The Mythical Zone

How to find yours for Peak

Performance in your sport.

Dr. Batool Kazim, MD
Southborough Medical Center
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.

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
Mental Aspects
of the Game
Ninety percent of
the game is half
mental

Jim Wohlford
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 & womens
sports and with foreign-born athletes
Increase consultative skills for working with teams,
coaches, and medical staffs
D.M. MD
The Mythical Zone
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
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
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


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
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



D.M. MD

Breathing Positive Focus Visualization Motivation
& Relaxation Self-Talk & Attention & Imagery & Persistence

Goal Setting and Self Evaluation

Pre-Competition Routine

Emotional Control/Intensity Regulation

Competitive Self-Confidence

Talent Fitness, Nutrition Life Balance
and Experience and Injury Prevention and Stress Control
Confidence Pyramid
D.M. MD
Peak Performance
GAME TIPS
Growth: progress not perfection
Attention: no pressure in the present
Motivation: you get what you create
Emotion: pace, dont 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
Mental Preparation
Training
Relaxation Training
Affirmations & Positive Self Talk
Imagery/Visualization
Attention & Concentration
Motivation & Persistence
Goal Setting
Precompetitive Routine Development
Intensity Regulation
Building Self-Confidence

D.M. MD

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

Mental Preparation

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

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.
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
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
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
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
Mental Preparation:
Pre-competitive Routine
The typical athlete goes all-out during
competition. Thats easy. The
exceptional athlete goes all-out to
prepare for competition. Thats
difficult.
Example: developing a pre-practice
routine in a mistake-prone quarterback
and a game routine in distractible
starting pitcher.
D.M. MD
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
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



D.M. MD
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
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


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



D.M. MD

Alcohols 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
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
Sports Psychiatry: Common
& Less Serious Injuries
Ankle Sprains
Shin Splints
Hamstring Strains
Knee Strains
Patellar Tendinitis &
Tracking Problems
Shoulder/Elbow Strains



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

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

D.M. MD
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
Sports Psychiatry: Mental
Disorders-Case Studies
Adjustment-I dont play enough
Anxiety-I get so nervous I vomit
Sleep-I think too much at bedtime
Anger Control-Im always frustrated
ADHD-I knew I wasnt learning
Eating-I binged to relieve stress
Grief-we knew he was taking them
Depression-the divorce got to me
Pain Disorder-Its just like other hip


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