Dr. John P. Sullivan is a Sport Scientist and Clinical Sport Psychologist. He has more than 20 years of clinical and scholarly experience, and he has worked with the same team in the National Football League (NFL) for the past 16 years, coordinating clinical care and sport science.
Freelap USA: Clinical mental health has focused mainly on symptoms stemming from concussions in sport, but depression and other challenges of the human condition affect athletes just as much as the rest of the population. Can you go into the reason that the profession of psychology should move towards a compass model instead of being typically on the bottom of many organizational totem poles? The brain is the top organ, yet it is often left until the end of any investigation into complex problems.
John Sullivan: What I think you are asking is what the barriers are for sport psychology to be optimally and fully integrated into sport. First, I would say that this question certainly has cultural context for each sport organization, so there is not just one model for all organizations. That being said, sport psychology and the brain sciences continue to take a one-down position in sport which is—in part—due to a lack of education about the brain and a few lingering myths in sport.
In general, we tend not to learn much about the brain in our education systems. In fact, unless someone has specialized in the study of the brain, there would be very little working knowledge about its impact on our daily lives. What is even more concerning is our lack of knowledge about brain health as the driver of our quality of life. That is one of the many reasons why Chris Parker and I have written the book, The Brain Always Wins (release date October 2016), to assist in closing this gap in knowledge.
To be clear, when I use the term “brain,” I am not speaking of “the mind,” as they are very different scientifically. That is, the brain is our organ that drives eleven other sub-systems, and the mind is our consciousness, which science (to date) does not fully understand.
The first myth in sport that often acts as a barrier is the belief that performance and health are separate concepts or processes. The evidence is clear that our ability to perform in any context is based upon our health, and this starts with the brain.
The second myth is that “mental toughness” and “grit” are sufficient, or even protective, barriers against the actuality that sport is trauma. The actual evidence about mental toughness and grit is that they have little to no scientific validity. The importance of context is ignored (most significantly, psychophysiology) and, when used as blunt tools or terms (which they often are, such as an athlete/individual being blamed for not being “tough” or “gritty” enough), we are ignoring the point that performance is comprised of many factors.
Mental toughness and grit have the illusion of validity, and people have belief bias concerning the terms because they seem to make sense. However, in actuality, they are overstated concepts that lack validity. The scientific truth is that the brain is wired to survive—so performance and survival are not about toughness or grit, and instead are the result of training, which allows for adaption, and eventual evolution.’Mental toughness’ has no scientific validity. Instead, performance depends on training. Click To Tweet
The third myth that shifts us away from including the brain in sport is that we desperately want to believe that sport and high performance are achieved via a simple formula, consisting of engaging in repetitions or perhaps having the right genes. However, the reality is that high performance is a complex multifactorial process that includes the brain every step of the way.
Although I think that psychology as a field can do more to advocate for incorporating brain health, it is also the case in sport that we critically need to work with others in sports medicine and sport science in a transdisciplinary fashion. This would require genuine collaboration with licensed and properly trained professionals, including licensed sport psychologists who have completed proper training in sport. It is also key that sport organizations advocate for these sorts of positions as a priority.
Freelap USA: Many sports technology companies try to ride the excitement of pro sports for bigger markets because venture capital (VC) money wants a big return on investment. This has left coaches feeling used or having management invest in the wrong technology because science—specifically biology—was out of the equation. Can you share how teams can invest into sports technology wisely, as nothing is perfect but it must be valid and accurate/precise enough to be effective?
John Sullivan: Since sport technology is a free market system, it can be difficult to differentiate what is actually “science” versus “marketing.” Furthermore, with the technology we have available to us at this time, we can measure almost anything. So, one way to answer your question is to provide critical questions that should always be considered when utilizing sport technology:
- Is there any chance of harm?
- Why and what are we using the technology to assess/measure?
- What are the ultimate goals?
- Who will be handling the data? (e.g., How are you protecting the data and who has the competency to interpret it?)
- How will the data be used, as well as what validation research has been conducted on the technology itself (e.g., construct, signal, laboratory, and ecological validation)?
In the September edition of the International Journal of Sports Physiology and Performance, you can find a commentary on this topic. “Wearable Technology for Athletes: Information Overload and Pseudoscience” was a project that I had the pleasure of working on with Dr. Shona Halson from the Australian Institute of Sport, and Dr. Jonathan Peake, Lecturer in the Faculty of Health, Queensland University of Technology.
Freelap USA: Injuries and burnout are real at lower levels and continue up to the pro levels. What do you feel is a great resource for coaches to help with the retirement of elites and even very successful athletes at lower levels? Giving up a sport forcefully because of age or injury is rough, and this process is often neglected with sports psychology because athletes usually come for help with cliché problems like “choking” and other similar things. What are good resources for this?
John Sullivan: Retirement from sport—either by choice or otherwise—comes with inherent challenges and health concerns. There has been a great deal of psychological research conducted in this area (e.g., 95,000 scientific articles on retirement from sport, and 2,090,000 scientific articles on psychological factors related to injuries (1)). A critical issue, considered another way, is the extent of involvement and support within organized sport with the goal of helping athletes transition from sport (e.g., by providing education and career planning), as well as having a focus on the integration of well-established psychological science in rehabilitation from injuries. Although some transition and planning programs exist, they are often not based on best practices or even sufficiently funded. A good starting place for learning more about this is the International Society for Sport Psychology’s (ISSP) “Position Stand: Career Development and Transitions of Athletes” (2).
We can all be doing a better job for this effort by asking for such programs within our organizations, including a team of properly trained professionals who can support and facilitate care. Furthermore, sport coaches and strength and conditioning practitioners can engage with continuing education to increase their awareness and competency regarding identification of issues, and thus know when to refer to licensed psychologists if/when brain health issues arise.
Another resource comes from the National Athletic Trainers’ Association (NATA), which has led a multi-association call for increased competency (3,4). They will soon also be offering further continuing education focused on brain/mental health.
Properly executed sports medicine and sport science require collaborative efforts, so increasing our working knowledge of other areas will allow us to increase the health of those we serve. Noting that health is the foundation of high performance ensures that talent is protected and allowed to develop.
Freelap USA: Sleep is a very popular topic of discussion, but few teams actually assess sleep beyond subjective questionnaires. Could you show how teams need to slow down and audit the process instead of skipping over things and giving superficial advice? Many athletes need more than casual suggestions like setting their alarms differently, darkening their rooms, or changing mattresses. Sleep is often disturbed by overreaching issues or personal problems like financial and family stressors, and athletes are human. Could you share anything you think teams are missing the boat on?
John Sullivan: There is no single panacea, but I would say that the lack of proper assessment, interpretation of data, and tailored, systematic programming with athletes are all keys with regard to sleep.
From my observations across a range of populations and cultural contexts—e.g., youth to elite sport, and individuals on different continents—I think that sleep is often misunderstood and underestimated. What I see with regard to sleep being misunderstood has to do with proper human intelligence/expertise, programming, and tools. The work needed to educate individuals about sleep is varied and complex, and this challenge is typically intensified when dealing with athletes who have a tremendous amount of human variation and demands on their systems. What I have observed with regard to programming is that sleep is either being ignored or there is no systematic approach to enhancing sleep behaviors. The belief is often that providing information alone will lead to the desired changes. Although providing information is an element of behavior change, it is far from sufficient to facilitate lasting change.
Importantly, tools that are used to evaluate sleep have often not been properly evaluated for their reliability and validity, so they offer little to no value. In some cases, where the tools/assessments are scientifically appropriate, the recipients of the data are not trained and therefore unable to translate the data accurately, so no value is added even still. Sleep is any organization’s No. 1 performance enhancer because of its protective factors for the brain and, ultimately, its impact on optimal performance and brain health.While sleep is the biggest performance enhancer, not enough is being done to fully understand it. Click To Tweet
Freelap USA: Fatigue is always seen as a neuromuscular factor, which oversimplifies the situation into a weak muscle or lack of specific exercises. While strength and conditioning is clearly a prime variable, general fatigue from meetings, emotional strain, and countless human components are also factors. Can you go into some fresh ideas that coaches can tap into regarding fatigue without getting too esoteric? Right now, we are seeing a lot of pseudoscience creating confusion here. It would be great to know how we can manage fatigue better without just doing the known physiological monitoring.
John Sullivan: A helpful way to think about fatigue is to understand that our brain is very focused on energy management because it stores very little of its own energy. Therefore, if we do not establish habits that provide energy balance, our central nervous system (CNS) reacts by shifting into varying degrees of survival. This, in turn, reduces essential adaptation throughout all of our systems and sub-systems (e.g., enteric nervous, cardiac, endocrine, skeletal, and neuromuscular systems).
This domino effect emphasizes the crucial need for systematic assessment of a performer’s habits through examination of strengths and areas for development—the outcome of which should be a developed plan that increases readiness and resiliency. Everything we do loads the brain, thus impacting our energy balance: Therefore, an ecological assessment (e.g., in situ review of daily activities) is key to assisting a performer and protecting their ability to recover and, in turn, increasing their readiness, resiliency, adaption, and evolution.
Similar to the points raised above regarding implementation of tangible plans related to sport technology, injury, and sleep, there is no single answer or “6:00 abs” response to share. Instead, it is critical for athlete success and care that we take a comprehensive and collaborative approach to proper assessment, interpretation of data, and tailored, systematic programming based upon sound scientific principles.
- Google Scholar search conducted 9/8/2016
- Stambulova, N., Alfermann, D., Statler, T. and Côté, J. “ISSP Position Stand: Career Development and Transitions of Athletes.” International Society for Sport Psychology (2009).
- Neal, T.L., et al. “Inter-Association Recommendations for Developing a Plan to Recognize and Refer Student-Athletes With Psychological Concerns at the Collegiate Level: An Executive Summary of a Consensus Statement.” Journal of Athletic Training. 48(5) (2009). doi: 10.4085/1062-6050-48.4.13.
- Neal, T.L., et al. “Interassociation Recommendations for Developing a Plan to Recognize and Refer Student-Athletes With Psychological Concerns at the Secondary School Level: A Consensus Statement.” Journal of Athletic Training. 50(3) (2015). doi: 10.4085/1062-6050-50.3.03.