Mental Health and Elite Sport: What s the Research and What s the Reality? Dr David Fletcher

Transcription

1 School of Sport, Exercise and Health Sciences Mental Health and Elite Sport: What s the Research and What s the Reality? Dr David Fletcher

2 Introduction

3 What is Mental Health? Mental health is an integral and essential component of health 1 Mental health is more than just the absence of mental disorders or disabilities 1 Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community 1 1 World Health Organization:

4 What is a Mental Health Problem or Disorder? Diagnostic and Statistical Manual of Mental Disorders (DSM) 1 Example: Depression Ranges from mild to severe (otherwise known as major or clinical depression) Diagnosis of clinical depression: Must have five or more depression-related symptoms over a two-week period, most of the day, nearly every day. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure Symptoms must be severe enough to cause noticeable problems in relationships with others or in day-to-day activities 1 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (fifth edition). American Psychiatric Publishing; Arlington, VA.

5 Mental Health in Elite Sport: The Performance-Problem Paradox The word Olympian, with it s roots in Greek mythology, is associated with Gods and superhuman beings Physical activity and exercise are purported to have a beneficial dose-response effect on mental health 1 Elite sport and athletes is not something associated with mortals who have health problems or illnesses 1 Biddle, S.J.H., Fox, K.R., & Boucher, S.H. (Ed.) (2000). Physical activity and psychological well-being. Routledge; Abingdon, OX.

6 Mental Health in Elite Sport: Diagnostic Difficulties

7 A (Brief and Selective) History of Mental Health in Elite Sport 2001: Silence of the Heart by David Frith 2007: Coming Back to Me by Marcus Trescothick 2009: Suicide of German football goalkeeper, Robert Enke 2009: Broadcasting of BBC Inside Sport: Mind Games Depression in Sport 2011: Death of British football ex-player and manager, Gary Speed 2014: Broadcasting of BBC Football s Suicide Secret Autobiographies, suicides/deaths, and broadcasts

8 Video: Depression in Sport Inside Sport: Mind Games Depression in Sport 2009 BBC

9 Video: Depression in Sport Inside Sport: Mind Games Depression in Sport 2009 BBC

10 2017: United Kingdom Government Duty of Care in Sport Review

11 2018: United Kingdom Government Mental Health and Elite Sport Action Plan

12 What do we Know about Mental Health in Elite Sport? Elite athletes experience a broadly comparable risk of high-prevalence mental disorders relative to the general population 1 Athletes at elevated risk: Retirement phase Performance failure Negative life events Sports requiring lean body shape Females Low social support 1 Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The mental health of elite athletes: A narrative systematic review. Sports Medicine, 46,

13 What Makes the Best Better than the Rest?

14 Most Important Psychosocial Discriminators Between Super-Elite and Elite Athletes 1 Achievement Career turning point How they behaved Mastery and outcome focus Total preparation for competition Counterphobia Importance of sport Who/what they became Experiences Ruthlessness and selfishness Need for success Obsessiveness and perfectionism Early negative life event plus positive sport event 1 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232,

15 Should Top Level Sport Come With a (Mental) Health Warning? Risk factors Childhood adversity and trauma Dark personality characteristics Nature of the sport (and celebrity) environment Personal and performance outcomes Complex interaction of (biopsychosocial) risk factors

16 Motivation and Sporting Success To say that elite performers must be highly motivated is a statement of the obvious. However, extremely high levels of motivation may be necessary to repeatedly produce the kind of high quality training sessions that are required for elite performance 1 (pp ) 1 Hardy, L., Jones, G., & Gould, D. (1996). Understanding psychological preparation for sport: Theory and practice of elite performers. Chichester, UK: John Wiley & Sons.

17 The Goldman Dilemma 1 If there existed a drug that would make you unbeatable for the next five years, after which you would die would you take it? 1 Goldman, R., Bush, P. J., & Klatz, R. (1984). Death in the locker room: Steroids and sports. London; Century. Connor, J., Woolf, J., & Mazanov, J. (2013). Would they dope? Revisiting the Goldman dilemma. British Journal of Sports Medicine, 47,

18 What Really Motivates the World s Best Athletes?

19 What Does it Really Take to Be Great?

20 John Henryism 1 High effort coping with adversity increases the risk of ill health 1,2 Three characteristics 1 Efficacious mental and physical vigor A strong commitment to hard work Single-minded determination to succeed 1 James, S. A. (1994). John Henryism and the health of African-Americans. Culture, Medicine and Psychiatry, 18, Bennett, G. G., Merritt, M. M., Sollers, J. J., Edwards, C. L., Whitfield, K. E., Brandon, D. T., & Tucker, R. D. (2004). Stress, coping and health outcomes among African-Americans: A review of the John Henryism hypothesis. Psychology and Health, 19,

21 A Double-Edged Sword? Striving for success may act as a doublededged sword ( 1, p. 2) Undermine health Facilitate success 1 Broady, G. H., Yu, T., Miller, G. E., & Chen, E. (2016). Resilience in adolescence, health, and psychosocial outcomes. Paediatrics, 138, 1-8.

22 A Darker Side to Personality and Sporting Success The normal man [sic[ is not a likely candidate for the Hall of Fame 1 1 Goertzel, V., & Goertzel, M. G. (1962). Cradles of eminence: A provocative and eye-opening study of the childhoods of over 400 famous twentieth-century men and women. London: Little Brown. Beisser, A. R. (1967). The madness in sport: Psychosocial observations on sports. New York City, NY: Appleton-Century-Crofts. Gogarty, P., & Williamson, I. (2009). Winning at all costs: Sporting gods and their demons. London: JR Books.

23 A Darker Side to Personality and Sporting Success The world s best athletes may have some dark, socially-undesirable personality traits Driven 1 Obsessional 1 Single-minded 2 Narcissistic 2 Self-serving 2 Indifferent 2 Malevolent 2 Obsessive/perfectionistic 3 Ruthless/selfish 3 1 Howells, K., & Fletcher, D. (2015). Sink or swim: Adversity- and growth-related experiences in Olympic swimming champions. Psychology of Sport and Exercise, 16, Sarkar, M., Fletcher, D., & Brown, D. J. (2015). What doesn t kill me : Adversity-related experiences are vital in the development of superior Olympic performance. Journal of Science and Medicine in Sport, 18, Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232,

24 A Darker Side to Personality and Sporting Success Winning in sport at the highest level isn t normal 1. Thus it is unlikely that sportspersons with normal personalities, normal relationships, or who fit into a normal system will achieve sporting excellence 2 The world s best athletes are different and have idiosyncrasies that make them exceptional, but potentially difficult to relate to and communicate with 2 1 Bell, K. (1982). Winning isn t normal. Austin, TX: Keel Publications. 2 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232,

25 Video: Winning at All Costs Lance Armstrong Oprah Winfrey 2013

26 Video:

27 Some Uncomfortable Truths? 1 Will a happy performer be a great performer? 2 Are the world s best athletes fuelled by something more than just happiness? 1 Maybe a bit of unhappiness is not such a bad thing? 1 Do nice guys finish last? Is a happy, successful, champion a myth? 1 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232, Hardy, L. (2015). Epilogue. In S. D. Mellalieu, & S. Hanton (Eds.) Contemporary reviews in sport psychology (pp.258-x). Abingdon, UK: Routledge.

28 Video: Should Elite Athletes be Role Models? I Am Not a Role Model Nike1993

29 Video:

30 Winning Really Isn t Everything

31 Some More Uncomfortable Truths? 1 Is there conflict, or at least a tension, between sport psychologists desire to enhance sport performance and their ethical obligation to optimize mental health, particularly at the highest levels of sport? 2 Will practitioners need to make difficult decisions between whether an intervention enhances sport performance but compromises mental health, or improves mental health but limits sport performance? 2 1 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232, Sarkar, M., & Fletcher, D. (2017). Adversity-related experiences are essential for Olympic success: Additional evidence and considerations. Progress in Brain Research, 232,

32 Video: On Being Enough Cool Runnings Walt Disney Pictures 1993

33 Video:

34 Success: It Not Always What You See

35 Thank you for your attention Any questions? Dr David Fletcher