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New era of protecting athletes’ mental health

Simone Biles is reducing stigma of mental health struggles for all women

CHICAGO --- Olympic athletes are changing the culture of elite sports so they can be seen as human and vulnerable to mental health struggles, just like anyone else.

“The public may be shocked that athletes like Simone Biles, Naomi Osaka, Michael Phelps and others can be champions and still have a mental health condition and need help,” said Courtney Albinson, director of Sport Psychology Services at Northwestern University Counseling and Psychological Services. “But it isn’t a reflection of someone’s inability to manage stress or pressure or failure to power through difficulties. Mental disorders affect the way we think, feel, behave and function in our daily lives. They affect our brains. That is now being increasingly understood and respected.” 

Northwestern University experts discuss the culture shifts being led by courageous athletes as well as the power of anxiety on athletes’ and anyone’s ability to perform at their peak. 

The experts

  • Courtney Albinson is director of Sport Psychology Services at Northwestern University Counseling and Psychological Services. 
  • Stewart Shankman is chief of psychology at Northwestern University Feinberg School of Medicine. 
  • Inger Burnett-Zeigler is an associate professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine and author of the new book “Nobody Knows the Trouble I’ve Seen: The Emotional Lives of Black Women.”  

How is the sports culture changing around mental health struggles of elite athletes? 

Courtney Albinson: “What is different about this time is a culture shift where elite athletes are able to talk more about what they are going through and be seen as humans. They are doing incredibly difficult and amazing things in their performances. At the end of the day, they are humans like everyone else. More and more athletes are being vulnerable and sharing that they are struggling with something. Resources are being put in place to help athletes and the big change we’ve seen this summer is a willingness to say, ‘I’m needing to step away.’ 

“It’s an act of courage for someone who has trained for so long to perform and compete to be able to say, ‘I need to step back and take care of myself because my health and well-being is more important than any performance.  

“In the past year, the United States Olympic and Paralympic Committee hired their first director of mental health services to provide a coordinated response for implementing mental health services and programs for Olympic athletes across the nation. This includes putting together a network of mental health providers who are qualified to work with Olympic athletes throughout the U.S.”

Stewart Shankman: “Someone like Simone Biles 'coming out' about her mental health problems will go a long way with reducing mental health stigma, not only among women athletes, but anybody. People will think that if a superhero like Simone is having problems like this, then it’s OK that I’m also struggling."

How does anxiety affect athletes’ ability to perform? 

Albinson: “Anxiety affects us mentally and physically. Athletes who are testing their bodies at this level and putting their bodies through so much stress and strain, when you put anxiety on top of that, their movements can be affected. When we are worried about things, we are not focused on the task at hand. We are not mentally fully present in the moment. Being focused and engaged in the moment is profoundly critical in gymnastics. Simone Biles and other gymnasts are doing things that are very dangerous. 

“It’s really important for athletes to learn skills to help direct their attention in the present moment. We use a lot of mindfulness and mediation training. It helps them develop skills to work with thoughts that may be coming up during performance that may be a distraction. For example, they might think, ‘I’m in first place, I have one event left, I hope I don’t mess up!’ or they might replay a mistake they made over in their head or look over at their coach to see if they are upset. It is helpful to teach athletes how to notice these thoughts and gently redirect their attention back to the task.” 

Shankman: "Anxiety has a cognitive component — negative thoughts or mind racing — and a physiological component — things like muscle tension and heart racing. Either or both of those components could interfere with your athletic performance, even with things you done 1,000 times before.  

“Athletes talk a lot of times about being in the zone when they are out of their head. If you have no audiences to give you emotional energy, no family in the stands to support you, and the threat of COVID hanging over your head, it makes it hard to get in that zone. Not only may you not perform as well, but you also run the risk of your mistakes leading to physical injury — particularly in a sport like gymnastics." 

Inger Burnett-Zeigler: “The pressure to perform and meet the expectations of others can lead to significant stress and anxiety that can be debilitating and ultimately impact performance. What's more is that Simone Biles has a history of childhood trauma and sexual abuse, which increases her vulnerability to mental health challenges, such as anxiety and depression. Simone Biles’ acknowledgement of her mental health needs and willingness to take the necessary steps to take care of herself, despite what others may think, is a radical example of self-care.

“As a world-class athlete, Simone Biles certainly is under intense pressure to perform as she doesn't want to let herself, her team and her country down. As a Black woman, of whom there are so few in the elite sport of gymnastics, she likely faces the added pressure to not let the Black community down. She knows she is a representative of the collective greatness of Black women, our ability to overcome adversity and that so many are looking up to her.”