Webinar: The Human Behind the Athlete

Charlie Health hosted a webinar presentation in collaboration with the U.S. Center for Mental Health and Sport and the Cognitive Behavior Institute on “The Human Behind the Athlete.”

Charlie Health is the largest provider of virtual Intensive Outpatient Programming for young adults and teens who struggle with high acuity mental health issues such as major depression, PTSD, anxiety disorders, and self harm. 

The Center for the Integration of Sports Movement and Mental Agility (CISMMA) provides mental health services for athletes as part of the Cognitive Behavior Institute. They provide outpatient mental health services throughout Pennsylvania. 

Presenters and guest speakers from this session included: 

• Dr. Shlok Kharod, Clinical Outreach Manager at Charlie Health in Illinois with experience in clinical psychology, sports, and exercise psychology. 
• Alicia Ramos, MS, a clinician at Charlie Health with 15 years of experience in nutrition, health promotion, and exercise science.
• Spencer Kilpatrick, MSW, LCSW, from the Center for the Integration of Sports Movement and Mental Agility.
• Margaret Domka, co-founder and Executive Director of the U.S. Center for Mental Health and Sport and former FIFA soccer referee. 
• Dr. Skye Arthur-Banning, co-founder of the U.S. Center for Mental Health and Sport and associate professor at Clemson University.
• Nosa Eguae, former football player at Auburn University War Eagle and Atlanta Falcons who has since pivoted into health counseling at Baxter Healthcare. 
• John Isner, a professional tennis player and former player at the University of Georgia. 

Participants of this session included coaches, teachers, parents, and clinicians who support athletes in their communities. They discussed the need to address challenges facing athletes in relation to their mental health and how to support them. Watch the webinar recording above! Keep reading for a full synopsis of the event.

Navigating the challenges of athlete mental health

Alicia Ramos began the presentation by calling attention to the cornerstones of athletic performance to be discussed throughout the webinar: athletic performance, achievement motivation, stress, burnout, mental health signs and symptoms, barriers, the path to wellness, and support and resources. Ramos touched on a few topics and how those elements relate to the athlete. 

Athletic performance

The goal of most, if not all, sports is simple—win by defeating your opponent. Athletic performance involves the mental and physical effort of an individual or team and how that effort helps to achieve that goal. 

Achievement motivation

Aside from skill and training for a particular sport, athletes deal with the psychology involved in sports as well. Being able to focus on their task and identifying their goal impacts their ability to succeed. The question then becomes, when does achievement motivation become too much? 

Stress

Believe it or not, stress isn’t always a bad thing. Good stress can provide a sense of motivation, focus, and adrenaline to contribute to peak performance levels. This type of good stress remains within the athlete’s control. Negative stress, on the other hand, is an overwhelming feeling. This makes it hard to cope with the pressure an athlete feels is put upon them. 

Burnout

Students are tasked with juggling school, homework, managing finances, and having social lives. On top of this, student-athletes are committed to their sport and adhere to a strict schedule. With team conditioning and practice, training, eating nutritiously, traveling, and performing well on game day, there isn’t much room for other factors that could affect their routine or mental health. The reality of this situation is with added pressure and stress often comes burnout.

Signs and symptoms

• Constantly tired
• Eating disorders
• Mood swings
• Feelings of isolation
• Loss of enjoyment in sport
• Self-criticism
• Withdraws from training
• Exaggerations of physical symptoms
• Negative attitude
• Complaints of lack of results

The Importance of Emotional Wellness

Ramos noted that oftentimes when we focus on wellness, we talk about physical wellness—the physicality of our bodies. At this age for student-athletes, the conversation should be opened up to include the discussion of emotional wellness. The National Center For Emotional Wellness defines emotional wellness as “an awareness, understanding, and acceptance of our feelings, and our ability to manage effectively through challenges and change.” In essence, this is our ability to connect with our feelings and move through them, not around them. 

It’s important to create a space for achieving goals as well as a space for connecting with your emotions. It’s only in this space that we can support athletes and help identify what is going on with them and how to overcome it. 

Early intervention framework

The bright side to this situation is that organizations, colleges, and communities recognize the need for mental health literacy and its place among student-athletes. The American Psychological Association defines mental health literacy as “knowledge about mental health disorders that are associated with their recognition, management, and prevention.” 

Real progress comes from removing the stigma associated with mental health, especially for athletes. The work being done by the American College of Sports Medicine (ACSM) is focused on developing the whole athlete. In order to achieve peak performance, both physical and mental health need to be tended to and addressed. 

Mental health signs and symptoms

Common behavioral changes include aggression, social isolation, substance use, and feelings of worthlessness. Athletes aren’t immune to depression and feelings of anxiety. In fact, a study conducted by ACSM showed that 35% of elite athletes struggle with burnout, eating disorders, depression, and anxiety. By identifying these symptoms and root causes, coaches, parents, and mental health professionals can then support these athletes to help them through it.

Ask John Isner

During the session, Ramos addressed John Isner, a professional tennis player, to share some of his thoughts surrounding mental health. Isner noted that fortunately, mental health has become more and more normal to talk about. If an athlete wants to perform well, it’s crucial to be in the right place, mentally. “It’s just getting everything in order, mentally, that supersedes everything,” he said. 

As far as managing stress and coping with loss, Isner makes it a point to learn from his losses, as losing is part of the game. “I’ve always found myself playing my absolute best when, quite frankly, I don’t care about the result of the match,” Isner explained. Yes, winning is the goal, but instead of putting the result ahead of the process, it helps to remind yourself to be happy, win or lose. “I just wanna go up there and try to play without pressure and really enjoy it.” 

As a tennis player, Isner’s experience as an athlete differs from those who play team sports. “Tennis can be a very, very lonely sport,” he said. As an individual player, Isner is responsible for finding his own coach and trainer. He realizes the value of having a good team surrounding him and that his family provides the most support. For those who are in need of support while traveling or during a tour, he recommends seeking out professionals and services to help athletes through difficult times in their careers. 

What is mental unhealth?

Mental unhealth refers to all facets of mental illness and the emotional pain a person feels when experiencing a life disruption. These disruptions can be everyday moments like transitioning from high school to college or taking a new position at work. A person’s character is often measured by their ability to overcome hardships alone, which can be incredibly isolating. It’s common to neglect or dismiss these disruptions as part of the stigma we experience due to our societal culture. 

Spencer Kilpatrick from CISMMA used the example of what occurred during the Bills and Bengals football game in January when DeMar Hamlin of the Buffalo Bills was almost fatally injured. Head coaches Zach Taylor and Sean McDermott advocated stopping the game to prevent their players from continuing to play after witnessing a traumatic injury on the field. This showed their connection to the athletes and their understanding of protecting their athlete’s well-being. Everyone has the capacity to heal from mental unhealth when they’re connected to a close other—this is the foundation of attachment science. 

Attachment science and mental unhealth

As a social species, humans are born with the need to create emotional bonds with each other. This inherent desire to create bonds with people continues all throughout our life. Put simply, attachment science is the study of how we connect with other people for support in order to continue to thrive. 

When faced with challenges, Kilpatrick finds athletes tend to respond in one of three ways. 

1. They quit. Athletes who choose not to participate or engage are seen as defiant, even though they’re capable of facing the challenge and finding success. This is often a form of self-sabotage. 

2. They pretend. Even though this athlete addresses the challenge ahead of them, they dismiss their achievements and feel that their win or success is somehow a fluke or sheer luck. 

3. They procrastinate. When an athlete ignores the challenge until they feel the pressure of time and there is no other choice but to face it. 

So how do we help athletes face these challenges? By providing them with a safety net. 

Safety net for athletes

For many athletes, there’s a lot of fear around failing. Creating a safe space for athletes gives them permission to face the challenge. They have an increasing sense of their personal potential. It can also protect the athlete’s identity by disconnecting the threat of the challenges and morphing it into an opportunity for athletes to showcase their abilities.

When athletes are connected to a robust safety net, they crave challenges and thrive even in the face of adversity. 

Creating a safety net

Think of the ropes of a net as an individual relationship an athlete has with someone else in their life. Coaches, family, teammates—each rope has the potential of being tied into the net. The strength of that knot in the net is linked to the depth of trust within that relationship. How do you strengthen that relationship? By engaging, repairing, and prioritizing that relationship so the athlete can carry that strength along with them. “This provides them with a sense of knowing they’ll be caught if they fall,” Kilpatrick said. 

The four S’s in being a close other for an athlete

Taken from psychology researchers Dr. Dan Siegel and Dr. Tina Payne Bryson, Kilpatrick discussed the four S’s to enable coaches, parents, and community members to become a Close Other for the athlete in their lives. 

• Safe. Start by making sure an athlete feels physically safe with you. 
• Seen. Don’t doubt an athlete’s feelings, but rather ensure that they’re being emotionally seen. 
• Soothed. Help to soothe the athlete by being in the present moment with them and their emotions. 
• Secure. Provide a sense of security and a trusting relationship between yourself and the athlete. 

When an athlete creates these relationships and builds their safety net, it’s much easier for them to face challenges and obstacles (in and out of the sport), knowing they have a support system to rely on when they need it. 

“It’s only natural that we and our children find many things hard to talk about, but anything human is mentionable, and anything mentionable can be manageable. The mentioning can be difficult, and the managing two, but both can be done if we’re surrounded by love and trust.” – Fred Rogers

Life after sports

Former football player Nosa Eguae began his segment of the webinar by quoting Dr. Brené Brown. “Only when we’re brave enough to explore the darkness will we discover the infinite power of our life.” Eguae reflected on being a student at Auburn University, his time in the National Football League (NFL) with the Atlanta Falcons, and being cut from the team. 

Eguae, like every athlete inevitably experiences in their career, was faced with the question: who am I outside of the sport? 

Unfortunately, tough discussions such as an athlete’s life after sports aren’t discussed within the world of sports. Why? Most people involved in sports are compensated for their performance as an athlete. “The incentives aren’t connected to an athlete being something more than just an athlete,” Eguae said. For many athletes, in their minds, there is nothing else they know how to do, and they self-sabotage by seeing themselves only as an athlete. 

Commit to open dialogue

As a way to prepare student-athletes transitioning out of sports, Eguae emphasized the need for open dialogue. Instead of using a sport as an identity, consider how playing a sport can propel an athlete for the rest of their life. Use their training and development, the discipline required to be a top-performance athlete, and recognize how that can prepare athletes for the rest of their lives. 

• Who else are you?
• What else can you do? 
• How can I support you?

Reinvention is not easy, but it becomes easier with a community.

Beyond the athlete

Dr. Skey Arthur-Benning and Margaret Domka from the U.S. Center for Mental Health and Sports moved the discussion forward by examining the community surrounding an athlete and how everyone within that structure lives and thrives within that space. The conversation up until this point in the session focused on the athlete and their mental health journey. Similarly, people within that support system—coaches, officials, parents, trainers, etc.—also experience their own mental health journey as well. 

Act

The first step is to hold mental health awareness training for everyone involved. This includes the athletes, parents, coaches, administration, leadership teams, family members, and officials. By including everyone in the process you form a community of support for each other to lean on. “Provide everyone with the tools that they need to walk away and understand how to start the conversation and how to help,” Margaret said. 

As part of this training, clarify what each person’s role looks like and what they can do in the event that someone within their community is struggling with mental health. 

• Coaches. Develop positive coaching strategies and a growth mindset. Ensure the athlete they’re respected at all times.
• Administrators. Create policies to protect and support athletes within their organization. 
• Parents and family. Remain open and willing to have tough conversations and provide a safe space for athletes. 

Say something

One of the biggest obstacles around mental health in sports is the idea that it shouldn’t be talked about. Despite the worry and fear surrounding this topic, organizations like the Sports Science Institute and the National Federation of State High School Associations encourage coaches, administrators, and community members to open up the conversation. State governments and official offices of the U.S. Surgeon General and Department of Health and Human Services are also promoting the need and recommendation of having discussions of mental health awareness within sports. 

A shift in sport policies

Arthur-Benning and Domka concluded their segment with insight into the need for reassessment of sports policies. These policies affect not only athletes, but everyone involved such as coaches, trainers, peers, and leadership members. Keeping these elements in mind will help create a better, safer environment. 

• Protection from harm. Feeling physically and emotionally safe within the sport. 
• Connection and community. Providing a support network for athletes to rely on. 
• Sport/life balance. Allowing and fostering athletes to have other identities outside of the sport.
• Being valued. Assuring the athlete of their value and place within the team and sport. 
• Opportunities for growth. Creating opportunities to learn. 

A common theme throughout the presentation was the fact that these conversations need to happen more. Although there has been growth and improvement surrounding mental health in sports, there’s still a lot of stigma. What’s most important is that we treat our athletes as humans, have these discussions, and honor their emotions. Charlie Health offers an athlete support group every first Tuesday of the month. Reach out now for more information on how you can support athletes and continue the conversation. 

Q&A

Who do you believe is the most effective person to have this conversation with the athlete?

“It’s a conversation that anybody within the sport can have. A therapist, a mental wellness professional that the athlete trusts and is willing to open up to. One of the things I struggled with was that no one wanted to tell me the truth. We need to start having real conversations.” -Nosa Eguae

For parents with young children in sports with no experience in mental health, how can they help their children in this situation? 

“My advice for these moments when working with a parent that has a kid who’s showing some defiance or mental health indicators is patience. Check in with them. Let go of that expectation of performance because what it should be is a moment of connection.” -Spencer Kilpatrick

When do we start having conversations with parents about children’s mental health?

“Most coaches are going to have the parent conversation at the beginning of the season. We also need to say, what would you like to do if we know that your athlete is struggling? Or, if someone in your family is struggling? I think we need to be able to rely on folks in our sports environments to be able to start having those conversations.” -Dr. Skye Arthur-Benning

‍

Student athlete care at Charlie Health

Whether you’re a student athlete or have a loved one who is playing sports and struggling with mental health: you are not alone. Charlie Health’s proram is designed for youngs people who need more support than weekly therapy but also need the flexibility of a virtual program. From major depression, anxiety and panic disorders, to self-harm, our virtual IOP offers solutions for student-athletes in need of a higher level of care. Get started with our online form today. ,

‍