Burnout in Elite Athletes

On September 17, 1995, Judy Messer, formerly McClintock, stepped on the medal podium in France to formally accept her title as the 1995 World Overall Water Ski Champion. This becomes even more incredible when you consider that Judy, 32, is also a very dedicated mother to her three children aged 1,3, and 5, works full-time in a nautilus club she owns in Massachusetts, and works full-time in her family’s water ski school in Cambridge, Ontario, in the summer. She is an 18 year veteran of the Canadian Water ski team of which she has won 16 of 18 national championships, and has consistently picked up international medals including golds in trick skiing and team overall performances. Dale and Weinberg (1990) explain, "Long hours of practice which require a great deal of physical and mental energy along with pressures to perform on game day make the situation ripe for potential burnout". Judy’s life involves more than just a competitive lifestyle. With demographics like this, many would have predicted that she would have suffered burnout a long time ago. Through my own participant and naturalistic observation, I have not noticed this; her neighbours agree, giving her the pet name "Iron Woman".

The question that logically follows is whether is she abnormal? Statistically, she definitely is abnormal, because she is at the extreme end of a symmetrical distribution, and even a skewed distribution, of a person’s ability to function efficiently. Her abnormality should not be thought of in a stereotypically negative way as she is functioning very constructively, instead of destructively. She also should not be thought of simply as a prodigy, as this would undermine her hard work. If one assumes that she is slightly above average in natural physical talent and cognitive abilities, then her success cannot be attributed entirely to uncontrollable factors, but instead to controllable variables. Studying what these variables are, and how they interact, can give future athletes explicit guidelines for attaining actualization.

As a grounding framework for this paper, I will draw a continuum with burnout at one end of the spectrum and actualization at the other. Burnout should be viewed in a continuum of low to high, because it is not an all or nothing concept (Perlman and Hartman, 1981). Both retroactive and proactive measures can be taken to improve ones standing along the continuum. In this paper, I will start at the "burnout" end of the spectrum. I will define some current models of burnout, and some retroactive treatment strategies for burnout. Then I will suggest some proactive measures for burnout which involve both increasing protective factors and decreasing risk factors of burnout. I will conclude this paper with an argument for more weighted use of proactive coaching methods for elite athletes.

Definitions of Burnout

There is a short history in the literature of burnout in athletes. The first literature in burnout occurred in the seventies, with the study of professionals. Later researchers took interest in top athletes and coaches because a steadily increasing number were dropping out at the peak of their careers, claiming that they were not experiencing any fun or meaningful rewards (Dale and Weinberg, 1990).

Burnout is a reaction to chronic stress involving an interaction of the environment and the person (Dale and Weinberg, 1989, Smith, 1986). It is a complex interaction among physical, behavioral, cognitive and affective components. An imbalance over a long term results in chronic stress which leads to burnout (Smith, 1986). Th following components are common among the many definitions of burnout. The first component is exhaustion, whose symptoms include loss of concern, energy, interest and trust. Exhaustion can take physical, mental and emotional forms. Secondly, exhaustion can lead to a negative change in the individual’s response to others. The athlete becomes more impersonal, unfeeling and cynical. Thirdly, a perception of low personal accomplishment, results in low self esteem, feelings of failure and depression, which in turn decrease performance levels even more. The forth component common in burnout definitions is there is a variation in individual reaction to chronic stress and the fifth component is that the overall uniqueness of each individual person must be considered. Idiosyncrasy is the main reason that it is difficult to define burnout (Dale and Weinberg, 1990). The lack of agreement of both an operational definition of burnout and the components of the syndrome continue to be the major problem in finding clear antecedents to burnout (Weinberg, 1990, Fender, 1989).

Dropout is often the end result of burnout. It may occur for many reasons, including group climate, attitudes towards competition, socialization factors, attributions, leadership in coach, having "other things to do" and burnout. So burnout is only one possible determinant of dropout. It is different in form than the other aspects of dropout because of the negative attitude towards the activity, and the physical and emotional exhaustion experienced (Dale and Weinberg, 1990).

Burnout has been measured both subjectively and objectively. The symptoms of burnout mostly have been identified anecdotally and autobiographically by athletes who have experienced it (Fender, 1989). The most accepted objective measure of burnout in athletes is the Maslach Burnout Inventory (Maslach and Jackson, 1981a) as it has acceptable convergence validity and test-retest reliability. Maslach Burnout Inventory measures the frequency and intensity of the feeling of burnout. It has three components – exhaustion, depersonalization and personal accomplishment – which are analyzed using factor analysis. Burnout cannot be measured as a sum of the overall burnout score because the type of interaction of components is just as important as the intensity of each component. In other words, burnout is affected by motivational and attitudinal changes that interact with environmental and situational factors (Maslach and Jackson, 1981a, Perlman and Hartman, 1981).

Models of Burnout

Definitions and measures of burnout provide some information of the mental state of an athlete, but give little information of what to do about it. Various models of burnout have been proposed, which attempt to explain the etiology of burnout, thus providing a framework from which intervention strategies can be built. I will start by dicussing burnout from literature in the field of abnormal psychology. Smith (1989) explains that stress and burnout are parallel models. Thus studying the types and affects of different stressors as precipitating factors to burnout can be useful in defining intervention strategies that control these stressors. There are also various models in sport psychology literature. First I will describe Smith’s (1986) cognitive-affective model of burnout. It describes burnout as a complex phenomenon resulting from an interaction amongst mental and cognitive-affective strategies. Next, I will explain Silva’s model of Training Stress Syndrome (1990) which is a psychophysiological explanation of burnout. Finally, I will describe Schmidt and Steins’ (1991) commitment model, which describes the dropout decision process.

Burnout was earlier defined as a reaction to chronic stress. In literature of abnormal psychology, excessive stress is seen to lead to decomposition. Perhaps this idea of decomposition is the definition of burnout used in sport psychology literature. Stressors can be positive or negative. Positive stress promotes constructive motivation, which does no physical or psychological harm. Negative stress results from frustrations, uncontrollable pressures and conflicts, which lead to decomposition. Decomposition has an all-encompassing negative effect. There is a lowering of adaptive efficiency and lowering of the immune system, along with maladaptive psychological functioning of emotions and cognitions. Decomposition depetes adaptive resources leading to either over-responsiveness or under-responsiveness to stressors. It also has an overall wear and tear on the system, which is never fully restored.

There are three factors that contribute to an individual’s vulnerability to stressors. These are, the nature of the stressor, the perceptual threat of the stressor, and the external resources available to deal with the stressor (Carson and Butcher, 1992, p.143). First, characteristics of stressors that increase vulnerability to future stressors include increasing duration of the stress, increasing intensity of the stress, and increasing time to deal with the stress. Stressors have a cummulative affect, which means that the more stressors the person has not dealt with, the increased vulnerability to the new stressor. Humans have a personal tolerance to stressors at which point the resilience of the person brakes. This is often referred to as the "last straw effect". Second, increased perception of threat and decreased individual tolerance to threat, results in increased vulnerability to stress. A traumatic situation in sport could result in some variance of post-traumatic stress disorder or panic response, which could unrealistically alter the perception of that sport situation. Fears associated with the sport itself are a big concern in inherently high-risk sports like downhill or water skiing. The General Adaption Syndrome (GAS) (Seyle) documents the phases one goes through both physically and psychologically in response to acute stress. The first is an alarm phase where a sudden decrease in stress tolerance is followed by a sudden increase in stress tolerance. Then a longer period of extreme resistance occurs. The last stage of GAS is a negatively spiraling decrease of stress tolerance. Only explicit intervention can change the direction of this downward spiral. The third major factor contributing to the vulnerability of stressors is the nature of external resources. Increased external resources and social support decrease the vulnerability to stress (Carson and Butcher, 1992, p. 143).

The literature in the field of abnormal psychology suggest that there are 2 ways that people respond to stress. A task-orientated response to a stressful situation occurs when the person deals with the requirement of the stressor, while the defense-orientated response to a stressful situation occurs when a person behaves to protect his/her self from hurt or disorganization (Carson and Butcher, 1992, p.). In sport, it is important that the requirement of the stressor is dealt with in a task-orientated manner.

Historically, the link between models of stress and burnout in abnormal psychology and models of stress and burnout in sport psychology was made in the eighties. Perlman and Hartman (1981) explain burnout in job performance based on a stress reaction which may skew the cognitive and perceptual abilities of how a person views him/herself and the environment. Similarily, Anderson and Williams (1988) explain how an athlete reacts in various situations is determined by the individual’s stress response. They define negative stress response as the psychological response associated with a perceived inability to respond to the demands of the athletic situation. The balance between the cognitive appraisal of the situation and the demands and consequences of the situation determine whether the stress response is harmful.

The first burnout model I will discuss with antecedent’s to sport, is Smith’s (1986) cognitive-affective model of burnout (Appendix A). This model parallels the Social Exchange Model (Thibaut and Kelly, 1959), which suggests that human behaviour is governed by the desire to increase positive experiences and decrease negative experiences. Similarly, in sport we compare the outcome of one activity to the outcome of another. Athletes drop out when the current sport comparison level is lower than the alternative activity. Hence, this model assumes that there is a parallel relationship among situational, cognitive, physiologic and behavioural components. Smith’s (1986) model of burnout was the framework for much further research and the understanding of the etiology of burnout.

Burnout has also been modeled as a maladaptive reaction to training. Henschen (1986) described the process towards burnout as precipitating from a slump, which occurs when there is an extended period towards burnout as precipitating from a slump, which occurs when there is an extended period of low outcomes with no detectable performance execution problems. This leads to the development of negative attitudes, or to overtraining, which further induces staleness and finally burnout. The Training Stress Syndrome (Silva, 1990) further describes the phases: staleness, overtraining and burnout. The precipitating factor is the reaction to stress. Training stress is described as the net effect of psychophysiological stress. A positive adaptation to training stress results in training gain; however, a negative adaptation to training stress results in lag in training gain. If a lag occurs, an increase in training stimulus is introduced, where the negative adaptaion takes the form of staleness. When further training stress is introduced, negative adaptation results in overtraining. If the negative adaptation cycle continues, burnout results. Burnout is defined by Silva as the exhaustive psychosocial response to repeated unsuccessful efforts to meet the demands of training stress. The fact that so much overtraining still occurs is not surprising since in many sport trainers and coaches still have the unsubstantiated belief that improvements in strength, endurance and skill are proportional to the volume and intensity of the workout (Cox, 1994, p. 373-376). Once and athelete is burned out, the decision process to drop out or continue is comprehensively explained in the Investment Model of Burnout and Dropout (Schmidt and Stein, 1991). These authors see two reasons for commitment to sport. The positive reason is reflected by high enjoyment of the activity. There is high personal reward, satisfaction and investment with low perceived costs, and few viable alternatives. The other type of commitment is negative, predisposing the athlete to burnout. The rewards and satisfactions from continual involvement decrease, while the stress-induced costs increase. The athlete feels "trapped", reluctant to give up years of personal investment and perceives few alternatives. Withdrawal occurs when the athlete perceives that there are many alternatives and the personal investments made to the sport hold little weight.

Retroactive interventions for burnout

Retroactive interventions focus on finding problems and then correcting them based on a fundamentalist prototype of both sport and personal skill. The advantage of this detection and correction method is that it is the fastest and easiest way to correct a prototypical skill. The major disadvantage of the retroactive approach, is that the athlete is not told anything unless it is incorrect. This can result in injuries both physically and psychologically. The athlete can get hurt physically because many mistakes are being made. Psychologically, and approach focussing only on the negative can lead to a negative cognitive set.

In the introduction of this paper, I defined burnout as an experience of different degrees along a continuum from severe burnout to mild burnout. It helps to understand the severity of burnout before deciding the intervention. The dominating symptom of sever burnout is the disinterest in the sport. Increasing intrinsic interest could reverse the symptoms. One can increase lost intrinsic interest by decreasing external rewards. For example, a burned out hockey player may play street hockey for free with children. Burnout of a lesser degree could be reversed using coping methods to increase self-efficacy. More realistic performance goals so that they are more achievable may improve self-efficacy. (Bandura, 1977, Cswalisz, Altmeir, Russel, 1992).

Smith (1989) points out that his cognitive-affective model of burnout is also a parallel model to stress and burnout. Consequently, intervention can target any of its four components: situational, cognitive, physiological and behavioral. He explains that the broader personal motivational aspect of an athlete can be targeted as this could affect any of the four components. His model is reciprocally interactive, so a change in any component will influence all the other components. Smith also claims that his model is recursive, although the diagram of his model has not included a recursive loop. Also, it is clear how personality and motivation can directly influence a situation. It is behaviour that changes the environment, and it is inthis way that this model can be defined as recursive. He explains that coaches must be effective in manipulating all the components, while most of the focus for athletes is in cognitive-affective stress management. Situational or environmental interventions include the changing of personal fitness level, game rules, and social changes like positive team environment and team cohesion. Behavioral interventions are accomplished by changing the training environment in the aacquisitionof new skills. Physiological changes include progressive relaxation, meditation, autogenic training, biofeedback and autohypnosis (Cox, 1994). Cognitive interventions are most common and include cognitive restructuring, thought stopping, centering, confidence training, goal setting, imagery, stress inoculation and desensitization (Cox, 1994). Although Smith’s model seems all-inclusive in possible burnout interventions, it does not give guideline as to where appropriate intervention should be. I will discuss this model again later in the paper in my colloquy on the appropriateness of intervention.

I have various concerns regarding retroactive interventions in sport. I will discuss two of them. The first is about appropriate use of cognitive appraisals which are commonly used in sport psychology, and then I will discuss the use of retroactive interventions in general.

In sport psychology literature, much is written about cognitive reappraisals with the assumption that what the athlete is perceiving is irrational (Ellis’ Rational Emotive Therapy, Beck’s Cognitive-Behavioral treatment). Competitive anxiety may indeed be irrational, but there are many realistic anxieties as well. There are also both rational and irrational fears associated with sport. One has to decide whether the athlete is experiencing anxiety or fear, and whether it is rational or not, before making an intervention. If an athlete is experiencing realistic fear or anxiety, then using persuasion tactics and suggesting attributions (Weiner, 1985) to convince the athlete that their fear is irrational, causes the athlete to lose a sense of reality, thereby unable to make proper decisions. This would result in slowing or even reversing performance improvements, increasing the probability of sever injury. Further, rational fears can follow the Anxiety Response Pattern (Carson and Butcher, 1992, p.182-183). This is a model of the genesis of anxiety as involving biological, psychological, and environmental events that become a self-sustaining feedback system. It is automatic in nature and therefore immune to rational processing and cognitive reappraisals. Other anxiety control measures like Meichenbaum’s Stress Inoculation or Wolpe’s Systemic Desensitization are more appropriate in these cases. In summary, a quick assumption that every negative experience an athlete has is irrational, should be replaced with an empathetic approach in understanding what the athlete is experiencing.

A criticism of the retroactive approach in principle is the assumption that elite athletes function in the same fundamental way as statistically normal athletes. Many assume that there is a prototype for world champion athletes and therefore the athlete must be "molded" into shape. No one has found this prototype – perhaps because there isn’t one – so these athletes are further confronted as if they were prototypically normal athletes. Most sport interventions focus on irrational anxiety and fears. From my own naturalistic observation, I have noticed that most elite athletes cope with irrational fears very well. Most stress related anxiety is not irrational, but due to other realistic factors, especially one’s of being lonely and misunderstood. "I’m pretty well on my own" are the words of a national downhill ski team member, as he describes how he is preparing himself for the 95/96 ski season. The feeling here is that although there are many specialists available to help athletes, it is up to the athlete him/herself to bring the individual sets of specific information into a coherent whole. There is frustration from the conflict between the shallow attributions demanded by the media, family and coaches while at the same time the realization that realistic attributions are required for success. Once athletes are "on their own", they receive no realistic feedback and may end up building defensive psychological walls. Unfortunately this leads to a self-perpetuating negative spiral because defensiveness makes it difficult to see things realistically. In summary, one has to be careful that retrospective interventions do not start promoting burnout instead of curing it. Specifically, elite athletes may be flooded with unrealistic feedback, forcing them to become defensive and perhaps lose site of reality elsewhere. This negative spiral is fuelled further when things go wrong, as the athlete is quickly blamed without any regard to the antecedents causing the negative spiral in the first place.

Proactive interventions for burnout

The fact that a large portion of this paper is devoted to the burnout end of the burnout-actualization continuum described at the beginning of this paper, is a reflection of the weighting of the literature in athletic excellence. A lot of attention is focussed on things that can go wrong, and how to fix them, with little attention spent on how to prevent the negative spiral that leads to burnout and how to aim for athletic excellence. This in turn is reflected in the coaching federation programs and specialized sport instructor courses, where bulk of the emphasis is spent on detection and correction. Awards are usually given in these programs to the students who are best in detection and correction, motivational enthusiasm, and communication abilities. These are fine skills to have when your athletes are trying to reach the prototype of the normal population; however, this method interferes with an athlete’s dream of becoming better than normal in his/her chosen sport.

The competition amongst elite athletes today is so close , that one should not be focusing on what makes elite athletes the same, but instead ate what makes them special. The athlete that is able to capitalize on his/her assets is the winner. One cannot aim for something, if they do not have a clear definition of what it is they are aiming for. Aiming for self-actualization as described by Carl Rogers should be the first thing explained to the athlete. In order to break into new ground in personal achievement and overall world achievement, a proactive approach should be utilized.

A proactive approach starts with the Humanist idea that one can grow and actualize as long as psychological and overt barriers are removed. Freedom from debilitating stressors enables elite athletes to design and rehearse procedures aimed at personal achievement. The advantages of a proactive approach are the opportunities to break into uncharted territory both personally and in the evolution of the sport itself. Because a preset prototype is not in place, either extreme ends of the statistically normal distribution curve – elite or challenged athletes - benefit because the program designs are highly individualized. Properly designed, the proactive approach would promote positive outcomes based on achievable goals, promoting a positive and realistic cognitive set.

Prevention is a large part of proactive intervention. It involves decreasing risk factors and increasing protective factors of injury. Elite athletes could decrease the probability of injuries by having a standard of 100% perfection and commitment. In other words, once an athlete has realistically decided what he/she is capable of performing, full commitment is made to that task so that the task is executed perfectly. This is the standard imposed on the Canadian water ski team by head coach Joel McClintock.

Finally, an egalitarian and empowering approach is taken in proactive interventions. As "normals" we can intuitively understand how people with less abilities than ourselves are functioning, as we all had lesser abilities as children; however, it is sophomoric to claim that kind of intuition regarding people who are more capable than ourselves. Communicating on the same levels offers a complete exchange and cooperation of ideas, along with a feeling of empowerment associated from this direct involvement towards success (Edwards, 1987).

Selecting appropriate interventions for burnout

Deciding the proper intervention strategy decreases the probability of misunderstanding of elite athletes and increases the probability of meaningful competitive strategies for elite athletes. The first step towards appropriate application is explicit definition of task requirements of the mental, physical and environmental aspects of the sport. Physical aspects include defining type of muscular movements (gross, fine, varying, repetitive) and energy requirements. Psychological considerations include focus and its implicit or explicitness, along with emotional considerations of realistic fears and competition stressors. In elite athletics the constant re-evaluation of the tasks involved are a requirement if any achievement is to be sought.

Once the task definition is made, the next step is to hypothesize how the athlete is going to accomplish this task. Smith’s cognitive-affective model (1986, Appendix A) is all-encompassing in targets for intervention; however, the model does not show which target intervention would be appropriate for a given situation. The ABCE framework of intervention (Carson and Butcher, 1992, p. 633, Appendix A) describes four general types of therapy interventions (cognitive, affective, behavioral and environmental) which are components of Smith’s model. Paralleling Smith’s coaching intervention along the same lines as psychological intervention (ABCE model) ensures that an eclectic and complete framework. The advantage of the ABCE framework is that it is described as a continuous self-sustaining loop, making causal primacy irrelevant. Effective therapy can occur by changing any pertinent component of the loop to interrupt the pathology-sustaining loop. The athlete and coach should intervene in the area that is holding the athlete back the most, and requires the least effort to fix, keeping in mind that a negative spiral leads to burnout while a positive spiral leads to actualization.

A coach-athlete relationship is like a parent-child relationship: both influence each other, but overall, the coach/parent has more influence. To encourage a more serious concern of appropriate application by coaches, more explicit measures of coaching effectiveness could be evaluated as suggested by a coaching model based on grounded theory (Cote et al, 1995). Perhaps the best approach to take in sport psychology intervention is to acknowledge that this discipline is in its infancy, and ironically the group of athletes least understood are the elite athletes.

As one discovers all the ways one can start spiraling negatively towards burnout, and the lack of understanding by many of what kind of positive spiral leads to actualization in sport and personal life, one becomes even more at awe with World Water Ski Champion, Judy Messer’s, accomplishments.

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