The Sports Doc Chalk Talk

Having studied psychology and mental health disorders for many years (as well as being a licensed practicing clinician), I have long been troubled by the trend for doctors to quickly prescribe anti-depressants to their patients without first encouraging other, safer alternatives.  Since the 1990′s, increasingly more doctors have quickly bypassed recommending things like professional counseling, exercise, or trying new hobbies and interests (all things that can really help with mood state), and instead quickly scribbled out scripts for anti-depressants.  Of course, if these new pills worked significantly better than the other ideas I just presented, and if these pills were 100% safe, I don’t think using them would be much of a concern.  Unfortunately, that’s simply not the case.

Last night 60 Minutes ran a segment on the efficacy of anti-depressants versus placebo effects, citing Harvard social scientist Irving Kirsch’s discoveries when evaluating real anti-depressant medications against placebos (or sugar pills).  Kirsch’s findings were really nothing new, and certainly not any different than what other research scientists have known for years — that is, anti-depressants only “work” because of the belief the patient has when using them, and not due to the chemical properties of the drugs themselves.  In other words, the changes patients claim they experience are due to the placebo effect, not the medication.

The problem, however, is that in the United States we are constantly bombarded with really great advertising that tells us if we are depressed, the answer to our problems might just be one quick office visit away.  As one of only two countries in the world that allows for direct drug marketing to consumers on television, these fancy ads coupled with our intense desire to get better provide for the perfect storm, so to speak.  In other words, when we feel depressed and are “ripe” for an answer, and then see a 30 second ad of a Zoloft egg bouncing around happy, it’s easy to see why so many potential consumers light up with excitement and quickly schedule a visit with their doctor as soon as possible.

Unfortunately, the problems we experience in life don’t simply “go away” by taking a pill (similarly to how they don’t go away from getting drunk, either).  The problems at home, mounting bills, and battles with health problems don’t get better by taking a pill — these situations only improve by learning important life coping skills.

So why are anti-depressants so widespread if:

A) they have been scientifically found to not work any better than a sugar pill, and

B) they put the patient at great risk for side-, interaction-, and withdrawal effects — check the black box warnings to learn more

Listed below are some of the big reasons why so many people continue to be prescribed these drugs:

• There is huge money in pharmaceuticals today, and these companies are not afraid to spend money.  This is the reason why we see so many ads today, and the more of the ads we see the more confident we become that these drugs really “work.”  Most people figure that if they see something enough, it must be true – this is called the mere exposure effect.
• Patients often ask their doctors directly for these medications, and often doctors are happy to acquiesce.  In some cases, doctors really believe in the value of anti-depressants, while in other cases doctors assume the placebo effect will “work” and that the potential side effects are worth the risk.  In other cases doctors know that patients expect to be given drugs during medical appointments, and would feel short-changed if the doctor told them the real things that help with mood state – like counseling and exercise programs.
• When clients do experience side effects, in most cases they continue to use these drugs because they blame the side effects on their disorder (i.e. depression), and not the medications!  In fact, in some cases patients take even more of the medication in order to overcome the side effects.

While we would all love to find a quick fix for our problems in life, the reality is these answers are not in the form of anti-depressant pills (as science is revealing through ongoing empirical findings).  Scott Peck, author of the popular The Road Less Traveled, starts his book with one very important sentence:

Life is difficult.

Think about that for a moment — the problems we face in life are difficult, and success doesn’t happen from casual efforts.  We need to also remember that there are no fast “silver bullet” answers when it comes to life’s problems, even if we wish there were.  Anti-depressants, which work no better than placebos and carry many potential problems with them, should not be the first thing we seek when we hit rough waters in life.  Instead, learning life skills like communication skills, conflict resolution, and stress reducing techniques should be tried first, along with developing a physical exercise program.  Most people dramatically improve their mood state from just those life changes, and professional counseling can help round out the self-improvement process for those still looking for even better improvement. 

Check out our Life Wellness programs to help improve mood state and the quality of your life!

www.drstankovich.com

The inevitable retirement transition from sports that all athletes eventually experience has always fascinated me, mostly because it usually happens relatively early in life, and rarely is it noticed or cared about by society.  Thousands of elite-level athletes retire from sports annually, and hundreds of thousands more will end their careers by the time they are teenagers.  For some athletes the transition is a welcomed one, while others seem relatively indifferent.  Still, there are many athletes who experience tremendous stress, frustration, anger, depression, and anxiety while facing the end of their sports careers (AHPS).

In the mid-1990′s, a colleague of mine (Ohio State athletic counselor Darin Meeker) and I created the nation’s first sport transition course at Ohio State, Positive Transitions for Student Athletes. In fact, I studied the efficacy of this course for my doctoral dissertation, finding mountains of empirical evidence that suggested many athletes do indeed experience an unplanned and life-changing event when they are faced with the sport retirement transition.  Most athletes we studied experienced issues with their post-athlete identity, role confusion, poor future planning, poor career development, and in some cases mood disorders.

Today it’s 2012, and if anything we have learned that we were really just scratching the surface looking back to our work in the 1990′s.  With the internet and social media, it seems commonplace these days to hear stories about athletes experiencing difficulty at the ends of their careers — stories that include financial hardships, depression, drug and alcohol abuse, and even suicide.  Of course, it would be crazy to think that all of these stories could be averted, but sadly, many of them could have turned out a lot better had more aggressive advances by high schools, colleges, and professional teams taken place since our early work.

Instead of seeing a surge in the number of courses and programs designed to help athlete at the ends of their careers, there’s been a flat line.  Sadly, when an athlete plays his or her final game, there is usually a harsh reality the individual faces: Few people seem to truly care. Rather than help the exiting athlete, schools and professional teams usually abandon them, turning their attention to the “next” great athlete coming to the team.

Sport psychologists and college athletic counselors help athletes when they can, but there are still only a select number of schools employing these types of professionals designated to help athletes transition out of sport.  Instead, it’s the “elephant in the room” — the schools/teams know that retirement looms, and that the athletes will likely be unprepared, yet usually don’t acknowledge it and instead casually look the other way.  This is not due to spite, or even negligence, but instead more likely due to the fact that the sportsworld lives by a “what have you done for me lately” philosophy – and retiring athletes are not of much worth.

It’s both fascinating to me that sport retirement is still as important to learn about today as it was 15-20 years ago, but frustrating that we really haven’t seen much academic or professional growth during this time.  In fact, our book, Positive Transitions for Student Athletes, is still just as relevant today (if not more) than it was in 1999.

www.drstankovich.com

As the end of 2011 nears we have witnessed some of the worst college sports stories heard in recent years – from the Penn State and Syracuse sex scandals to the less horrific, yet still terribly unfortunate, stories that unfolded at Miami, Ohio State, and other colleges.  In all of these examples, crimes to some degree were committed (from child molestation to breaking NCAA rules and/or laws), and in each case the universities responded in their own unique ways to the allegations.  Of course, looking back now is like playing “Monday morning quarterback,” but it’s still worthwhile to do so if we want to handle future troubling issues in better and more effective ways (AHPS).

It appears that in most cases the immediate response by these universities has been to either deny, spin, or deflect.  Of course, that’s understandable – especially when taking into consideration the tremendous value of some of these “brands.”  It goes without saying that negative public image can (and often does) correlate with many important factors, including alumni gifts, future student enrollment, and apparel sales (to name a few).  On the other hand, the denial response – while having great potential upside – also brings with it the increased risk for the drip-drip-drip negative and scandalous review by the NCAA, the media, and fans.  Of course, none of this is unique to athletics, as we have seen politicians and others take the same “nothing to look at here” approach to allegations that have later been proven true.

The short-term gain in deflecting stories and/or getting rid of a sacrificial lamb may appear to work, but in the end more often than not the foundational problems still remain (i.e. the casual athletic culture).  So while the “nothing to see here” response may seem attractive at first, it actually behooves college administrators to take a more in-depth and measured view of the totality of the problem and overall tone of the athletic department culture.  Yes, this is certainly a more riskier PR move than telling people everything is fine, but this approach is more responsible and far better in the long-term (especially in these days of data left behind in email and text messages, sure to be exposed by somebody eventually).

Human beings make mistakes regularly — we have all said or done things we wish we could take back or do differently if given another chance. My article here today is not about being perfect, nor is it designed to come off as some righteous way of living.  No, my goal is to simply remind people who run colleges about the importance of damage control – especially as it applies to handling tough situations respectfully, professionally, and thoroughly

If any college adminstrators are listening, here are a few tips to consider:

• When a negative story breaks, the first move should not be anything that sounds like “nothing to see here.”  Of course, this does not mean to immediately assume all guilt, either.  The best and most responsible answer is to simply state the issues are being taken very serious and that a university response will be forthcoming.
• Check out the allegations and see if they are true.  If you learn rules/laws have been broken, take some time to look through the eyes of the victim, or if it is an institutional charge that impacts competitive fairness, try to see how the problems at your school could impact the overall interest and success of the game.
• Admit when you are wrong.  Yes, this is very difficult for people to do, but when people take ownership of a problem and a sincere apology given, most people are very quick to forgive and forget.
• Take appropriate measures to correct/fix the problem – which may include removing people with big names and reputations.  Again, this may not be easy to do, but in some cases it is warranted in order to truly remedy a situation.
• Go above and beyond to help the victims, or to make right whatever systemic problems that may have negatively impacted others.  Show that you are serious, and not just sorry that you got caught.
• Think about the overall welfare of your institution, not just the athletic department.  While sports are certainly a big part of the overall college experience for most students, it will be the perceived value of their degrees that help them the most in the future — not the wins and losses of the football team.

Damage control is not the most favorite or easiest part of a college administrator’s job, but it is becoming an extremely important part of it.  In this day and age of electronic messages and pictures, empirical data seems to be around every corner when it comes to covering up or denying rule and law breaking.  It is for these reasons, along with it simply being the right thing to do, that college administrators work diligently to do a better job of responding to crises in the future than some have done in 2011.

www.drstankovich.com

As we regain our perspective on the horrendous sexual crimes that were alleged to have occurred at Penn State regarding Jerry Sandusky and countless young boys, many people are just as confused at how many Penn State athletic department personnel seemingly kept the stories from surfacing as much as they are in Sandusky committing the crimes in the first place.  I have had a number of incredibly provocative conversations in the past week about this tragedy, with most of the dialogue centering around how the people who knew about kids being sexually abused could have possibly kept their mouths shut and not reported it immediately to the police.  It is from this position of curiosity that I attempt to offer a few thoughts on why this negligence may have occurred — reasons that go much deeper than the immediate surface level that clearly speaks to the importance of immediately reporting allegations of sexual crimes, especially when it includes innocent children.

Again, I would like to be very clear with something before I delve into the psychological variables that were likely at play and prevented people from speaking up when they came into news about Jerry Sandusky sexually abusing children — what Sandusky did was clearly wrong, and about as horrible a crime that could ever be committed. It was also very wrong for anyone – be it a coach, administrator, janitor, or anyone else to have not acted and called the police when they first learned of these crimes.  I say this as I want to be as straightforward as I can be about where I stand morally as my views pertain to this situation.  In fact, I cannot think of a single reason to not immediately protect innocent children – this case is a no-brainer when it comes to doing the “right” thing.  Still, it appears many people did not do the right thing – and that’s where I would like to pick up today.

Assuming these crimes did occur (and there is a mountain of allegations and pending evidence suggesting the charges are indeed true), the big question seems to be around how so many people who supposedly knew of Sandusky’s crimes (either directly through personal observation or indirectly through reliable source information) could have remained silent and not reported Sandusky to the police?  It does appear from news reports that a minimal level of legal responsibility occurred in the graduate assistant telling Coach Paterno, and Paterno supposedly reporting the news to his superiors.  Still, there were no calls to the police and worse yet, no follow up on the rape victim?  How could this have ever happened?

There are really only a few possibilities, actually.

1.) Everyone at Penn State was “in on it” and participated in some sort of underground sex ring operation. This premise, while clearly outlandish, would assert that not only did people cover up these tragedies, but that they also willing facilitated and/or participated in the crimes. So far the only perpetrator mentioned has been Sandusky, so we can assume (for now) that no other PSU employee was a part of these crimes through direct involvement.

2.) All the PSU athletic staff is comprised of “bad” people who are heartless and indifferent about the well-being of kids. Again, this assumption is quite shallow and an incredible stretch.  Even if you believe some people in this world are inherently “bad” people, the likelihood of an entire staff to be seemingly this aloof probably speaks to other interpersonal dynamics at play more than it does the moral code of all the individuals supposedly “in the know” about what happened (in other words, I can’t see anyone on the PSU staff thinking for even a minute that this stuff was “OK”).  The verdict?  It’s very unlikely PSU is comprised of terrible, kid-hating employees.

3.) The group dynamics at-play dramatically impacted the perception and action (or lack thereof) following reports of these crimes. Group dynamics refer to the study of groups, and how individuals sometimes change their thinking and behaviors as a result of the group’s norms, roles, desire to belong and be accepted, and social influence.  More simply, we as people oftentimes act differently when in groups than we do as individuals.  Again, this is not an excuse as much as it is an explanation, as it in no way “clears” or makes the folks at PSU less culpable for not acting.  It does, however, prompt us to widen our perspective and examine some additional factors that may have impacted individual decision making.

Sport psychologists spend a lot of time studying group dynamics, and it behooves them to do so when you consider how many sports today are “team” sports.  Group dynamics include the delicate, tenuous, ever-changing relationships individuals have with one another, all played out on the canvass we commonly refer to as “team culture.”  Group dynamics help us understand and explain, to some extent, why people do things differently in groups than they would if left to their own devices.  These dynamics also typically include power, coercion, and suggestion (direct and indirect).  In groups, there is also commonly a “diffusion of responsibility” that often occurs, whereby individuals in the group simply assume that “somebody else will do it.” If you hated singing as a kid and yet were made to be part of a choir, it’s likely you may have lip-synced during the performances, knowing that others would “pick up the slack” and compensate for your decision to not sing.

Group dynamics are a lot easier to discuss and examine when talking about innocuous subjects, like the choir example above.  Unfortunately, these dynamics also occur in situations as horrible as the current PSU scandal, and yes, even in cases of rape there are countless examples of people over the course of time who had information and simply sat on it – never telling anyone, including police.  This is terrible, morally speaking, but from an understanding perspective it’s important we go deeper in order to better understand (not justify) the situation.

4. Denial – out of sight, out of mind. Again, it may be hard to believe that we as people can sometimes do this, but it’s well accepted amongst mental health professionals that for some horrific crimes (like rape), people can (and do) sometimes completely block the story from their mind.  For the victim this may even help with short-term healing by not having to replay dark memories when trying to regain personal strength.  Sometimes we hear stories that we think are so outlandish that we erroneously believe there was no way they could have occurred — and many would argue the Sandusky story might easily fit within that line of thinking.  The point is that denial is an ego defense, and it is something we all do from time-to-time.  In the PSU case, it’s quite possible that when some of the personnel heard “rumors” about Sandusky that they simply could not get their arms around there being any way in the world the rumors could have been true — after all, to the untrained eye how could a guy running a program for kids ever in a million years sexually abuse kids???

What happened at Penn State was dead wrong, and all the explanations of the psychological variables that may have impacted the situation do not justify or minimize the horrific nature of child sexual abuse.   It is important, however, that we learn more about why nobody seemed to have acted responsibly, as well as the variables that impact group culture that appear to have clearly impacted what happened at Penn State.  When we better understand how terrible things can happen through oversight, negligence, covert pressures, and diffused responsibilities, we can better identify when future problems may be developing and more swiftly and responsibly attend to them.

www.drstankovich.com

As we await Joe Paterno’s final fate at Penn State pertaining to the Jerry Sandusky pedophile case (where Paterno was expected to act more swiftly and comprehensively out of moral obligation, if not legal expectations), many PSU fans (as well as sports fans across America) are experiencing what is known in the psychology world as cognitive dissonance.  What this means is that people often experience distress when attempting reconcile two opposite and competing views (in the case of Paterno, his “good guy” status of running a clean program for 40+ years versus the accusations where he acted passively when provided with the news of Jerry Sandusky raping a child in the PSU locker room shower).  If you are struggling to make sense of all this, and how such a respected and revered figure like Joe Paterno could also be the same guy who did very little to help an innocent child who was raped on campus, then you are experiencing cognitive dissonance.

The Responsibilities of Coaches?

Perhaps the bigger question, though, is the pedestal we have come to place coaches on these days – a position that gives off the impression either indirectly (Joe Paterno simply maintaining a clean record for many years) or directly (Jim Tressel writing books on character and morality) that coaches are somehow “above the fray” and incapable of making bad decisions, cheating, or acting irresponsibly.  Is it time we re-frame the roles and responsibilities of coaches – in other words, simply responsible for building winning teams, and not responsible for morals, character development, leadership, integrity, and all those other wonderful adjectives that have over the years become what we expect from coaches?  Keep in mind aside from youth sports (and even this is questionable), coaches are hired to develop winning athletic teams.  Coaches are not hired to be moral saints — that only comes along as a bonus if the coach can also win games.  We don’t expect superior morals from our accountant, barber, or mailman, so why do we expect our coaches to never make mistakes?  This is not meant to minimize the crimes at PSU, but instead to have us reflect on what pedestal we have put coaches on over the years.

With all the big money being given to coaches these days, and all the commercialization of sports through the mainstream media, it’s easy to see how coaches have transformed into bigger-than-life characters – making their transgressions become even more shocking and alarming.  It’s obvious that Paterno should have done much more than passively mention to his superiors that he heard a concerning story, but if we only knew Paterno as simply a football coach would our reaction today be so shocking (remember, he fulfilled his legal obligation to report to his superiors)?  Of course we would have still wanted him to do more, but many people would have also minimized his exposure and placed his value within the university perhaps differently.  In other words, his lack of action would still be bad, but would it be this bad?  Maybe – but it’s also possible more people would quickly turn their attention away from the football coach and toward college administrators more responsible for the culture and reputation of the university – not to mention the welfare of the victims.

Should Society Re-calibrate the Way Coaches are Perceived?

My purpose in writing this today is not to minimize the value of coaches today, but to perhaps help us recalibrate our views of what coaches should be in the eyes of society.  Coaches teach athletes how to play sports – and really good coaches sometimes go above these expectations and provide life skills, off-field mentoring, and appropriate social modeling.  But these are the exceptions, not the norm.  Similar to how accountants go to work to crunch numbers, or journalists go to work to write stories, some coaches would like to go to work and teach X’s and O’s and not assume the greater responsibilities of teaching and mentoring athletes when those responsibilities should be the responsibility of parents.  Why is it that we expect coaches to be responsible for life skills development, but don’t expect that from college professors, employers, or other adults who are involved with kids?

It’s clear that in the aftermath of the past year, one in which major college coaches including Jim Tressel, Joe Paterno, and Bruce Pearlman have faced harsh criticism from perceived expectations, that maybe it’s time to revisit the role coaches play in the overall success of society.  Should these men and women be expected to be perfect, or should we never have had such lofty expectations of coaches in the first place?  The crimes that occurred at Penn State are horrific, and it goes without saying that anyone/everyone who came into information about child abuse should have acted swiftly and responsibly (including Joe Paterno), but maybe it’s also time for us to re-position coaches, the expectations of coaches, and the magnitude of the responsibilities that have been placed upon coaches.

Perhaps we wouldn’t have as much cognitive dissonance if we viewed coaches as more human and capable of human errors rather than “Gods” simply because they know how to draw up winning plays on a sports field.

www.drstankovich.com