The Mythical Zone
How to find yours for Peak
Performance in your sport.
Dr. Batool Kazim, MD
Southborough Medical Center
The Mythical Zone
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The Zone is a state of being when you have the
ability to perform at your highest level when it
matters.
It can also be described as being your best friend
and not your worst enemy at crucial times
whether in sports or other areas of your life,
esp. under pressure.
Sports Psychiatry:
Strategies for Life
Balance & Peak
David R.McDuff, M.D
Performance
W
www.mdsports.net
[email protected]
McDuff DR, Morse E, White R: Professional and Collegiate Team Assistance Programs: Services and Utilization in Clinics in
Sports Medicine. Edited by Toffler I and Morse E, Elsevier Inc, 4:943-958, 2005.
McDuff DR, Baron D. Substance Use in Athletics: A Sports Psychiatry Perspective in Clinics in Sports Medicine. Edited by
Toffler I & Morse E, Elsevier Inc. 4:885-897, 2005.
McDuff DR. Sports Psychiatry: Strategies for Life Balance & Peak Performance, American Psychiatric Pub, Wash DC, Apr 2012
Mental Aspects
of the Game
“Ninety percent of
the game is half
mental”
Jim Wohlford
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Learning Objectives
Identify the traits of high achieving athletes
Describe the scope of practice of applied sports
psychiatry & psychology
Utilize a five-step model of peak performance
and life balance
Implement stress control & sleep-energy management
routines
Identify common athletic substance problems & organize
brief interventions
Utilize a four-step model of injury recovery
Diagnose and treat the common mental disorders
Improve clinical skills working with youth & women’s
sports and with foreign-born athletes
Increase consultative skills for working with teams,
coaches, and medical staffs
D.M. MD
Sports
Psychiatry
The Mythical Zone
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Believe It!
Balances Sports & other Life Areas
Encourages & Supports Teammates
Lets Go of Mistakes/Defeats Easily
Image about Self & Abilities is Positive
Enjoys Training & Competition
Visualizes Success
Evaluates Performance & Outcome
Intensity (Maintains Focus &
Aggression)
Talk (Uses Positive Affirmations)
Traits of High
Achieving
Athletes
D.M. MD
Emotional Control (manage feelings & impulses
despite competitive pressure)
Self-awareness (maintain perspective between ideal
& actual play)
Internal motivation (passion for practice, play, and
getting better)
Empathy (compassion and support of others)
Socialization (effective communication and
bonding)
Emotional Competencies
of High Achieving
Athletes
D.M. MD
Rick Aberman 2011; www.lennickaberman.com
Traits of High Achieving Athletes:
Attention, Reactivity, Coping(ARC)
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Automatic Attention-High (Zone Trait)
“Intense Effortless Focus”
Automatic Reactivity-Low (Zone Buster)
“Excessive Negative Thinking &
Physiological Arousal”
Automatic Coping-High (Zone Facilitator)
“Inhibition of R-L Brain Transfer of Negative
Emotions”
Carlstedt RA (2007) Integrative Evidence-Based Athletic Assessment &
Intervention: A Field Tested & Validated Protocol. J Amer Board Sport
Psychology. 1:1-30.
D.M. MD
Eight Core Skills
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Mental Preparation-Mental Skills
Stress Recognition & Control
Sleep & Energy Regulation
Substance Prevention/Control
Injury Recovery & Pain Control
Mental Disorder Management
Developmental & Cultural Competence
Working With Teams & Medical Staffs
D.M. MD
Sports Psychiatry:
Scope of Practice
Injury Recovery
Substance Misuse
Mental Disorders
Sleep & Energy
Fitness
Nutrition
Mental Preparation
Team Consultation
Cultural Competence
Stress Control
Injury
Energy
Sports Skill Training
Mental Profile
Talent Experience Life Balance Family & Coaches
Performance Enhancement
D.M. MD
D.M. MD
Confidence Pyramid
Competitive Self-Confidence
Emotional Control/Intensity Regulation
Pre-Competition Routine
Goal Setting and Self Evaluation
Breathing
& Relaxation
Talent
and Experience
D.M. MD
Positive
Self-Talk
Focus
Visualization Motivation
& Attention & Imagery & Persistence
Fitness, Nutrition
and Injury Prevention
Life Balance
and Stress Control
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Growth:
“progress not perfection”
Attention: “no pressure in the present”
Motivation: “you get what you create”
Emotion:
“pace, don’t race”
Thought:
“actions follow thoughts”
Image:
“what you see is what you get”
Preparation: “practice aids performance”
Self-Confidence: “perform to a + self-image
Peak Performance
“GAME TIPS”
D.M. MD
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Relaxation Training
Affirmations & Positive Self Talk
Imagery/Visualization
Attention & Concentration
Motivation & Persistence
Goal Setting
Precompetitive Routine Development
Intensity Regulation
Building Self-Confidence
Mental Preparation
Training
D.M. MD
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Primary Goal: to develop a set of
mental & behavioral skills that
allow athletes to consistently
perform at the upper end of his/her
talent range under a variety of
competitive circumstances.
Mental Preparation
D.M. MD
Quality Preparation
“Ready to Compete”
 Competitive Follow Thru
“Get the Job Done”
 Accurate Self Evaluation
“React to Results” Charles Maher, Ph.D.
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Mental Preparation
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“Stress is anything that causes energy
to be expended-recovery is anything
that allows energy to be recapturedbalancing stress and recovery is
fundamental to becoming a tough
competitor”
Example: teaching relaxation
techniques to a lacrosse goalie with
excessive tension & divided attention.
Mental Preparation Training:
Relaxation
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“If the scene that you are perceiving
has a high level of personal meaning
for you, then you will tend to imprint
it more intensively & later you will be
able to recall it more clearly and
completely”
Example: low confidence in a ice
hockey goalie
Mental Preparation Training:
Imagery/Visualization
D.M. MD
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“Focus on the positive not the
negative, the present not the past,
the process not the result, the target
not an image of the self”
Example: divided attention in a
platform diver and level 8 gymnast.
Mental Preparation Training:
Focus & Attention
D.M. MD
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“The mental message will dictate the
physical action and help determine
its quality”
Example: introducing positive selftalk professional golfer whose recent
performance had been inconsistent
Mental Preparation:
Affirmations &
Positive Self Talk
D.M. MD
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“Goals set without commitment are
wasted-goals serve you, expectations
serve others”
Example: reducing expectations and
establishing realistic practice and game
goals in a high school soccer player
D.M. MD
Mental Preparation:
Goal Setting
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“The typical athlete goes all-out during
competition. That’s easy. The
exceptional athlete goes all-out to
prepare for competition. That’s
difficult.
Example: developing a pre-practice
routine in a mistake-prone quarterback
and a game routine in distractible
starting pitcher.
Mental Preparation:
Pre-competitive Routine
D.M. MD
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“The difference between the clutch
player & the choke player is that the
clutch player gets his state of
relaxation and intensity level under
control before the action”
Example: controlling competitive
aggression and mistakes in a
defensive back
Mental Preparation:
Intensity Regulation
D.M. MD
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“The greatest obstacle on the road to
confidence is fear-the successes we
have achieved in the past are more real
than the failures we fear in the future”
Example: developing consistency
through visualization, positive self-talk
and body focus in a special teams
football player
Mental Preparation:
Building
Self-Confidence
D.M. MD
D.M. MD
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Know the facts
Recognize symptoms early
Trigger relaxation
Think positively/look calm
Develop support
Take regular breaks
Improve time management
Stay informed/ignore rumors
Sports Psychiatry:
Stress Control Tips
D.M. MD
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Three energy systems (phosphate,
anerobic glycolysis, aerobic
metabolism)
Food, fluid, electrolyte resupply
Wakefulness & alertness, acute fatigue
Sleeping, sleep debt, jet lag & naps
Chronic fatigue, & burnout
Stimulants & stimulating activities
Sports Psychiatry:
Energy Regulation
D.M. MD
D.M. MD
Alcohol
 Marijuana & Other
Cannabinoids
 Stimulants
 Anabolic Steroids &
Other Muscle Mass
Builders
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Sports Psychiatry:
Substance Misuse
D.M. MD
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Diuresis & dehydration
Lateness & poor preparation
Carbohydrate metabolism
Hangover & reaction time
Fights, falls, arrests
Poor sleep quality
Weight gain
Unprotected sex-STDs
D.M. MD
Alcohol’s Negative
Performance Effects
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Anabolic Steroids
Peptide Hormones, Growth Factors
Beta-Adrenergic Agonists
Hormone Antagonists
Diuretics & Masking Agents
Case Study: AAS Use/Injury
Case Study: AAS Addiction
Anabolic Androgenic
Steroids & Other
Muscle Mass Builders
D.M. MD
Ankle Sprains
 Shin Splints
 Hamstring Strains
 Knee Strains
 Patellar Tendinitis &
Tracking Problems
 Shoulder/Elbow Strains
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Sports Psychiatry: Common
& Less Serious Injuries
D.M. MD
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Brain contusion & concussion
Cervical spine/cord & paralysis
Eye & Dental Injuries
Fractures
Knee disruptions
Dehydration & heat injury
Shoulder & elbow dislocations
Lumbar spine injury & pain
Muscle, tendon & ligament tears
Sports Psychiatry: Serious Injuries
D.M. MD
Acute Injury
 Rehabilitation
 Return to Play
 Departure from
Sports
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Sports Psychiatry: Four
Stages of Injury Recovery
D.M. MD
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Adjustment
ADHD/Learning
Anxiety
Mood & Grief
Sleep & Eating
Impulse/Anger Control
Pain & Somatoform
Prescription Med Misuse
Sports Psychiatry:
Common Mental Disorders
D.M. MD
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Support network
Environmental change
Perspective shift
Brief therapy
Sleep meds
ADHD meds
Anxiety meds
Depressions meds
Chronic Pain meds
Sports Psychiatry:
Treatment Strategies
D.M. MD
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Adjustment-I don’t play enough
Anxiety-I get so nervous I vomit
Sleep-I think too much at bedtime
Anger Control-I’m always frustrated
ADHD-I knew I wasn’t learning
Eating-I binged to relieve stress
Grief-we knew he was taking them
Depression-the divorce got to me
Pain Disorder-It’s just like other hip
Sports Psychiatry: Mental
Disorders-Case
Studies
D.M. MD
D.M. MD
Conclusion
Quick review of mental skills:
5 Basic Skills:
Relaxation
Positive Self Talk
Imagery/Visualization
Focus/Attention Shifting
Commitment/Persistence
Conclusion
Complex Skills:
Goal Setting
Self-Evaluation
Pre-Game Routine
Intensity/Emotional Regulation
Stress Control
This is just a start……