Mental Health vs. Mental Illness: Is the sporting world confused?
Let me start this blog by clarifying: In addition to teaching skiing for 34 years, I am a positive psychology practitioner having completed a master's degree in Applied Positive Psychology (MAPP) last year. So, what exactly is positive psychology (PP), how did it come about and how does it fit with this topic of mental health/illness?
PP (a sub field of psychology) came to prominence in the year 2000 when Martin Seligman and Mihaly Csikszentmihalyi wrote a paper introducing the idea (Seligman & Csikszentmihalyi, 2000). PP is the scientific study and practice of what makes life worth living. It focuses on the individual, institutions and society to help improve the quality of life, bring more meaning to life and prevent the illnesses that can occur when life becomes barren or meaningless. A wide range of subjects come under the heading of PP such as mindfulness, flow, resilience, self-compassion, hope, meaning, strengths, wisdom and emotions.
I was prompted to write this blog because of all the recent media coverage about the subject of mental health in sport, including a recent live Q&A hosted by the British Association of Snowsports Instructors (BASI) for its members. The focus of this coverage has centred around the importance of being more 'open' about poor mental health and being comfortable about having conversations with coaches, fellow athletes, parents etc. And while I completely agree with this, I am also slightly concerned that there is, generally, a lack of understanding when it comes to mental health and mental illness. Furthermore, where does sport psychology fit into all of this? Hopefully what follows will add value to the conversations that instructors/coaches/teachers/parents/athletes etc. have when discussing mental health not only in sport but in life in general.
Mental health is the absence of mental illness but poor mental health can lead to mental and physical illness. What is important to clarify here is that "mental health" can be discussed in terms of good mental health or poor mental health and in positive psychology the idea of a mental health continuum from languishing to flourishing has been widely written about (Keyes, 2002, 2007). Seligam (2011) goes further by stating that "positive mental health is not just the absence of mental illness" (p. 183) and this supports the idea that there are levels of mental health and that those who are flourishing would have a combination of high levels of emotional, psychological and social well-being. As a positive psychology practitioner my role is to help people move from languishing to flourishing, while recognising that 'acceptance' of the negative stuff is part and parcel of life, which is very much embodied in Second Wave Positive Psychology: embracing the dark side of life (Ivtzan, Lomas, Hefferon, & Worth, 2016).
Mental illness includes a host of disorders such as depression/bi polar, eating disorders, post-traumatic stress disorder (PTSD) and substance abuse to name just a few. And it is beyond the scope, or indeed purpose, of this blog to discuss these, not least, because I do not have the expertise to do so. However, one of the major concerns within sport is the increase in suicide or attempted suicide amongst athletes. And that is why initiatives such as the recent live Q&A by BASI are important steps in the right direction.
So, is there some confusion?
Listening to all of the media coverage about mental health caused me to reflect on what appears to be a degree of confusion! Firstly, there seems to be an automatic assumption that when talking about mental health that this means poor mental health or even mental illness!! I am not sure that physical health is thought of in the same way? Remember that mental health is, as a minimum, the absence of mental illness, so the conversation on mental health should be about both poor and good mental health and more importantly how to move along the continuum from languishing to flourishing.
Secondly, while it is important for instructors/coaches/teachers/parents/fellow participants to be aware of the signs of mental illness there needs to be a recognition that poor mental health is not a mental illness and if a mental disorder is suspected then this should be referred to a suitable professional e.g., clinical psychologist, psychiatrist, psychotherapist etc. Mental health first aid training is a great way, for all those involved in sport, to be able to offer initial support to those individuals who may be developing a mental illness or experiencing a worsening of an existing condition. But it must be stressed, once again, that, like traditional first aid, such training is not about diagnosing or treating a mental illness but simply offering support until the appropriate professional help is received.
And thirdly, many of the mental challenges faced by sports participants/athletes are a part of the sport, and in exam and competitive situations learning to deal with these issues, more often or not, dictates the difference between preceived success and failure. After all, success comes from dealing with, accepting and learning from failure. This is where sports psychology becomes so crucial and why training mental skills is equally as important as training technically, tactically and physically. Having taught skiing for so many years, to all ability levels, I can say, without doubt, that helping people to deal with the mental side of the sport is a big part of what I do. Emotions, for example, can be labeled as positive or negative but in many cases they can be either. And even those emotions that would seem to be clearly negative e.g., anxiety and fear, can be a useful and necessary part of the learning process e.g., fear can help keep you safe as it is part of your own risk assessment process. Hence there can be power in negative emotion (Kashdan & Biswas-Diener, 2015).
So, one of the best ways to help people deal with the mental challenges, associated with sports participation, is to develop their mental skills through training. And, while this blog is not about all the different approaches that sports psychologists can use, it is timely that as I have been writing this blog a friend and colleague of mine Dave Burrows who created "The Ski Instructor Podcast" has just put out his interview with world renowned sports psychologist Dr. Jim Taylor, which is well worth a listen. And from my own experience and training one of the increasingly popular sports psychology tools is mindfulness. There are a number of excellent training programmes available that incorporate mindfulness such as the Mindfulness Based Skiing Specific Intervention (MBSSI; Tate, 2019), Mindfulness Meditation Training in Sport (MMTS; Baltzell & Summers, 2017) and Mindfulness Acceptance Commitment approach (MAC; Gardner & Moore, 2007). And a really interesting aspect of using mindfulness approaches is that it helps participants to 'accept' what is occurring, be it positive, negative or neutral, rather than trying to block out or suppress their experiences. Incidentally, the MBSSI programme, that I developed when working with the Irish Interski Demo Team , is available for free via our documents page.
Mental health includes good and poor mental health but poor mental health is NOT mental illness.
While poor mental health can lead to mental and physical illness dealing with mental disorders should be referred to the appropriate professional.
Mental challenges are part and parcel of participating in sport and mental skills need to be trained and developed alongside other skills.
However, in the context of the above, being comfortable to have that conversation about feelings, emotions and mental challenges is something that should be encouraged, not only in sport but, in society as a whole. Being more open, and at ease, about discussing these issues can only help with reducing the likelihood of poor mental health deteriorating toward mental illness.
If this blog has been of interest then why not join us next October at Chill Factore, Manchester, for the Parallel Dreams Coaching Academy Sports Coaching Conference on Health and Well-Being through Sport and Mountain Life. The conference takes place from the 9-11 of October 2020 and registrations are now open.
Baltzell, A., & Summers, J. (2017). The power of mindfulness : Mindfulness meditation training in sport (MMTS). Springer International Publishing.
Gardner, F. L., & Moore, Z. E. (2007). The psychology of enhancing human performance: The Mindfulness-Acceptance-Commitment (MAC) approach. New York: Springer Pub. Co.
Ivtzan, I., Lomas, T., Hefferon, K., & Worth, P. (2016). Second wave positive psychology : embracing the dark side of life. London and New York: Routledge.
Kashdan, T. B., & Biswas-Diener, R. (2015). The power of negative emotion : How anger, guilt and self doubt are essential to success and fulfillment. Oneworld.
Keyes, C. L. (2002). The mental health continuum: From languishing to flourishing in life. Journal of Health and Social Behavior, 43(2), 207–222. https://doi.org/10.2307/3090197
Keyes, C. L. (2007). Promoting and protecting mental health as flourishing. American Psychologist, 62(2), 95–108. https://doi.org/10.1037/0003-066X.62.2.95
Seligman, M. E. P. (2011). Flourish : a new understanding of happiness and well-being--and how to achieve them. London and Boston: Nicholas Brealey Pub.
Seligman, M. E. P., & Csikszentmihalyi, M. (2000). Positive psychology: An introduction. American Psychologist, 55(1), 5–14. https://doi.org/10.1037/0003-066X.55.1.5
Tate, D. (2019). Mindful ascending for flowing descending: Can teaching alpine ski instructors mindfulness strategies foster more flow experiences on the slopes? Dissertation for Masters in Applied Positive Psychology (MAPP).