Confronting Fear When Injured Part 1: What is Fear?
A marbling of blue color.
Injury does happen as much as many of us would prefer that it not happen.Who wants to be sidelined with any injury or even worse taken out of your favorite sport all together? What about the journey back from injury? It can be filled with many different emotions, thoughts, and experiences. This post is going to focus on fear. Yes, fear when it comes to coming back from injury. While we may not want to talk about it, we are going to go there because it is essential. It is best to start at the beginning, which means we need to understand fear and what some common fears are for injured athletes. Chances are while reading, you may recognize some of your own experiences. This is only part one of a two part series. The second part will look at techniques and concepts for helping to address fear.
Understanding Fear
Fear and anxiety evoke defensive behavioral responses that have evolved to allow organisms to avoid or reduce harm, ensuring survival (Tovote et al., 2015). Yes the research definition, but let’s say it more simply. Fear serves a purpose to help humans survive. Yep, fear serves a purpose in our lives. It is not in our lives just to cause us trouble. Drilling down more specifically about what fear and anxiety are, they are brain states that arise from external and internal stimuli and that underlie measurable behavioral, physiological, hormonal, and autonomic reactions (Tovote et al., 2015). Think about this for a second. How do you feel when you are scared? What do you experience in your body? What actions do you take? The questions could go on. Does the HPA axis sound familiar? Think flight or fight.
Now that we have a baseline for fear, how do we make sense of reactions and their impact on injured athletes’ rehabilitation. Let’s explore an example. The behavior that emerges from fear may impact adherence to the rehabilitation program. What if I fail at my rehabilitation program? What if it hurts? What if I can’t come back? What happens to my support system? All these questions and associated behaviors potentially do have an impact on adhering to a program. They may help or they may hinder.
A bit more neuroscience to finish off this section. There is a distinction between circuits underlying two classes of responses that are elicited by threats, according to LeDoux and Pine (2016). The first is the behavioral responses and accompanying physiological changes in the brain and body. The second is the conscious feeling states reflected in self-reports of fear and anxiety. According to LeDoux and Pine (2016), this distinction leads to a "two systems" view of fear and anxiety. Why take the time to mention that there are two classes of responses? Because it is important when it comes to sport and performance psychology and how a professional can help injured athletes. Translation - when working with fear both the behavioral responses and physiological changes and the conscious feeling states need to be addressed and provide avenues for helping address fear. Oftentimes people tend to focus on the mental side and forget that the body can be a valuable access point and a great resource.
Common Fears
Some of the typical athlete fears include loss of their position on the team; different treatment from coaches, teammates, or peers; loss of attention from others; isolation from their team; re-injury after return to competition; not fully recovering; and the uncertainty of not knowing if they can return to play (Petrie, 2007). Whether the fear is rational or irrational is not the point. To us or anyone who is experiencing fear, it is their or your experience, and that must be honored. Athletes feel their fear individually, meaning overcoming fear is an individual process (Petrie, 2007).
While the focus was on fear in the context of injury, it is important to understand fear in general in sports and life. It is when we learn about fear, honor its purpose, and work with it rather than fight it that we can grow from our fear experiences.
take action today moment:
How does fear show up in your life? Maybe you are injured currently and experiencing some fear. If that is the case, how is fear showing up? It begins with identification so that you can take steps to address the fear. The same is true if you are not injured right now. Begin by identifying how fear shows up in your life. Also, how does your body let you know that you are afraid? Do you clench your fists or teeth? Do you feel the urge to run away? Etc…
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References
Flint, F. A. (2007). Modeling in injury rehabilitation: Seeing helps believing. In D. Pargman (Ed.), Psychological bases of sport injuries (3rd ed.) (pp. 95-107). Fitness Information Technology.
LeDoux, J. E., & Pine, D. S. (2016). Using neuroscience to help understand fear and anxiety: A two-system framework. American Journal of Psychiatry, 173(11), 1083-1093. https://doi.org/10.1176/appi.ajp.2016.16030353
Mahoney, J., & Hanrahan, S. J. (2011). A brief educational intervention using acceptance and commitment therapy: Four injured athletes’ experiences. Journal of Clinical Sport Psychology, 5(3), 252-273.
Mohammed, W. A., Pappous, A., & Sharma, D. (2018). Effect of mindfulness based stress reduction (MBSR) in increasing pain tolerance and improving the mental health of injured athletes. Frontiers in Psychology, 15(9), 722. doi: 10.3389/fpsyg.2018.00722
Petrie, T. A. (2007). Using counseling groups in the rehabilitation of athletic injury. In D. Pargman (Ed.), Psychological bases of sport injuries (3rd ed.) (pp. 193-192). Fitness Information Technology.
Shortway, K. M., Wolanin, A., Block-Lerner, J., & Marks, D. (2018). Acceptance and commitment therapy for injured athletes: Development and preliminary feasibility of the return to ACTion protocol. Journal of Clinical Sport Psychology, 12(1), 4–26. https://doi.org/10.1123/jcsp.2017-0033
Tovote, P., Fadok, J. P., & Lüthi, A. (2015). Neuronal circuits for fear and anxiety. Nature Reviews Neuroscience, 16(6), 317-331.
Vealey, R. S., Garner-Holman, M., Hayashi, S. W., & Giacobbi, P. (1998). Sources of sport-confidence: Conceptualization and instrument development. Journal of Sport and Exercise Psychology, 20(1), 54-80.