Psycho-social Risk Factors
Psychosocial Risk Factors
There is a growing body of evidence confirming that there are identifiable psychosocial risk factors associated with the onset of musicians' focal dystonia. Many musicians with the condition report difficulties with or relating to, professional or personal relationships, trauma, high workloads, tight deadlines, or a lack of autonomy within the teacher/student environment.
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Of course, all musicians will experience some or all these conditions at some point during their training or their professional life. However, what is becoming increasingly important to observe, is how psychosocial problems or difficulties may be negatively affecting playing.
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The Teacher/Student Relationship
Instrumental lessons are often a stressful environment for the student. For some, this may be a result of a particularly strict or inflexible teacher, for others, it may be a constant need to impress or to not feel inadequate in some way. For many musicians, the conservatoire style, "sage on the stage", or "top-down" instrumental teaching style remains the status quo. Although most students experience healthy and re-affirming relationships with their teachers, many experience difficult relationships that can significantly affect their musical careers.
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In general, difficult teacher/student relationships occur in response to unrealistic expectations and often inflexible attitudes to playing and playing technique. There is no, "one size fits all" approach to teaching. While some will flourish, responding positively and adapting both physically and psychologically, for some, the technical or musical inflexibilities imposed by a particularly difficult teaching relationship may lead to a cycle of stress and anxiety, lack of confidence, biomechanical issues, excessive tension, and unhealthy perfectionism.
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Professional Pressures
An immense pressure to perform to a certain standard, meet expectations, and maintain a high level of consistency can lead to stress and anxiety, potentially triggering dystonia. Emotionally abusive conductors. difficult colleagues, time constraints, tight deadlines, high profile concerts, can all affect the way in which the body responds, including contributing to alterations in fine motor control.
Physical Strain
Excessive practice without adequate rest or with improper techniques can lead to physical strain and overuse, increasing the risk of the onset of the condition.
Lack of autonomy
Not having creative control over their music or performances can create psychological distress, once again, provoking changes in the body's responses to stress, affecting wellbeing, and leaving the nervous system more vulnerable to focal dystonia.
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Burnout
Overwork without periods of rest, recuperation, and recreation can lead to physical and mental burnout, which again might predispose musicians to dystonia.
Fear
The fear of being replaced, stage fright, and performance anxiety can create a great deal of psycho-social stress, contributing to the onset of MFD.
Lastly, it's essential to note that these factors are potential risk factors, meaning that they might increase the likelihood of developing musicians' dystonia under certain circumstances. Still, they do not necessarily guarantee the onset of the condition. Each individual is unique, and there's considerable variability in how these factors may impact a person. A combination of biological, psychological, and environmental factors all play a role.​