Advice from Dr Tim Rogers on how athletes can cope during the Coronavirus changes

I remember interviewing Dame Sarah Storey and asking her if she’d ever used Imagery. She said she uses it all the time; but whilst on the bike, visualising the events going on around her. Never lying on a dusty floor being talked at. She couldn’t see the value in that. And she is not alone. There are lots of mental skills we teach in sport psychology which work wonderfully. But they often require athletes to sit still, or sometimes even lie down, eyes closed, to learn them. Those techniques are not popular. When we introduce them eyes will roll and stomachs will sink. They want to be outside, in the gym, on equipment – using physical energy.

So, take these athletes, who want to be outside, to be active. Cancel all their races. Wipe out their goals. And, if they are not key workers, ask them to spend three, four or five weeks at home with only a short amount of time to exercise each day. Of course, they understand why and will do what they can to help. But it doesn’t make it easy.

So I asked Tim Rogers, one of the UK’s leading sports psychiatrists for ideas to help them cope.

TIm Rogers photo

What do you see as the biggest mental health challenges for athletes who have to isolate?

Athletes don’t escape the same issues as non-athletes.  In that sense, although social distancing prevents infections, social isolation can significantly increase the risk of other health problems, both physical and mental.  Blanket corona virus coverage on social media and through 24-hour news cycles mean we miss nothing, including hearing about everyone else’s worries.  Worry and anxiety become unhealthy when “what if” thoughts multiply and fill our thinking space with scary things all day.  This is tiring and hard to sustain.

Specifically, in sport, athletes and coaches across the board are struggling with the sudden unexpected loss of their goals, their events (major and minor) and sometimes even their livelihoods.  This was unthinkable only a few months ago.

Elite sports people can find these losses harder to cope with – emotionally – for a few reasons.  Sometimes they have had to invest such a large amount of themselves in their sport: who they are; what they value about life; how they spend their time; who they connect with in their social groups; that sudden changes like this can feel catastrophic.  Sometimes, they have set themselves extremely high expectations for what they want to achieve for their season.  Although there is nothing they could have done to control the onset of a pandemic, they nevertheless find themselves feeling guilty about not training, having a negative conversation with themselves or feeling that they have in some way let themselves down.

The combination of these things can place emotional wellbeing at risk, at a time when it’s important to look after yourself in all respects (both mental and physical).

How do you advise athletes to cope with a complete change of expectations for their season?

Take a moment to pause, step back and notice how you’re feeling during such an unprecedented time.  It’s OK not to be OK, whether or not it has anything to do with corona directly.  If at all you do need support: reach out in the normal way; don’t tell yourself you need to push on through, single handed or alone.

Putting yourself out there to compete in sport has to come with an awareness that things might not go as expected.  Sometimes this is the small stuff.  Right now, it’s something unprecedented.  Striving to achieve amazing things also means being flexible to adapt your goals when you have to.  Once you’ve done the best you can, remind yourself that this is enough.  It’s ok to readjust expectations.

Self-isolation need not mean social isolation.  Being connected to others in a supportive community does more than just help us feel better, it buffers the biological effects of stress hormones/pressure. It’s so easy to forget to reach out and connect but it’s still possible to experience the same sense of community and the same mental health benefit digitally.  One of the benefits of our era of tech is how readily we can now do this from our phones, tablets and computers.  A great example is the digital community in which I work: Big White Wall

Don’t just reach out to those closest to you, reach out to your wider group and be together with them online.  Giving support can be just as beneficial as receiving it.  When you do that, take a moment to notice how many non-sports areas of life you actually value really highly: family; relationships; friends; community; hobbies; spirituality; leisure; physical health; politics; caring for the environment; something else altogether.  Falling back onto the things that are important for each of us helps us through difficult moments and helps us manage unhelpful thoughts and feelings.

How do you advise athletes to cope with the increased levels of frustration and boredom?

A little worry or frustration can be useful if it nudges us to plan our way through difficult moments. Don’t revert to reading the news too much or ‘lurking’ on social media.  Set aside 10 minutes each day to get up to date with the latest developments, then that is enough until tomorrow.  If you are online for other reasons, think about what you post.  Share stories of coping, share care and support and share the things that have helped you.

Give yourself permission to focus on something else: a to-do list for today.  Any more worry about what might or might not happen in the future (or what cannot now be achieved) is not helpful for you or for others.

Routines are helpful.  I read a great thread about life on a submarine recently.  Submariners cope by routine: from making sure they rise early, wash and dress; all the way through the other aspects of the day.

There are lots of ways to help you get back into the moment right now, whether free mindfulness resources online, or anything else that pulls your focus into the present.  This enables us to cope and to problem solve.  Is there something you can take the opportunity to get done?

Your full training plan might not be possible for now but movement is still medicine.  Set yourself a goal to find the best ways of staying active and fit for your own situation.  For most people (except in situations of exercise dependence or disordered eating) any activity – however little – helps your mental health. Try to find some physical activity that is fun and enjoyable for each day.

Tim’s biography:

Tim is a medical doctor and consultant sports psychiatrist.  For many years, Tim has worked across the spectrum of wellbeing and performance with both individuals and teams in elite football, in the Olympic and Paralympic Systems, elite rugby, cricket, tennis, horse racing and many other areas.  He is one of a very small number of experts to have undertaken dual postgraduate training in applied sport and exercise psychology.  He understands the culture of professional sport and the unique pressures that come with this. Tim is also clinical director at the Big White Wall, an anonymous online mental health service with projects across sport, both in the UK and internationally.

Managing emotion through tough times

Emotion wheelJust a short post as I am trying to fit as much writing in before the schools and nurseries close and I have to work whilst entertaining an energetic and adventurous 3 year old. If any magazine articles get published in the next few months with random Peppa Pig phrases in them you’ll know why!

But as everything is up in the air I have really been thinking about how athletes cope. They are often used to uncertainty and ‘controlling the controllables’ but in this COVID-19 situation what is controllable? If you are someone who likes certainty, and things to grab hold of and dates to work towards and plans and goals then the next few months might be really tough.

Discipline is needed in sport but, when you get really used to following a disciplined approach, sharing your emotions can be hard. We may believe that to be taken seriously we just need to ‘suck it up’. but we can only do that for so long before it harms our wellbeing and then it can then be very difficult to tell people how we feel, what worries us, when we are scared or when we are angry.

Something I have recently started using with the younger athletes I work with is an emotion wheel and I think it could benefit all of us, whatever our age. There are thousands of emotions but I would guess that from the top of our head most of us could only name 10-20. An emotion wheel names 130 of them. If we are soon to be confined to our flats and houses for weeks on end then having good quality, open communication will become vital. Without a way to escape and get some space we may get resentful or hostile. Being able to chat up front about this, looking through the wheel each day and having a chat about which is the word you are currently feeling can help deal with some of those issues and open the door to better communication. Better communication and seeing things from each others’ perspectives will make a much less stressful living environment.

The emotion wheel I usually direct people towards has been created by Geoffrey Roberts and is downloadable here: https://imgur.com/a/CkxQC

Would love to hear if anyone tries it and how you get on.

Racing interrupted…

A virus we hadn’t even heard of when we entered many of this season’s races and competitions may now cancel many of them. We might feel upset and stressed because everything we have been working towards feels uncertain and also feel guilty for feeling that way as we know people are already poorly and it is important that we don’t contribute in any way to the spread of this disease.

I was both upset and guilty when I heard a rumour Paris Marathon might be cancelled. My motivation went out the window. My race the next day was lacklustre and my attitude sucked. Once it was officially postponed it was easier. I had stability and confirmation and I could plan around it. With a little reflection I could see there are far more important things in the world and that I had already learnt so much on my marathon training journey to date that nothing was wasted.

Part of the strategy when we get a setback is to allow space to sulk. We suggest about 48 hours is fine to throw all your toys out of the pram, to stomp your feet and be a grump. But then it is time for action. The five steps I follow with athletes in this position are:

  1. Sulk
  2. Research
  3. Adapt plan
  4. Find the positives
  5. Get back on track.

I think this can work really well for a specific setback – such as just one race being cancelled for say logistical or weather reasons. But as we are looking at so many competitions having to cancel or postpone maybe a wider, more strategic mental approach is required. I asked on Twitter how athletes are approaching these challenges and how they are maintaining motivation. The awesome answers that came back seem to fit into five main categories.

Reframing

One of the strongest responses, and something we often practice in sport psychology is to reframe a situation. I loved the response from Gill Bland (super speedy runner and writes for Fast Running) that all challenges can be seen as training opportunities. We can use tough times to see that and do things differently. We can also use this period to get some perspective. It is just a competition we are missing and we are incredibly lucky we are fit and healthy enough to be able to compete in the first place.

IMG_9446

Unplanned, but beneficial improvement space

Many amateur athletes are squeezing their sport into already full lives; family to care for, money to earn, friends to socialise with. We schedule everything to within an inch. An unexpected and unplanned interruption can be a blessing in disguise as we get some space to reflect and then focus on areas which usually get forgotten. More yoga, strength and conditioning, specific skill weaknesses can all become part of our maintenance programme.IMG_9443

Helps you become more flexible

To do well in sport we need to be able to focus on just those things we can control, and minimise our thoughts around those we can’t. We should be doing this for any competition which matters to us. Get a sheet of paper, divide it vertically into three columns. On the left hand side write all the things you can control about the situation you are in, on the right, all the things you can’t, and the middle is the things you might be able to influence. Then focus 90% of your mental energy and preparation on the left hand column and just roll with whatever happens on the other side of the paper. These interruptions offer a great practice opportunity.

IMG_9447

Helps you uncover whether you have been extrinsically or intrinsically motivated.

I loved the response from Alice Hector (ex Pro triathlete and generally a super supporter of anyone doing long distance stuff) which was that cancellations offer us a chance to reflect on why we are competing. Do we do our sport because we love it (intrinsic motivation) or because we have goals to reach (extrinsic motivation). When the goals disappear we can clearly see if we are in our sport because of the feeling of doing it, the joy it brings us, the way it makes us feel. If we are not maybe it isn’t the right sport for us, maybe there is something out there which would give us genuine joy even when there is nothing external in it for us? So perhaps these interruptions can help you either see what you do love about your sport (and that we just really benefit from the process) – or help you to hunt out something you might love instead.

IMG_9448

And if we are intrinsically motivated, as Kate Carter (fabulous runner and running journalist) reflects, then you get a chance to consider exactly what it is you love about your sport so you feel more motivated to do more of it.

Kate tweet

Practice without pressure

Finally, while sport is brilliant – it is fabulous for physical, mental and cognitive health and wellbeing – and we should treasure what it gives us – it can also create pressure. Once we start to take it seriously, instead of relieving some of the strains and stresses of life, it can add to them. Races or competitions being cancelled can give us an opportunity to get back to the fun side, the bits that helped us fall in love with it in the first place.

IMG_9450

5 weeks to go…magic mantra

Big Half medalSo the big focus for this past week was The Big Half. A fab half marathon which starts near the Tower of London, heads under the Rotherhithe tunnel all the way to Canary Wharf, back to Tower Bridge and along to Greenwich. You finish in front of the Cutty Sark. We got a stunning day and the organisation was great but I forgot to tell my body all this. I’ve had a cold which had started to go into my chest and while I thought I would be fine I know realise my asthma inhaler wasn’t working and so I felt like I only had the top third of my lungs working. I was light headed and wobbly and just had nothing. Knowing my little girl would be waiting with a high five was enough to get me to Tower Bridge at seven miles but by eight miles I was really low. I had a little sit down on the curb. Sulked. And had a chat with myself. This could either be a DNF and I’d feel rubbish for ages or it could be an opportunity to prove I was mentally tougher than I think I am. I repeatedly realised I would have to tell my little one that mummy found it too hard and quit. That was enough of a kick to stand up and go again. I also realised having to write a blog post about DNFing was going to seriously dent my ego. I kept repeating my mantra (more below) and just jogged it though. Finished in 1:55. Probably a personal worst time for the distance but proud I made it. Next time though I won’t race when struggling with my asthma. It is not big or clever!

Pace chartI know an additional issue was that the night before the race the French government banned all gatherings of over 5000 people. This meant the Paris Half (supposed to be starting 12 hours later) got cancelled and now we don’t know if Paris Marathon will go ahead. Frantic searching for another marathon in April which still had places led me to the Bungay Black Dog marathon. Not what I was hoping for in a big city marathon but all reports suggest really nice and friendly and interesting course. And it is near my parents so I might get some extra support. But because that big goal I was working towards got all fuzzy I definitely lost excitement for The Big Half. When we don’t have a strong ‘and tummy turning with excitement’ goal it is really hard to stay motivated.

Anyway – as the Big Half went so badly I had a chance to practice some mental skills. The main one being some mental toughness not to DNF. I used to DNF a lot and I really disliked it about myself. With my little girl coming to watch lots of races I don’t want her to see things getting tough and me quitting. I built this into my mantra.

A mantra is a short word or phrase we use to focus our mind to either maintain our motivation, keep us focused on our goal or to remind ourselves of something that will help us run better.

It works best when it is really personal so it resonates deeply. When we have a dark moment (or dark five miles in my race) repeating our motivational mantra over and over again will help us stay focused and working hard. It is really useful for athletes in sports (just like runners) who have a lot of time to think and to talk themselves out of putting in the required effort, especially as research has shown using a mantra can help increase perseverance.

Good times to use your mantra are on the start line of a race if feeling nervous, mid race if you realise you are not doing so well or when you feel your effort levels dropping.

The mantra you choose doesn’t need to be set in stone. You can choose one which really works for you in every competition or mix and match depending on the race ahead. The one which works best though will make you slightly emotional, giving you a bit of a lump in your throat thinking it. To be most effective it needs to be positive, purposeful, memorable and short.

My mantra revolves around my daughter Hattie. At her christening we asked our friends and family to help us develop and maintain three characteristics in her; happiness, kindness and bravery. And as we know role modelling is so important for what children internalise it means we as parents need to show our happiness, do kind acts and be brave when we really don’t want to be. So I use this in my mantra; Make Hattie Proud.

Mantra band

Once you’ve decided on your race mantra, until you get into the habit of repeating, it you can write it on your hand or use a wrist band – we have some in our Sporting Brain Box to help people practice. A really nice touch if you have a mantra that really works for you is to write it on stickers on your gels. Gives you a little reminder every time you take out a gel in your race.

Anyway, on Sunday ‘make Hattie proud’ took me through five miles of misery all the way to Greenwich. Her first question after a high five at the finish was ‘Did you win mummy?’ I answered that ‘anyone who finishes is a winner’. And I meant it. And I have my magical mantra to thank for making me one (in her eyes anyway!).