, reflecting both the shared mechanisms and the distinct features of performance anxiety (American Psychiatric Association, 2013).

Differentiating Typical and Clinical Anxiety

Performance anxiety can be understood by looking at its context, intensity, persistence, and impact (Hofmann et al., 2004):

• Context and triggers: Typical anxiety is situational and proportionate; clinical anxiety may arise even in minor or imagined performance scenarios.
• Intensity and symptoms: Typical nerves are mild to moderate; clinical anxiety can provoke severe, panic-like symptoms.
• Behavioural impact: Typical anxiety allows performance with coping strategies; clinical anxiety can lead to avoidance and lost opportunities.
• Duration and persistence: Clinical anxiety persists across many performances, often lasting six months or more.
• Cognitive patterns: Typical worry is realistic; clinical anxiety involves excessive, intrusive thoughts disproportionate to actual risks.
• Functional impairment: Typical nerves have minimal impact on life or career; clinical anxiety can significantly disrupt functioning.

Shared Mechanisms in Social and Performance Anxiety

Both SAD and performance anxiety share underlying mechanisms: fear of negative evaluation, self-focused attention, and heightened physiological arousal such as a rapid heartbeat and trembling (Hofmann et al., 2004).

These similarities explain why treatments developed for SAD – including cognitive-behavioural therapy (CBT), exposure-based interventions, and emotion-focused therapy (EFT; Elliott & Shahar, 2017) – are also effective for performance anxiety (Hofmann & Smits, 2008).

Key Differences

SAD tends to appear across a wide range of social situations, while performance anxiety is more specific to contexts where identity and ability feel on the line (Niering et al., 2023). Both are rooted in heightened self-consciousness and fear of judgement, underpinned by self-critical beliefs and a tendency to interpret situations as threatening.

Importantly, even socially confident individuals can experience performance anxiety. This is often seen in situations such as public speaking, which may be viewed as a specific form of social anxiety characterised by fear of negative evaluation (Bodie, 2010). Clarifying these distinctions enables clinicians to determine whether performance anxiety occurs as part of a broader diagnosis of social anxiety disorder (SAD) or represents a separate concern requiring targeted intervention.

Beyond Symptoms: The Self-Relationship

Research shows that both SAD and performance anxiety are maintained not only by external fears of judgement but also by how individuals relate to themselves in stressful situations. Many worry about revealing perceived flaws or inadequacies, reinforcing avoidance and distress (Moscovitch, 2009).

Traits such as self-criticism, perfectionism, and internalised shame intensify physiological arousal and avoidance, creating a self-perpetuating cycle (Capaldi & Elliott, 2023). Internal self-criticism, rather than fear of external evaluation alone, often plays the central role in maintaining anxiety.

Approaches that focus on the self-relationship (Capaldi, 2024) complement standard treatments by fostering self-compassion, non-judgemental awareness, and supportive self-talk. This shift helps to reduce anxiety in the moment and build resilience over the long term.

The Self-Relationship: An Internal Mirror

The self-relationship reflects how we think, feel, and behave towards ourselves, encompassing our beliefs about our abilities, emotions, and responses under pressure. This relationship can take several forms, including:

• Inner critic – attacking, rejecting, shaming, or comparing ourselves to others.
• Neglectful self – overlooking our physical, emotional or psychological needs.
• Controlling self – striving for perfection, pressuring ourselves, or overly monitoring our thoughts and actions.
• Isolating self – withdrawing to avoid vulnerability.
• Compassionate self – nurturing, validating, respecting, and accepting ourselves.

In social and performance anxiety, the inner critic often dominates, predicting failure and fuelling fears of inadequacy. Capaldi and Elliott (2023) describe this as Negative Treatment of Self (NTS), a pattern of harsh self-derogation, rigid perfectionism, self-neglect and withdrawal. These patterns often originate in earlier relational experiences where emotional safety was lacking.

A Model for Healing: Self-Relationship Training®

Self-Relationship Training® (SRT), developed by Dr Kay Capaldi, offers a structured framework for rebuilding this sense of internal safety and addressing unhelpful self-relationship dynamics:

1. Recognise: Identify patterns of negative self-treatment such as self-criticism or neglect.
2. Externalise and process: Use reflective and experiential methods to bring patterns and emotions such as shame, fear, or sadness into awareness.
3. Develop a compassionate inner voice: Practise self-soothing, boundary-setting, and nurturing responses to balance the inner critic.
4. Integrate: Apply journalling, mindfulness, and other practices to embed awareness and encourage emotional growth.

By shifting from adversarial self-monitoring and criticism to supportive self-regulation, SRT aims to address the root of anxiety rather than just its symptoms.

Why This Matters

SRT and related approaches offer more than mere symptom relief; they promote lasting change by transforming the performer’s relationship with themselves. Through this process, individuals are able to:

• Rely less on external validation for their sense of self-worth and confidence, cultivating an internal sense of assurance.
• Strengthen resilience to rejection, whether it is real or perceived, allowing setbacks to be met with greater composure.
• Develop a secure, supportive inner foundation, creating a stable base from which to thrive both personally and professionally.

By shifting the focus inward, these approaches equip performers with tools that extend far beyond performance contexts, enhancing overall well-being and self-reliance.

Conclusion: You Deserve to Be on Your Own Side

Recovery from clinical anxiety is not simply about acquiring coping techniques – it is about cultivating a deeper sense of allegiance to yourself. When the inner critic is met with compassion, acceptance, and clarity, its intensity begins to soften. This inward journey is less about eliminating nerves entirely and more about reshaping your relationship with them. In doing so, performers discover a path to resilience, allowing them to move forward with greater confidence, authenticity, and ease.

Acknowledgement: AI-based tools (OpenAI, 2023) were used to support background research and language editing. All interpretations, analysis, and conclusions in this blog remain the author’s own.

References

• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). American Psychiatric Publishing.
• Bodie, G. D. (2010). A racing heart, rattling knees, and ruminative thoughts: Defining, explaining, and treating public speaking anxiety. Communication Education, 59(1), 70–105.
• Capaldi, K. (2024). The power of Self-Relationship Training [Blog series].
• Capaldi, K., & Elliott, R. (2023). Negative treatment of self in socially anxious clients. Person-Centered and Experiential Psychotherapies, 23(1), 101–121.
• Elliott, R., & Shahar, B. (2017). Emotion-focused therapy for social anxiety (EFT-SA). Person-Centered & Experiential Psychotherapies, 16(2), 140–158.
• Hofmann, S. G., Heinrichs, N., & Moscovitch, D. A. (2004). The nature and expression of social phobia: Toward a new classification. Clinical Psychology Review, 24(7), 769–797.
• Hofmann, S. G., & Smits, J. A. J. (2008). Cognitive-behavioural therapy for adult anxiety disorders: A meta-analysis of randomised placebo-controlled trials. Journal of Clinical Psychiatry, 69(4), 621–632.
• Moscovitch, D. A. (2009). What is the core fear in social phobia? A new model to facilitate individualised case conceptualisation and treatment. Cognitive and Behavioral Practice, 16(2), 123–134.
• Niering, M., Monsberger, T., Seifert, J., & Muehlbauer, T. (2023). Effects of psychological interventions on performance anxiety in performing artists and athletes: A systematic review with meta-analysis. Behavioural Sciences, 13, 910.
• OpenAI. (2023). ChatGPT (GPT-5) [Large language model]. Used for background research and language editing.

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When I sat down to write this blog about men’s mental health in the performing arts, I spent far too long searching for a clever angle, something new, or interesting to say. Yet, I kept circling back to the same familiar themes: low self-esteem, addiction, violence, and the ongoing uncertainty about what it even means to be a man today.

These issues are well-known, but they persist because they continue to shape the emotional landscape of many men, that I support.

This morning, on International Men’s Day, I heard Tim Stanley’s, “Thought for the Day” on the radio. He admitted he was “very suspicious” of the concept of even having such a day. He also pointed out that many men remain resistant to therapy and that the self-pitying man, can be almost as unattractive, as the muscle-bound man shouting at us on social media to drink protein shakes.

That line captured my attention, because it reflects two extremes that countless men feel caught between.

As a performance psychologist, my work is centred on understanding each person I meet as an individual. Gender does not define the relationship, humanity does. My aim, is to understand the unique mind in front of me, how it works, where it struggles and how to help that person perform at their best, while remaining grounded and healthy.

And it suddenly became obvious to me: perhaps the real tension many men feel lies in the polarisation itself. On one side, the “self-pitying man” who seeks help. On the other, the hyper-masculine figure selling strength, certainty and protein drinks.

In a world that amplifies these extremes, it’s easy to forget something simple and profoundly grounding:

You are a human being first.

Before performance.�� Before masculinity.�� Before expectation.�� Before comparison.

Recognising this is a powerful starting point. Being human means having needs, vulnerabilities and limits. And understanding this allows men to approach themselves with self-compassion, rather than criticism.

Visibility Matters: Why Performers Opening Up Helps Everyone

Many leading performers, such as Lewis Capaldi, have begun openly sharing their mental health experiences with fans and the wider world. Their honesty is reshaping the conversation.

“Therapy has been such a massive part of my… last two years, a massive part of the reason that I’m able to be a musician again.”
— Lewis Capaldi (The Scotsman)

This openness is invaluable, not only for other performers, but for people in all walks of life. It allows audiences to vicariously experience the reality behind the curtain: the struggle, the seeking of help, the gradual rebuilding and ultimately the return to performing with renewed strength.

Celebrities who speak openly about their mental health journey, use their platform to reach millions. They can help the public understand that mental illness is common, treatable and nothing to be ashamed of. Importantly, they encourage those who are struggling to seek help, rather than suffer in silence.

Returning to Our Humanity

When performers and men more broadly feel torn between cultural caricatures of masculinity, returning to the simple truth of our shared humanity can be deeply grounding.

• Being human means needing support.
• It means learning to show yourself self-compassion.
• And it means recognising that asking for help is not an act of self-pity, but an act of courage.

Here are 3 tools you could do today to build your self compassion:

1. Approach yourself as you would a friend

During challenging times, pause and ask:

1. What supportive words would I say to my friend in this situation?
2. Would I use the same tone I’m using on myself right now?

This instantly shifts your inner dialogue from criticism to support, which reduces stress and improves focus.

2. Build a 30 second refocus plan after mistakes

Self-compassion is not only emotional, it’s also behavioural.�� If you make a mistake rehearsing or performing, have a routine to help you get back into your performance.�� A simple reset could include:

1. One deep, slow breath
2. Rolling and relaxing your shoulders
3. Saying a grounding phrase like ‘focus’ ‘calm’, or ‘ready’

This tiny habit trains your nervous system to recover faster and with more kindness.

3. It’s important to separate your self-worth from your performance.
   Your value as a person is not defined by how well you play, act, dance, or sing. Instead, anchor your self-worth in your values and in all the areas of your life, your relationships, your character, your efforts, and the way you show up as a human being, not just as a performer.

November being Men’s Mental Health Awareness month, perhaps the most meaningful starting is, remembering that you are allowed to be human.

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