By Meadowlark Monaghan
I can recall the day, sitting on the squishy floor of UCSB’s Counseling & Psychological Services, when I learned that psychiatrists could actually prescribe their patients exercise as a medical treatment for depression. “Of course they can,” I remember thinking, “the mind-body connection has been underplayed for too long.” That was 2013. Now, between Simone Biles' public priority of her mental health in Tokyo and Naomi Osaka's withdrawal from the French Open due to overwhelming media pressure, the mind-body connection has finally made its way onto the global stage.
Although our understanding of this connection can veer towards toxic positivity, like telling someone who’s depressed to simply “go for a run,” there is an inextricable link between exercise and our mental healthcare. Movement benefits our brain health and emotional health exponentially. In fact, one study found that just fifteen minutes of running (or one hour of walking) per day reduces risk of major depression by 26 percent.
So, how do we avoid the more dismissive toxic positivity attitude while still acknowledging the very real connection between mind and body? Dr. Hillary Cauthen, PsyD, CMPC, and executive board member of the Association for Applied Sport Psychology, says that it starts with “being kind to yourself, first and foremost. Have compassion for yourself and know that there is a reason why you want to initiate change and there is a reason why you are curious [about how movement can help].” We spoke with Dr. Cauthen over Zoom about the emotion tracking skills she teaches her professional athlete clients, the systemic side of body image issues, and how we can all learn to better listen to our bodies.
I am a clinical licensed psychologist, I specialize in mental health in athletes, and I am trained as a mental performance consultant. This field is a continuum and it’s advancing with what the athletes need. We are now realizing that athletes are more than performers, they also have mental health concerns. I have been an athlete my entire life, I played soccer and basketball and specialized in track and field in college. I knew what it was like to be a competitive athlete, but I also knew how much sports impacted me in other areas of my life. I wanted to use my training as a licensed psychologist to help athletes, but then also use exercise and sports as an intervention for individuals who might be struggling with life problems or have clinical symptomatology of depression or anxiety.
The concept of sports psychology is built on the idea that mental health is the same as our physical health. We have to keep it in check. Exercise plays a part in that because if I move my body daily, it impacts the mind by increasing our serotonin and dopamine levels, which are your happy endorphins. The second thing that happens is that if you exercise with someone else, you now have a social connection, so, along with moving your body, you can get happier because you are connecting with others [which causes even] more endorphins to fire. The third thing is that our bodies feel better. We feel good and can see positive changes taking place. So it’s a trifecta: the natural chemical response, a social connection, and a beneficial engagement with our bodies. Once you can tap into it and feel it, you quickly realize, "wow, this is really good for me.” It’s the initiation part, where you choose to start moving your body, that is difficult.
I am all about emotional awareness and regulation. Feel your feelings. If you can tap into knowing what your emotion is, then you can [ask yourself] “What is the best emotion to put you in the right environment to succeed and perform?” I tell people to regulate an on-ramp and an off-ramp. So, how do I prepare myself for going into the workout or workday? What is my routine? Do I have music that I listen to and a coffee to get my mind ready to go be in that performance zone? [What do I need] for the work hours, knowing I need a certain level of energy to do my best? And you also want to know if you need to recharge – if I am fatigued from Zoom calls, maybe I’ll go for a 10 minute walk to recharge and get my mind back into it.
Then, that off-ramp at the end of the day is so key. What do you do to take your day out of the performance zone of the work day? When I come home, I pull into the driveway and just listen to one more song on the radio, taking three more minutes for myself because I know that when I turn the doorknob, I am now mom, not the sports psychologist. We have to learn how to shift and get our minds into different states because our emotional framework has to be set up to perform whatever task is coming at us in each moment.
I think most people are high achievers and performers in their own way for their own reasons. No one really likes to fail, even if they are not this go-getter, highly competitive person, no one ever is like, "let me fail at my job." So, I actually flip it. I am not a responsive practitioner. I try to use consistent coping so, instead of teaching coping when there is a maximum problem, like an emergency or when someone is already burnt out, I reframe it and say, "Okay, what are we doing right now that helps you feel good? What are the things that we can make a larger part of your daily process?"
That means asking: are you sleeping well? Are you taking time to reflect, even if that’s over your morning coffee? What does your routine look like? How do you currently respond to stress? What boundaries, plans or systems do you have in place? Where do you need help managing and getting into a routine? It’s about having awareness of the routine and doing things that make you feel good every day, consistently. If those things stop working, then we have to re-evaluate or try a higher level of coping that you know works for you but might not do all the time, like getting a massage or something else [more extravagant].
I think the first step is emotion identification, which sounds so simple. I say, "Look, we all have feelings. We all have six basic, universal emotions." I usually throw in some quirky examples from the movie “Inside Out.” Then, that individual has to identify where they sit on a range of each emotion. So, if we go with joy, maybe “excitement and exhilaration” are the highest emotions they’ve experienced when it comes to joy, while the lowest emotion would be just “fine.” For someone else, that might be “content” or “okay,” it’s whatever their range is. Then, I do the same thing for fear, within which people can experience emotions like “anxiety” and “shame.” We work through the continuum of emotions for each person. I say, "What are we constantly feeling at our baseline? And where do you feel your best at?"
I have them track [their emotions], and there are tons of apps that you can use to do this that are free, like Daylio. You can put an emoji on there or journal about it in more depth. So I might say, first thing when you wake up in the morning, how do you feel? Do a body scan. Now, at mid-day, how are you feeling? Then your rate your emotions at the end of the day. I try to have [my clients] track at least three times per day, bare minimum.
I am a core believer of quieting the mind and meditating. Breath control is a thing we do without thinking about it, but when you do intentional breath control, it’s a game-changer, so teaching people how to regulate their breath and find that space is important. When I ask someone to meditate and they’re resistant, I’ll ask, “Can you breathe for three minutes, three times a day?” I start people off in phases: can they sit for five minutes with music at first? Can they sit for 10 minutes without music? And so on.
First and foremost you need to ask: Why are you doing it? What is your reason? You have to know your why because that is what will tap into your motivation, which fuels you to actually commit to the choice of doing it. Have a goal to complete. A lot of group exercises can be really scary because we feel we “don't look the part”. Before you engage in any exercise and [especially] if it is new, watch a YouTube video. The beautiful thing we have now is social media which allows us to educate ourselves beforehand and watch a preview of the exercise. What can I look at and learn about this exercise or this gym to know if I can feel comfortable in the environment? We just want to belong. If you feel like you will have a sense of belonging and comfort, then you are more likely to maintain and engage in that process.
Body image is a systemic, cultural issue that we have to work on. It starts with the culture of the coaches and their awareness of it. If I am working 1-on-1 with an athlete, I ask them, "What does your body do for you? How does it work for you? Is it reaching a level that you need it to reach?" It’s not so much about the physique and the looks, but a question of “is it moving the way you need it to move?”
Once I figure out the mismatch between the reasons why they feel the need to change [their body] versus how it functions for them, then we can identify the problem. More often than not, it is a cultural or external factor that is causing them to want to change their bodies. It happens in different areas for men and women – different sports are really hard because, in some, your body has to perform a certain way and is expected to look a certain way. Those aesthetic judgments can be really difficult especially as the body changes with puberty. What people don't realize is how much men go through this, too.
They can say "Hey, I know you are struggling, what have you tried that is helpful, and how can I help you? Would you like to go for a walk and talk to me? Do you want to go outside?" When you are sad and really in a state of depression, it is very hard to do a lot of things, and sometimes just showing up is good enough. Showing up means something different for everyone. Running might be a great exercise for one person, but for someone else some slow stretching and yoga could be better. It is more so about asking, what can you do today, what have you tried, what is working, how can I help you, and just listening. You want to ask, not assume.
It is super hard [to get through an injury or finishing a sport]. But you haven’t actually changed from the person you were when you were performing at your peak, you just have to perform differently. So, I think just taking time to process and reflect like, "yes, running was something that I did, but it’s not who I am. What did I become because I ran? What were the qualities that I brought with me? How can I bring those into other areas?" You became something because of your sports experience and you don't ever have to lose that, you just take that energy and put it into other goals you have. Maybe that’s family, school, or creating something new. The energy and the drive don’t have to change. You have to say to yourself, "wow, I have all these amazing skills, I am a high performer and really good at routine, let me apply that to whatever my next phase or venture is."
I think we can utilize science to help us more because we can get so much data on the right aspects of the way the body moves and functions and how we can work to maintain that. We also have to do our due diligence in educating and changing the sports system, particularly with coaches. Unfortunately, our coaches coach the way that they were coached, especially when we look at youth sports. Most of them are volunteers, they were athletes when they were younger, but they haven't gone through the rigorous training that a collegiate or pro coach might go through. We need to be better about giving them resources [on how to work with athletes without doing harm] because they are molding young brains and emotions in the sports world. Those kids are malleable and they are going to take in everything they hear and perform based on what their coaches are saying. A lot of coaches are causing damage without even realizing it.
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