The Benefits of Mental Health Therapy for Endurance Athletes

·9 min read
Photo credit: Thomas Barwick - Getty Images
Photo credit: Thomas Barwick - Getty Images


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When you get serious about a sport, it can feel like you’re in a relationship—in fact, you might even see your bike more often than your partner! But just like any relationship, your connection to cycling can come with ups and downs. And just like in other relationships, other factors can play a role in those ebs and flows, including job stress, an illness in the family, parenting, or maybe just a lost love for something you used to admire so deeply.

When you have these types of relational issues with another human—stress, loss of enjoyment or connection, confusing or complicated feelings—you’d probably consider seeing a mental health therapist to help you figure out what’s going on. Well, as an endurance athlete in a relationship with your sport, you can gain the same benefits from mental health therapy to support and improve your performance.

The research on how mental therapy helps athletes is surprisingly limited, but some research suggests slight performance benefits in psychological skills training (that includes things like imagery, self-talk, goal setting, and arousal regulation) and advantages to mindfulness practice—particularly when the interventions last for several weeks and include a daily practice. One case study also demonstrated that using the techniques practiced in cognitive behavioral therapy or CBT (a type of talk therapy) helped an elite skier overcome a debilitating anxiety that kept her from competing. (Many studies back up the anxiety-relieving benefits of CBT). Another study on 62 novice basketball players found that instructional self-talk improved skills performance.

“I work with athletes when they’ve had a best-friendship with their sport, and they ‘go into business together’ because it felt so good,” says Emily Saul, a sport psychology coach and licensed mental health counselor based in Boston. “They were really loving it and enjoying themselves, and the more they do it, they’re like ‘oh I can get good at this,’ and then goals are all that matter.” That can complicate a cycling relationship, as it takes away from the process and puts all the focus on the outcome. A therapist can help you see this.

Therapy is a space for you to go when you’re feeling some sort of disconnect with your life—whether it be with yourself, your partner, your sport, or anything else. And you don’t need to be an elite to go to therapy to talk about your sport—nor do you need to feel like you’re broken. Many people go to therapy just looking for a “tune-up.”

In fact, there are myriad reasons why someone would consider therapy. Here’s why it might benefit endurance athletes, specifically, plus what to do if you want to start mental health sessions.

The Benefits of Mental Health Therapy for Athletes

Have you ever had an injury that kept you from riding, and felt like you might fall apart because cycling helps you keep it together? “If you know more about how you’re navigating your own [mental health], your sport can be a supplement, rather than a primary means of caring for it,” Saul says.

Therapy can also teach us how to apply the strength and grit that get us through sport to other areas of our lives. “If I understand how I calm myself on the bike, but I don’t know how to get through this thing in my life—if I’ve done it on the bike, I might be able to access that skill [in life],” Saul says. She says that this can work the other way around too—how you approach big projects at work can help you realize how to psyche yourself up for longer rides or going faster or tackling hills.

The Types of Therapy and How to Find the Right One for You

Ultimately the most important factor towards “’success” with a therapist is the strength of your relationship with them. That’s why it’s key to find someone you like and trust.

With that said, there are many types of therapy that can help you narrow down what to look for in a therapist. For example, many athletes enjoy and do well with cognitive behavioral therapy (CBT), because it aligns with the part of them that thrives off of training plans.

CBT is a modality that examines someone’s thought patterns to see how they lead to behaviors that might not be serving the individual. For example, a therapist might offer thought-stopping exercises that help people interrupt the rumination on worst-case scenarios. Some ways to thought-stop include using positive self-talk (“I pulled through that really hard workout—I can do this!”), interrupting yourself out loud by saying “stop!” or “not now, brain!,” or using an elastic band on your wrist to literally snap yourself out of it.

Specific things a CBT therapist might ask an athlete to do are goal-setting or going through a mental rehearsal of what you want a workout or race to look like. A therapist might also focus on arousal management exercises—in sports psychology, this means managing your physical and psychological states to optimize your performance through both mental and physical exercises. Those exercises can include things like repeating a mantra and taking deep breaths.

Another type of therapy that is helpful for athletes is rational emotive behavioral therapy (REBT). This type of therapy challenges one’s rigid and irrational thoughts to find more helpful ones to meet their goals. For example, a REBT-focsued therapist might suggest changing the belief “big races make me anxious” to “big races bring me concern.” The first phrase sets someone up for anxiety; the second helps someone see how they can adapt their behaviors to the concerns.

REBT can also help athletes coming back from an injury who are afraid of becoming re-injured. That’s because REBT can help them identify and challenge irrational thoughts like “I’m going to get injured again and never be able to compete again and I will be miserable!” and shift their inner narrative to a more realistic one, like “I would be upset if I got injured again, but it wouldn’t be the end of the world, and I’d be able to deal with it” or “I have rehabbed my injury the best I can—all I can do now is be smart about my training. I may get injured again, but I also might not get injured.”

Motivational interviewing therapies—a technique that can be used to help people find their motivation and ability to make a positive behavioral change—can be a helpful and welcome change from “tough love” coaching (or self-talk). This therapy technique helps people find where their ambivalence to change resides and helps them find the answers within themselves to take action.

How to Find a Therapist That Suits You

Because a solid relationship with your therapist is paramount to the success you’ll see in working with them, it can take some trial and error in finding the best person.

The best way to start the search is to ask for personal referrals—either from a friend or from your doctor. If you work for a company that has an employee assistance program (EAP), they can usually provide you with a few free sessions relatively quickly and then help you find a therapist to work with on a longer-term basis.

You can also use directories like Psychology Today or Alma to help you find a provider in your area who takes your insurance, if you have it. (You will want to check if they are in-network or out-of-network, and what types of sessions or specific professionals your plan allows. If they you find an out-of-network therapist and you have a PPO, you may be able to submit a superbly for partial reimbursement.) If you don’t have insurance, Open Path Collective and Therapy4thePeople work with those who don’t have insurance and can’t afford a full fee. For those looking for a provider of color, there are directories such as Therapy for Black Girls and LatinX Therapy.

The good news is that telehealth also makes it easier to find a therapist even if there is not one in your immediate geographical area. (Though the therapist does need to be licensed in the state you live in to be able to work with you.)

What to Ask a Therapist

Saul says it’s important to tell a potential therapist that you’re an endurance athlete who puts many hours into their training, and that it is a key part of your life. It’s important to do this because someone who doesn’t understand endurance athletes or cycling might view it as an obsession. She suggests asking: What’s your experience in working with people who put lots of time into something that’s outside the norm?

She recommends also giving them a scenario specific to your life. For example: “I do a lot of training for cycling—could you give me a sense of how you’d respond if I came in really struggling with disappointment for something I trained for months for not going well?” This approach can give you good insight into how curious they are. (And you want your therapist to be curious about your life!)

It can also be helpful to ask how they will handle it if you’re unhappy with therapy. A good provider should feel comfortable with feedback and working with you to find a better fit, if necessary.

Just as you might go to prehab physical therapy to prevent injury, keep your body strong, and optimize performance—think of psychotherapy as doing the same for your brain. It can keep you not only cycling strong, but finding peace and passion out of the saddle, too.

The Bottom Line on Mental Health Therapy for Endurance Athletes

People often say things like “exercise cures depression” or “cycling is my therapy.” And while exercise has certainly been shown to support and even boost mental health, it’s not the same as seeing a therapist. In fact, others who hear this may internalize that something is wrong with them because their training isn’t “enough” to deal with their mental health. This hurts everyone, but especially those who are struggling with depression.

Studies suggest that the prevalence of depression may actually be higher in endurance athletes, compared to the general population. Saul also says that more people experience trauma than they even realize. This is all to say that you don’t need a diagnosis to seek mental health therapy.

Whether you do feel depressed, anxious, or stressed, you’re looking to bring the passion back to your sport, or you simply want to get over a mental hurdle in training, seeking a therapist can help you through the struggle. It’s all about finding one you like working with, you trust, and that helps you discover things about yourself that keep you pedaling forward.

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