The Shame Surrounding Beta Blockers: Why It Weighs More Than The Nerves

Gökçe Kutsal
Jun 18
8 min read

Updated: 5 days ago

Dark slide with headline The Shame Surrounding Beta Blockers: Why It Weighs More Than The Nerves and a sad paper bag face

* Where I describe clients in my blog posts, I've changed names, instruments, and other identifying details to protect their privacy. Sometimes I'm describing one person, sometimes a pattern I've seen across several. The essence of the experience and what we worked on together remain true.

** And one more thing: I'm a performance coach, not a doctor. Nothing here is medical advice, and none of it is a recommendation to start, stop, or change anything you're taking. Beta blockers are prescription medication, and the only person who can tell you whether they're right for you is a doctor or pharmacist who knows your history.

A harpist I worked with once told me about the thing she was most ashamed of.

She was a teacher in her fifties with decades of playing behind her, so I assumed it would be something big... and it was a quarter of a small white pill.

She had taken a beta blocker before recitals for years.

And the pill itself had never really been the problem. After all, it did its little job: Her hands steadied, and she played.

What she couldn't forgive herself for was needing it. A musician of her experience, her standing, still reaching into her bag before a recital like a frightened beginner.

She taught students who looked up to her. She would never, not once, have shamed one of them for doing the same thing. She simply couldn't extend the same mercy to herself.

That gap, between the kindness we hand out freely and the kindness we refuse ourselves, is what this post is about.

Because the shame around beta blockers is real, and common, and almost never spoken aloud.

And it weighs far more than the nerves it's attached to.

The Thing Nobody Admits They Feel

Let's start by separating two things that usually get bundled together.

There's the fear itself:

The racing heart, the shaking hands, the dread that arrives in the days before a performance. That's hard enough on its own.

But sitting on top of it, much bigger and heavier, there's often a second thing. A verdict.

Some version of what is wrong with me that I still feel this, after all these years... that I still can't walk out there without help.

That second thing is shame.

(And no, it isn't the same as guilt. Guilt says I did something wrong. Shame says I am something wrong. Guilt is about an action, and an action can be put right. Shame is about you, the whole of you, and it offers no repair, only a verdict to carry around forever.)

When a musician feels bad about taking a beta blocker, it is almost never guilt.

They don't think taking this pill was a mistake. They think needing this pill means something about who I am.

And that is heavier than the pill.

Two Shames, Actually

It helps to notice that there are usually two of them, stacked on top of each other.

The first is shame about the nerves themselves. The belief that a real professional, at a certain level, simply shouldn't be this frightened. That fear is for students, for amateurs, for people who haven't yet put in the hours.

So to feel it at forty, or fifty, or sixty, with a whole career behind you, starts to look like proof that you're secretly not as good as everyone seems to think.

(If that particular dread is familiar, you might recognise it from what imposter syndrome actually is.)

The second is shame about the solution. Even once you've made some peace with being nervous, there's still the matter of the pill.

And here a particular belief does an enormous amount of damage: The idea that an achievement only really counts if you earned it the hard way, through grit and hours and willpower alone. By that logic, a pill is a shortcut. A cheat. Something that makes the success a little less yours.

By the way, it's a very perfectionistic way to keep score, and perfectionism and shame have always travelled together.

(That belief is also why some musicians mentally file beta blockers under cheating, like a kind of doping for the concert hall. I'll take it on properly another time :) For now I only want to point at what it does to the person taking the pill: When it turns a small medical decision into a referendum on their character.)

Anyway...

Can you see how both shames point the same direction? It's just inward and down.

How the Shame Feeds Itself, and the Silence

You see, shame has a nasty habit. It makes the very thing it's ashamed of worse.

A musician embarrassed by their shaking hands becomes more fixed on the shaking, more braced against it, more certain the whole panel can see it... and all that watching and bracing tightens the body and makes the hands shake more.

The shame about the symptom feeds the symptom. It's a small private loop, running secretly under the music.

But there's a bigger loop, and this is where the private feeling turns into a profession-wide one.

I remember reading a piece by Brené Brown, who has spent two decades studying this. And she puts it like this:

Shame needs three things to grow... secrecy, silence, and judgment. Give it those and it flourishes.

And the musician who feels ashamed of the pill does the most natural thing in the world with it. They hide it. Take it secretly, tell no one, keep it at the bottom of the bag.

Now multiply that by an entire profession. As I wrote in my beta blockers post, a companion piece to this one, something like seven in ten musicians have taken a beta blocker, and the great majority do it in exactly this private, unspoken way.

The result is a silence so complete that each person standing inside it reaches the only conclusion available to them: I must be the only one. And being the only one is the loneliest, most shaming place there is.

So the loop closes: Your shame makes you hide the pill. Everyone hiding the pill makes a silence. The silence convinces each of you that you're alone in it. And being alone deepens the shame that started the whole thing.

The private feeling and the collective hush are not actually two separate problems. They build each other.

The Lie at the Centre of It

Okay, before we move further, we have to address the thing the silence keeps from you: The fact that you were never the only one.

Look again at that number:

In a waiting room of 10 musicians before a big audition, the research suggests somewhere between 3 and 9 of them are carrying the very same little bottle you are.

You know, the one whose calm you're secretly envying. The one who looks like they were born for the stage.

There's a good chance they took something an hour ago, and an even better chance they're looking at you and thinking you're the one who has it all together :)

This isn't my version of a pep talk, by the way. It's just a fact, and it happens to be the fact that takes the legs out from under the shame.

Shame runs entirely on the belief that you are uniquely defective... that everyone else copes, and you alone need a crutch. The numbers say the reverse. You are not the exception. You are, I'm sorry to say, the rule.

Kristin Neff, who built much of the research on self-compassion, has a name for the thing you're missing in that waiting room: Common humanity.

It's the recognition that struggling is part of the shared experience of being a person, rather than a private flaw that fences you off from everyone else.

Notice how it is the exact opposite of the isolation that shame feeds on.

And here you don't even have to talk yourself into believing it, the way you sometimes do with comforting ideas. It's simply true.

The room is full of people doing what you're doing.

What Actually Helps (and Hey, I Have Proof!)

So what do you do with shame, once you've caught it in the act?

You don't argue it away, and you certainly don't start shaming yourself for feeling ashamed, which is only another loop.

What helps is self-compassion (and there's a real weight of research behind this now).

Neff describes it as three things working at once:

Being kind to yourself rather than harshly critical, remembering you're not alone in the struggle, and holding the painful feeling in steady awareness instead of drowning in it.

It is, more or less, the heart of the work I do.

To illustrate, here's the test I gave the harpist:

Imagine a student of yours, someone you're fond of, came to you and admitted, eyes down, that they take a quarter of a beta blocker before recitals and feel like a fraud for it. What would you say to them?

She knew immediately. She'd be warm. She'd tell them it's common, it's sensible, it says nothing whatsoever about their worth as a musician. She'd be kind.

The entire problem was that she kept one voice for her students and a far crueller one for herself.

(A quick word for the part of you already objecting that self-compassion sounds soft, and that you need to stay hard on yourself to stay any good. The research doesn't back you up. Self-compassion turns out to be linked to more resilience, and more willingness to learn from your mistakes, not less. It isn't the same as self-esteem, which needs you to keep succeeding in order to top it up. It's the thing that's still standing there on the days you don't.)

And I've watched this numerous times, with numbers to show for it.

In a research project I ran in 2022, I measured shame directly in four professional singers, before and after a course of this kind of work.

Every one of them began above the healthy range. Every one finished below it.

The shame wasn't a fixed feature of who these singers were. It was a weight they picked up along their training... and it turned out that weight can be set down.

Sometimes it helps to put the pill back in its proper box too. A beta blocker doesn't make you play better than you are. It adds nothing you didn't already bring.

It is performance-enabling, not performance-enhancing... far closer to a pair of reading glasses than to a gym-bro steroid. It moves a physical obstacle out of the way so the musicianship you already have can actually come through.

In my view, there's no more shame in it than in reaching for an inhaler.

Back To The Harpist

The harpist still takes her beta blocker. Half a tablet, sometimes a quarter, before a recital that matters to her. That part never changed, and there was never any real reason it should.

What changed was what it meant.

It no longer feels like a confession she carried and became a small, practical thing she did, like reaching for her reading glasses before checking a score (ironically, we needed to convince a part of her to accept reading glasses were necessary to properly read the score too!)

So over time, it stopped being evidence of some flaw and turned into a tool that is used by a competent adult who knows herself well.

You see, you don't have to give up the pill to be free of this. You just have to put down the shame.

If any of this sounds like the voice you keep for yourself, the cruel one you'd never dream of using on a student, that's the exact thing I work on with musicians in private coaching.

About

I'm Gökçe Kutsal, a music performance coach for professional orchestra musicians and opera singers, with an MA in Voice Pedagogy, plus coaching and teaching experience since 2017. I work with orchestral musicians, soloists, and audition candidates across Europe, the UK, North America, and Australia — and I write about performance anxiety, audition preparation, and the craft of practice for musicians who already have the technique and are trying to work out why it doesn't always hold up under pressure.

More about me | Ways to work together

Research Cited

Brown, B. (2018). Dare to lead: Brave work. Tough conversations. Whole hearts. Random House.

CutCommon. (2017, August 13). No shame in beta-blocker use? https://www.cutcommonmag.com/no-shame-in-beta-blocker-use/

International Conference of Symphony and Opera Musicians. (2017, June). The 2015 Musicians' Health Survey results.Senza Sordino. https://www.icsom.org/senzasordino/2017/06/the-2015-musicians-health-survey-results/

Klickstein, G. (2010, March). Musicians and beta-blockers. The Musician's Way Blog. https://www.musiciansway.com/blog/2010/03/musicians-and-beta-blockers/

Kutsal, G. (2022). Acoustic Spectrogram as a Tool for Evaluating the Effectiveness of Acceptance and Commitment Training (ACT) as a Music Performance Anxiety (MPA) Management Method in Professional Singers [Unpublished master's project, Voice Study Centre]. https://www.gokcekutsal.com/post/supporting-research