Stress management refers to the environmental, physiological, cognitive, and behavioral techniques employed by an individual to manage the factors and components that underlie the stress process or experience of stress. A primary goal of stress management in sport is to allow the athlete to effectively regulate competition related demands to facilitate optimal performance as well as to enhance psychological well-being (PWB). There are numerous stress management techniques that can be classified into various heuristic categories. Many of these are covered in this entry. However, to understand why these techniques are effective under specific conditions, it is important first to understand the stress and emotion process.
Contemporary thinking in sport psychology (SP) conceptualizes stress as a complex dynamic transaction between environmental demands, such as those associated with high-level competition, and the athlete. Stress occurs when the demands tax or exceed the resources, such as skills or support, that the athlete has at his or her disposal. Since competitive sport is by nature demanding, how athletes evaluate and cope with the demands they encounter has a large impact on the stress process. The environmental demands, as well as internally generated demands from personal expectations and goals, are typically called stressors. Stressors can be acute, chronic, or intermittent, and they can also be expected or unexpected.
The stress process is highly influenced by how athletes evaluate the personal and social meaning of stressors. Such evaluation, typically called an appraisal process, can be rapid and automatic or reflective and is shaped by social learning, culture, and memories. In many cases, emotional feelings and patterns of thought and behaviors are activated, with corresponding physiological and neurological activation, action impulses, cognitive plans, and actions. Thus, the stress response can include changes in emotion, feelings, cognitions, behavior, and autonomic physiological systems. Stress responses differ from athlete to athlete, and, for any given athlete, stress responses can take different forms in varying situations. Thus, effective stress management can target the actual demands and/or enhance the athlete’s ability to regulate the factors that are associated with the appraisal, emotion, and cognitive behavioral response.
Stress management techniques in sport typically target somatic, behavioral, and/or cognitive affective symptoms of stress. Somatic responses involve the athlete’s physiological reactions, such as changes in heart rate (HR), respiration (R), sweating, gastrointestinal functioning, muscular tension and control, pupil dilation, urinary system, and salivation. Behavioral responses are the direct actions taken because of the stress, including engagement or disengagement in certain strategies or activities, as well as distraction. Finally, cognitive affective responses include the thoughts associated with the stress, including worries, beliefs, apprehensions, and negative expectations about performance as well as action plans to manage stress. Distinguishing between and being aware of each of these aspects is important for the athlete, coach, and SP consultant, as this knowledge helps to ensure the appropriate stress management skills are applied.
Effective stress management also needs to recognize the temporal aspect of the stress process. Stressful transactions in sport often involve anticipation, confrontation (engagement), and post-engagement stages and can result in an athlete feeling overwhelmed. Stress management techniques can target specific stages or combination of stages.
Types of Stress Management Programs and Techniques
There are a number of stress management approaches in sport to deal with various components of the stress process. Some practitioners advocate a multimodal approach, which involves using different tactics thought to be more effective in combination. Others suggest focusing on the dominant stressor with a unimodal approach, which uses a singular, focused intervention strategy. Multimodal approaches tend to be favored because of their effectiveness on a wide range of factors related to different elements of the stress process (i.e., actual stressor, emotional feeling, cognition, behavior, and physiological responses). However, there is evidence that situations dominated by one particular stressor may be more efficiently treated with a unimodal approach. The effectiveness of any type of stress management ranges depends on variables such as the athlete’s situation, his or her coping resources, and the appropriateness of the approach for the stressor. It is best to create individualized stress management skills programs designed to meet each athlete’s specific needs. Common stress management interventions are briefly outlined next, in alphabetical order. These approaches can been seen as an application of theoretical and clinical knowledge to produce a more practical approach, and each of the approaches has varied levels of empirical support, depending on important factors such as context and person variables.
Anxiety Management Training
Anxiety management training involves an athlete’s learning to employ relaxation strategies under stressful or arousing situations, including those producing emotions such as anger and anxiety. During anxiety management training, the athlete visualizes the stressful situation and allows the accompanying physiological arousal to be generated within himself or herself. Relaxation techniques, such as applied relaxation, progressive muscle relaxation, breath control or deep breathing, or meditation (outlined later), are then used by the athlete to reduce the symptoms of physiological arousal, such as increased HR, R, and blood pressure (BP). This may also promote management of behavioral responses such as loss of coordination, acts of aggression or frustration, “choking,” or withdrawing from sport.
The aim of applied relaxation is to learn the skill of relaxation and develop the ability to apply it rapidly where needed, in any situation. Connected to this approach are six stages. The first stage is progressive muscle relaxation, a technique where muscles are contracted or tensed and subsequently relaxed, which is used to help facilitate relaxation and help the athlete reduce somatic anxiety symptoms. As the athlete becomes proficient in this skill and moves to stage two, muscle relaxation is promoted by relaxing the muscles without tensing them first. In stage three, the term relax is conditioned to bring on a relaxed state when spoken or thought by the athlete. A focus on breathing is also promoted in this stage, as well as a focus on passive concentration, which is an effortless, automatic, yet focused state of mind, similar to mindfulness. Stage four requires the athlete to learn to use the skill in real-life settings, relaxing appropriate muscles while engaging ones needed for activity. Stage five focuses on having an athlete relax while in a naturally occurring, nonstressful situation. Breathing is the trigger of relaxation in this stage and is practiced 15 to 20 times per day. The sixth and final stage is called application training. The relaxation technique is implemented in a practice or training session and then in a low-stakes competition. The more frequently and completely it is implemented, the easier it will be for the athlete to use the strategy in a higher level of competition.
Arousal or Energizing Techniques
Some research suggests that athletes differ on the level of activation needed to produce optimal performance. Various levels of arousal are often conducive to high performance, and it is paramount that the athlete perceives the arousal as beneficial (see Cognitive Control later in this section). While many stress management approaches take an arousal reduction focus, strategies to increase arousal include imagery, self-talk, goal setting, and cognitions or thoughts focused on heightening stimulation.
Autogenic training, first introduced in psychiatry by Johannes Heinrich Schultz, involves a series of exercises designed to produce sensations such as warmth or heaviness, to help promote relaxation. The program is based on six stages, each with a separate goal. The stages are learned and practiced in the following order: heaviness in the extremities, warmth in the extremities, regulation of cardiac activity, regulation of breathing, abdominal warmth, and cooling of the forehead. Verbal cues to the athlete can be used to aid in prompting the sensations.
Biofeedback training (BFBT) can help control autonomic physiological stress responses, such as increased HR and BP. It also has been used to control anxiety disorders as well as anxiety connected to particular environments or contexts. The premise behind biofeedback (BFB) is for the athlete to become aware of how stress is manifested physiologically, such as changes in BP, HR, breathing, or muscle tightness, using different modes of objective feedback and monitoring. With this increased awareness, athletes are better equipped to control their actions. With training, athletes become less reliant on the feedback, learning to control their physiological responses on their own.
Breath Control and Deep Breathing
Breath control is a relaxation technique using the physical strategy of breathing. It is an effective and relatively easy stress management technique to apply. Irregularities in breathing, such as holding one’s breath, hyperventilating, or random shallow breaths, can affect performance, potentially influencing coordination, focus, or rhythm, or can cause the athlete to feel unsettled, causing further stress. Breath control can be practiced by taking a slow, complete breath. Often, the lungs are conceptualized in three parts to aid in proper instruction of a slow, complete breath. The lower lungs are filled by pushing the diaphragm down and forcing the abdomen out. The middle portion of the lungs is then filled by expanding the chest cavity, expanding the rib cage. The upper lungs are then filled by raising the chest and rib cage. The breath is held for several seconds, and then a slow exhalation is made, taking approximately double the time taken for the inhalation process. Breath control is commonly used before a competition or during a natural break during the competition, as it is most practically applied during nonactive times.
Cognitive Affective Stress Management Training
Cognitive affective stress management training is one of the most comprehensive multimodal stress management programs used in sport. Originally designed by Ronald Smith, the program is designed to teach the athlete relaxation and cognitive skills that can aid in controlling physiological reactions and cognitive thought patterns. Intervention consists of both cognitive and physiological strategies, including relaxation skills, cognitive restructuring, and training that is self-instructed and targets the physical and mental reactions to stress. The premise behind the combination of physical and mental coping strategies is the development of an integrated coping response. The program, which has some empirical support, is educational rather than psychotherapeutic in nature and is designed to help athletes increase their self-control.
The cognitive affective stress management program consists of four distinct phases. In the first phase, the pretreatment assessment, the consultant uses an interview approach as well as questionnaires to assess the athlete’s issues with stress—namely, what situations tend to produce stress, how the athlete responds to stress, and how the resultant stress affects performance and other behaviors. The athlete’s cognitive and behavioral skills are assessed to determine existing resources. This stage is integral in understanding the unique aspects and situation of the particular athlete in question, allowing for a personalized program to be tailored for the athlete. The next phase is the treatment rationale phase, the aim of which is to help the athlete better understand his or her stress responses through analysis of personal stress reactions and experiences. Next, in the skill acquisition phase, athletes receive training in muscular relaxation, cognitive restructuring, and self-instruction. Muscular relaxation is taught under the guidelines of progressive relaxation, described earlier in this section. Cognitive restructuring, as described in more detail later in this section, involves the identification of irrational and destructive thoughts and the subsequent refocusing into more positive thoughts. Self-instruction training aims to teach athletes to provide themselves with specific instructions designed to improve concentration and promote problem solving. The final stage is skill rehearsal. In this stage, different levels of stress are induced by the consultant using mediums such as videos or imagery. The athlete is required to apply, and thus practice, the coping skills he or she has learned in the program.
Cognitive control involves changes to cognitions that trigger, maintain, exacerbate, or reduce the stress and emotion response process. Many cognitive control strategies were developed for cognitive therapy and help athletes understand how thought processes are involved in the experience of stress. Strategies to control unwanted or maladaptive thoughts include cognitive restructuring, positive thought control, and attentional refocusing. Cognitive restructuring involves helping an athlete to recognize and challenge irrational thoughts and to change these thoughts so that they become more adaptive. There are several steps in cognitive restructuring including identifying automatic thoughts or beliefs that are irrational and negative, challenging or debating the rationality of these thoughts, and then replacing these automatic thoughts with more positive and rational thoughts. Positive thought control involves self-awareness to identify negative thoughts and replace them with more adaptive ones. Positive thought control involves three elements: using negative thoughts in a positive way, controlling negative thoughts, and training positive thoughts. The aim is to have the athlete take a more positive orientation regarding the situation. Attentional refocusing involves shifting attention or focus from a stressful issue to one with fewer negative connotations attached to it. Some athletes may become too focused on their thoughts and stress reactions, causing them to become more anxious. To a large extent, attention refocusing attempts to shift attention from a self-focus to more of a focus on the features of the sporting environment.
Hypnosis involves getting the athlete to an altered state of consciousness in which he or she is relaxed and where perceptions, feelings, thoughts, or actions can be changed through suggestion. Although still somewhat controversial and misunderstood, hypnosis has been employed with athletes to help reduce anxiety and manage stress, as well as enhance other mental skills, focus attention, and increase confidence. Other stress management techniques such as relaxation and imagery or visualization are often used in conjunction with hypnosis, but the athlete is in a hypnotic state before they are applied. Typically, hypnosis is applied in four phases. The induction phase involves putting the athlete in a relaxed state and then inducing hypnosis using imagery and/ or attention-focusing techniques. In the hypnotic phase, athletes are given suggestions designed to target the issue at hand, most of which will be carried out once out of hypnosis. The waking phase consists of the athlete coming back to a conscious state, and the posthypnotic phase involves the athlete carrying out the suggestions given to him or her while in a hypnotized state. Athletes will benefit from hypnosis only to the extent to which they are able to be influenced on a subconscious level.
Meditation is another method of raising self-awareness, allowing an athlete to better manage stress. Through meditation, the athlete becomes more attuned to physical sensations and builds an understanding of the connection between physiological functions (e.g., increased HR, nausea) and psychological state (e.g., anxiety, confidence). There are a variety of approaches to meditation, all directed toward increasing awareness of internal physical and psychological triggers that have potential to prompt certain outcomes. This knowledge can help to promote relaxation or direct other stress management approaches, depending on the situation.
Performance and Competition Planning
Preperformance and competition as well as performance and competition plans can help the athlete manage the stress that is inherent in competition. Such plans allow the athlete to take a proactive stance on stress, identifying ahead of time triggers of stress, and formulating a plan to counteract those issues. Planning allows many athletes to feel more in control of the situation and the self, thereby often decreasing further experiences of stress. It also provides a structure for them to incorporate other stress management and psychological skills into their preperformance and performance routines. Preperformance and performance plans have been suggested to promote proper focus and attention toward task relevant issues and help to attain the proper level of activation for performance, promoting both physical and mental readiness to perform.
Self-compassion interventions can help prevent athletes from becoming overly self-critical. Based on the work of psychologist Kristin Neff, self-compassion has three key components. Self-kindness involves being understanding and accepting toward oneself in instances of adversity as opposed to being overly self-critical. Common humanity is the acknowledgment that one’s experiences are not isolating, as others also have these experiences. Finally, mindfulness involves a balanced perspective, keeping thoughts and feelings in a state of equilibrium, as opposed to over identifying with them. Strategies to promote self-compassion include writing, imagery, and psychoeducational components. Interventions are currently being adapted for sport.
Stress Inoculation Training
Stress inoculation training (SIT), developed by Donald Meichenbaum, is based on the idea that if an athlete is exposed to stress and learns to cope or deal with that stress in amounts that increase incrementally, an increased tolerance to stress will be obtained. It is a multimodal approach using coping skills that include creating productive and adaptive thoughts, images, and self-statements designed to benefit the athlete’s psychological state, as well as performance. It has been found to be effective in reducing anxiety and enhancing sport performance. SIT involves three stages. The conceptualization stage aims to raise the athlete’s awareness on the effects of positive and negative thoughts, self-talk, and imagery. The rehearsal stage involves the athlete’s learning to use a number of specific coping skills such as arousal control, imagery, and self-talk, which creates coping resources. The actual skills will depend on the specific needs of the athlete. Finally, the application stage involves the athlete’s practicing the skills in increasingly stressful situations. A key feature of SIT is the gradual exposure to stress such that the athlete becomes “inoculated” and is less affected. The application begins with low-stress situations and gradually builds toward higher stress situations as coping skills become more advanced. Specific application procedures involve imagery, role-playing, and simulations of increasing perceived stressfulness.
Other Associated Psychological Skills
There are a number of other psychological skills, such as imagery, identifying strengths, and goal setting, that can be incorporated into stress management programs. Calming imagery, such as visualizing oneself in a safe, relaxing place, can be used to help reduce cognitive anxiety and arousal and to bring on physical relaxation. Conversely, imagery can be used to energize and motivate by visualizing more stimulating, exciting places or scenarios. Imagery is often incorporated into athletes’ preperformance and performance plans and routines. Identifying strengths can help refocus athletes’ thought processes toward what they can do rather than what they cannot do and assist in developing competition plans that maximize assets. Goal setting can help the athlete stay focused on the task at hand and keep attention on relevant issues. Setting reasonable goals— ones that are measureable and challenging, yet attainable—can also help keep stress from becoming overwhelming. This is most commonly incorporated into preperformance and performance plans and routines.
Stress management techniques can include any intervention that can modify one or more components of the stress process. Stress management techniques need to be directed at individual needs and the issue at hand, as well as take into account the coping resources the athlete has available. As with the acquisition of any skill, application of stress management techniques requires training, time, and practice. Knowledge is not sufficient, as it does not guarantee an athlete can apply the necessary skills or program to his or her specific issue. Application and practice are necessary, and effort is needed on the part of the athlete to make gains in stress management ability.
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