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1 Sports Psychiatry & Psychology: Helping Athletes Reach Their Potential David R.McDuff, M.D ; McDuff DR. Sports Psychiatry: Strategies for Life Balance & Peak Performance, American Psychiatric Publishing Inc, Wash DC, Apr 2012 No Disclosures Except For Small Royalties From Book
2 Sports Psychiatrist & Clinical Professor of Psychiatry *Baltimore Orioles: team psychiatrist & mental preparation trainer (1996-present) *Sports Psychiatrist(office practice-1997-present) *NFL Sports Psychiatry Consultant (2013-present) *Baltimore Ravens: team psychiatrist( retired) *University of Maryland School of Medicine Faculty: resident/fellow teaching and addiction research (treatment effectiveness & SBIRT-screening, brief interventions, and referral to treatment for tobacco, alcohol, drugs & Rx meds) *US Army Medical Corps Colonel (ret-2002): 28 years service; Persian Gulf War Veteran
3 Learning Objectives Identify common emotional & behavioral barriers to injury recovery Recite the traits of high achieving athletes Utilize several models of peak performance to counter the negative effects of pressure Identify common clinical barriers to peak performance Sports Psychiatry & Psychology: Mental Skills & Performance Barriers
4 Acute Injury Rehabilitation Return to Play Departure from Sports Sports Psychiatry: Four Stages of Injury Recovery
5 Stage Reactive Emotions Contemplative Emotions Critical Issues Acute Injury Hurt Anxiety Fear Disappointment Sadness Doubt Annoyance Apprehension Uncertainty Embarrassment Shame Pressure Confusion Concern Pain Control Sleep Energy Information Support Rehab & Recovery Frustration Anger Stress Doubt Anxiety/Fear Tension Optimism Pessimism Hopelessness Certainty Distrust Distraction Guilt Apathy Persistent Pain Boredom Social Isolation Complications Motivation Substance Use Return to Play Anxiety Fear Guarding Intensity Doubt Fear (Re-injury Fear (Injuring Others) Tentativeness Intensity Confidence Range of Motion Speed/Quickness Endurance Confidence & Focus Soreness Departure From the Sport Depression Uncertainty Anxiety/Fear Resentment Loss/Grief Resentment Remorse Regret Jealousy Contempt Chronic Pain Loss of Function Financial Strain Lifestyle Change Career & Identity Substance Use Stages of Injury Recovery: Emotions & Critical Issues
6 Support network Perspective shift (get better in some area) Brief motivational therapy Sleep hygiene & meds Pain management Anxiety/mood meds Stretching program Mental preparation Sports Psychiatry: Injury Treatment Strategies
7 Why do teams, athletes & other performers need sports psychiatrists & psychologists? Ninety percent of the game is half mental Jim Wohlford
8 Mental Aspects of the Game Performance = Potential Negative Effects of Pressure Tom Hanson, Ph.D
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11 Believe It! Balances Sports & other Life Areas Encourages & Supports Teammates Lets Go of Mistakes/Defeats Easily Image about Self & Abilities is Positive Enjoys Training & Competition Visualizes Success Evaluates Performance & Outcome Intensity (Maintains Focus & Aggression) Talk (Uses Positive Affirmations) Traits of High Achieving Athletes
12 Emotional Control (manage feelings & impulses despite competitive pressure) Self-awareness (maintain perspective between ideal & actual play) Internal motivation (passion for practice, play, and getting better) Empathy (compassion and support of others) Socialization (effective communication and bonding) Rick Aberman 2011; Emotional Competencies of High Achieving Athletes
13 PERMA (M Seligman) P (positive emotions) E (engagement) R (relationships) M (meaning) A (accomplishments) Burnout vs Happiness
14 Over-thinking/indecision Dwelling on mistakes Inattention/distractibility Impulsivity Emotional reactivity Arousal & anxiety Anorexia & insomnia Muscle chain tightness Reduced visual acuity Injury/pain Poor communication Low motivation Team conflict How Does Pressure Affect Athletic Performance?
15 Focused For Football Step 1 Focused For Basketball Step 2 Physical Step 3 Technical Step 4 Mental Step 5 Flow Rhythm Intensity Style of Play System Emotional Lifestyle Five Steps to Complete Performance
16 Confidence Pyramid Competitive Self-Confidence Emotional Control/Intensity Regulation Pre-Competition Routine Goal Setting and Self Evaluation Breathing Positive Focus Visualization Motivation & Relaxation Self-Talk & Attention & Imagery & Persistence Talent Fitness, Nutrition Life Balance and Experience and Injury Prevention and Stress Control
17 If the scene that you are perceiving has a high level of personal meaning for you, then you will tend to imprint it more intensively & later you will be able to recall it more clearly and completely Example: low confidence in a high school tennis Player Mental Preparation Training: Imagery/Visualization
18 Performance = Potential - the negative effects of pressure THanson
19 The mental message will dictate the physical action and help determine its quality Example: introducing positive self-talk in a high school distance runner whose performance had consistently been below her potential Mental Preparation: Affirmations & Positive Self Talk
20 The typical athlete goes all-out during competition. That s easy. The exceptional athlete goes all-out to prepare for competition. That s difficult. Examples: developing a pre-collision routine in a high school lacrosse player & a pre-practice & shot routine in a college basketball player. Mental Preparation: Pre-competitive Routine
21 Youth (ages 9-14) High School (14-18) College (18-25) Professional (21-40) Adult (25-60+) Performance Barriers Across the Lifespan
22 Early shift to highest competitive level One-sport specialization Year round training Win at all cost mentality Parent-coach-child conflicts Sports Psychiatry: Youth Sports Trends
23 Social isolation/burnout Immaturity/entitlement Disordered eating Aggression Early sexual activity Internalized sense of failure Perfectionism Damage to self-esteem & confidence Injury (repetitive motion, concussion) Sports Psychiatry: Youth Sports Concerns
24 My son can t sleep & worries about his competition too much (10 yo swimmer) My daughter gets short of breath & has to come out of the game (11 yo basketball) My daughter is afraid to do backover or blink skills and freezes (12 yo gymnast) Sports Psychiatry: Youth Sports Case Studies
25 She is too good a skater to quit (16 yo) My sons becoming isolated & his grades are dropping (15 yo soccer player) I don t even like tennis anymore (18 yo) She stopped eating to get her times down (17 yo runner) Sports Psychiatry: High School Case Studies
26 Early commitment/departure Academic underacheivement Self confidence & self esteem Weight & joint health Serious Injury (face, knee, fractures) Chronic injuries & pain Alcohol & stimulants Sports Psychiatry: College Sports Concerns
27 Im afraid to pitch (21 yo relief pitcher) I hate this school, my coach & teammates but I m stuck (18 yo lacrosse player) I miss too many classes to care about grades (20 yo softball player) He gets drunk & abusive (22 yo football) Sports Psychiatry: High School Case Studies
28 Partner Violence/Divorce Career planning/bankruptcy Suicide & contagion effect Serious Injury (fractures, brain trauma) Chronic pain & addiction Sleep, Stress, Mood Alcohol, stimulants, cannabis & pain killers Sports Psychiatry: Pro Sports Concerns
29 I can t sleep because of this burning pain (23/football) My divorce was hard, then I missed my kids (35/baseball) I m not ready to leave tennis-it s been my whole life (32 yo) I hurt everywhere & now I m addicted to pain killers & soma (35 yo retired football) Sports Psychiatry: Pro Sports Case Studies
30 Overuse Injuries Transition out of competition and/or sports Serious Injury & Return to Competition Fear Performance Slumps Balancing Sport, Work & Family Sports Psychiatry: Master Athletes Concerns
31 I can t control my emotions anymore (55/equestrian) Ive been an athlete my whole life (42/injured runner) I ve got talent, but I choke (58/billiards) I get so frustrated, I should quit (55/golfer) Sports Psychiatry: Masters Case Studies
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33 Know the facts Recognize symptoms early Trigger relaxation Raise energy Think positively/look calm Develop support Take regular breaks Improve time management Stay informed/ignore rumors Sports Psychiatry: Stress Control Tips
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