2025 PAMA International Symposium Reflection

In July, I attended my second International Symposium of the Performing Arts Medicine Association (PAMA) in Washington, D.C. It was wonderful to meet in-person colleagues from around the world for the first time, and to reconnect with those I had met in London in 2024. This year, I walked into PAMA with a new challenge: presenting my first poster, which centered around mentally preparing for performances. I was thrilled to have been chosen as a poster presenter and to have the opportunity to share how mental skills training can enhance performance. You can view my poster presentation on my website here. Over the four days of this symposium, which concentrated on the theme of occupational health in the performing arts, I was immersed in keynotes, workshops, and research presentations.

Engaging in the performing arts involves accepting unique physical, psychological, economic, and socio-cultural risks. One keynote astutely noted the need for collaboration among institutions for global buy-in, awareness, and funding for research specific to performing arts professionals. Research is a critical means of advancing preventative treatment and rehabilitative care for the health of performing artists. Johns Hopkins University, where our symposium took place, is actively working on this research. You can learn more at https://www.occupationalhealthinmusic.org/. Institutional commitment and cultural change are essential to the overall health and well-being of performing artists.

A new case study on music performance anxiety in students found that the most helpful strategies include breathing techniques like box and belly breathing, cognitive restructuring, and mental practice. But as a practitioner, I often tell my clients to try out different mental skills and use the ones that are most beneficial to them. One of my colleagues, who is also a professional opera singer, gave this reminder to participants in her workshop: “Your skills toolbox is customizable.” She discussed numerous tools, such as breathwork techniques, mindfulness, and a body scan that performers can combine to best serve them and their needs before, during, and after performance.

One of the most impactful workshops I participated in was a strategic visioning session, which challenged us to write a vivid description of what “success” looks like ten years in the future. Once we wrote what “success” would look like, we identified the gaps between our vision and the current situation. Gap identification was the easiest part because I have witnessed and have been trying to work through the “lack ofs” when it comes to performance psychology and the performing arts for the last few years. The “lack ofs” are industry-wide and include a lack of knowledge, understanding, and education of performance psychology, a lack of funding not only for specific performing arts-focused research, but also for performing artists to receive support from a performance psychology professional, and a lack of buy-in from both performing artists and the organizations and individuals in power who employ them. Performing artists are not seen as elite performers in the same way as athletes are, though this is slightly improving. Performing artists do not get the same attention, resources, opportunities, information, or participation in research trials, surveys, and processes as other elite performers, such as athletes. I encourage:  

• If you are a researcher, consider performing artists as a focus area.

• If you are the leader of an arts organization or employ performing artists, ask your performers what additional support could benefit them. Be open to learning from research in performance medicine so you can better care for the artists you work with.

• If you are a performing artist, be open to learning from research, ask questions of those doing the research, or other professionals in the field. Search out information and resources in performance medicine that could support you.

Lastly, here are a few key points that stand out from my notes:

• Start listening to your artists; you never know what you are going to hear. You can practice being a better listener by limiting distractions, asking thoughtful questions, reflecting on what you are being told, and showing appreciation to the person sharing.

  • Injury prevention systems do not work if you do not listen to your artists and only look at research.

  • Listen before you plan, ask before you assume, build with and not for.

• Do not normalize chronic stress and burnout. Burnout affects the workplace; it is not an individual problem.

• For practitioners, you can be evidence-based in your work even if you do not come from or fully understand the specialty. You have to skill up to be of service. Learn and skill up on everything you can about the specialties you work with.

• Be curious, have a hunger for knowledge, and do not stop learning.

Overall, PAMA 2025 was a rejuvenating experience. I left D.C. curious to dig further into the research that was presented and to continue supporting performing artists and building my consulting business.