Wednesday, March 31, 2010

The Myths of Focal Dystonia


“A neurological condition that causes the involuntary contraction of muscles.”

Focal dystonia is a common, but incorrect application of the term describing the paralyzing condition experienced by too many instrumentalists and singers. The condition is very rarely involuntary contraction of muscles. Most often, it’s involuntary paralysis of muscles.


“There’s nothing wrong with your chops. Your mind is messing them up.”

I recall the time I first met a very fine professional trumpet player who came to me for help with the paralysis he was experiencing when he tried to play. He was in danger of losing his job as principal of a second tier American orchestra.

His first words to me were, “Roger, I have bad news. I just came from the doctor and he told me there’s nothing wrong with my chops.” I replied, “That’s the good news!”

In 1976, while I was a member of the Seattle Symphony, I personally experienced total paralysis when I attempted to play the tuba. The condition developed over a period of about two years. It took me two years to recover well enough to play again professionally. Like a person with a history of substance abuse, I have been in recovery ever since. However, recovery from such a devastating hell can be a wonderful learning opportunity! It’s a life altering experience similar to someone who recovers from a near fatal illness.

Unfortunately, very few musicians recover because they don’t understand the cause of the condition and they don’t know what to do about it. Frequently, they are advised by the medical or educational communities to give up their careers because there is no treatment. I have heard of some ill advised treatments such as cortisone injections in the lips.

I have watched some of the finest musicians in the world give up their careers because they believed what they were being told. I have helped myself and many others resume their careers.


1. The paralysis is physical rather than psychological.
2. The paralysis is not treatable.


A few years ago, I received a call from a very fine flutist who I first met when she was as a high school student. She was in her forties and had a professional career for many years. She told me that she had seen doctors and flute teachers all over the world. She was told she had focal dystonia.

I asked her to describe her physical symptoms. She replied, “There is pain in my right hand and it is paralyzed. I can barely finger the instrument” I asked, “Are these symptoms present only when you play the flute?” She responded, “Yes!” I immediately understood that she did not have a physical problem with her hand. The problem was psychological.

I remember asking her two important questions:

1. How long have you experienced symptoms of pain and paralysis? She responded,
"Fifteen years!"

2. What were you doing professionally fifteen years ago? "I was giving eighty private flute lessons per week."

It became obvious that she was influenced by the elementary level playing she was experiencing endlessly.


"After a day of giving lessons, I sound more and more like my students."

As the quality of her playing deteriorated, she became anxious and unhappy. She tried to treat the symptoms of her deteriorating tone and technique. Eventually, the flute became a "hot stove". Her subconscious mind reacted to prevent further emotional pain by creating paralysis and physical pain in her right hand. The protective reaction was no protection because it greatly exacerbated the condition.

I brought her back to the music by having her vocally sing and finger the flute. Interestingly, she had no pain in her hand unless she fingered and played the flute.

Essentially, I applied the SBP formula without the buzzing. When she was able to maintain mental singing as she played, her hand functioned without pain. As she repeated the singing and fingering process, her playing returned to normal and she was able to renew her professional career.

Adolph Herseth understood that the lower performance level of students could have a negative influence on his playing. He always said that his first duty was as principal trumpet of the Chicago Symphony so he limited his private lessons to a few select students.


Since no one intentionally wills paralysis when playing an instrument or doing anything else, all muscle paralysis is involuntary. Most often, involuntary paralysis occurs in the hands of woodwind, string, and keyboard players, and with the embouchure, tongue, or breathing of brass players.

Most musicians and teachers make the mistake of attempting to treat the symptoms rather than the cause of paralysis. Misdiagnosis always leads to greater paralysis and more failure.

The first symptom of paralysis for woodwind, string, and keyboard players is usually pain in their hands or their inability to finger technical passages that were easy in the past. The first symptom for brass players is usually their inability to play initial notes in rhythm. Later, accuracy and range gradually diminish. I frequently notice that brass players, who have advanced stages of involuntary paralysis, can no longer function in their midrange or lower register. They may retain some function in their upper register.

Since this condition takes some time to develop, I have never seen it in beginners. It can be somewhat common in intermediate musicians, but the worst cases I have encountered are in highly accomplished professionals.


“Most people never realize their dreams because they are paralyzed by fear of failure.”

“Fear is motivated by an expectation of impending doom. It can only be controlled by altering the expectation.”

“If you are fearful because you are standing at the edge of a 1000 foot cliff, step back from the edge of the cliff.”


“A trumpeter’s life is risky business. No greatness can be achieved if the player is paralyzed by fear.”

“If you are fearful when you play the trumpet, you should consider not playing it.”


The emotion of fear is a subconscious protective reaction to an expectation of physical or emotional harm. It cannot be controlled by the conscious mind. If we say to someone or ourselves, “relax” or “Don’t be afraid”, they usually become more aware of their fear and even more fearful.


Physical and emotional experiences while playing eventually become associated with and influenced by the instrument.


Most people are familiar with the experiment of the salivating dog and bell by the well known Russian behavioral psychologist. He rang a bell each time he provided food to a dog. In time, a powerful association developed between food and the sound of the bell. Eventually, the sound of the bell alone caused the dog to salivate even though no food was present.


From experience, everyone eventually learns that touching a hot stove is a harmful and unpleasant experience. When it occurs, we don’t have a conscious intellectual decision about what to do next. We don’t think, “This is very uncomfortable and harmful, what should I do about it?”

There is a powerful protective reaction is the subconscious
(Mark Douglas, Trading in the Zone)that immediately overrides the conscious will, causing the hand to move away from the hot stove. It’s almost impossible to prevent this subconscious reaction from occurring.


The instrumentalist’s emotional and physical experiences eventually become associated with the instrument they are holding for endless hours. If the history is dominated by failure, they will develop and expectation of failure. Unfortunately, a brass player receives a double dose of negative conditioning from their failure. They experience both emotional pain and physical discomfort. The protective reaction in the subconscious reacts powerfully to both in the same manner.


“We always realize our expectations.”


Unfortunately, the subconscious mind reacts to protect us from experiencing the emotional and physical pain of failure by causing paralysis. This is no different than the paralysis that prevents us from touching the hot stove. In time, the instrument becomes a hot stove!


Consciously, the musician wants to create the mechanics necessary to play their instrument. Subconsciously, their mind wants to protect them from experiencing the emotional pain and physical discomfort of failure. This antagonistic relationship always results in increased failure and an even greater expectation of failure. The downward spiral eventually leads to total paralysis if the condition is not alleviated.


“The subconscious mind is infinitely more powerful than the conscious will. If there is conflict between the two, the subconscious will always win the battle.”

“When playing an instrument or doing anything else, we must always achieve a symbiotic, rather than an antagonistic relationship, between the conscious and subconscious mind.”

ROBERT CARTER (The Secret of the Ages)

“The conscious mind is the gateway providing information to the subconscious.”


I received a call from a very fine professional horn player in Chicago. He had been performing in the pit orchestra for a very successful show that had been running for several years. He said, “I have been on vacation from the show for the past two weeks. My playing has deteriorated to the point where I don’t think I can continue.”

Although we had never met, I immediately understood what was going on. Because he had been performing the same music eight times a week for several years, he began to play less mindfully. His playing became somewhat “automatic” or on “autopilot”. As a result, he opened the door for failure to make an appearance. The feel of symptoms of failure became increasingly dominant while his awareness of the music faded away.


“In addition to the poor sounds coming from the bell, the brass player also experiences physical symptoms associated with their failure.”

A friend colorfully describes the physical symptoms. “It feels like I’m trying to push a piano up the stairs when I play my trumpet.”

It’s normal for us to try to alleviate such uncomfortable physical symptoms, which usually manifest themselves in the embouchure, breathing, and sometimes the throat.


"Sound is the criteria for how we do this and that."

The horn player described the physical problems with his embouchure that he was trying to correct. Of course, I immediately understood that source of his symptoms was not in his embouchure. It was in his “state of mind.”

We spoke in the phone for an hour. I explained his embouchure malfunction was only symptomatic of problems in his conscious mind. He needed to restore his dominance to musical awareness rather than “feel” awareness.


“Feel and fail are four letter words to a brass player.”

“Playing by feel is like trying to drain a swimming pool with a straw.”

“If your playing is not motivated by a powerful awareness of sound, you will attempt to motivate it with a weak sense of feel. Failure will be the only possible outcome.”


I instructed him to apply the SBP formula in sets of three repetitions until he was able to restore his ability to execute playing mechanics normally. It is important to understand that I did not discuss playing mechanics.


“Playing mechanics cannot be motivated by the conscious will because the motor skills are much too complex for the intellectual mind. Playing mechanics can only be achieved by the powerful subconscious (reactive) mind.”

“Your subconscious mind already knows how to execute the notes. Your conscious mind only needs to be highly aware of the notes you want to play, not mechanics.”


The knowledge of how to produce sound was established in his mind many years ago. And, it was still present but it needed to be motivated by his powerful awareness of sound.


“It is sound motivates function, not function motivates sound.”


“The seventh cranial nerve transmits my musical thoughts to my lips, but I don’t know a thing about how it happens.”

“I was a good brass player until my first analytical teacher came along and attempted to teach me how to play.”


“Think sound, not mechanics.”

I’m happy to report the horn player did return to the show successfully. Over a period of three years, he had about six lessons. He is now performing at the highest level of his career.



“All our life experiences are stored in long term memory forever. Memory cannot be deleted like files in a computer.”

“We cannot erase our past. It must be replaced.”

“Being chased by a tiger is fatal only if you cannot outrun it.”

“There is no cure for our bad habits. There is a treatment, which is to create new habits that dominate the old. However, if we discontinue treatment, without fail, the old habits will reemerge.”

“The bad news is that there is no cure for your paralysis. The good news is that it’s treatable and you will be able to continue your career. If you are highly motivated, you will emerge from this experience performing at new levels of excellence.”

“If you want to understand what I’m teaching you, teach it to someone else.”


“To teach is to learn twice.”


1. The paralysis experienced by so many highly accomplished musicians is treatable.

2. The treatment does not involve medications or injections.

3. Playing skills that were present before paralysis occurred, are stored in long term memory.

4. It is not necessary to relearn our playing skills. We only have to understand how to access the skills that have not disappeared.

5. Playing mechanics are motivated, at the subconscious level of the mind, by a brass player’s conscious awareness of musical sound.


"The brass player should be somewhat unconscious of their physical maneuvers but highly conscious of their musical sound."

"I sing the notes in my head as I play them. It doesn't matter how my lip feels or how I feel."

"It's not what you sound like that's important. What is important is what you want to sound like."

MAXWELL MALTZ (Psycho Cybernetics)

“The mechanisms of failure and success are the same.”


“Climbing the ‘Ladder of Awareness’ of sound will bring you to the notes you want to play.”

“Feeling good is a by-product of playing correctly. You cannot establish correct playing by trying to feel good first.”

“Failure is permanent only if the brass player doesn’t understand how to create success.”

“Follow the yellow brick road.”


  1. Wow. This is exactly what was on my mind as I was walking home today though I didn't know it was something discussed this much. I've been having momentary "paralysis" in my fingers (I'm a horn player) in fast, fingery passages particularly when under pressure. The worst was in a recent audition where my fingers absolutely froze and it seemed as if there was no connection between them and my brain.

    Reading this reminds me to play for the music and not for executing an impressive passage. And I've played the passages currently in question many times, very well. If I'm focused on expression the notes will come out just as I want and just as I hear in my head.

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