There is an intense mental toll of reaching—and remaining—at the pinnacle of a sport. “The top six inches of the body matter just as much the rest,” says Matthew Cunliffe, a sports psychologist, who spoke with Quartz about what goes through the minds of elite athletes and how psychologists can help them win. The conversation has been edited and condensed for clarity.

Exercise psychology and sport psychology involve the scientific study of the psychological factors that are associated with participation and performance in sport, exercise and other types of physical activity. Sport psychologists are interested in two main areas: (a) helping athletes use psychological principles to achieve optimal mental health and to improve performance (performance enhancement) and (b) understanding how participation in sport, exercise and physical activity affects an individual's psychological development, health and well-being throughout the lifespan.


It’s a really tough time for athletes. They would go through a period where they are questioning themselves, their work, and their skills. As a psychologist, I’d like to give them time to digest what’s happened, especially at the Olympic games for which they’ve been training for four or eight years. Then they can come to me and reflect on what’s happened. I’d like to be a mirror so that they can talk and open up. To be a sounding board for the athlete, and to start rebuilding if they are ready to do so.
Even when coaches adopt a more empirically validated approach than McNulty did, they still tend to fall into the trap of treating the symptoms rather than the disorder. That’s because they typically derive their treatments from behavioral psychology. Of course, behaviorism has been a great boon to psychiatry in recent years. Findings from this discipline have helped people enormously in controlling specific behaviors and learning to cope in particular situations. But treatments derived from behavioral psychology are sometimes too limited to address the problems that disrupt executives’ ability to function.
There is also a range of options available, from one-on-one meetings to phone sessions to CDs and tapes. McGrail and Grossman agree that while potentially useful, recordings are not usually as effective as personal sessions. And there’s no shortage of opinions on the best ways to quit smoking; the gamut runs from hypnotherapy to Zyban and Nicotine Anonymous.
It further identified target groups that would benefit from sports psychology, including active amateur and professional athletes; sports teams and leagues, athletes suffering from temporary or permanent injuries; as well as the family members, teammates, coaches and friends of athletes. Finally, the APA identified specific problems and the techniques that could be used to address them, including mental skills training, visualization and motivational techniques, rehabilitation counseling after injuries, stress management, boosting self-confidence, leadership and team-building training, and counseling for eating disorders or substance abuse.
Cancer, a very common and sometimes fatal cause of unexplained (idiopathic) weight loss. About one-third of unintentional weight loss cases are secondary to malignancy. Cancers to suspect in patients with unexplained weight loss include gastrointestinal, prostate, hepatobiliary (hepatocellular carcinoma, pancreatic cancer), ovarian, hematologic or lung malignancies.
"It is my belief that psychotherapy has the best chance to be effective when the client and therapist have a strong therapeutic alliance. That is, they have a good working relationship and are working toward exactly the same goals using methods or approaches best suited for the client. I strive to achieve this by providing a warm and safe climate, listening closely to the needs of my clients, and discussing our options and strategies."
Although there are different techniques, clinical hypnotherapy is generally performed in a calm, therapeutic environment. The therapist will guide you into a relaxed, focused state and ask you to think about experiences and situations in positive ways that can help you change the way you think and behave. Unlike some dramatic portrayals of hypnosis in movies, books, or on stage, you will not be unconscious, asleep, or in any way out of control of yourself. You will hear the therapist’s suggestions, but it is up to you to decide whether or not to act on them.
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