What to Know When Providing Therapy for Elite Athletes

Feb 14, 2022

What to Know When Providing Therapy for Elite Athletes

Curt and Katie chat about the specific competence required to work with elite athletes. We explore how elite athletes present (including diagnosis) as well as what treatment looks like for elite athletes. We also talk about the training cycles and periodization, developmental stages, and identity formation for competitive athletes. We also look at what healthy training environments include and how athletes can take care of their own well-being.

In this podcast episode we look at what therapists need to know about working with elite athletes

For our second continuing education worthy podcast, we wanted to support therapists in understanding what they need to know (or know that they don’t know) about working with elite athletes.

The differences between being a fan and being competent to work with elite athletes

The types of competence needed to support athletes who are at an elite level
Sports psychology and other areas of specialty to support athletes
The stringent criteria to be called a sports psychologist

What diagnoses do athletes present with when they enter therapy?

Not necessarily anxiety, but it can be anxiety related or unrelated to sport
Diagnoses can be related to the sport due to body, substance, or changes in circumstances
Diagnoses can also be related to other elements of their life and transitions

What does treatment look like for elite athletes?

High school and college athletes are most likely the clients we’ll see
The integral nature of their team and who is best to be included in the treatment team
Logistics and scheduling due to games and practices, obtaining required consents
Training schedules, food information is relevant to therapeutic work
The different goals for elite athletes than for other folks who enjoy sports
Looking at in the moment frustrations versus a desire to leave the sport
Sports assessments to identify athletic coping skills
Helping athletes to make decisions for themselves and identify when it’s burnout and when it’s a mismatch

Understanding training cycles and the impact on athlete clients

Specific language that athletes may use
Periodization, micro, meso, and macro cycles in training
The importance of planned growth and rest as well as peaking at the right time
The focus of timing for everything
How injuries or changes in schedule (like with covid) can impact this timing and what that means for athletes

Developmental factors for young athletes

The focus of training for younger children as well as the investment phase for youth
Developing one’s identity as an athlete
What can positively impact and negatively impact the future commitment to sport
Other developmental factors related to being a teen interacting with these developmental elements

What a balanced life looks like for elite athletes

Who athletes spend time with, share their life with
The hobbies that complement the sport
Understanding how maintenance impacts the rest of the schedule

The factors that improve an athlete’s well-being

Myths related to the tangential benefits of being an elite athlete (i.e., I’ll get college paid for)
The importance of having a therapist who isn’t just a “fan”
The differences between team and individual sports
The competency needed related to understanding the sport to understand all of the dynamics
What good social systems around athletes have in common
The understanding of how each person in the athlete’s circle interacts with the goals
The culture created within the team and with the people around the athlete
Simone Biles and Naomi Osaka – a look at how they have been taking care of themselves

The transition out of being an elite athlete

Injury and unplanned retirement
Planning for an intentional retirement
Moving out of the athlete identity into something new

Our Generous Sponsor for this episode of the Modern Therapist’s Survival Guide:

SuperBill

Interested in making it easier for your clients to use their out-of-network-benefits for therapy? SuperBill is a service that can help your clients get reimbursed without having to jump through hoops. Getting started is simple - clients complete a quick, HIPAA-compliant sign-up process, and you send their superbills directly to us so that we can file claims with their insurance companies. No more spending hours on the phone wrangling with insurance companies for reimbursement. Superbill eliminates that hassle, and clients just pay a low monthly fee for the service.

If your practice doesn’t accept insurance, SuperBill can help your clients get reimbursed. SuperBill is free for therapists, and your clients can use the code SUPERBILL22 to get a free month of SuperBill. Also, you can earn $100 for every therapist you refer to SuperBill. After your clients complete the one-time, HIPAA-compliant onboarding process, you can just send their superbills to claims@thesuperbill.com. SuperBill will then file claims for your clients and track them all the way to reimbursement. By helping your clients get reimbursed without the stress of dealing with insurance companies, SuperBill can increase your new client acquisition rate by over 25%. The next time a potential client asks if you accept insurance, let them know that you partner with SuperBill to help your clients effortlessly receive reimbursement. Visit thesuperbill.com to get started.

Receive Continuing Education for this Episode of the Modern Therapist’s Survival Guide

Hey modern therapists, we’re so excited to offer the opportunity for 1 unit of continuing education for this podcast episode – Therapy Reimagined is bringing you the Modern Therapist Learning Community!

Once you’ve listened to this episode, to get CE credit you just need to go to moderntherapistcommunity.com/podcourse, register for your free profile, purchase this course, pass the post-test, and complete the evaluation! Once that’s all completed - you’ll get a CE certificate in your profile or you can download it for your records. For our current list of CE approvals, check out moderntherapistcommunity.com.

You can find this course here: What to Know When Providing Therapy for Elite Athletes

Continuing Education Approvals:

When we are airing this podcast episode, we have the following CE approval. Please check back as we add other approval bodies: Continuing Education Information

CAMFT CEPA: Therapy Reimagined is approved by the California Association of Marriage and Family Therapists to sponsor continuing education for LMFTs, LPCCs, LCSWs, and LEPs (CAMFT CEPA provider #132270). Therapy Reimagined maintains responsibility for this program and its content. Courses meet the qualifications for the listed hours of continuing education credit for LMFTs, LCSWs, LPCCs, and/or LEPs as required by the California Board of Behavioral Sciences. We are working on additional provider approvals, but solely are able to provide CAMFT CEs at this time. Please check with your licensing body to ensure that they will accept this as an equivalent learning credit.

Resources for Modern Therapists mentioned in this Podcast Episode:

We’ve pulled together resources mentioned in this episode and put together some handy-dandy links. Please note that some of the links below may be affiliate links, so if you purchase after clicking below, we may get a little bit of cash in our pockets. We thank you in advance!

APA Division 47: https://www.apadivisions.org/division-47

Offensive lineman weight maintenance: https://www.theringer.com/nfl/2020/5/5/21246544/offensive-linemen-diet-weight-loss-gain-eating

Some sports psychology assessments: https://premiersportpsychology.com/assessments/

Kaplan, E. (2020, July 6). How NFL offensive linemen escape the 5,000-calorie lunch and transform in retirement. Retrieved on January 30, 2022 from https://www.espn.com/nfl/story/_/id/29399747/how-nfl-offensive-linemen-escape-5000-calorie-lunch-transform-retirement

For the full references list, please see the course on our learning platform.

Relevant Episodes of MTSG Podcast:

Outside Obsessions

Finding Your Blind Spots (Deliberate Practice Part 1)

Be a Better Therapist (Deliberate Practice Part 2)

Who we are:

Curt Widhalm, LMFT

Curt Widhalm is in private practice in the Los Angeles area. He is a member of the California Association of Marriage and Family Therapists ethics committee, an Adjunct Professor at Pepperdine University, lecturer in Counseling Laws and Ethics at California State University Northridge, a former Law & Ethics Subject Matter Expert for the California Board of Behavioral Sciences, and former CFO of CAMFT. Learn more at: www.curtwidhalm.com

Katie Vernoy, LMFT

Katie Vernoy is a Licensed Marriage and Family Therapist, with a Master’s degree in Clinical Psychology from California State University, Fullerton and a Bachelor’s Degree in Psychology and Theater from Occidental College in Los Angeles, California. Katie has always loved leadership and began stepping into management positions soon after gaining her license in 2005. Katie’s experience spans many leadership and management roles in the mental health field: program coordinator, director, clinical supervisor, hiring manager, recruiter, and former President of the California Association of Marriage and Family Therapists. Now in business for herself, Katie provides therapy, consultation, or business strategy to support leaders, visionaries, and helping professionals in pursuing their mission to help others. Learn more at: www.katievernoy.com

A Quick Note:

Our opinions are our own. We are only speaking for ourselves – except when we speak for each other, or over each other. We’re working on it.

Our guests are also only speaking for themselves and have their own opinions. We aren’t trying to take their voice, and no one speaks for us either. Mostly because they don’t want to, but hey.

Stay in Touch with Curt, Katie, and the whole Therapy Reimagined #TherapyMovement:

www.mtsgpodcast.com

www.therapyreimagined.com

www.moderntherapistcommunity.com

Patreon Profile

Buy Me A Coffee Profile

https://www.facebook.com/therapyreimagined/

https://twitter.com/therapymovement

https://www.instagram.com/therapyreimagined/

Consultation services with Curt Widhalm or Katie Vernoy:

The Fifty-Minute Hour

Connect with the Modern Therapist Community:

Our Facebook Group – The Modern Therapists Group

Modern Therapist’s Survival Guide Creative Credits:

Voice Over by DW McCann https://www.facebook.com/McCannDW/

Music by Crystal Grooms Mangano http://www.crystalmangano.com/

Transcript for this episode of the Modern Therapist’s Survival Guide podcast (Autogenerated):

Curt Widhalm 00:00

This episode of the Modern Therapist's Survival Guide is brought to you by SuperBill.

Katie Vernoy 00:05

Interested in making it easier for your clients to use their out of network benefits for therapy. Super bill is a service that can help your clients get reimbursed without having to jump through hoops. Getting Started as simple. Clients complete a quick HIPAA compliant signup process and you send their super bills directly to us so that we can file claims with their insurance companies. No more spending hours on the phone wrangling with insurance companies for reimbursement. Super bill eliminates that hassle and clients just pay a low monthly fee for the service.

Curt Widhalm 00:34

Stay tuned for details on SuperBill's therapist referral program and a special discount code for your clients to get a free month of service.

Announcer 00:42

You're listening to the modern therapist survival guide where therapists live, breathe and practice as human beings to support you as a whole person and a therapist. Here are your hosts, Curt Widhalm and Katie Vernoy.

Curt Widhalm 00:58

Hey, modern therapists, we're so excited to offer the opportunity for one unit of continuing education for this podcast episode. Once you've listened to this episode, to get CE credit, you just need to go to moderntherapistcommunity.com register for your free profile, purchase this course pass the post test and complete the evaluation. Once that's all completed, you'll get a CE certificate in your profile, or you can download it for your records. For a current list of our CE approvals, check out moderntherapistcommunity.com.

Katie Vernoy 01:30

Once again, hop over to moderntherapistcommunity.com. For one CE once you've listened well.

Curt Widhalm 01:37

Welcome back modern therapists. This is the Modern Therapist's Survival Guide. I'm Curt Widhalm with Katie Vernoy. And this is the podcast for therapists about the things that we do in our practice the clients that we see and considerations that we need to take into account. And this is another one of our deep dive continuing education eligible episodes. And you can find information about how to get your continuing education in the announcements before and at the end of the show, as well as in our show notes over at mtsgpodcast.com. Today, we are diving into the world of working with clients who are elite athletes.

Katie Vernoy 02:22

Yay.

Curt Widhalm 02:23

Now, this is something where the Olympics are going on right now. And this year's Olympics are a little bit weird. But I think it's important to frame kind of where we're coming from and the qualifications that we have as far as being able to talk about this to the level that we are and this being a very introductory level workshop as far as working with elite athletes. Katie I'm going to let you go first. What is your background and qualifications to be teaching other therapists about working with elite athletes?

Katie Vernoy 02:57

Well, in fact, I don't have qualifications of that I've I've had my own forays into some sports and worked with some athletes. But I would say that I am here in the role of facilitator and interviewer and excited to learn more. How about you, Curt?

Curt Widhalm 03:17

Thank you for asking. So in addition to being a therapist and podcast host, I am actually a USA track and field certified level two coach. And there are three levels of certification within USA Track and Fields. This is kind of the masters level of those three certifications. It is a and my particular area of coaching expertise here comes in endurance events, typically considered the 800 meter race and up through ultra marathon distances. So I have been doing this for several years I have competed regionally competitively. I've placed in a marathon before, it was a boutique one. So but I think that this brings us to kind of our first point is that a lot of us in the world are fans of sport. And a lot of us are going to have a lot of opinions about sports and about things that are going on with athletes. And this is one of those big reminders that you got to have the right competencies to work with specialized populations. And this is one where I think that we have the potential as a lot of people in this profession to let our fandum-ness get in the way of our own assessments of our abilities to accurately work with clients who come from these backgrounds. And that's going to be a really big common theme throughout the episode today is: are you competent to be able to work with this kind of a population? Because at the elite levels, we're not talking recreational people, you know, when I was running and competing myself, I still considered myself a very recreational runner. And I was running most weeks, 60 - 70 miles a week, some weeks, I'd be running up to 90 miles a week, and I tell a lot of my friends this and they go, I can't possibly conceive of what that means. And so these are the kinds of things where these are people whose schedules are filled with being the best physically performing that they can be. They're going to have schedules that are all over the place, they're going to be inconsistently available, they're going to have a lot of commands and demands that might come across as entitled, but the biggest priority of their life is being physically capable of performing. So this is where you have to be on your game, knowing the type of client that you're working with, and what it's going to take to work with this client successfully, in order to actually have good successful therapeutic treatments.

Katie Vernoy 06:20

And when we were talking ahead of time, I think there's the clarification that there are folks where this is their specialty that you know, sports psychologists, folks that have gone through that extra training. And we can link to some of that in the show notes. So if you're wanting to pursue this as a career, that would be the way to go. Again, reiterating this as a entry level course to let you know what you don't know, really, to say, hey, refer out or get more training. I think it makes sense to talk about what are some of the basics of what would make someone competent to work with elite athletes or becoming a competent, quote unquote sports therapist,

Curt Widhalm 06:58

The American Psychological Association division 47, is who outlines what a sports psychologist is. And they go so far as to say you really have to have the competencies to do this, to call yourself as a sports psychologist, you have to be trained in sports psychology. And they go so far as to have an FAQ on their page. As far as, hey, I've got an athletic background, I was super competitive in this. And now I'm a psychologist. Can I call myself a sports psychologist? And the APA's answer is basically, no. So. So what makes a competent sports psychologist is having a knowledge that encompasses and having a training that encompasses knowledge of the psychological skills of athletes, the well-being of athletes, and the systemic issues associated with sports organizations, and in the development and social aspects of sports participation. In other words, this is knowing all of the ins and outs of what it takes to be a participant in the sport, the developmental aspects of being able to approach sport, understanding the systemic pressures around them, and how to navigate them. And I think that that last piece of it is where this is a population where we can have a lot of opinions of how people handle things in normal, everyday life that just does not apply to the systemic issues in a sports world. And I think we'll talk about some people in stories throughout this episode today that kind of illustrate some of these points. And apropos to our last continuing education podcast, we won't be making any diagnostics of any of those people showing up in the media, but talking about what their experiences are, and what their descriptions and some of these media releases that they've had or interviews that they've done for other people.

Katie Vernoy 09:06

So let's start with the treatment part just to kind of get that out of the way. Because it seems like that's the minimal piece that a lot of people will will interact with, but then there's like, what's the real deal? So starting with the kinds of diagnoses that athletes are usually going to present with.

Curt Widhalm 09:27

Sure. So, most of the time, athletes are not going to be coming in with necessarily anxiety related issues. And while they might come in with, you know, having this block towards performance, a lot of times they're going to be referred for things like eating disorders, that especially for a lot of weight or image based sports, things like gymnastics, wrestling, crew as another example where weight is going to have a factor into, especially losing weight is going to have a factor into performance. This is sometimes where athletes can go too far and end up into disordered eating territory. Stress is obviously a very, very common one. While sometimes there is anxiety, it's not necessarily always about performance, it might be anxiety about maintaining a position on the team, or anxiety about managing other aspects of their life. There are also a tremendous number of substance use disorders that athletes end up presenting with, typically, you're gonna see this with alcohol. But by far, the most common diagnosis that you're gonna see with elite athletes is adjustment disorders.

Katie Vernoy 10:47

Explain that a little bit more

Curt Widhalm 10:48

There are a number of different aspects of changing in life that athletes are going to go through and a little bit we're going to talk about this as far as some of the developmental factors. But it helps to think that people don't just one day as adults magically appear as elite athletes. That this is something where many of them have been practicing and finely tuning themselves for years to be able to get to where they are, where they want to be. And along the way, comes bumps and bruises, injuries that prevent them from being able to perform, there comes a time in your life where developmentally you're, you're hoping for just a nice linear growth of your ability to continue to get better and better at something. And when you inevitably don't, there is a mental adjustment that goes along with understanding why you're not performing in the way that you are. There are adjustments of things happening outside of the sport, family issues, friend issues, school issues, at the very highest levels - media issues that end up needing to have an adjustment, or at the very end of people's careers, also adjusting to retirement and changes in identity from things that they have spent their whole life doing to now the absence of that thing completely.

Katie Vernoy 12:20

Makes sense. I think one diagnosis that you didn't include here was PTSD. And I know for myself, I had people that I had people that were no longer elite athletes are not on that, that trajectory. But I'm even just thinking about, you know, huge amounts of women, gymnasts, who were sexually assaulted. I know that there are even kind of a parody of, you know, abusive coaches, those types of things. Is that Is that relevant here the PTSD diagnosis?

Curt Widhalm 12:51

It is, but it's not. And I'll tell you why.

Katie Vernoy 12:55

Okay.

Curt Widhalm 12:57

A lot of our research on working with elite athletes does not consider former athletes or retired athletes as part of their research base. So we'll include our reference lists over in our show notes of some of the stuff that we're talking about here. But the the particular research is focused on people who are currently athletes, or people who are at the end of being in their athletic career potentially looking at transitioning out. And this does not discount what you're saying, as Yeah, that stuff does happen. But what you're talking about, in particular, is more of working with former athletes. So...

Katie Vernoy 13:40

Sure, my mind's working with former athletes, but I'm thinking about like, the whole US Olympic gymnast gymnastics team, you know, like, I would imagine, there would be a lot of PTSD there around sexual assault.

Curt Widhalm 13:51

I think we're going to come back to that point later in the episode because of some of the stuff that we're going to talk about in the middle of the episode.

Katie Vernoy 14:00

All right. All right. I'll leave that there then. Okay, so you have someone come in, they might have one of these diagnoses, the fact that most likely it's adjustment disorder, and there's going to be a lot of stuff we talked about, that you've already previewed for me, which is really, really interesting. may seem like it's surprising that we're looking at just an adjustment disorder. So, okay. And then solo practitioners oftentimes work solo, it seems like there might need to be a treatment team here who is in that treatment team for athletes.

Curt Widhalm 14:31

So think of what the world of somebody whose life revolves around athletics might include, and recognizing that realistically, most of our audience, well, while we would all love the LeBron Jameses to be our clients and the wonderful, you know, pride that you might have in working with them, realistically, the most common people that we're going to have coming from this world into our offices. are high school and college athletes operating at the highest levels of their performance. And while there might be, you know, some consent issues, as far as getting enough signed releases around to everybody, you have to consider the major important people in a athlete's life. And first and foremost is going to be their coach. Because at the end of the day, the coach's decision, as far as who plays, how they play, how often they play is going to be something that really ends up factoring into a lot of the individual decisions that your client is going to make. And it's understanding the coaches culture idea. And realistically, knowing that you're not going to be probably talking with a lot of coaches very often, of what the environment that they set up is. And so you're talking about, you know, women's gymnastics team here and some of the abusive situations that have happened since forever. It does start with the culture that the coach ends up bringing to a certain gym or a certain team type attitude, that is going to set up where your client is approaching their day to day job. Now, as I mentioned earlier, this is people who are very, very busy. So a lot of scheduling might end up taking place through parents, that having to work around schedules, and especially with a lot of athletics that take you know, multiple days out of the week. Baseball is an example where it wouldn't be unrealistic for a client to be having three or four baseball games in a week, scheduling is gonna change a lot. And when your client shows up to the office, it may be irregular, it may be done through communications with the parents. Particularly in those weight based sports - but also, I do see a lot of colleges appropriately, having nutritionists working with teams. So you might be working with nutritionists as well, in helping to understand where your client's food plans are going to go. And even that's going to be very dependent on the sport that they're talking about. We were talking before the show of the major differences in what happens with eating as an offensive lineman on the football team, versus what might be different with an endurance athlete who's running marathons.

Katie Vernoy 17:31

Sure.

Curt Widhalm 17:31

And then, because of the amount of time that athletics takes up, you may also be working with educators as far as what the role of education is taking, and particularly if you're working with athletes who might not be spending as much time in class or falling behind on their grades, and needing to be able to work with educators to keep them eligible as well.

Katie Vernoy 17:58

So these are all people who have a lot of impact on the client. Who are part of their team, and, and thus should be part of the treatment team. The question that comes up for me here is really about identifying where, where the client fits in. And maybe this goes later too, but I just feel like there's they're oftentimes when we're working with some of these folks, they are, especially the ones who are not health professionals, you know, coaches, parents, that kind of stuff. They are not objective, they have very specific motives they have specific outcomes they are looking for, how do you manage a coach or a parent who is pushing for something that may not be in the best interest of the client? And or not what the client wants? I mean, I think there's, there's elements of this that maybe we talk about in the social systems, but I'm just curious on like, how do you develop the relationships with the this broad array of people that have very different perspectives on what might be best for the client?

Curt Widhalm 19:01

And I think inherent in your question is a little bit of the naivete that we take, as a typical mental health professional

Katie Vernoy 19:10

Yes.

Curt Widhalm 19:12

That from a team approach, the end of the day, it's whether or not the team won. That that is, what the the goal of the team is and kind of that social environment is geared around how to get towards winning. And while what you're talking about may apply to kind of more of our garden variety recreational athletes or people who are happy to be on the team sort of things when we're talking about the elite athlete sort of things. This is a world that is built around winning and losing. Your role as a mental health professional in this is understanding the psychological skill of your client to be able to get back into that winning environment. And while you're talking about some more of that client choice into this aspect is, it's being able to really tease out with clients like this. That what is their in-the-moment sort of voice? Or is this a consideration of leaving the sport altogether? Oftentimes, when I've worked with college athletes, or I've read autobiographies or interviews with people, you know, Andre Agassi's book that he wrote back in the 90s, talks about one of his first dates with Steffi Graf, before they got married, and they sat down to dinner. And their first conversation was, I fucking hate tennis. And these are people who continued to play at in elite level for quite a while after that, and have remained a big part of the tennis world. That if you're working with an athlete who's considering what is best for them, it's got to be done through the competence lens of understanding what their role and what their identity is to the sport, and how they can come back to that. And the specialized training that goes into this is going to need to use quite a few different assessments that frankly, most therapists just don't end up getting trained in, unless they go through specialized training, I'm talking about things like you know, the athletic coping skills inventory, the ACSI-28, it's a psychology assessment that measures an athlete's psychological coping skills in seven different areas. There's the disc model that can be used not only with athletes, but also with coaches that looks at dominance, influence, steadiness and compliance. These are the kinds of assessments that should be a regular part of what you have at your disposal to help determine the scope of competence of the scope of practice that you're going to end up doing with an elite athlete. Beyond kind of the naivete of the where does the athlete fit into this? These are the kinds of things that help the athlete come to some of those decisions themselves.

Katie Vernoy 22:17

That makes sense. I think the the thing that I am still trying to sort out and maybe maybe this is more of a clarifying question, does do these assessments, assess for this? But as I mentioned, I've worked with folks who were kind of on that elite path, and fell out. And a lot of the the ways they discussed it, were this was: I was good at it, I enjoyed it, I no longer enjoyed it. It was really my parents pushing me to do this, or my coach pushing me to do this. And I am so relieved that I'm no longer in it. And granted, this could be that they didn't have the right person at the right time saying the right thing. But I feel like there, there are folks that at many different stages fall out and say what was I doing? This wasn't good for me. It was never good for me, why didn't anybody help me? Why did people keep pushing me to try to do this thing? And so how do we does the assessment, sort those questions out to see what the influences are around them?

Curt Widhalm 23:19

And those two are just a couple of the assessments that sports therapists and sports psychologists end up using. That part of being able to take into account some of the factors like burnout that you're talking about that is going to look at people as you're describing who have been so pushed beyond burnout, that they no longer want to be in the sport. You know, I've heard from again my world for it's more endurance, athletics sort of things is heard from division one athletes who run 5k 10k Cross Country type races that say, I never want to run a race again, that... And those are typically in sports, where the competition outside of you know, at that division one level is going to be participating in road races gather are professional, you know, sort of circuits that they can go and compete in, but they're not as popular of professional sports, the livelihoods in those sports are are going to be much smaller than compared to something like basketball or or football or something where there's the potential to make millions of dollars in in a career. It is a question that you can ask and help athletes kind of figure out what their involvement and what their continued desire to participate is. And it's helping them to accept and understand what that means as far as their ongoing participation in it. And I think that part of what I hear from some of the younger athletes who, whose parents do push them into kind of some of these training things is helping to understand training cycles and development, not only physically but also psychologically as well.

Katie Vernoy 25:15

So let's let's move into that then because I think that's really helpful to give us a little bit more context. So what what the therapists need to understand about training then? Let's start there.

Curt Widhalm 25:26

So, training does not have a linear progression to it. And longtime listeners of the show know that I'm a big fan of Scott Miller as far as his work towards development of therapist and therapeutic skills. In turn, Scott Miller's work is largely influenced and started by Anders Ericsson, who was one of the first people to look at development and expertise across a number of different fields. And both of them led to the whole big deliberate practice sort of movement.

Katie Vernoy 26:02

Sure.

Curt Widhalm 26:03

Now with psychological or conversational type skills. Those are things where we all experienced burnout, a lot of us take steps back, and you know, we come back after an appropriate time away, we come back and we start doing therapy better. Just because we are recharged correctly. It's understanding that we physically, in response to physical stressors, like practices and training, also go through very predictable periodization techniques, or have to use periodization techniques, in order to train at our best. You can't just go out and practice at 100% every single day, and expect to see the same kind of linear growth throughout a season. And this takes into account that there are different terminologies for different kinds of things, a workout might be a specific one hour set of activities that somebody does, a series of workouts across a week is called a micro cycle, a seven day period. And this is where, you know, you might hear this from your crossfitter friends or people at the gym, you know, today's an arm day, the next the next day is a back and chest day, the next day, never skip leg day, folks. But you know, it's being able to kind of cycle through all of the different parts of the body in a predictable and structured way to optimize the development of those muscles.

Katie Vernoy 27:34

And that's a micro cycle.

Curt Widhalm 27:35

That is a micro cycle across a week. So you've got your Monday workout, you've got your Tuesday workout.

Katie Vernoy 27:40

Yes,

Curt Widhalm 27:41

Typically, we're going to see about three weeks of growth. So three micro cycles of growth, of increasing strenuous activity from week to week, that then requires a larger rest day in response to it. And so we're looking at a month of four micro cycles. We call this a meso cycle. And so this is where you might see a buildup of, you know, three weeks of increasing workouts and then a week where you're still having your workouts, you're still going through a very intentional shorter microcycle that backs off allows for some recovery allows for more rest, and this is intentionally done. So that way just like us coming back from vacation, this is a little bit of a vacation that's built into a schedule for athletes to kind of rest and recover and build back in.

Katie Vernoy 28:38

Okay, so we've got a microcycle, which is a week. Meso cycles, which are a month and that's, you know, increasing and then dropping off for a rest week. What's a motorcycle?

Curt Widhalm 28:50

A motorcycle? A motorcycle is a two wheeled engine driven machine. I think what you're going for is a macro cycle.

Katie Vernoy 29:03

No, I was going for motorcycle but what is a macrocycle?

Curt Widhalm 29:08

A macro cycle is going to be how different meso cycles fit together. And this can range anything from a year to four years. As far as some training plans go.

Katie Vernoy 29:19

That's pretty macro.

Curt Widhalm 29:21

And this is talking about the people at the very highest levels of of sport. Olympic athletes are going to plan for years of how their training is going to fit together. Lower levels this is planning through a season or it might be planning through academic year for those like cross country and then distance running athletes who would have like a fall season and then a spring season. But oftentimes, athletes physically are going to peak at one to two times per year. That once you reach kind of your your peakness as far as a physical response, you're not going to hold on to that for months and months. Typically, at least in the endurance athlete community, you're gonna hold on to that for about three weeks. And then your body is naturally going to need a much longer sort of recovery time, this is where a lot of marathon training plans are going to sit between 20 and 24 weeks, it's going to be that your peak is on race day. You don't want in other sports, you don't want your athletes peaking, the third game of the season and then just kind of trying to hold on to that all season puts them at greater risk for injury. So understanding these cycles is important. Because the way that workouts are laid out physically, are going to have different responses to different kinds of workouts, and particularly for a population that when they feel that things aren't going well for them physically, where their response is going to be, I need to make up for that workout. I need to work out more in order to catch up. It's having an understanding of this on the therapeutic side of hey, where are you at in your in your cycle? Are you in week 13, you in week 15, because there's a difference between those that we have to understand is going to bring out different emotions. Because a lot of mesocycles, that month long thing are going to plan for overload, an intentional functional overload in that third week of the mezzo cycle. In other words, that's where you're going to be build build build. And it's going to be tiring, and it's going to be frustrating. And it's going to take up more of your time where you're gonna hear some of that burnout language. I don't know if I can do this, again, I don't... that helps the clients to be able to step back and understand there's an emotional reaction depending on where they're at in their cycle.

Katie Vernoy 32:01

Yeah, that makes a lot of sense. I mean, to me, understanding, having the language and understanding what someone's microcycle is meso cycle is, macro cycle is, and whether they drive a motorcycle. Alright, so understanding the language, understanding what somebody's training cycles look like being able to have some sort of a prediction, or predictive ability, maybe, of how that part of the cycle is going to impact them is pretty important. So if they're at that build, build, build and burning out that makes sense. If they're on the rest week, or at the end of the rest week, maybe not so much. You know, maybe there's there's some different elements that are really important to consider. To me, in the the folks who I've worked with kind of peripherally. It seems like timing of injuries, even kind of the minor injuries that oftentimes get worked through or you only take a few days break, it seems like that could be really hard to navigate within these different cycles.

Curt Widhalm 33:07

Yeah, and timing starts to become everything for some people. I have permission to share this. But I was told years ago by a former Olympic gymnast, that their plans for children revolved around being born in the correct years for the Olympics, that being, especially in women's gymnastics where you know, your career peak is going to typically fall somewhere between the ages of 16 and 24. That the difference between showing up as a 14 year old versus showing up as a 16 year old is a decision that your parents are making when they're making love to create you.

Katie Vernoy 33:55

That's intense.

Curt Widhalm 33:57

And so some of the pressures around this are, you know, your born in the right here, put if COVID happens in your Olympic year.

Katie Vernoy 34:07

Oh, that is ridiculously sad.

Curt Widhalm 34:10

So timing on some of this kind of stuff is that, hey, some of the injuries that show up is then helping to create and these are again, little tiny adjustment disorders. No, don't fit that workout in into your periodization you know, rest week or Recovery Week, that that is a recovery week to let your body recover. And it's and this is where having that understanding of at least knowing what the coach's training plans for training cycles are going to be. So that way you can help create the emotional support because if there's one thing that I know from back in my training days as well as the coaching that I have done, and then also the athletes that have come into my office, the number one thing that I end up working most with clients on is getting appropriate rest and recovery, that it's not just about stressing and working out more. But it's allowing for body and mind recovery, to be able to trust their training.

Katie Vernoy 35:16

I think that's interesting, because I think that resonates probably with a lot of therapists is that most of the people we work with who are on the the more driven side or anxious side, we're also pushing for that rest. But I think we're pushing for different things. So what does rest actually look like for an elite athlete?

Curt Widhalm 35:37

Depends on where in their cycle that they are. And so, for example, a lot of this is going to come down to active versus passive recovery. Passive recovery is just like, go lounge around, sit on the couch, kick up your feet and watch Netflix, which.. There is space for it, but a lot more of athletic. active recovery is going to be things like stretching, slow walks, being able to make sure that that is part of what their plan is, it's cross training appropriately. In a meso cycle, it might be making sure that in the build weeks, it's getting enough sleep, it's being able to remain hydrated enough, it's getting the appropriate sort of nutritional intake and caloric intake. It's not adding in a bunch of extra things into their recovery week, just because they have more time because their workout schedules are less. And if you're talking about macrocycles, former Olympian Bernard Lagat is a middle distance runner from Kenya competed for America, but would take typically the entire month of December off each year without running at all, in order to be able to prepare for the next year in his macro cycle. So it's being able to look at it not only as a here's a blanket plan, but it's here's a specific and catered plan to you and your sport. On a day by day on a week by week and a year by year sort of approach.

Katie Vernoy 37:15

We're back at this year by year thing. I'm curious because we you mentioned stuff around kind of the developmental factors. And it seems like for the the clients that most of our folks would interact with, you know, high school and college athletes. There's a lot of just normal development that's happening during those critical years. But you're also suggesting that there is development that happens in the identity as an athlete.

Curt Widhalm 37:44

Absolutely. And I think where you're talking about some of these parents that are pushing their kids into sports is the biggest goal for introducing a lot of sports to young kids. I'm talking kids ages five to 12 is going to be fun and recreation. And while there's going to be some kids who are good, some kids who are naturally a lot more athletically developed, may even have the the setup to become a bigger, stronger athlete later on. This particular developmental phase as far as their identity to athletics is to have fun, and to keep them in the sport. Now, you can't make a six year old into a major leaguer as a six year old, but you can definitely set them up on a path to hate baseball and not become a major leaguer at six years old.

Katie Vernoy 38:38

Sure.

Curt Widhalm 38:40

And so the developmental factors at that age are just around being able to have fun in relation to a sport becoming an area of interest. Now we're talking about the typically high schoolers, maybe post high school into college, but usually high schoolers. This phase is the investment phase into sports. This is where it needs for those people who are going into that elite caliber of athlete track. This is where the investment to get there really has its basis in most sports. And this is where it's going to be more time playing the game more time practicing more time traveling more time doing the extra things to fit in that create the basis for either being able to compete at the next level. It might be a traveling team. It might be an all star team. It might be you know, moving into the collegiate ranks, that people who don't make those same kinds of investments typically don't get. And it's not just playing well on the field. It's also doing all of the connecting with other coaches and getting your highlight reels up onto YouTube so that way they're shareable and getting you noticed by other people, that ends up taking up a bigger portion of your life. Now, I don't know if you remember being a teenager?

Katie Vernoy 40:12

Are you saying something about my age, Curt?

Curt Widhalm 40:15

I'm saying that for a lot of people who don't remember all of the other parts of being a teenager, there's also your social development, there's also wanting a girlfriend or a boyfriend or wanting to not have to, you know, train and perform every single day. And it's being able to help clarify what some of the internal goals are towards this kind of a pathway. I obviously did not become a professional athlete, I did not get offered any sort of collegiate, you know, hey, we're really wanting you to come out and be a star on our team. In fact, I got exactly one letter in the four sports that I played in high school, I got a letter from one university being like, if maybe you're kind of interested, you can come and try out as a walk on at our very teeny, tiny college. And I chose not to do that whatsoever. I'm fairly certain that they sent this letter out to everybody.

Katie Vernoy 41:28

Got it. So that wasn't your your specific experience.

Curt Widhalm 41:34

But looking back at my own specific experience, one of my high school classmates did play Major League Baseball. And so there is a little bit of a comparison here that the investment that he made into sports was much greater than mine, I pursued a lot of different interests. I was in clubs, I had jobs I had, I didn't have girlfriends. He did. But, but his development became more and more specified towards baseball, the older that we became, and it paid off for him and took a lot of extra training for him to do that. That was more and more sports specific.

Katie Vernoy 42:24

Yeah - Yeah, I mean, my experience was more I was, I was performing elitely as a singer of all things. So I was spending tons and tons of time on singing and making sure that I could speak and sing at the right times, and, and all of that. So there was a little of that, that I experienced, I did not get a music scholarship, but I didn't want to continue to pursue music. So it wasn't a thing. But my dad actually was a an athlete on and was recruited for a football team. And I actually was born while he was there. And, and so that the stories were all around that, you know, really how his life was centered around being a football player. And, and so to me, it is a very, it's a center point of a, an identity. But I think there are other pieces that go into it. I wasn't just a singer, My dad wasn't just a football player, there were other things that went into that, and, and to me, and now neither of us are doing those things professionally. So it's not the same thing. But I think there is an element of how balanced can a life be when you're pursuing this higher, higher goal, because it seems like the amount of time it takes for, especially depending on the sport, but the amount of time it takes, and the focus and the the need to be on your game, even when you're not playing your game. Because of the impacts on your body. And when you need to show up and when you need to peak and all those things, it seems like it would be hard to have a balanced life.

Curt Widhalm 44:03

And for those on that trajectory towards becoming an elite athlete, that you are working typically with teenagers or very young adults, to get them to be able to take a step back and looking at how the things in their life serve as a balance within what their primary identity goal as an athlete is. For instance, the people who you know, typically are elite college athletes tend to date other elite college athletes because their training cycles end up needing to be around people who a) understand it b) you know, kind of have their own thing to do that. But c), and maybe most importantly, aren't interfering with their own cycle, that there's exceptions to every relationship rule - everybody don't send us you know, complaints on that - but but this kind of a pairing is really where it's the day to day intricacies of it, of being able to find the hobbies that you can rest and relax with, but don't become so consuming that they become the side hustle that interferes with being able to go out and perform at the top of your game at the right point in your macro cycles.

Katie Vernoy 45:25

So there really is kind of a curation of the people around you when you're that focused.

Curt Widhalm 45:31

Yes. And this is, you know, really where the mentality and the pathway to get to some of these multi million paying jobs in those areas where there are those jobs, or the areas that don't necessarily have all of the, you know, flash and sizzle - the, you know, non revenue, sports and colleges, that that does end up having a lot of reliance on parents to pay for things. You know, a lot of, you know, division one college athletes get like five meals per week provided by the school as part of their educational allowance. Going back to offensive lineman, I was showing Katie a video - we'll link to this in the show notes - of an offensive lineman who may need four or 5000 calories a day, is not getting 5000 calories a day off of five meals a week from the school cafeteria. And, and so the food bills for these kinds of athletes end up becoming exorbitant. But it's also something where the video that we're gonna share shows that the relationship to not only foods but also to the people around you can be something that's greatly impactful and a consideration that we have to have with the kind of athlete and the kind of sport that we're working with. Because, in this video, for those of you who aren't going to go and watch it, he blends up grits, a couple of bananas, six scrambled eggs, peanut butter, and red Gatorade, I will forever die on the Hill that Gatorade flavors are only based on the color that they are, but blends it up, chugs it down. And this video went out on social media kind of went viral. And a couple of weeks later, he's like, I don't get why people are making such a big deal out of this. I do this a couple of times a day, in addition to all of these other giant meals that I eat. And so the maintenance of having a day to day life as an elite athlete has a lot of things beyond just what they're doing out on the field. But it's the things that they put themselves into, in order to continue to show up even when they don't want to. And what really ends up separating out the people that do show up every day who do continue to perform. And the people that you kind of keep bringing this question back to of like, well, you know, those who are considering maybe not, the difference in that grit is the ability to accept some of these roles that being in this particular sport for them end up having as a part of that sport society,

Katie Vernoy 48:25

I hear you, I understand what you're saying. And I have this other element that I think about, which is folks who are talented, they enjoy the sport. But getting to college sports is critical, so they can afford to go to college. And there's this other element of I need to earn the money. And it becomes - it has a different flavor to it. And there's also a big push from the people around them. Like if you don't do this, you can't go to college, we can't afford it. Or this is how you're going to make your mark like it seems like and maybe it's both can be true that someone really wants to pursue this. And they're, they're leaning into it. And it's still hard and all those things, but that the people I'm talking about are people who do make it and it's sacrificing completely, not just to the sport and the talent they have around the sport and the skills they develop on the sport but also to the financial reward.

Curt Widhalm 49:27

I will say from being around this community long enough talking with enough parents and athletes themselves. That is a myth. As far as college being paid for by sports that the number of available athletic scholarships for the vast majority of athletes who are participating in sports get there. They're paying more money to participate in sports, get these extra trainings and this kind of stuff than what their scholarships will actually end up paying out statistically.

Katie Vernoy 50:00

That makes sense. I think there's another piece of getting into a good college and being able to up their ability to do those things. I mean, to me, it seems, it feels a little bit - this is the wrong word, but I can't think of a better one - mercenary. Like it feels like I have to do this like that who, ah, because of this end goal, I mean, is that just all a myth?

Curt Widhalm 50:23

No. People do get into that mindset. And it's being able to help channel the mindset into when they eventually hit the reality of that not being what's actually true.

Katie Vernoy 50:36

Got it.

Curt Widhalm 50:37

And so, you know, this is where, you know, as much as I crap on CBT. This is where CBT really ends up working well with a lot of athletes as far as being able to look at some of those specific mindsets and challenge some of those ideas. And even beyond CBT, particularly Acceptance and Commitment Therapy, ends up being something that really helps to balance out some of these concerns that you're bringing up with the realities of the environments that these kinds of clients are operating in, in their day to day life.

Katie Vernoy 51:13

Are there cultural considerations here that we're not talking about yet?

Curt Widhalm 51:17

There will be I think that those are going to depend not only on a, the particular client cultures that people are facing, whether it's race, gender, economic, but I think that there's also culture within individual sports that are going to be unique, and there's going to be a lot of intersectionality about, I'm acknowledging that. And that goes way beyond the scope of the introduction of these ideas today. And those are largely going to be dependent on first looking at it from the sport perspective first, and then all of those other intersectional identities. I mean, one of the major ongoing ones today is the role of trans athletes. And that's going to be pages and pages of an hours of discussion that I'm not qualified to be the one leading a discussion on that, nor am I, the one who would be the best for you to listen to on that.

Katie Vernoy 52:18

I guess the other element of the the cultural aspects are also in how the system is set up around an athlete given some of their demographics. So let's, let's table the trans athletes conversation, because I think that is beyond the scope of this conversation. And I don't think we should shortchange that conversation. But I think there there are, are ways in which people are going to interact around sports, the sports they choose, but also the society and the system that builds up around them. And so to me, it feels like understanding that better would be helpful, because I think we're talking about kind of athletes in a vacuum almost to this point.

Curt Widhalm 53:03

And it's looking at the ways that we even conceive of it. You know, if anybody is getting a phone call of, hey, this caliber of athletes wants to be your client, there's an excitement of like, I get to be a part of this world. And owning your own relationship to sports and athletics is a really key part of it, because you don't want to be, you know, fanboying or fangirling out to your clients in front of you, that's a easy way to have them quickly move on to somebody else. But it's also looking at the ways that they end up relating to, you know, any other even within their own sports, any other athlete and the way that that sport gets looked at differently. And when I was in high school, I played offensive and defensive line on in football. And so I have a particular appreciation for the unappreciated guys in the trenches, you know, your dad is a center I appreciate nobody is looking at the left guard being like, that is somebody that we want to you know, really go and hang out with everybody's looking at the quarterback, the the flashy, wide receivers those guys. And I've seen, you know, social media posts from some former offensive line people who are like, I'm more famous for how much weight I've lost since playing than anything that I did in my 10 year career as an athlete.

Katie Vernoy 54:37

Yeah, well, yeah. And even talking earlier about how you were saying how, like, you know, after you retire, you know, the body size changes and depending on what sport you're in the body size changes. So I'm assuming as a football player, you were a little bit larger and then getting down to marathon size. My dad's a cyclist, so you know, you just go a totally different body shape and it's it's a very weird thing, but we're off topic, but so the system's around them. So it depends on the sport, it depends on how the team interacts. What are the different presentations on individual versus team?

Curt Widhalm 55:11

So individual sports, you're out there all by yourself, you know, whether it's a one to one sports, something like boxing, wrestling, MMA you are out there, and it's you against somebody else. And there is no place to hide if you lose. Athletes coming from individual sports, or, you know, there's also, you know, individual sports like marathon running, where it's everybody's competing all at once. Athletes in individual sports tend to be less resilient, when it comes to not performing at their level of expectations. And this is because of unique protective factors in the team environment where you win as a team, you lose as a team, it might be one player's mistake out there that cost a game. But overall, the the positive athletic environments end up having a team identity first. And so there's a lot more of being able to relate well to other teammates that helps make athletes from team sports responds to things better, they're less likely to, you know, present with things like depression, or that depressive adjustment disorder type diagnostics, whereas individual athletes are putting themselves in a position to be evaluated and having to face the ownership and sometimes shame of not placing or performing as well as they individually felt that they could.

Katie Vernoy 56:42

What about the the kind of hybrid sports so like, you know, a lot of I'm thinking gymnastics, I'm thinking the track team, like I had individual events when I was running track. And then I also did a relay. And so obviously, the relay is a team sport and or team event and you know, doing the 880 was individual. But when you have both of those elements within how you work, I'm thinking specifically of like gymnastics, you have the individual, and then you also have the team scores, how does that impact an athlete?

Curt Widhalm 57:16

So and this is, again, another opportunity to gently point out the competency of knowing the sports that your athletes are participating in. You're specifically talking about gymnastics as a individual in a team thing, which is particular to Olympic Gymnastics, whereas at like collegiate gymnastics, it's about the team score. And that's where you'll see a lot more, you know, of that celebratory team aspects that goes along with collegiate gymnasts, as you might in comparison to seeing more of that individually focused Olympic gymnast thing. There's also entirely different scoring systems. But you do bring up a good point, as far as some of that hybrid aspect, I think that this speaks to what good social systems around athletes end up having in common. And a big piece of that is the opportunities for inclusion in a supportive training community. And one of the athletics that I did in high school was one of the things that you listed was track and field. And what I can say is that I did not contribute very often to the overall team score. I did once and that is forever my favorite day on the track team.

Katie Vernoy 58:37

Nice.

Curt Widhalm 58:39

And there were people on my team that carried us to second place in the state my senior year that I and I did not contribute to that team score whatsoever.

Katie Vernoy 58:52

It sounds like we were similar high school athletes.

Curt Widhalm 58:56

But that's that environment did is there was a lot of support, there was a lot of, hey, you're out there performing as an individual, your success is supported by the team that in comparison to you know, more of those individualized sports even, you know, as I'm looking back on it now, in comparison to other sports, like this - wrestling, cross country where there's an individual component and a team component. I think it's gonna vary depending on the sport some,

Katie Vernoy 59:29

Okay

Curt Widhalm 59:29

It's and maybe it's just because the other teams that I was on didn't place but it felt like, you know, in wrestling that the individual accolades mattered more than the team ones, whereas in track and field both seem to really come and maybe it was the environment that our particular track coaches had really set up well there.

Katie Vernoy 59:50

Well, let's, let's get to a little bit more of of what these social systems should look like. Because it seems to me having a really nice supportive training community is one of them. What else should an athlete be looking at? What else should therapists be supporting their clients and accessing?

Curt Widhalm 1:00:08

Exciting some research from Hendrickson at all hear that there are certain components of a successful athletic environment that share a unique number of features. And that first one is that supportive training community. The second one that they identified as having role models, in other words, people who've done this and done it well, and this is a community that is, you know, elite athletes that is largely based on, they're gonna listen to people who have been there and done that, where maybe, you know, a lot of coaches and stuff do come from their own high performance, athletic backgrounds themselves, Of hey, I can trust you, because you've done this. The third factor, and this is really where therapists can either get on board with this or get in the way of this is having the support of the sporting goals by the wider environment, you are part of the wider environment.

Katie Vernoy 1:01:08

Yeah.

Curt Widhalm 1:01:09

And if where you're not, you know, supportive of how this particular athlete fits into the team, then you're going to not make it. Other components that Hendrickson et al discuss is focusing on long term development rather than short term success. Where are you at in your cycle, you're outperforming you know, where you're at in your macro cycle, you need to back off, this is the goal of this particular workout or this particular race, it's not necessarily to win, it's for you to get this kind of a performance out of it.

Katie Vernoy 1:01:43

That makes sense

Curt Widhalm 1:01:44

Integration of factors outside of sports, such as school, family, other components to the environment, dating, relationships, those kinds of things. And a coherent organizational culture. And this is where, you know, I've heard from some of my clients before that, they knew that the cultural organization wasn't the same when there was things like coaching changes, you know, not necessarily at the head coach level, but assistant coaches, where people had kind of different opinions on things that started to look at the erosion of their team's ability to perform. So those factors overall, and everybody being in support towards the same goals ends up leading to successful treatment of athletes. And, again, this is where you're gonna end up treating these kinds of clients a lot differently than you would with somebody else who's like, you know, I'm kind of burned out at my job.

Katie Vernoy 1:02:41

Sure, sure. Yeah, to me, it seems like there's, there's a nuance here, that I don't think we have time to go into around how we support the healthy expression of this identity. And also support what's in this integration of factors outside of sport, which is the other elements of their identity, because I think they're, you know, depending on I guess, where they are in their cycles, the sports identity needs to come central. And I think that will be, that would be hard for me to be like, okay, yep, you know, this is the, this is the microcycle, that you have to be pushing really hard, you know, everything else off the table, like, I don't know that I could, you know, kind of, I would have to kind of get my head around it to be able to do that, because I feel like there was a push outside of this community toward a work life balance or toward, you know, moderation. So to me, I feel like there's there's a challenge there in, in folks who don't get it. To be able to it's this isn't intuitive to me, like some of these things make a lot of sense. Some of its intuitive, some of its optimal performance. We've talked about this before, we'll talk about it again. But some of this is like someone hates what they're doing. It's potentially hurting their bodies. And yet, this is what they need to be doing this week. Because next week, they're going to rest like, that's the part where - not necessarily totally intuitive for me to be able to just ride with that.

Curt Widhalm 1:04:18

And that's why we started this episode, really focusing on having the competency to know what you're working with and what the the larger goals of this particular client are. Because if you've spent all of your life going towards becoming performing at the highest level, and knowing, you know, at, like a division one school, I've had, you know, athletes, you know, one of the wonderful things about being a therapist in Los Angeles is it's a great college town. We have a lot of very competitive colleges in a number of different sports. That, you know, particularly at some of the division one schools around I've heard from clients like, I was phenomenal as a high school athlete, I was all state, I, you know, put in the work I did the traveling teams. I'm seventh best at my position in this particular sport, and if I don't show up, it's my scholarship. It's my, it's everything that I've built up to, and yes, I'm hurt, or yes, I'm depressed or Yes, I want to, you know, talk about, you know, not being able to find dates, who, you know, are willing to walk around with a 300 pound lineman or a six foot six, you know, female basketball player, you know, that these are the kinds of things where they have considerations outside of their life, that they don't fit into normal society. And we have to accept that as supporting providers in their life.

Katie Vernoy 1:05:58

It just seems like so much of their life, and their identity is wrapped up in being this athlete. And, and to me, I think about permanent injury, like maybe not there, it may be permanent, like it affects their whole life, but permanent in that they cannot play their sport or play at the level or retirement. I mean, I think this is where, you know, to close out this conversation as the time's running down, it seems like that dramatic transition, whether planned or unplanned, you know, depending on if it's a an injury, or retirement, it seems to me like that would be huge and really hard to navigate.

Curt Widhalm 1:06:38

It is. And it's something where, again, this is going to fall under a very particular adjustment disorder type treatment. But it's not going to necessarily be something that you're going to treat as a normal adjustment disorder type thing. Somebody who's intentionally retiring. You know, this is me, you know, in the news, at the time of recording this episode, Ben Roethlisberger, retiring from 18 years in the NFL, this is a planned retirement sort of thing he is going out on I have made this decision, I am transitioning to a different part of my life. That is going to have a much different transition and treatment approach than somebody who has a broken leg and isn't able to play anymore, or is not making the team after, you know, several years of being on the team and got outperformed by somebody younger, faster, stronger. Or somebody who's been in an accident. So that retirement adjustment is going to have a very heavy focus on not only appropriately grieving that kind of a period of their life, but helping them to form a new identity. This is different than you know, hey, I'm leaving this agency job and I'll go find a different kind of, you know, therapy job. This is more akin to like, leaving the military where it's a very functional shift as far as what your role is, and what your approach to the rest of the world is. There's a number of stories and again, my soft spot for NFL linemen the underappreciated, but link to at least one article in the show notes of people talking about the transitioning out of being a NFL lineman to where you spent years and years eating 1000s and 1000s of extra calories per day just to be as large as possible, where it's also, you've shut off that part of your body of relating to what foods means that you can't tell if you're hungry or not. You're used to having several meals out of the day, and you're stopping at fast food restaurants just because it's that time of day when I normally have 1000 calories, and being able to even have a different relationship with their body at that point. So there really is a core identity change that happens at that end of career as well.

Katie Vernoy 1:09:12

So before we close up, that led me to another question, and I think there's some questions that potentially are on the minds of folks, when they started this episode. Is that there's the question, the hanging question of: Is this reasonable to expect people to perform at this level? I mean, because it gets harder and harder. I mean, we didn't talk about steroids and other you know, performance enhancing drugs. You know, there there are things that as a society, we ask of our athletes that really push them very far into what I would consider unhealthy patterns, if they're eating so many calories so they can stay at a certain weight or they're restricting so much so that they can stay at a certain weight. That is disordered eating. By the by definition, right. And I think there's there's also folks who we, you know, if we look at Simone Biles or Naomi Osaka who have stated being at the top of their game, I can't show up today or I'm not going to do this today and really opening the conversation around is this something as mental health professionals that we should support for every person that can that could perform at that level?

Curt Widhalm 1:10:31

You know, you're you bring up Simone Biles and Naomi Osaka as a couple of good examples here. That it's not an all or nothing approach to working with athletes. And it's looking at the particulars of a given situation. And Simone Biles walked away from a portion of the Olympics and got almost universal support from other gymnasts, a lot of mental health professionals and, and I'll throw my hat in the ring on this, I support what she did at least what was in the news because it gave a space in a conversation to when you're at the top of your game, and you know that you can't perform, there should be more permission to step away. Now, where I think that some people in our therapist community have taken that is, the sport should not be that way, it should not have that amount of pressure. And I don't think that that's a reality. I don't think that that's a possibility. And so this is shifting our focus as a mental health professional in working and commenting on these types of situations of accepting what the reality is. and working within that rather than trying to create some utopia that doesn't exist

Katie Vernoy 1:11:49

I'm sure we can get a lot of feedback on that statement. Because we've also talked about if there is a need for advocacy, that's one thing that therapists can do.

Curt Widhalm 1:11:58

And the advocacy is to step up and make the space for this, you know, Naomi Osaka is the other example, you know, refusing to talk to the media at the French Open and accepting the consequences of that, hey, in order to take care of myself, it doesn't mean that there shouldn't be media talking to athletes, it doesn't mean that athletes can't talk to the media if they don't want to. It's that, alright, in order for me to do my best, I'm going to do this, and I'm going to accept this consequence.

Katie Vernoy 1:12:27

Yeah. And so I guess what you're saying is, look at it in a more of a nuanced lens don't necessarily go straight to the social justice lens.

Curt Widhalm 1:12:38

Exactly.

Katie Vernoy 1:12:38

Of what is society asking of these folks, and is it reasonable, but looking at what are these, what how are we empowering these individuals who have chosen to perform at this high level? How do we empower them to lead healthier lives?

Curt Widhalm 1:12:53

Yes, exactly.

Katie Vernoy 1:12:55

All right.

Curt Widhalm 1:12:56

You can find our show notes including our references over at mtsgpodcast comm you can also find out the information of if you want to get continuing education for listening to this episode. And until next time, I'm Curt Widhalm with Katie Vernoy.

Katie Vernoy 1:13:13

Just a quick reminder, if you'd like one unit of continuing education for listening to this episode, go to moderntherapistcommunity.com purchase this course and pass the post test. A CEU certificate will appear in your profile once you've successfully completed the steps.

Curt Widhalm 1:13:28

Once again, that's moderntherapistcommunity.com.

Katie Vernoy 1:13:32

Thanks again to our sponsor SuperBill.

Curt Widhalm 1:13:35

If your practice doesn't accept insurance super bill can help your clients get reimbursed. Super bill is free for therapists and your clients can use the code super bill 22. That's super bill to two to get a free month of super bill. Also you can earn $100 For every therapist you refer to super bill. After your clients complete the one time HIPAA compliant onboarding process, you can just send their super bills to claims at thesuperbill.com. SuperBill will then file claims for your clients and track them all the way to reimbursement by helping your clients get reimbursed without the stress of dealing with insurance companies superville can increase your new client acquisition rate by over 25%.

Katie Vernoy 1:14:18

The next time a potential client asks if you accept insurance, let them know that you partner with SuperBill to help your clients effortlessly receive reimbursement. Visit thesuperbill.com to get started.

Curt Widhalm 1:14:30

Hey everyone, Kurt and Katie here. If you love this longer form content and would like to bring the conversations deeper, please support us on our Patreon. For as little as $2 per month we're able to bring you more content, exclusive offerings and more opportunities to engage in our growing modern therapist community. These contributions help us to expand our offerings for continuing education events and a whole lot more. If you

Katie Vernoy 1:14:55

don't think you can make a monthly contribution no worries. We also have a buy me a coffee profile For one time donations, support us at whatever level that you can today. It really helps us out. You can find us at patreon.com/mtsgpodcast or buymeacoffee.com /moderntherapist. Thanks everyone.

Announcer 1:15:15

Thank you for listening to the Modern Therapist's Survival Guide. Learn more about who we are and what we do at mtsgpodcast.com. You can also join us on Facebook and Twitter. And please don't forget to subscribe so you don't miss any of our episodes.