Performance anxiety
Anxiety attached to high-stakes moments: a final, a tryout, a presentation, a performance review. The pressure tightens the body and narrows attention, which is often the opposite of what the moment needs.
Services · Sport & performance
Performance pressure, on and off the field.
Online psychotherapy for adults across Ontario: competitive and recreational athletes, high performers, and parents carrying their own stress around a child's sport. The work moves at a pace your nervous system can actually hold.
- Fee
- $160 to $180 · 50-minute individual session
- Free consultation
- 15 minutes, no charge
- Format
- Secure online video via Jane
- Modalities
- CBT, ACT, attachment-based, somatic-informed
- Clinicians
- Daniella Simas Medeiros (RP Qualifying, CRPO #19387), Katelyn Matias (RP, CRPO #10340)
- Receipts
- Provided for extended-health reimbursement · HST-exempt
About sport & performance therapy at Anchor & Bloom.
Sport and performance therapy at Anchor & Bloom is virtual psychotherapy for adults across Ontario who carry the weight of performing: competitive and recreational athletes, people in high-pressure roles, and parents navigating their own stress around a child's sport. Sessions are offered by Registered Psychotherapists trained in evidence-based approaches including Cognitive Behavioural Therapy, Acceptance and Commitment Therapy, attachment-based therapy, and somatic-informed work.
The work is collaborative and paced. We do not push, and we do not ask you to relive anything your system is not ready to look at. We see adults only. When a parent comes to us about a child, the work supports the parent, not the child.
What performance pressure can feel like
The shapes performance pressure takes.
A stomach that drops the night before a competition. A mind that replays the missed shot for days. A sense that one bad result undoes everything. A body that cannot settle even when the season is going well.
Performance pressure shows up differently in different people. Sometimes it is the sharp spike of pre-competition nerves. Sometimes it is the slow grind of feeling that your worth rides on the next result. In session, we work with whichever version is yours.
Common patterns people describe in early sessions:
- A racing or noisy mind before competition, tryouts, or a big performance moment
- Physical symptoms: tight chest, shallow breathing, gut tension, muscle holding, fatigue
- Fear of failure that grows louder as the stakes rise
- A sense of identity fused with results, where a loss feels like a verdict on who you are
- Slumps that linger because the harder you try, the tighter everything gets
- Pushing harder, training more, and tolerating less rest as a way to feel in control
Fear of failure
The dread of falling short, letting people down, or confirming a private fear that you are not good enough. It can make a person play not to lose rather than play to compete, and it tends to shrink once it is named.
Identity fused with results
When who you are feels inseparable from how you perform, every result becomes a referendum on your worth. The work gently widens the sense of self so a single outcome carries less of it.
Pre-competition nerves
The buildup before a game, race, or performance: racing thoughts, broken sleep, a body braced for something. The anticipation often weighs more than the event itself, and there are ways to work with it rather than fight it.
Slumps and blocks
Stretches where performance dips and effort seems to make it worse. Often the body is stuck in a loop of overactivation, and the way out runs through settling the system, not forcing it.
Injury and retirement transitions
The disorientation of being sidelined by injury, or stepping away from a sport that shaped your identity for years. These are real losses, and they deserve their own pacing and care. See also self-esteem therapy.
Perfectionism
The standard that is never quite met, the win that never feels like enough. Perfectionism can drive high performance and quietly erode the joy of it. We work with the fear underneath the standard, not the standard itself.
Sports-parent stress
The pressure parents carry around a child's sport or a child's anxiety: sideline nerves, worry about saying the wrong thing, the strain of wanting it for them. The work supports you, the adult. We do not treat the child.
The arc of the work
How sessions are structured.
Most people move through a rough arc, though no two courses of therapy look exactly the same. The phase boundaries below are illustrative, a way to picture how the work tends to unfold, not a fixed sequence. Some people stay longer in one phase. Some return to an earlier one. Pace is set collaboratively, and revisited often.
Settling in.
The first few sessions are about building enough safety to do the work. We map current patterns, what triggers the pressure, what feeds it, what the body does in response. We start to notice the physical signals the nervous system uses to flag stress, which is often the first time people have paid that kind of attention to themselves.
Pattern work.
The middle of the work. We slow automatic responses, work with the nervous system rather than around it, and where useful, explore the fear of failure and the identity tied to results. Attachment patterns often come into focus here, the ways early experiences shaped how pressure shows up now.
Integration.
Translating insight into training, competition, and daily life. Working with the routines, relationships, and environments that either support or strain the new patterns. We also plan for maintenance, what people carry with them when the formal work winds down, and what signs would bring them back.
The nervous system frame
Polyvagal-informed care: what that actually means.
Polyvagal theory, developed by Stephen Porges and translated into clinical practice by Deb Dana, offers a useful map of how the body responds to perceived threat. We use it not as a science lecture, but as a working frame for understanding why performance pressure can feel the way it does.
The simple version: the nervous system has three rough states. The first is the calm, connected state, present, focused, able to compete or perform without bracing. The second is the activated, mobilizing state that pressure often lives inside, chest tight, mind racing, body ready to do something even when the moment calls for steadiness. The third is the collapsed, shut-down state that can follow long periods of activation, flat, disconnected, hard to feel motivated or connected to the sport.
Performance work is, in large part, nervous-system work. The goal is not to force calm. The goal is to widen the range of states the system can move through, and to shorten the time spent stuck in the activated or shut-down ones. That is why pacing matters. Pushing too hard, too fast, often deepens the pattern instead of moving it.
In session this means we pay attention to what is happening in the body in real time. We notice when a topic, a memory of a loss, an upcoming event, activates the system. We slow down. We do not treat the body as a problem to override. When the system has more capacity, focus gets clearer, choices feel less reactive, and competing feels less loaded.
Fit matters
Who this fits, who it doesn't.
A good fit for
- Adult competitive and recreational athletes working with performance pressure
- High performers in demanding roles, creative, professional, or academic
- People navigating slumps, blocks, or a loss of confidence in their sport
- Adults working through injury or retirement transitions
- Perfectionism and identity fused with results, see also self-esteem therapy
- Parents carrying their own stress around a child's sport or a child's anxiety
Not the right primary fit for
- Minors, we see adults only (18 and over) and do not assess or treat children or teens
- Active suicidal ideation requiring stabilization, please use the crisis resources listed on our contact page
- Skills coaching, game-day tactics, or mental performance consulting, which is a different discipline
- Conditions that require medication management or psychiatric assessment as the main intervention
If you are unsure whether sport and performance therapy is the right next step, the free 15-minute consultation is a good place to ask.
How therapy helps
Less about silencing the pressure, more about understanding it.
Recognize the pattern
We work together to name what triggers the pressure, what feeds it, and what you do in reaction. Once a pattern has a name, it is easier to step out of.
Settle the nervous system
Practical tools for grounding and regulation, used between sessions and inside them. The body is a real part of the work, not an afterthought, and it is central to how you perform.
Loosen the grip of results
Methods drawn from ACT and CBT help you work with the fear of failure and the identity tied to results, so a single outcome carries less of your worth.
A typical course
What sessions look like.
- First session. An hour to talk about what is happening now, what you would like therapy to help with, and how we work. You ask questions; we share our approach.
- Following sessions. A mix of talking, noticing what is happening in your body, and trying small things between sessions. Pace is yours to set.
- Modalities used. CBT, ACT, attachment-based therapy, EFT, somatic-informed approaches, and mindfulness, blended around your needs.
- Frequency. Weekly for the first 6 to 12 weeks is common. Many people move to biweekly as patterns settle. Some need less, some need more.
- Format. Online video sessions through Jane, a PHIPA-compliant Canadian platform.
- Length. 50 to 60 minutes.
Signs the work is taking
What changes when therapy is working.
Progress in performance work is rarely a clean disappearance of pressure. It looks more like a slow widening of the space around it. Some of the shifts people tend to notice, in their own words:
- You notice the moment before you tighten, not just the tightening. There is a beat of awareness that did not exist before.
- Nerves still arrive, but they do not take the whole week. The recovery time after a loss gets shorter.
- The body settles faster after activation. Sleep, appetite, and breathing patterns are often the first signals.
- You stop avoiding the hard things, the tryout, the conversation with a coach, the return after injury.
- A bad result feels like information about a performance, not a verdict on who you are.
- Your sense of why you compete, and what is yours versus what others want for you, gets clearer.
Therapy does not aim to remove pressure from your life. The aim is a different relationship with it, one where it is information rather than instruction.
What we draw from
Modalities we use.
We do not work from one orthodoxy. Different parts of performance pressure respond to different approaches, and most courses of therapy blend several. Below are the frames that most often come into play with sport and performance work specifically.
Cognitive Behavioural Therapy (CBT)
Working with the thought patterns that feed pressure, catastrophizing, all-or-nothing thinking, mental filtering after a loss. Useful when the loop is mostly cognitive and people want concrete tools to interrupt it.
Acceptance and Commitment Therapy (ACT)
Less about arguing with anxious thoughts, more about loosening their grip and competing in line with what matters. Particularly useful when fear of failure has narrowed the joy of the sport.
Emotionally Focused Therapy (EFT)
Working with the emotional core underneath the pressure, shame, fear of disappointing others, unmet needs. Helpful when performance is tangled up with close relationships or has a clear emotional charge.
Attachment-based therapy
Looking at how early relationships shaped the patterns that show up now. Many performance responses make sense once placed in the context of the history that taught them, including how achievement was met growing up.
Somatic-informed work
Including the body as a real part of the conversation, tracking breath, posture, tension, and the small physical signals that arrive before thoughts do. Pressure lives in the body; for athletes the work belongs there too.
Polyvagal-informed pacing
A framework for how the nervous system shifts between calm, activated, and shut-down states. Used in session to pace the work so the system is not pushed past what it can metabolize.
For performance pressure that overlaps significantly with broader worry, see anxiety therapy. For pressure that has tipped into exhaustion and depletion, see stress & burnout therapy.
Who offers this
Clinicians who work with performance pressure.
Daniella Simas Medeiros, RP (Qualifying)
Registered Psychotherapist (Qualifying), CRPO #19387, supervised under Katelyn Matias
Lead clinician for athlete and high-performance work. Affirming support for adults navigating performance anxiety, fear of failure, perfectionism, and the pressure of high-stakes roles. Modalities include CBT, EFT, somatic therapy, and mindfulness.
About DaniellaKatelyn Matias, RP
Registered Psychotherapist, CRPO #10340
Founder of Anchor & Bloom and clinical supervisor. Trauma-informed, attachment-based work for adults and couples, including the identity and relational pressure underneath performance. Modalities include EFT, ACT, CBT, and somatic-informed approaches.
About KatelynCommon questions about sport & performance therapy.
Who is sport and performance therapy at Anchor & Bloom for?
We work with adults: competitive and recreational athletes, high performers in demanding roles, and parents navigating their own stress around a child's sport or anxiety. We support the adult. We do not assess or treat minors. If your child needs care, we can talk about that in a consult and point you toward appropriate options.
Do you provide therapy for my child athlete?
No. We see adults only (18 and over). When a parent comes in about a child's sport pressure, the work focuses on the parent: managing your own anxiety, sideline stress, and the way performance expectations land in the family. The child is not our client.
Is this sport psychology or psychotherapy?
It is psychotherapy with an understanding of the athletic and high-performance context. We are Registered Psychotherapists, not certified mental performance consultants. We work with the anxiety, identity, and pressure underneath performance, not skills coaching or game-day tactics.
Is online therapy effective for performance pressure?
Research from the Canadian Mental Health Association and the American Psychological Association supports the effectiveness of virtual psychotherapy for anxiety and stress for most adults, with outcomes comparable to in-person care. Online format also fits training schedules and travel.
Will therapy interfere with my competitive drive?
The aim is not to dull your drive. It is to loosen the grip of fear, perfectionism, and identity fused with results, so the drive feels more like yours and less like pressure. Many people find their relationship with the sport steadier as the fear of failure eases.
How much do sessions cost and is it covered by insurance?
Individual sessions are $160 to $180. Most extended health benefit plans through Canadian employers cover Registered Psychotherapist services. Confirm with your insurer before booking. Psychotherapy is exempt from GST/HST as of June 2024.
For plan-by-plan coverage details, direct billing notes, and how to submit a claim, see Fees & Insurance.
Further reading
Trusted Canadian resources.
For general information on anxiety, stress, and mental health, the Centre for Addiction and Mental Health and the Canadian Mental Health Association are good starting points.
For information on the regulation of psychotherapists in Ontario, see the College of Registered Psychotherapists of Ontario.
Start with a free conversation.
A 15-minute consultation is a low-stakes way to ask questions and see if the fit feels right.
Online therapy across Ontario
Sessions are virtual province-wide, with local support for:
Toronto · Mississauga · Oakville · Burlington · Hamilton