The founder of Music City Psych discusses his integrated approach to working with musicians and other high performers as they navigate life in and out of the spotlight.
At Music City Psych in Nashville, founder and clinician David Pearl blends deep clinical training with a practical, performance-focused coaching mindset. He works with high-performing clients across industries, from touring musicians and other stage performers to corporate executives and athletes, helping them manage anxiety, imposter syndrome, and the unique pressures that come with doing work in the spotlight.
Rather than offering quick fixes, David partners with clients to build skills, routines, and perspectives that help them “drop into the moment” and perform at their best, whether they are on stage, in the boardroom, or transitioning from work to home life.
David recently joined host Wes Luttrell on the Everybody Else podcast to talk about his work with performing artists and high achievers in Nashville and beyond. In the interview, he discussed how he helps clients understand why they feel stuck, build intentional routines, navigate conflict in bands and teams, and align their daily choices with their deeper values for sustainable performance and better mental health.
You can find Wes and Dave’s full conversation here.
Knowing the “What” and Discovering the “Why”
When people seek David out, they know something is off, but they do not always understand why. They might be able to identify that they struggle with stage fright, anxiety before big meetings, or getting stuck after a mistake. David sees his role as helping them work with both the immediate problem and the deeper story underneath:
“They come with the ‘what.’ They don’t necessarily know the ‘why.’ And so part of my job is to balance how much we go into both of those.”
On one level, clients want something they can do right away. They want tools they can use tonight at the show, tomorrow in the studio, or before their next big presentation. On another level, they often need to explore past experiences, patterns, and beliefs that shape how they respond to pressure. David’s work blends performance coaching and psychotherapy to address both levels and ultimately integrate them.
“In the immediacy, people want some degree of relief. They want to feel like they’re getting real value. So it’s really thinking about particular skills they can utilize to address whatever it is they’ve named as the ‘what.’
But it also gets to a point for a lot of people where it’s like, ‘Okay, we know the why. Now what?’ So it’s also being able to come back and weave into this idea of, ‘What’s going on for you in this moment? Where is it that you’re trying to go? How do you want to get there? How do you want to show up?’”
That combination of insight and action is at the heart of David’s approach. Clients are encouraged to understand themselves more deeply and then practice showing up differently in real time, based on that insight.
Building Routines That Support Peak Performance
One of David’s key performance coaching themes is routine building. He encourages clients to think about performance as a sequence of intentional routines rather than a single high-stakes moment.
“Routine building is really important. Whether you’re talking about musicians, athletes, or high performers in business, it kind of works across industry.”
David breaks performance down into four types of routines:
- Practice routines are how you set up your environment and mindset when you are writing, rehearsing, or preparing for a presentation.
- Pre-performance routines help you manage your energy and nerves before you walk on stage or step into the boardroom.
- In-performance reset routines are the tools you rely on when you make a mistake or hit a difficult moment, to prevent spiraling.
- Post-performance routines are the ways you come down, evaluate, and let go of a performance so you can return to the rest of your life.
Routines are sets of concrete practices that are different for each person. David helps clients build and fine-tune their routines to stay aligned to the mindset and energy level needed in each part of the performance sequence:
“I’ve had musicians where they get really amped up before they go on stage. We could say, ‘We want to be really high energy,’ but we probably want to figure out where that appropriate level for them is. So maybe part of their pre-performance routine is doing a bunch of push-ups to a degree where they still feel energized and present and engaged, but they don’t feel everything rushing through them in the same way.”
Routines save the day when things go wrong mid-performance. If a guitarist blows a solo or a singer misses a note, having a specific cue and reset (a breath, a phrase, a physical gesture) allows them to let the mistake go and stay in the moment, rather than mentally replaying it for the rest of the show.
For David, routines are not rigid rules; they are flexible structures designed to support presence and resilience.
Intentional Transitions: From the Stage to the Living Room
Post-performance routines matter just as much as the other three types. David encourages performers to give themselves space to feel the emotions of a show, and then intentionally transition out of that state.
“If you need to hold a guitar pick, or keep your performance clothes on your body backstage for a little bit, just to give yourself that time to be in the performance, do that. But then be really mindful and intentional about putting down that guitar pick or taking off those clothes. In doing that, you’re letting go of that performance so you can get back into your family life or go out with friends.”
Many of David’s clients struggle with the transition moments in their day: leaving work, walking off stage, or going from “artist mode” to their roles as parent or partner. He saw this transition challenge amplified during the pandemic, when many people were working from home.
“People were accustomed to closing their computer, getting in the elevator, getting into their car, driving home. There was this natural separation, to then enter into their house. COVID disrupted that. People would wrap up their last meeting or their last thing, and then they would just be out in the living room with their family.”
Without any buffer, people would often carry their work stress into family life.
While Covid amplified this phenomenon, it exists every day in subtler ways across the lives of creatives and high performers. David helps people build small, intentional rituals to mark transitions and reset periodically at key moments. Something as simple as closing a laptop, taking one deep breath, and walking through a doorway with purpose can be powerful.
“So much of what I talk about is being intentional, being in the moment. I really like these tangible things, for instance, using the doorway as, ‘Okay, now I’m coming into this new space.’ Otherwise it’s too quick of a shift. We’ve got to give ourselves time to adjust so we can act with purpose.”
Building these transition routines ties into a greater theme in David’s work, which is viewing each client as a whole person, not just a performer. This is where his dual experience as a performance coach and therapist allows him to approach his clients’ needs more holistically.
“The stuff that is going to be happening at home is going to impact your performance. The things that happen in your performance are going to impact how you show up at home. We can talk about compartmentalizing…but the reality is, we are people. I work with people, so we have to think about all the different areas of life and how they show up in different ways.”
Values, Vision, and the Choices That Really Matter
For David, “vision” is not a rigid five-year plan, but an ongoing relationship with your values.
“When I think about a vision, it’s where do you want to go and how do you want to get there? A lot of what we’re doing in that vein is really around value setting and value understanding.”
To distinguish between values and goals, he uses a metaphor from psychologist Russ Harris:
“Values are like directions on a compass. You can head West, but you can never actually be West. The goals are the things along the way that you check off from a box.”
For David, it is vital that goals are tied to values. Otherwise, someone might climb their version of Mount Everest and still feel strangely empty at the top. He encourages clients to use their values as a guide, especially in high-pressure or high-conflict moments.
“We’re constantly met with these choice points where it’s really important to stop and pause and think, ‘Am I acting in line with my values here?’ When you act in line with your values, the result almost doesn’t matter, because you get to lay your head down at night and say, ‘I feel really good about how I approached this.’
When we act in ways that are not in line with our values, it might feel good in the immediacy, and then very quickly we have feelings of regret.”
That framing applies to decisions made in our personal and professional lives. It also shapes how David helps clients approach conflict, which he sees not as a failure, but as an opportunity for growth.
Learning to Navigate Conflict and Communicate Effectively
Bands, creative teams, and touring crews are full of strong personalities and tight deadlines. Conflict is inevitable. David’s goal is not to eliminate conflict, but to help people approach it more effectively.
“Conflict is going to happen. It’s not a matter of if, it’s a matter of when. Conflict needs to be a source of opportunity to grow in that moment or that relationship, as opposed to feeling like a threat.”
Rather than focusing on who is right or wrong, he focuses on understanding.
“I’m not in the business of agreement. I’m in the business of understanding. We don’t have to agree, but it is really important that we understand.”
He teaches clients to shift from “you” language to “I” language, especially in tense conversations. For instance, instead of, “You never listen,” a more constructive approach would be, “When you said X, here’s what happened for me.”
This shift reduces defensiveness and opens the door to validation and empathy.
“If I’m talking about me and my experience, there isn’t really anything for you to get defensive about. When we validate someone authentically, we’re basically saying, ‘You’re not crazy. You make sense to me.’ Once someone feels seen and heard, we can pretty much say whatever we need to say next, because they know we get it.”
When it comes to conflict resolution, a big part of David’s work with artists and leaders is helping them name the stories they are telling themselves about other people, and then test those narratives against reality. That exercise can be the difference between a band breakup and a hard, honest conversation that actually brings people closer.
From D.C. to New York to Nashville’s Music Scene
Although David now works with many people in the music world, he does not come from a musical background himself. He grew up in the Washington, D.C. area, attended the University of Wisconsin-Madison for undergrad, and then moved to New York City for graduate school and clinical training.
In New York, he joined a group practice that specifically worked with clients in high-performing roles.
“The practice was built around high performers, so a lot of my caseload could be a Broadway performer, or someone in The Ballet, or a singer-songwriter, but it could also be a hedge fund manager or a lawyer or someone in finance or private equity. It worked across industry.”
David always knew he wanted to be a clinician, and working in the NYC practice showed him how much he enjoyed partnering with driven people who were already successful but still wrestling with transitions, pressure, and expectations.
“I like to think of myself as a thought partner, someone that can encourage people to think a little bit differently than they typically do.”
When his wife, a Nashville native, became pregnant with their first child, the couple moved to Tennessee. David opened Music City Psych in Nashville, where his background with high performers naturally translated into working with clients in the music industry.
He now works with:
- Artists and singer-songwriters
- Touring musicians and performers
- Producers, managers, and agents
- Business professionals and executives
- Athletes
- Other high-achieving professionals
Even though he is not a musician himself, he has gained a wide-angle view of the music ecosystem and understands the pressures that come with building a career in that world.
He also sees how isolating success can sometimes feel.
“If you have an artist that is developing and starting to take off, something that can happen is not feeling like their peer group has been able to keep up with them. They still have challenges, but who can they go to? Sometimes people around them think, ‘You’ve made it,’ so it can feel pretty isolating.”
In these cases, part of his role is helping clients find or rebuild community and decide who has earned the right to hear their most vulnerable thoughts.
A Thought Partner, Not a Fixer
David is clear on his role as a performance coach and therapist: he is a partner, not a fixer. He sees himself as a collaborator who listens deeply, asks good questions, and helps clients access their own wisdom to solve problems.
“Most people are actually really capable and really resilient. They need a place where they can think about what it is that is holding them back. My job is to be curious. I can help facilitate, but it’s not my job to fix. People aren’t broken.”
For David, this approach gives both therapist and client freedom. When the goal is not to come up with the perfect answer, there is more room to experiment, adjust, and find what actually fits each individual.
“If I can let go of this idea that I have to have all the answers, that’s an amazing amount of freedom. I can throw a lot of ideas and this questions out there. I’m okay being wrong. It allows us to really partner in thinking about what makes sense for you, which is going to be different than the next person who comes into my office.”
Work with David at Music City Psych
David Pearl’s work sits at the intersection of performance, mental health, and everyday life. Whether his client is a touring artist, a creative professional, an athlete, or a high-achieving executive, his focus is on helping them:
- Show up fully in the moments that matter
- Build routines that support sustainable performance
- Navigate conflict and relationships with more skill and understanding
- Align their small and large decisions with their deeper values and long-term vision
If you are interested in working with David or learning more about individual therapy, performance coaching, or support for artists and high performers, contact Music City Psych in Nashville to get started.
This post contains excerpts condensed and adapted for this format. Listen to Wes and David’s full conversation on Episode 27 of the Everybody Else podcast.
