If so, you may be experiencing grief and loss, and the application of sport and exercise psychology skills and principles can help you bounce back. The support of a psychologist, even for one session, may assist you in managing the psychological process of healing and getting back to life.
Can using sport and exercise psychology skills really offset or insulate people from physical and emotional suffering in times of significant, even life-changing or career-ending injury?
Going through the stages of grief and loss in a healthy way, when coming to terms with pain, injury, uncertainty and lack of mobility, can be made easier with professional support. Sport and Exercise Psychologists specialise in assisting with injury recovery support, as well as enhancing performance.
Injury for an athlete or active person can be devastating, and we can assume that injury that disrupts or limits physical functioning will be taken much harder by active people than the inactive population. This is due to the impact on identity, and the magnitude of the disruption of daily life routines (these people have more physical activity in their daily lives, so injury affects them more).
It can especially be true in terms of the emotional toll injury has on active people and the resulting low mood, irritability and negative thinking that they frequently display, post-injury. That is, until they have fully processed the situation.
Grieving the Loss of your Active Lifestyle
But what does it mean to process the situation – and move forward with a positive attitude – when your body is under the stress of pain, and your mind is under the stress of the inevitable wait and setback, not mention the possible ending to your sporting career?
A commonly used model of grief and loss may help us to understand what active people go through, when they are forced to cope with significant injury.
The Kübler-Ross 5-stage model of grief and loss introduced in 1969 in the book “Death and Dying”, was not intended to help discuss an athlete’s experience of significant injury, rather it came from the study of terminally ill patients and their families. In general people do not always go through these stages in a linear fashion, and can move through them in any order. Individuals may relapse or skip steps, but it is the best fit model to describe “the norm” when it comes to experiencing significant loss, like death or a very bad separation.
It can also help to inform us in terms of sport and exercise injury, and the emotional roller-coaster active people experience in the recovery/rehabilitation process.
Stages of Grief after a Sport or Exercise Injury
- Denial and isolation: Emotions and shock to the system are too overwhelming for our coping resources, so denial acts to protect us from the emotional roller-coaster. We resist and withdraw from anyone or anything that would make us face the facts leading to isolation.
- Anger: When denial wears off and we have to face the loss we become angry as a way to deflect the emotional pain from our core. It’s easier to turn our attention outward and resent the world or people for dishing us out this does of pain. This is often a very irrational response but its very human. The guilt for being angry makes us more angry and resentful.
- Bargaining: Once the reality of the loss has sunk in, we feel helpless and grasp at any possible – even impossible – idea of how we can salvage or reverse the loss. A lot of “should have, could have and would have” thinking occurs at this stage, and we run hypothetical situations of how it could have been different in our minds on replay.
- Depression: In our final stages of grief and loss, the reality and practical implications lead to deep sadness and worry about the changes and uncertainty we face. This can revolve around the lack of/limiting of control (and perceived control) in our lives due to the loss. This depression is also defined by the internal “letting go” process (a loved one, a goal, your expectations about your immediate sporting future).
- Acceptance: The final stage of grief and loss is the ultimate acceptance of the reality of the loss, and surprisingly is often associated with social withdrawal. This is because in some ways grief and loss is a personal and solitary affair. Ultimately we all have this experience in different ways, most markedly around the death of a loved one or our own impending death. Acceptance is not a happy shift, but it is quite different from depression in that it is a calm making peace with the immediate reality that allows us to step away from suffering.
Wiese-Bjornstal, Smith, Shaffer, & Morrey (1998) developed the Integrated Model of Psychological Response to Injury and Rehabilitation.
This model describes three interdependent responses which individuals make when injured, that will in turn determine the approach and adherence to the rehabilitation process. Targeting all three responses can help us maintain motivation and self-belief in our recovery. All three responses are mediated by both personal (personality, motivation, self-belief, perception on control, resilience, history of injury, coping skills) and situational factors (aocial support, resources available, life stressors, requirments of the sport/exercise). These three responses are:
- Cognitive Appraisal: What we think about the injury and its relations to our lives and goals;
- Emotional Response: How we feel about the injury, our future, how are mood and energy are effected;
- Behavioural response: What we do in response to injury and functional loss, planning-execution.
Personal Experiences of Sport and Exercise Injury
From my experience working with sports people and playing sport myself, here are some common psychological barriers I have observed after a significant injury requiring time off and rehabilitation:
- “She’ll be right” fairytale – ignore, pretend, distract, entertain fantasy story of prognosis/recovery
- Fear and catastrophising, quick debilitating periods of hopelessness and sadness
- Frustration and agitation, handing over reins and entering dependency on others
- Ruminating about the lost time, lost training and strength, hyperfocus on injury and pain
- Confidence in ability to bounce back and perform the same is riddled with doubts
Here are some positive steps I have seen in emotionally resilient sporting people:
- Acknowledging the sacrifices needed to get back, accepting limitations
- Emotion regulation and expression
- Social support and communication
- Finding the silver lining – positive thinking
- Checking in with negative thinking
- Creative approach to use of “lost time”
- Making a plan and sticking to it
- Channeling the negative into motivation
- Self-belief and vision of recovery
- Perception and focus on controllables
- Ability to adjust goals creatively
If you are struggling with a recent sport or exercise injury – or an old niggling injury – and think that some professional assistance in creating positive momentum in your healing process is needed, please contact me for an initial consultation. We can investigate how to improve your drive and outlook, and develop additional skills related to staying positive and accepting the road ahead to rehabilitation.
Author: Abra Garfield, BPsych, MPsych (sport & exercise), MAPS; Medicare ATAPS provider.
Abra Garfield is an endorsed Sport and Performance Psychologist, with a passion for helping others to achieve optimal performance whether on the sports field, in the classroom, home or office. By drawing on a range of therapeutic techniques including Mindfulness, Acceptance and Commitment Therapy, and Cognitive Behavioural Therapy and Motivational Interviewing, Abra helps many people with goal setting, motivation, and overcoming anxiety.
Abra is the Principal Sport Psychologist and founder of Summit Performance Psychology. Visit the Summit Performance Psychology website to learn more or like us on Facebook to receive Summit Performance Psychology Articles and event updates.
Psychologist Abra Garfield has moved.
Find his details on his website: Summit Sport & Performance Psychology.