sports psychologist & clinical psychology

Sports Psychology Article: The 10 Biggest Issues Seen in Private Practice

Sports Psychology Article: My name is Dr. John F. Murray, a clinical and sports performance psychologist in Palm Beach, Florida. I have been licensed and in practice since 1999, providing a variety of mental coaching and psychotherapy services to athletes, business people, and people just looking to live a healthier or more successful life. This work can occur in the office, by phone or skype, or at client locations, and I also deliver workshops and speeches worldwide.

While I believe clinical psychology skills and training are vital in providing sports psychology services because people and their range of issues need to be understood and often treated, it is interesting that the vast majority of people who have hired me come in initially seeking performance enhancement for their sports, businesses, or performing arts. The truth is that mental skills are rarely trained in formal education and so there is a huge gap and need. Just as true, people who struggle with clinical disorders find it very difficult to achieve lasting success in any endeavor.

Today, as I look back on 17 years in private practice, I would like to share what I believe to be the top 10 issues that I have dealt with in working with clients. These issues are in no particular order in terms of frequency and severity, and each case in unique, but this should be a pretty representative sample of what I have seen. I’m sure I am missing many issues, but this will account for a huge percentage of them.

(1) PERFORMING WELL IN PRACTICE BUT NOT IN GAMES: Athletes often get in my door with this one. They tell me or their parents tell me that practice is great but actual live games are a total mess. While there may be many reasons for this, competitive pressure comes to mind as a frequent culprit. Sometimes the person is not training properly. Learning to face the pressure in guided imagery, relaxation, goal setting, and cognitive restructuring can work wonders. Here is an article by Larry Stone of the Seattle Times that I contributed to that addresses the issue of pressure in baseball.

(2) ANXIETY: This is an overworked word and one person’s anxiety is never another’s anxiety, but for lack of a better term let’s use it. People in all walks of life think too much, obsess, worry about what other people think (often coaches, parents or teammates), and lose the game or botch the boardroom presentation long before it even begins. Luckily for those who come in, anxiety is one of the problems that resolves best with treatment. I use a variety of techniques depending on the client. Often an approach that combines new learning, classical conditioning, and some form of relaxation with guided imagery is the key to success. It might take a little time to make progress or it might occur rather soon because each case is so different. It is one of my favorite problems to work with because the success rate is so high. Here is an article by John Nelander in the Palm Beach Daily News that I helped with that addresses the problem of anxiety.

(3) LOW SELF-ESTEEM OR LOW CONFIDENCE: While these are different issues, I lump them together here for simplicity. People are rarely born with confidence, and any number of past or current factors can tear away at confidence. The most typical problem is when an athlete is in a slump or bombarded by what is perceived as failure. Just like any solid mental skill, confidence is a tool that needs to be sharpened and continually used in battle in order to gain the edge. I build confidence in a variety of ways through education, self-talk modification, stories, examples, quotes, audios, videos and just good old solid cognitive-behavioral therapy. In fact, all of these approaches may be used in treating the 10 issues in this article. Here is an article I once wrote on the topic of confidence for a regular column I was writing for the Tennis Server website.

(4) POOR FOCUS OR CONCENTRATION: Since human beings are designed to be distracted with what is called the “orienting response” (it had survival value in the wild for our ancient ancestors to be easily distracted by the crocodile when stopping to get water from a lake) we are quite susceptible to distractions of all kinds, both sensory distractions and distractions from inner thoughts and feelings. Add to this the number of clients whom I have seen with attentional disorders such as ADHD, and you soon realize that focus in anything is never guaranteed and rarely natural. Like any mental skill it needs to be properly practiced and refined. Golfers lose focus in a tournament just as much as linebackers do in football, and training is called for. I use a number of techniques to help including pre-performance routines, key words and phrases, guided imagery with relaxation, and goal setting. Since focus might be the most important mental skills for success, it is vitally important to ensure that the person is optimally thrilled in the moment of whatever they are doing. Here is an article I wrote about how to get better focused in football.

(5) ANGER OR FRUSTRATION: Competition can bring out the best and worst in us, and one nasty little enemy is the anger that often builds up without relief, and then explodes at the wrong time to wreak devastation on the competitor in whatever they do. Communication fails when couples try to resolve their issues with anger, MMA fighters lose poise and get submitted more quickly, and tennis players blow the next four points and ultimately the entire match as their emotions sandbag them. Like anxiety, a cousin of anger, treatment for anger has very high success rates. The sources of anger and anxiety begin in the deep temporal regions of the amygdala, that little part brain shared by almost any walking organism on the planet. It was a great alarm mechanism in caveman days as it sends important signals of danger and allows quick fight or flight reactions automatically. Unfortunately, it rarely helps the quarterback thread the needle on a critical 4th down pass. Many techniques are successful here including helping a client learn new ways to break the pattern, and these behaviors like any new learning need to be rehearsed many times in imagery and practice before they become habits that sustain future success. Success here might also require a total change in how a person perceives reality. Here is an article in Men’s Fitness magazine that I contributed to about ways to control and manage anger better.

(6) RELATIONSHIPS: People are social creatures, and I learned in doing my doctoral dissertation on the 1996 national champion Florida Gator football team, and in other studies, how incredibly important social support and feeling the right things from others can be in achieving success and coping with stress. The problem is that people are so very different. It’s hard to get along, and stress of competition can often spell disaster for relationships. On teams, the coaches have important decisions to make and players who are snubbed or overlooked often feel slighted. Favoritism happens a lot in junior athletics, when the baseball manager starts his son or best friend’s son over another player just as good or better. Feelings are easily hurt and sometimes hard to repair. Football players may worry about what coaches think about them, and corporate executives might have serious philosophical differences with the way the CEO wants things done. Treating these problems requires experience and savvy. Helping people see things a bit differently or helping them to communicate more effectively often works. Being relaxed and less stressed can also do wonders. Changing expectations and learning to be more assertive without being too aggressive is useful too. Here is an article in the Sun Sentinel that I helped with right after the tragedy of 911 that was focused on the value of relationships with others.

(7) PERFECTIONISM: Think about who might be the first person to seek out a sports psychologist for mental coaching. It is of course the perfectionist, seeking another avenue for success in their relentless pursuit of the ideal. The problem is that true perfectionism is actually like a mental disorder. The perfectionist is never really satisfied, and despite extraordinary attempts to be the best at all costs, the person usually sabotages performance rather than enhancing it. I like to get my clients to see the pitfalls of perfectionism and encourage them to strive for excellence which is a far healthier recipe for advancement. This takes a little time and savvy, but it works well. Here is a column article I wrote entitled “Eliminate Perfectionism for Success”

(8) DEPRESSION: This problem, like many other clinical problems, illustrates why it is so helpful if your sports psychologist is also a trained and licensed psychologist. In a lifetime, a huge percentage of people (over 25%) will be depressed in their lifetime, whether they are the cleanup hitter for the New York Yankees, a world champion boxer, or your next door neighbor. Athletes and top executives are people like all of us, so they get depressed and need help too. The problem is that mental disorders like depression are stigmatized, labeling a person weak or telling him or her to just suck it up. As Jon Wertheim so aptly pointed out in his article “Prisoners of Depression” in Sports Illustrated over a decade ago, those with serious clinical depression are more impaired than a person with a broken leg. A broken leg will heal nicely and teammates will cheer on the recovery, but a person with depression is still often seen as a team outcast or virus and their performance usually suffers just as if their leg were broken. Many cases go untreated due to shame. I’m hoping for a day when mental problems are taken just a seriously, or more so, than physical ailments. Suicide is one of the leading causes of death in young people. To treat depression, I use an eclectic approach, often finding cognitive behavioral psychotherapy to be effective as the client learns to change irrational or illogical thoughts and perceive their world differently. While I am not equipped to prescribe medication, and believe that less intrusive approaches such as talk therapy should be attempted first, I also keep a keen eye to the severity of depression and suicidal ideation. More severe cases might justify my referring the client to a medical doctoral for a medication evaluation to go along with the psychotherapy we are doing. Here is that article ‘Prisoners of Depression” that Jon Wertheim wrote.

(9) LOW MOTIVATION/WANTING TO QUIT: Parents bring me their junior athletes for any number of reasons, usually just to help them perform better, but this can also be a reason for referral. An athlete or high performer who has done very well for a number of years might suddenly lose the fire and want to quit. This can puzzle those around the person. The reasons can vary from A to Z, but hiring a trained professional to help sort out the issues and provide treatment can often be the difference between that child going on to compete at the college and professional level or quitting at age 14. This problem also presents amongst older athletes or those considering retirement, or just normal people in jobs they’ve lost passion for. As a clinician, it is important that I determine if there is a serious clinical disorder, or if this is a temporary phase including mostly staleness, burnout, or stress. Quitting might be in the best interests of the client. While I never make this decision for the client, I can help sort it all out, and rule out many factors that might have been overlooked. Intrinsic motivation is so important in all that we do and passion and joy is important for any success. Often time off from physical training and competition combined with psychotherapy or mental coaching helps. This is a tough one to treat but that does not mean that it does not need to be addressed. On the contrary, the person’s entire sport or career could be at stake. Self-esteem and huge money could be on the line. Here is an article by Janie McCauley in the Associated Press that I helped with recently about athletes retiring in the prime of their careers.

(10) TRAUMA/SUBSTANCE ABUSE/EATING DISORDERS: I’ve put these three clinical problems together as one just for the purposes of this article because they often go together, but technically they are quite different. Past horrible events and circumstances can often play themselves out later in life and the diagnosis of PTSD is one of the most common amongst those who have been in war or have been sexually or physically abused. Did you even wonder why so many NFL and NBA players who have the world at their fingertips and multi-million dollar contracts suddenly throw it all away as a result of domestic violence, drug use, or other criminal behavior. While some people are just wired wrong and need to be incarcerated to protect society, I would venture to say that this is rare and that the vast majority of these serious problems have their roots in serious problems that have huge historical origins, often of a traumatic nature. The media and public is often quick to condemn people who act out but slow to truly examine why they do it. Society has a long way to go. Again, these types of problems are rarely going to be well treated by a mental coach guru without proper training and credentials as a psychologist too. The truth is that many people, often evident in pro sports but even more prevalent in the general population, struggle with things that happened many years ago. It can sabotage self-esteem and lead to so many inappropriate ways to compensate including murder. Serious psychotherapy is needed and it is needed as soon as possible. This is just one why all 4 major sports should have a licensed clinical and sports psychologist present in the team headquarters throughout the year. This person should be equipped to deal with these more serious problems just as well as being able to provide mental coaching and lectures to the teams and players needing just a mild to modest performance boost for their upcoming game. Here is an article in AFP (Paris) about the effects of trauma for a skier.

I truly hope you have enjoyed this brief exploration into the world of sports psychology!

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