Orchestral musicians may appear, as they mould performances of consummate skill and artistry, to be paragons of grace and harmony.
In reality they can be prey to a range of physical and mental problems, from bullying, burn-out and stage fright to hearing damage and dependence on drink or drugs.
The problems are so serious that this past weekend the Association of British Orchestras (ABO) launched the Healthy Orchestra Charter, creating a code of practice to help tackle or prevent the afflictions. Orchestral musicians have a notoriously unhealthy lifestyle, including working long hours in difficult or cramped conditions, spending lengthy periods on the road and encountering the stress and tension associated with performing.
Both mental and emotional problems, according to the ABO's Joanna Morrison Mayo, are widespread -- but difficult for musicians and orchestral managers to admit and deal with.
"We are hoping this charter will open some people's eyes. We think there is an ostrich effect with some of these issues," she said.
Andy Evans, who trained as a double bass player before becoming a psychologist, specializes in working with musicians. Social problems in orchestras can involve individuals being bullied or victimized.
"Players can harbor grudges against certain people -- think they come in too late all the time, for instance," he said.
And, despite the fact that professional musicians appear on stage day in, day out, performance anxiety is common, affecting, he estimates, up to two-thirds of players at one time or another.
Serious stage fright can mean string players getting the shakes. Or it can mean musicians become terrified of vomiting on stage.
Seeking help is relatively rare, however, and many players tackle problems of stress and anxiety with alcohol or drugs. Paul Russell is a psychotherapist who runs the Smart Treatment Center, a clinic specializing in substance abuse by musicians.
Orchestras are "boozy cultures," he says, where beta blockers or alcohol are often used.
"The culture in orchestras is that if you can't deal with it, the weak go to the wall," he said, adding that these attitudes go back to colleges and conservatoires.
Physical problems are better documented -- the risk of hearing damage from exposure to high volumes means that steps are being taken to change rehearsal practice and to program concerts with awareness of volume levels.
Hazel Province, the director of the Royal Opera Orchestra, said she encouraged players to have hearing tests and that the pit at the Royal Opera House in London had received acoustic treatment to try to minimize potential damage.
The new charter will also discourage exceptionally loud pieces from being programmed together and very loud passages from being rehearsed at length.
Repetitive strain injury is prevalent among string players -- three or four members of the orchestra will, she says, be receiving treatment for shoulder, neck or wrist injuries at any one time. Province encourages the use of therapies such as massage and reflexology.
At the Bournemouth Symphony Orchestra, the sub-principal double bassist, Mark Thistlewood, has instituted body control Pilates classes after rehearsals to help relax and realign the body.
"A lot of people in the music industry are carrying injuries, living in constant discomfort, if not pain," he said.
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