The Mythical Zone How to find yours for Peak Performance in your sport.

1. The Mythical ZoneHow to find yours for Peak Performance in your sport. Dr. Batool Kazim, MD Southborough Medical Center

2. The Mythical Zone 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.

3. Sports Psychiatry: Strategies for Life Balance & Peak Performance David R.McDuff, M.D W www.mdsports.net dmcduff52@gmail.com 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

4. Mental Aspects of the Game “Ninety percent of the game is half mental” Jim Wohlford

5. Sports Psychiatry 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

6. The Mythical Zone

9. Traits of High Achieving Athletes 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) D.M. MD

10. Emotional Competencies of High Achieving Athletes 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) Rick Aberman 2011; www.lennickaberman.com D.M. MD

11. Traits of High Achieving Athletes: Attention, Reactivity, Coping(ARC) 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

12. Sports Psychiatry: Scope of Practice Eight Core Skills 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

13. Performance Enhancement Injury Recovery Substance Misuse Mental Disorders Sleep & Energy Mental Preparation Team Consultation Cultural Competence Stress Control Fitness Injury Sports Skill Training Nutrition Energy Mental Profile Talent Experience Life Balance Family & Coaches D.M. MD

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15. Confidence Pyramid D.M. MD

16. Peak Performance“GAME TIPS” 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 D.M. MD

17. Mental Preparation Training D.M. MD Relaxation Training Affirmations & Positive Self Talk Imagery/Visualization Attention & Concentration Motivation & Persistence Goal Setting Precompetitive Routine Development Intensity Regulation Building Self-Confidence

18. Mental Preparation 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. D.M. MD

19. Mental Preparation Quality Preparation “Ready to Compete” Competitive Follow Thru “Get the Job Done” Accurate Self Evaluation “React to Results”Charles Maher, Ph.D.

20. Mental Preparation Training: Relaxation “Stress is anything that causes energy to be expended-recovery is anything that allows energy to be recaptured-balancing stress and recovery is fundamental to becoming a tough competitor” Example:teaching relaxation techniques to a lacrosse goalie with excessive tension & divided attention.

21. Mental Preparation Training:Imagery/Visualization “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 D.M. MD

22. Mental Preparation Training:Focus & Attention “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. D.M. MD

23. Mental Preparation:Affirmations &Positive Self Talk “The mental message will dictate the physical action and help determine its quality” Example: introducing positive self-talk professional golfer whose recent performance had been inconsistent D.M. MD

24. Mental Preparation: Goal Setting “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

25. Mental Preparation:Pre-competitive Routine “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. D.M. MD

26. Mental Preparation:Intensity Regulation “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 D.M. MD

27. Mental Preparation:Building Self-Confidence “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 D.M. MD

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29. Sports Psychiatry: Stress Control Tips Know the facts Recognize symptoms early Trigger relaxation Think positively/look calm Develop support Take regular breaks Improve time management Stay informed/ignore rumors D.M. MD

30. Sports Psychiatry: Energy Regulation 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 D.M. MD

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32. Sports Psychiatry:Substance Misuse Alcohol Marijuana & Other Cannabinoids Stimulants Anabolic Steroids & Other Muscle Mass Builders D.M. MD

33. Alcohol’s Negative Performance Effects Diuresis & dehydration Lateness & poor preparation Carbohydrate metabolism Hangover & reaction time Fights, falls, arrests Poor sleep quality Weight gain Unprotected sex-STDs D.M. MD

34. Anabolic Androgenic Steroids & Other Muscle Mass Builders Anabolic Steroids Peptide Hormones, Growth Factors Beta-Adrenergic Agonists Hormone Antagonists Diuretics & Masking Agents Case Study: AAS Use/Injury Case Study: AAS Addiction D.M. MD

35. Sports Psychiatry: Common & Less Serious Injuries Ankle Sprains Shin Splints Hamstring Strains Knee Strains Patellar Tendinitis & Tracking Problems Shoulder/Elbow Strains D.M. MD

36. Sports Psychiatry: Serious Injuries 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 D.M. MD

37. Sports Psychiatry: FourStages of Injury Recovery Acute Injury Rehabilitation Return to Play Departure from Sports D.M. MD

38. Sports Psychiatry:Common Mental Disorders Adjustment ADHD/Learning Anxiety Mood & Grief Sleep & Eating Impulse/Anger Control Pain & Somatoform Prescription Med Misuse D.M. MD

39. Sports Psychiatry:Treatment Strategies Support network Environmental change Perspective shift Brief therapy Sleep meds ADHD meds Anxiety meds Depressions meds Chronic Pain meds D.M. MD

40. Sports Psychiatry: Mental Disorders-Case Studies 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 D.M. MD

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42. Conclusion Quick review of mental skills: 5 Basic Skills: Relaxation Positive Self Talk Imagery/Visualization Focus/Attention Shifting Commitment/Persistence

43. Conclusion Complex Skills: Goal Setting Self-Evaluation Pre-Game Routine Intensity/Emotional Regulation Stress Control

44. This is just a start……