A “shrink” can expand your athletic performance.

By Paul Schienberg, PhD

Look what you’ve done, Yankee fans.

According to a report in the New York Daily News, New York Yankee third baseman Alex Rodriquez said he was undergoing therapy with multiple therapists to deal with his personal demons.

Rodriquez made the admission after he and his wife, Cynthia, donated $200,000 to a mental health program at the Children’s Aid Society in Washington Heights.

“I don’t know where I’d be (without therapy),” Rodriguez told the television show “Extra” in a segment to air Wednesday night at 7 E.T.

“I think it’s a different life that I’ve discovered and I thank Cynthia for that because therapy is an incredible thing and you might get to know someone you didn’t even know was in there.

“Why let the train wreck come before you fix it?”

Rodriguez did not specify the reasons for his ongoing therapy, but characterized his sessions as a “maintenance thing.”

The admission is a rarity in the world of professional sports.

After struggling during his first season in New York, Rodriguez has rebounded in his second go-around. His two homers during the Yankees’ 12-3 win over the Tigers Tuesday gave him a major league best 16 home runs and 46 RBI’s.

“It’s helped in baseball, for one, in terms of my approach to everything,” Rodriguez told the Daily News. “I think it would be great if kids out there realize that it can be a great benefit.”

Rodriquez has previously admitted to a rocky relationship with his father, Victor, who abandoned him when he was just nine years old. Victor resurfaced when the younger Rodriguez reached the major leagues, but the two remain estranged.

“I know where he came from and I know where he came from and I know his background and seeing how successful he is as a man, as a husband, as a friend, it really hits home with me,” Rodriguez’s wife Cynthia told the show. “It’s because of therapeutic intervention that he’s been able to discover and flourish as a person.”

In today’s modern world, we often hear individuals who exercise make statements about how they feel better than they did before they started exercising. If you were to ask these people to clarify what “better” means, most people would focus on the physical benefits. There is no doubt that engaging in activity has many physical benefits including weight management, improved cardiovascular fitness and control over diabetes and osteoporosis. However, there are also many psychological benefits to exercise which include positive effects on memory & thinking and improvements in levels of depression and anxiety. Let us take a closer look at each one of these.

Memory & Thinking

Many researchers have examined the effects of aerobic and anaerobic exercise on memory and thinking. The results have been mixed but for the most part indicate that that moderate levels of exercise (regardless of type) improves performance on memory and thinking tasks including addition problems, recall of numbers and words, perception & discrimination of geometric figures, and organization. It is important to note that both high and low levels of exercise have been found to either have no effect or actually impair performance on the tasks. The reason for this is unclear and is currently being studied.

Depression

Clinical depression is one of the most common psychological problems in our country. According to data from the President’s Committee on Mental Health, one of every four Americans suffers from depression at any given time. Depression is characterized by withdrawal, inactivity, and feelings of hopelessness and loss of control. By acting on each of these symptoms, physical exercise can be a useful therapeutic intervention for depression. Indeed, people who are physically active, have lower rates of diagnosable depression. One study conducted over a twenty year period found that those individuals that were most physically active at the beginning of the study were less likely to develop depression at a later date.

Researchers have even examined exercise as a treatment for depression. Individuals who had been diagnosed as depressed were put into three groups: time limited psychotherapy (10 weeks), time unlimited psychotherapy, and a running treatment group. The runners met with a running therapist and would stretch, walk and run for thirty to forty-five minutes, and discuss issues while exercising with little emphasis on the depression itself. Results indicated that 6 of the 8 patients in the running treatment group were essentially well at the end of three weeks, another at the end of the 16th week, and one that neither improved nor deteriorated. This should not be taken to mean that depressed individuals should drop out of traditional forms of treatment, just that running is a useful adjunct to traditional treatment.

Anxiety

One generally accepted benefit of exercise is anxiety reduction. In other words, people who exercise just feel less stressed or nervous. In general, research has supported this notion. In one study, subjects were placed into one of three groups: jogging, stress inoculation training, and waiting list. Individual’s self-report statements indicated that both the jogging and stress inoculation groups had lower levels of anxiety than the waiting list group immediately following the intervention. Furthermore, this finding held true when the researchers followed up one month and 15 months later. It is important to note that the joggers only continued to experience lower levels of anxiety if they continued to exercise (which was about 40% of the original group).

The reasons for improvements discussed above are unclear. Some people feel that various exercise strategies serve to divert or distract subjects from anxiety and depression-producing stressors. In addition, if you are working out at a gym or park, social contact works to reduce the isolation typically associated with depression. Another reason for the improvements in psychological well-being is that exercise alters various neurotransmitters within the brain (norepinephrine and seretonin) which is precisely the function of medication that is prescribed by psychiatrists. This should not be confused with the unsubstantiated theory that the release of “morphine-like” chemicals within the pituitary gland and the brain serve to reduce the painful effects while also enhancing the euphoric effects.

Conclusions

From the above discussion, it is clear that there are many benefits on psychological functioning that result from exercise. However, it is important to note that the relationship between physical activity and mood should be thought of as correlational not causative. That is to say, they are related but exercise should not be thought of as being the sole cause for the improvements in mood.

Although some studies featuring highly anxious patients have shown that exercise reduces both anxiety and depression significantly more than a placebo treatment, others have found the reverse to be true. More specifically, one group was told that their regimen was specifically designed to facilitate psychological well-being and no such intervention was made with the control group. The results showed improvements in fitness for both groups; but, the experimental subjects improved significantly on a measure of self-esteem when compared to the no intervention control group. This means that just thinking that something is good for you, is enough for it to have a beneficial effect.

So how should exercise be used to improve mood? If you have been diagnosed with an anxiety or mood disorder, probably the best approach to take is to use it as an adjunct to the treatment you have discussed with a mental health professional. Always use and follow the guidelines that they set forth for the treatment of your particular disorder and be sure to voice your interest in using exercise as an adjunct to treatment.

One of my students once asked me why there was so much research in the field of sport psychology on anxiety but very little devoted to depression. She was right, a disproportionate amount of attention has been given to anxiety disorders and eating disorders in the sport psychology literature. After giving it some thought, I have come to the conclusion that this is because of the nature of the problems. While we often hear that athletes do not perform at their expected level because of performance anxiety, you rarely hear that the cause of the problem is depression.

Think about the Superbowl. It is not unusual to hear that players to have a bad case of “nerves” which interferes with their performance. Simply put, they are too up for the game. You never hear that he was too depressed to play like he usually does. Depression is a disorder that typically involves withdrawal, inactivity and feelings of hopelessness and loss of control. This is not at all descriptive of the emotional character of an athlete. As a matter of fact, it would seem that physical activity actually combats each of these symptoms.

While data from the President’s Committee on Mental Health indicates that the rate of depression in American society might be as high as 25%, the rate is substantially lower among individuals who are physically active and regularly participate in athletic activity. In fact, level of fitness has been found to be inversely related to depression. It would seem that participation in physical activity actually protects you from depression.

Athletic Activity As Treatment

Exercise can be as effective as traditional forms of psychotherapy. One study that compared clinically depressed patients seeing a therapist once a week with those involved in a running group five times a week (discussing issues while exercising with little emphasis on the depression itself), found no differences in the improvements experienced by either group.

In most cases I strongly urge that individuals seek the services of an experienced psychologist. However, the benefits of athletic activity in the treatment of depression are clear. Be sure to discuss participation in sports as an adjunct to treatment with your therapist.

So, athletic activity can protect you from developing depression, and it can even help you once you have been diagnosed as clinically depressed. The question remains, why? Two theories may help explain this – Seligman’s Learned Helplessness Model and Beck’s Cognitive Therapy of Depression.

Seligman’s Learned Helplessness Model

Marty Seligman is a psychologist who believed that individuals learn much of their behavior from their experiences in interacting with the world. He proposed the theory that depressed people feel helpless because of efforts that have not resulted in desired outcomes. After this process is repeated over and over, people get to the point that they learn no matter what they do it will result in failure. To use his terminology, they make internal, stable and global attributions. This simply means that the belief that they are at fault for failure and that this will always be the case no matter what the situation.

Sports provides people with a forum to combat this feeling of helplessness. Although they may not always win the game or the race, most athletes experience some degree of success – even if this is only during practice. This is especially true today where organized sports allows for improved competition based on age and achievement level. For example, in most races people are grouped according to age. Many golf competitions take into account an individual’s handicap in order to level the playing field. You can readily how this model accounts for why athletes are rarely depressed.

Beck’s Cognitive Theory Of Depression

Aaron Beck is one of the leading researchers in the field of clinical depression. His work is the basis for much of the treatment that is conducted by psychologists today. According to his theory, depression is caused by dysfunctional automatic thoughts about the self and the world which he calls schema. Schema are models of the self, others and the world that develop throughout the course of life and are used to navigate the environment. According to Beck, depressed individuals process information from the environment such that they only pay attention to that information that confirms their beliefs.

Beck believes that depressive ideation involves what he calls “the cognitive triad.” This triad focuses on negative thoughts about the self, the future and the world. Therefore, physically active people are protected from depression because they have a reference point – their athletic achievements – to develop more positive schema. How does this occur?

• Negative views about the self:Typically, depressed individuals have had repeated experiences which cause them to have low self-esteem or a negative view of themselves. In other words, they have formed a schema in which they feel worthless. Whether it was comments from their parents, teachers, or employers they have simply never had the opportunity for success. Athletes, on the other hand, have many experiences with success. Whether it is in little league baseball, a pick up game of basketball at the gym, or beating their best time in a 1 mile run, they have experienced some success. Even when they have experienced a catastrophic failure, such as Bill Buckner in game 6 of the 1986 World Series, they have developed positive schema which allow them to view their failure as a single isolated event.
• Negative views about the future: Understandably, once negative schema have been developed they have a significant impact on an individual’s ability to be optimistic in the future. Thoughts such as “I’m never going to amount to anything” or “I’ll never be successful” are all too common for the depressed person. Clearly this will have a significant impact on their future performance which just serves to confirms their beliefs. Athletic individuals have a more optimistic outlook. “I lost today but I’ll get him next time” or “So what if I blew that play, I’ve done it a thousand times before and I’ll do it again” are typical thoughts. You can easily see how the schema that are used by these people help to protect them from depression.
• Negative views about the world: Once a person has developed a negative view of themselves and the future, it is next to impossible to have a positive view of the world. Thoughts that the world is an unfair place and that success is something that is controlled by others are not uncommon. Given the nature of their automatic thoughts this is something that is very difficult to control. Athletes have had more positive experiences. Although the referee may be favoring the other team on a particular day, this is not a universally occurring phenomenon. In this situation, their schema would probably cause them to try even harder because of their belief in their control over their own destiny.

Conclusion

The nature of most forms of athletic activity is such that it is not characteristic of depression. While the depressed person is isolated, inactive, and has feelings of hopelessness and loss of control, the athletic environment actively serves to combat each of these. People are forced to get out into the world and participate in something where they are bound to experience success. If you or someone you love is feeling depressed, encourage them to participate in sports as away of combating these feelings. Why not do it anyway just to keep these feelings away altogether?

Irrational and Distorted Thinking

Four general irrational beliefs may interfere with athletes reaching their potential. These four beliefs are: I must do well in sport and if I don’t I am an incompetent, worthless person; I must do well to gain the love and approval of others and if I don’t it is horrible; Everyone must treat me with respect and fairness of all times; and The conditions of my life must be arranged so that I get what I want easily and quickly. These general beliefs can contribute to emotional distress for athletes and contribute to the pressure already present in achievement situations.

Distorted thinking styles interfere with performance by providing the athlete with faulty information about the competitive environment, resulting in misdirected attention, emotional distress such as excessive anxiety and lowered self-concept. The following is a list of distorted thinking styles have been employed by athletes:

1. Perfectionism. This unrealistic expectation leads to excessive pressure, unavoidable failure, and undermining of effective coping. Perfectionist desires may lead to successful performance. But, perfectionist demands and commands destroy athletic careers. It also leads to negative self-concepts and a fear-of-failure syndrome supported by extreme negative consequences tied to less than perfect performance.
2. Catastrophizing. Exaggerating potential consequences of imagined or real negative events comes along with perfectionism. Those suffering with this distortion expect the worst in every situation – most often worse than reality or previous experience suggest. This can contribute to actual negative outcomes.
3. Self-worth Depends Upon Achievement. Athletes see their self-worth as directly related to their performance and success. This idea is particularly concerning to the young athlete who looks to their parents, coaches and peers for their sense of self. The result is even more stress related to performance, low and unstable self-worth, and interference with fun while participating in sports.
4. Personalization. When this distortion is employed by an athlete, there is a tendency to overestimate their personal responsibility for every failure and mistake. “If I only made that last free throw, we would have won the game.” Repeated usage of this type of thinking can result in low self-esteem, high performance anxiety and decrease in desire to participate and take chances.
5. Fallacy of Fairness. The concept of fairness often translates into “wanting one’s own way versus what someone else thinks is fair or best for the group.” Unfairness often results in interpersonal problems, inappropriate focus of attention, and coping with adversity.
6. Blaming. Some athletes excessively attribute failure externally. They get to not experience any responsibility. This gets in the way of improving performance.
7. Polarized Thinking. Athletes are tempted to view things in black and white terms. Labels are employed that simplify self and others into unidimensional terms (i.e., losers, cheaters, unbeatable opponents). They provide a weak mental perspective to learn from and improve performance.
8. One-trial Generalizations. Athletes often use a single event to define expectancies for future performances. After the first few games of this season, a New York Knick basketball player was heard to say, “We are a three quarters basketball team.” The result of such thinking can be self-defeating prophecy, lack of focus and preparation for the first three quarters of a game, and lack of attention.

Identifying and Modifying Irrational & Distorted Thinking

Identifying these cognitive distortions is the first step toward modifying disturbed thinking styles and enjoying the benefits of rational thinking. Athletes are most available to learn immediately following a competition. Coaches should review with the player, the performance and related thinking, especially when there has been a negative result. Memory fades with time passed. Distorted thinking styles are often learned from coaches. Therefore, coaches should become aware of their own irrational beliefs and the way they model distorted thinking for the athletes.

Three phases for implementing cognitive restructuring interventions with athletes have been identified. In the Identification phase, the boundaries of the effected behavior and the irrational beliefs or self-defeating verbalization present in the situation are defined. The identifications can be helped by journal writing and conversations. During the Restructuring phase, the athlete is convinced of the inappropriateness of the thoughts and more effective replacements of new thinking patterns are created. The effectiveness of the intervention depends on getting an athlete to recognize the need to change, In the Pairing Stage, the athlete uses self-instructional imagery and verbal cues to facilitate the application of new thinking patterns into actual performance. The athletes should practice the imagery several times a day to make the new thoughts automatic.

It is important to emphasize the importance of underlying beliefs in maintaining automatic thoughts. Challenging underlying beliefs is a vehicle for long-term change in thinking patterns. Purposefully acting counter to identified, irrational beliefs is a way of experiencing new thinking and feeling. For example, an athlete who employs excessive criticism and self-abuse after every mistake may try to smile and be overly complementary after a few mistakes to experience the positive consequences (thoughts, feelings and performances) associated with the new behavior.

Athletes and their coaches must make an effort to substitute rational for irrational thinking during all phases of training and competition. If athletes have a particular difficult irrational belief to rid themselves of, they may benefit from daily affirmation statements counter to the belief. Physically relaxing may also increase the effectiveness of attempts to counter irrational beliefs. Most irrational beliefs create anxiety and tension, thus decreasing receptivity to more effective, rational thoughts. If doubts exist whether a belief is irrational or ineffective, the following questions can be employed to make the assessment of the belief: Is the belief based on objective reality? Are they helpful to you? Are they useful in reducing interpersonal conflicts? Do they help you reach your goals? Do they reduce emotional conflict? If the athlete answers “no” to any of the questions, the belief is likely to irrational or counterproductive, and the individual will benefit from modification.

Conclusion

Irrational beliefs are well entrenched in our culture and sports in particular. Examples include “No pain, no gain.” And “Practice makes perfect.” And “Winning Isn’t everything, it’s the only thing.” Many important figures (coaches, parents, athletes) believe that modify some of the thinking can lead to less competitiveness or drive to win. It is more likely that the modification in thinking styles recommended in this article would lead to better performance because athletes would be more relaxed, more focused and motivated during competition and training. In our next article, we will turn our attention to “self-talk” as another approach to cognitive change in the service of improved athletic performance.

There was Refrigerator Perry, defensive tackle, for the football Chicago Bears. Why the nickname? He weighed well over three hundred pounds (almost the same size as a Frigidaire) and probably spent more time lifting food from shelves than lifting free-weights. He proudly boasted how many burgers and fries he ate in one sitting or standing. Then there was George Foreman, a boxer and spokesperson for a meat roaster. He became more famous for his relationship to food consumption and cooking than being the heavyweight champion of the world. Moe Vaughn is a first baseman for the New York Mets baseball organization. The team invested millions of dollars last year to get him from the Boston Red Sox. Never known as a slim fellow, he came into spring training significantly over weight, never regained his normal size and had a terrible year. Women athletes (gymnasts, skaters, divers, etc.) are often pressured by parents, peers, coaches and judges into making them lose weight to get better scores. These individual names are less known to the public. As much as the men tend to build themselves to get larger, women rip themselves up to get slimmer. Regardless of gender, poor weight management tendencies result in athletes performing at lower levels, having shorter sports careers, developing eating disorders and endangering their health. This article is intended to bring this important issue into our awareness and provide information to help athletes and educators identify and prevent the development of eating habits.

Prevalence

In order to assess the magnitude of eating disorder problems we need to share common definitions. Anorexia Nervosa can be identified by a refusal to maintain body weight over a minimal normal weight for age and height of the athlete; intense fear of gaining weight or becoming fat, even though underweight; in females, absence of at least three menstrual cycles when otherwise expected to occur; disturbance in the way in which one’s body weight, size, or shape is experienced. Bulimia nervosa is characterized by recurrent episodes of binge eating; feeling of being out of control over eating behavior during the eating binge; self-induced vomiting; use of laxatives or diuretics; strict dieting or fasting or vigorous, exercise in order to prevent weight gain; a minimum average of two binge-eating episodes a week for at least three months; and persistent over concern with body shape and weight.

The prevalence of either eating disorder is difficult to achieve due to the secretive nature of these problems. In sports the discovery could result in serious repercussions for the athlete including being cut from the team or program. Parents and roommates don’t become aware that there is a problem until something life threatening occurs and professional help is needed. In a recent prevalence survey, 695 male and female athletes reported 3% met criteria for anorexia nervosa, 21% met criteria for bulimia nervosa. Keep in mind that these numbers are lower than a real count because of the tendency to hide. It also found that there is a sport-specific prevalence for eating disorder conditions, but cautioned that no sport should be considered exempt from having individuals susceptible to eating disorders.

A second study assessed the frequency of eating behaviors that were just slightly below required criteria for eating disorders in female athletes. Thirty-two per cent practiced at least one pathogenic weight-control behavior – self-induced vomiting, use of laxatives, diet pills or diuretics. These behaviors were sport-related – 74% of gymnasts and 47% of distance runners. In addition, 83% of the athletes used pathogenic weight control behavior to improve their performance and 7% did so to improve appearance.

Predisposing Factors

Many aspects of various sports promote a focus on weight. This can be especially dangerous to a person who is predisposed to an eating disorder or weight-management problem.

The following sports have weight classifications that determine in which group an athlete competes: boxing, wrestling, weightlifting, judo, tae kwon do, and rowing. Some athletes desire to compete with lighter competition to improve their chances of success. Accomplishing this may require resorting to unusual and dangerous practices immediately before a weigh-in and competition: dehydration (sauna, sweat box, heat-restrictive clothing), use of laxatives, use of diuretics, fasting, crash-dieting, purging and fluid restriction. A lineman for the Minnesota Vikings died during a summer practice last year caused by dehydration. Often there is not enough time to re-hydrate before the actual competition. By and large it is not known that dehydrating in combination with significant weight loss for larger athletes can result in a health crisis.

Diving, figure skating, gymnastics and synchronized swimming are Olympic sports that use judges to determine performance outcome. Physical attractiveness is considered by participants to be a critical factor in a female athlete’s final score. It is known that there is open communication between judges, coaches and athletes about perceived body weight. There is no scientific information that supports a positive correlation between loss of body weight and improved performance. However, there is a strong relationship between athletic performance and muscle mass.

Scientific research has increased coaches’ awareness of physical attributes and levels of sports performance. There is a significant relationship between low percentage body fat and high performance levels in swimming, speed-skating, long distance running, cross country skiing. The problems here arise when this information is applied to every athlete without consideration of individual differences in body structures. There is no evidence that proves that for every athlete the leaner the body the better the performance.

A coach often pressures an athlete to lose weight by having frequent team weigh ins (6 times per month) and individual weigh ins (14 times per month). Also, if an athlete is referred to a therapist for an eating disorder, the coach expresses concern that the athlete will be encouraged to abandon the sport or reduce a competitive drive.

The close and shared experiences of people who train, compete and travel together increase the possibility of peer modeling of destructive weight-loss techniques. This is more true in a sports environment than in any other area of life. The major reasons given in self-reports for weight loss are performance excellence, aesthetic ideals of beauty, remarks of athletic staff about need to lose weight, and a desire to meet a lower weight category.

Recognizing Eating Disorders in Athletes

Again, these problems are not always obvious. It is important to keep in mind that early detection and early intervention improves likelihood of recovery.

There are assessment tools (Diagnostic Survey for Eating Disorders, Eating Disorders Inventory, Eating Attitudes Test) that should be used in the initial training stages. They should be administered by a licensed psychologist and followed up in a clinical interview.

Behavioral observations by coaches and teammates are critical. Some signs of a problem include weight loss, eating alone, preoccupation with food, mood changes and body distortion statements. Anorexics are often very involved with the preparation of food, but only eat their portions after everyone has finished. Bulimics eat alone so they can purge after the meal; they make frequent trips to the bathroom, have bloodshot eyes, and much talk about composition of food and caloric content. Depression, irritability, and wide fluctuations in moods are associated with an eating disorder in athletes. Other noted personality characteristics are highlighted by dissatisfaction with one’s body, feelings of ineffectiveness, interpersonal distrust and perfectionism.

A thorough medical assessment is required to detect an eating problem. The following physical symptoms might point to an easting disorder: anemia, leucopenia, osteopenia, renal and liver problems, peripheral edema, electrolyte imbalance, cardiac problems, dental problems and gastrointestinal problems. Fatigue and increased susceptibility to infections should trigger a concern for an eating disorder problem. A body image that is quite different from objective viewpoint is cause for serious focus.

Perfectionism can create a desire to hide valuable information in the assessment of eating disorders and resistance to referrals for professional help. These athletes want to please others. Therefore, they are concerned about disappointing fellow players, coaches and parents. Another cause of resistance to detection and treatment is loss of a spot on the team or suffering reduced playing time. A referral discussion should be targeted to feelings, not the eating behaviors. Eating is often experienced by the athlete as the only part of her life she has control over.

Preventing Eating Disorders

Communicating knowledge about eating, weight, health and sports performance to athletes is vital. A prevention program should target the junior and senior high school populations because adolescents are more at risk than any other group.

In an athletic training program, there should be an emphasis on fitness over body weight. An ideal weight range must be developed individually through the assistance of an exercise physiologist and the coach. Nutritional education and counseling should be mandated. Coaches and athletes would benefit greatly by a sports nutrition and weight control workshop. As part of the program, coaches should curtail team weigh-ins, setting arbitrary weight or body composition goals, punishments for not making weight, insensitive remarks about weight issues, associating weight with enhanced performance, and minimize the detrimental effects of rapid weight loss or gain.

Summary

Eating disorders and their manifestations exist all too frequently in the sports’ world. In-service training programs should play a vital role in reducing the frequency and detrimental effects of pathological weight management with amateur and professional athletes. Our children’, teammates, and friend’s lives are on the line. Early detection and referral is necessary if we hope to achieve a more successful recovery. As with any compulsive behavior where shame or hiding is a key component, significant others in an athlete’s life need to be sensitive to the signs of eating disorders. Then, they need to step forward. A clear plan of action with a relevant team of professionals should be in position to provide immediate and on-going assistance.

The use of drugs and alcohol by professional athletes has become an all too common occurrence. A lthough attempts are made to help the individual receive treatment, often they fall short of their mark and the athlete is allowed to continue down the path of addiction. Intervention needs to be taken seriously by family members, friends and the professional organization in order for it to be effective. However, the “win at all costs” mentality often results in people turning the other way when faced with obvious signs of substance (click here for an article on identification). This is often referred to as enabling and can be quite damaging to the individual since the earlier treatment is received, the grater the chance of maintaining a substance free life-style. While the motivations for drug use vary from athlete to athlete, the pattern of enabling needs to be stopped before treatment can begin.

Case Illustrations

Daryl Strawberry played right field for the New York Mets. He was part of the World Championship team in 1986. His talents were impossible to ignore. The only questions seemed to be how many records he would break over the course of his playing career. He and his teammate, Dwight Gooden (pitcher), were going to be the foundation of a dynasty. Not long after the Championship season both players got seriously involved with substance abuse. Daryl, Dwight, and the Mets began to spiral into the darkness of addiction. To date, Daryl’s life has almost completely fallen apart. He is presently behind bars for violating parole. He has been in and out of various rehabilitation programs. Finally, he decided that the only way he could stop using was to be in jail. His story is filled with anecdotal information that shows how difficult it is to break clear of the vicious cycle of abuse. Especially obvious, in his case, is the role of family in supporting addictive behavior. Not one of his family stepped in and confronted Daryl because he was taking care of everyone. Addiction is often spoken of as a family disease … not only the biological family but also the family of a sports team that enable an athlete to continue using.

John Daly is a professional golfer. He could hit a tee shot further than anyone. He broke upon the PGA tour with great fanfare. Early victories made him an instant celebrity. It looked for a moment as if no one and nothing could possibly beat him. John had won a major tournament which qualified him to play in the three other majors for that year. He seemed invincible. But, everyone was wrong. Alcohol was beating him. Before you could even join his fan club, he had entered a rehab. During his treatment stay, he missed out on one major and was banned from another. In addition to alcohol, he was a totally devoted cigarette smoker. You would almost never see him hitting a golf ball without one in his mouth. He was very over weight and clearly had a problem with over eating also. As long as John could hit a golf ball so far, everyone over-looked his various addictions. He was like a cult figure. Crowds would cheer. But, he was killing himself. He is back on tour today and it is unclear whether he has broken with the substance abuse history. It is a problem that just doesn’t completely go away. It is a life time commitment to change one’s life. Regardless of whether your statue in life, substance abuse problems is like gravity … no one is so powerful that they can just will away the effects, specially when management and fans are enabling them.

A couple of weeks ago, Bob Hayes died as a result of prolonged alcohol and drug abuse. Readers may not remember him but back in the 1960′s, he was designated as “the world’s fastest human.” This honor was given to the man who could win the 60 and 100 yard dash in the Olympics. Bob did just that. He was then drafted by the Dallas Cowboys as a wide receiver. No one thought he could make the transition from tack and field to football. But, he did and did it big time. Football teams were forced to create different defenses in order to stop him. Once he caught the ball, there was no stopping him from getting to the end zone. There was only one thing that did stop Bob from his goals in life … substance abuse. His feelings of invincibleness got the better of him. Also, everyone around him thought he was invincible. They needed to believe in someone who could be so powerful and enabled him to continue his use.

These three examples clearly show that enabling behavior form individuals in an athlete’s life can have a significant negative impact on the individual’s problem. Once an athlete has been identified as having a substance-abuse problem, treatment steps should be taken immediately. This is necessary to increase the likelihood of success. Although friends, family, and professional organizations believe that they are doing the right thing letting the individual try to help himself, they are just prolonging his or her pain. Established treatments can make a significant change in an individual’s life and can in the long run be more “cost-effective” then simply letting the problem continue.

Treatment

&nbspThe goals of this initial phase are for the athlete to acknowledge the possibility of having this problem. Different types of treatment approaches are discussed and the impacts upon family, athletic career and team should be discussed. If severe enough, it is often necessary for an athlete who has substance abuse problems to be removed from the environment so that the recovery process can begin. If detoxification is necessary, inpatient programs provide the environment to monitor withdrawal symptoms and medical assistance. These programs last between 4 – 6 weeks while the person is participating in group and individual psychotherapy. Alcoholics Anonymous is often introduced during the in-patient stay. Family members are usually involved in the treatment process by attending family treatment and education on the important issues of alcohol and drug abuse. Sometimes, recommendations are made to attend Al-Anon meetings – a 12 step program for the addict’s significant others.

When an athlete is released from in-patient treatment, the aftercare phase of treatment begins. Most people think that since the athlete has been clean for a month that the addiction problem has been resolved. The fact of the matter is that the hardest part is now coming. All too often, the athlete is returned to the same environment that contributed to the cycle of substance abuse. Specifically, the athlete returns to the competition that created pressures and stress that motivated the abuse. The aftercare phase of treatment usually lasts between 3 months and 2 years. Serious consideration should be given to keeping the athlete out of participation in sport competition for a good deal of this time. Everyone is going to be under pressure to get the athlete back performing earlier rather than later. The focus of aftercare is get a person re-adjusted to contact with the family, social network, occupation and the team. Attention should be given to teammates who may not know how to respond to the returning athlete. Facilitation of normal communications and honest disclosure can be taught by the coach.

It is suggested that outpatient treatment be continued indefinitely. This can occur while participation in the athlete participates in sports, family and personal pursuits. This type of treatment is only successful if the person stays clear of all alcohol and drug abuse. It needs to be understood at the deepest level possible that substance abuse involves distorted thinking and an intolerance of emotions. Just because the athlete is not using does not mean the thinking is corrected and emotions are being handled effectively. In fact, it is often quite the contrary. The same painful thinking and emotions are operating, but, now, there is no substance to numb them out. It takes great courage and persistence to deal with this aspect of treatment. If this does not occur, there is a great likelihood of going back to alcohol and drug abuse. Just ask Daryl Strawberry and John Daly! It’s too late to ask Bob Hayes.

&nbspThere are a number of specific factors that should be considered by the therapist and client in the treatment of a substance-abusing athlete. The effect of the clash of self-images between that of the healthy athlete and the sick patient should be explored. The impact of public exposure on the treatment process should be kept in the forefront of everyone’s mind. Also, the effect of organization policy on treatment needs to be assessed. Exercise can either hamper or enhance treatment outcome for an athlete.

Conclusion

&nbspA couple of days ago it was revealed by a sports reporter that one of the Mets minor league players was video taped smoking marijuana. The Mets organization might light of it and tried to smooth over the story. The reporter was concerned that the entire team could be infected with this problem. He was on a track that makes perfect sense. It would have sent a more productive message to the athletes if the organization did respond with concern for the teammates instead of enabling him. Even after Daryl’s demise, it could be asked what has the Mets organization learned? They maybe more concerned about the team’s image than the health of their athletes. It doesn’t make much sense – even from a monetary point of view. They invest tremendous amounts of money developing athletes. It wouldn’t take much more money to protect their investment. This problem doesn’t just go away by wishing, denying, or acting dumb. Knowledge and sensitivity can bring us all to a healthy way of interceding.

In today’s modern world, we often hear individuals who exercise make statements about how they feel better then they did before they started exercising. If you were to ask these people to clarify what “better” means, most people would focus on the physical benefits. There is no doubt that engaging in activity has many physical benefits including weight management, improved cardiovascular fitness and control over diabetes and osteoporosis. However, there are also many psychological benefits to exercise which include positive effects on memory & thinking and improvements in levels of depression and anxiety. Let us take a closer look at each one of these.

Memory and Thinking

Many researchers have examined the effects of aerobic and anaerobic exercise on memory and thinking. The results have been mixed but for the most part indicate that moderate levels of exercise (regardless of type) improves performance on memory and thinking tasks including addition problems, recall of numbers and words, perception & discrimination of geometric figures, and organization. It is important to note that both high and low levels of exercise have been found to either have no effect or actually impair performance on the tasks. The reason for this is unclear and is currently being studied.

Depression

Clinical depression is one of the most common psychological problems in our country. According to data from the President’s Committee on Mental Health, one of every four Americans suffers from depression at any given time. Depression is characterized by withdrawal, inactivity, and feelings of hopelessness and loss of control. By acting on each of these symptoms, physical exercise can be a useful therapeutic intervention for depression. Indeed, people who are physically active, have lower rates of diagnosable depression. One study conducted over a twenty year period found that those individuals that were most physically active at the beginning of the study were less likely to develop depression at a later date.

Researchers have even examined exercise as a treatment for depression. Individuals who had been diagnosed as depressed were put into three groups: time limited psychotherapy (10 weeks), time unlimited psychotherapy, and a running treatment group. The runners met with a running therapist and would stretch, walk and run for thirty to forty-five minutes, and discuss issues while exercising with little emphasis on the depression itself. Results indicated that 6 of the 8 patients in the running treatment group were essentially well at the end of three weeks, another at the end of the 16th week, and one that neither improved nor deteriorated. This should not be taken to mean that depressed individuals should drop out of traditional forms of treatment, just that running is a useful adjunct to traditional treatment.

Anxiety

One generally accepted benefit of exercise is anxiety reduction. In other words, people who exercise just feel less stressed or nervous. In general, research has supported this notion. In one study, subjects were placed into one of three groups: jogging, stress inoculation training, and waiting list. Individual’s self-report statements indicated that both the jogging and stress inoculation groups had lower levels of anxiety then the waiting list group immediately following the intervention. Furthermore, this finding held true when the researchers followed up one month and 15 months later. It is important to note that the joggers only continued to experience lower levels of anxiety if they continued to exercise (which was about 40% of the original group).

The reasons for improvements discussed above are unclear. Some people feel that various exercise strategies serve to divert or distract subjects from anxiety and depression-producing stressors. In addition, if you are working out at a gym or park, social contact works to reduce the isolation typically associated with depression. Another reason for the improvements in psychological well-being is that exercise alters various neurotransmitters within the brain (norepinephrine and seretonin) which is precisely the function of medication that is prescribed by psychiatrists. This should not be confused with the unsubstantiated theory that the release of “morphine-like” chemicals within the pituitary gland and the brain serve to reduce the painful effects while also enhancing the euphoric effects.

Conclusions

From the above discussion, it is clear that there are many benefits on psychological functioning that result from exercise. However, it is important to note that the relationship between physical activity and mood should be thought of as correlational not causative. That is to say, they are related but exercise should not be thought of as being the sole cause for the improvements in mood.

Although some studies featuring highly anxious patients have shown that exercise reduces both anxiety and depression significantly more than a placebo treatment, others have found the reverse to be true. More specifically, one group was told that their regimen was specifically designed to facilitate psychological well-being and no such intervention was made with the control group. The results showed improvements in fitness for both groups; but, the experimental subjects improved significantly on a measure of self-esteem when compared to the no intervention control group. This means that just thinking that something is good for you, is enough for it to have a beneficial effect.

So how should exercise be used to improve mood? If you have been diagnosed with an anxiety or mood disorder, probably the best approach to take is to use it as an adjunct to the treatment you have discussed with a mental health professional. Always use follow the guidelines that they set forth for the treatment of your particular disorder and be sure to voice your interest in using exercise as an adjunct to treatment.

INTRODUCTION: The first article in this series (Techniques to Reduce Stress I), we reviewed Diaphragmatic Breathing and Imagery techniques in reducing stress. It was noted that both can improve the positive impact on lowering stress and anxiety in an athletic situation that is being or will be encountered. This article will introduce more cognitive and physical techniques aimed at the same purposes. Again, remember that not all techniques work equally well for everyone. So, try them out, give them a chance, and keep those that seem to work for you and throw away those that prove to be of no benefit.

COGNITIVE TECHNIQUES: Change your attitude in order to perceive negative events in a positive way! For example, instead of believing that it is going to be difficult to return a fast serving tennis opponent, think about how you can use the pace of his serve to your benefit.

• Talk to yourself in a positive way! If your team has reached the semi-finals of the basketball tournament for the first time, tell yourself it is do to the improvement in team cohesion, abilities and effort over the course of the season.
• Visualize positive results instead of imagining failure! An example would be to see yourself getting a great jump on the pitcher, sliding around the shortstop’s tag and hitting second base with your outstretched hand.
• Be flexible enough to change! If an approach to hitting your golf drive is not working due to deteriorating weather conditions, it is important to be able to consider other clubs that would encounter less problems in keeping the ball in the fairway. Also, if a club just doesn’t seem to be working for you today, leave it in the bag and turn your attention to those that are effective.
• Never try to be perfect! Perfect is never enough! Since it is impossible to play any athletic event perfectly, you are going to be under constant stress regardless of success or failure. If the only thing that is emotional acceptable is getting a 300 score in bowling, yes, you may get there once, twice, etc, but to expect it every time is debilitating.
• Take time out from practice! All too often you hear about young great athletes who have burned themselves out by the time they might be reaching their peak. Very often the explanation is the relentless pressure on young minds and bodies.
• Find the best time for you to work and the best environment! Sometimes athletes find that early morning runs are better than late in the afternoon. Obviously, it might be better to practice during the times and under the conditions that the competition will occur. This will leave you with less stress at the time of the real event.
• Don’t dwell on the past! Focus on present and future! Most anxiety and stress is caused by obsessing about events of the past and anticipation of problems in the future. Often, the calmest state can be found in the present because there is usually nothing go on that is troubling.
• Change or avoid negative situations! If you are having struggles communicating with a coach, try to shift the interpersonal dynamics or change coaches. Stress between people is intensified by trying the same old thing with the same people. Try to communicate clearly without hidden agendas.
• Talk to a fellow athlete or a professional! Sometimes we are too close to the problems we are having in our sport to see what the problem is. We keep trying and think it should be coming out differently. We need someone with objectivity to spot the difficult and offer a solution.

BASIC RELAXATION TECHNIQUES: These techniques can be practice before any athletic event – sitting on the bench, during the national anthem, waiting turn to hit a golf ball, in-between shift changes in hockey, etc. Tense each of the following muscle groups and hold for ten seconds.

1. Relaxation of arms: Clinch right hand (make a fist) and tense forearm; clinch left hand and tense left forearm. Clinch both right and left hands and forearms; tense right biceps (front of upper arm) by bending right arm at elbow. Tense left biceps by bending left arm at elbow. Tense right triceps (back muscle, upper arm) by stiffening right arm. Tense left biceps by stiffening left arm.
2. Relaxation of head area: Wrinkle forehead; frown and crease brows. Close eyelids. Close eyelids tightly and keep them closed throughout the remaining exercises. Rotate eyes in clockwise circles – return to center; rotate eyes in counterclockwise circles – return to center. Rotate eyes to the far right. Rotate eyes to the far left. Rotate eyes to the top of the sockets. Wrinkle nose and cheeks. Press lips together tightly (or purse them). Clinch jaws. Press chin against the chest. Press tongue against the roof of the mouth. Begin to swallow, and hold. Tense throat. Tense throat and larynx muscles by humming a high note without making any sounds. Then hum down the scale to a low note.
3. Relaxation of trunk: First, tense shoulder muscles by bringing shoulders up to your ears. Then, pull the shoulders back and the upper back muscles. Arch lower back and tighten lower back muscles. Then reverse and pull shoulder muscles inward to the front and tighten the chest muscles. Next, tighten your stomach muscles by pulling inward and downward. Tighten pelvic muscles in groin area – like stopping urination in the middle of urinating. Last, tighten your buttocks by pulling them together.
4. Relaxation of legs: In the following order, tighten right upper leg, left upper leg, both upper legs (pull legs together at knees and straighten legs), tense right calf and shin (raise foot as though to touch leg), left calf and shin, tense right foot and toes followed by left foot and toes.
5. Intensifying the relaxed state throughout the body.
   1. Take a deep breath in through your nose. Hold it to the count of four and exhale to the count of four.
   2. Repeat this several times. Notice the tension in your chest. As you exhale, notice what happens throughout the body. Let your muscles go further and relax very deeply; go on and deep breathe many times and notice the tension. Notice it go throughout your body.
   3. Breathe deeply and evenly, and enjoy the sensations of warmth, full relaxation. Remember these feelings.