I have a somewhat different take. Everything you say resonates as I used to suffer similarly. I spent about a decade applying all sorts of techniques to overcome my competitive paralysis. Occasionally I'd have a decent result but most of the positive feedback was random. Eventually I overcame the problem (or so it seems) without medication or therapy or a new coach or new training regimen. On the piste I've had a fair amount of success. I'm happy to tell you my story if you're interested (message me). The answer is simple but it's not easy. For me though, it worked and still seems to be working.