How to Manage Performance Anxiety
Therapy for Athletes in Philadelphia: How to Manage Performance Anxiety
Athletes are often expected to be mentally tough, resilient, and focused under pressure. But behind the scenes, many athletes experience intense anxiety before competitions, games, or important performances.
Pre-performance anxiety is a state of heightened stress or physiological arousal that occurs before a sporting event or performance when the outcome feels important or uncertain. Research suggests that 30–60% of athletes experience performance-related anxiety, which can impact focus, confidence, and overall performance.
For athletes in high-pressure environments, from high school sports to collegiate athletics and competitive adult leagues, learning how to understand and manage this anxiety can make a meaningful difference.
If you’re searching for therapy for athletes in Philadelphia, working with a therapist who understands both mental health and performance psychology can help you build tools to perform at your best while protecting your wellbeing.
Below are five evidence-based strategies commonly used in therapy and sport psychology to help athletes manage performance anxiety.
1. Understanding the Symptoms of Performance Anxiety
Performance anxiety can show up in several ways, and recognizing the signs is the first step toward managing it effectively. Athletes often experience symptoms in three main categories:
Physical symptoms
Increased heart rate
Muscle tension
Nausea or “butterflies”
Cognitive symptoms
Racing or intrusive thoughts
Difficulty concentrating
Doubting your ability
Behavioral symptoms
Avoiding competition situations
Pacing or restlessness
Withdrawing from teammates or coaches
One important concept in sport psychology is that anxiety itself is not always harmful. What matters most is how the athlete interprets those symptoms.
For example, butterflies in the stomach can be interpreted as “I’m nervous because I’m going to fail.” or “My body is preparing me to compete.”
In therapy for athletes, learning to reframe anxiety as readiness rather than danger can help shift how these sensations impact performance.
2. Building Confidence That Isn’t Dependent on Winning
Many athletes tie their confidence solely to outcomes: winning the game, making the team, or achieving a specific time or score. But research shows that sport-confidence acts as a protective factor against performance anxiety. In therapy for athletes, one important strategy is redefining success in ways that are within the athlete’s control.
Some examples of ways to refocus success on could be:
Executing a specific skill
Maintaining focus under pressure
Supporting teammates
Improving technique
Demonstrating effort and resilience
When athletes learn to measure success through controllable behaviors rather than outcomes, they often feel more confident and less overwhelmed by competition pressure.
3. Challenging Negative Performance Thoughts
Performance anxiety often intensifies when athletes get caught in negative thought loops.
Common examples include:
“If I mess up, everyone will notice.”
“If I don’t perform well today, my coach will lose confidence in me.”
“If I try something new and fail, I’ll embarrass myself.”
These thoughts can quickly escalate anxiety and interfere with performance.
A strategy commonly used in therapy is cognitive restructuring, which involves identifying and reframing unhelpful thoughts.
One simple technique is the “If–Then” reframing method.
For example, instead of thinking, “If I miss this shot, the game is over”
You might reframe it as “If I miss this shot, I can still stay focused and contribute to the next play”.
This approach helps athletes develop more balanced and constructive internal dialogue during high-pressure moments.
4. Creating Pre-Performance Routines
Many elite athletes rely on pre-performance routines to help manage nerves and enter a focused mental state. These routines help regulate attention, manage arousal levels, and create a sense of control before performing.
Examples include:
Breathing exercises
Visualization
Listening to music
Repeating cue words
Specific warm-up sequences
A powerful component of these routines is cue words—short phrases athletes use to guide their attention before a movement or action.
Examples might include:
“Focus.”
“Smooth.”
“Strong and steady.”
When practiced consistently, these routines help the brain associate specific behaviors with calmness, focus, and readiness to perform.
5. Using Reflection to Improve Mental Performance
Managing performance anxiety is an ongoing process. One strategy used in sport psychology and therapy is structured reflection.
Athletes benefit from regularly reflecting on questions like:
When do I tend to feel the most anxious?
What strategies helped me manage pressure?
What did I do well mentally during the competition?
What would I try differently next time?
Reflection and pattern recognition helps athletes better understand their mental patterns and gradually build more effective coping strategies.
Over time, this process can strengthen confidence, improve emotional regulation, and support more consistent performance.
When Therapy Can Help Athletes
While some level of performance anxiety is normal, therapy can be helpful when anxiety begins to interfere with:
Confidence in sport
Focus during competition
Enjoyment of athletics
Relationships with teammates and coaches
Sleep or recovery
Motivation or burnout
Overall mood and self-worth
Athletes may also seek therapy for:
Injury recovery and mental resilience
Identity and life balance outside sport
Perfectionism and self-pressure
Transitions out of competitive athletics
Working with a therapist who understands the unique pressures athletes face can provide a supportive space to develop skills that improve both performance and overall mental health.
Finding Therapy for Athletes in Philadelphia
If you’re an athlete experiencing performance anxiety, you’re not alone and support is available. Therapy for athletes can help you understand your relationship with pressure and underlying factors, develop mental performance strategies, build confidence and resilience, and strengthen your connection to sport and teammates/coaches.
For athletes in Philadelphia, working with a therapist who integrates mental health and sport psychology principles can help you perform at your best while maintaining your wellbeing.
Because at the end of the day, the goal isn’t just performing better, it’s creating a healthier, more sustainable relationship with your sport.
Looking for a therapist for athletes in Philadelphia or virtually in Pennsylvania, New Jersey, Delaware, Ohio or Vermont? Reach out today through my contact page!
References
Courtney Stevens, Barbi Law & J. Paige Pope (06 Mar 2025): Five Modules of Support: Pre-Performance Anxiety Management Strategies, Journal of Sport Psychology in Action, DOI: 10.1080/21520704.2025.2475191