Part I : Stress Management from the “Outside In”

By Susan Farber, MA, LMFT

The following article is Part 1 of a two-part series on prevention of burnout and the management of stress. Part II, Stress Management from the “Inside Out”, will address an individual‟s internal dialogue creates stress.In my practice, as a psychotherapist, clients often come to me feeling overwhelmed and anxious by the amount of stress in their lives. Athletes will report a lack of motivation to train and poor performance. With a bit of questioning, I often discover they are suffering from burnout. Burnout is a condition of physical and mental exhaustion from being exposed to excessive and prolonged stress without allowing adequate recovery time to replenish the expenditure of energy.

Symptoms of burnout include:

  1. Chronic fatigue –a sense of being physically run down, decreased motivation
  2. Irritability/negativity -low frustration tolerance, feeling put upon and angry by other‟s demands
  3. Escapist/Acting Out Behavior–partying, shopping binges, overeating, internet addiction
  4. Depression
  5. Anxiety/panic attacks
  6. Isolation
  7. Powerlessness/hopelessness
  8. Problems seem insurmountable
  9. Weight loss/gain
  10. Somatic symptoms/Illness–Frequent headaches, gastrointestinal disturbances, body aches/pain
  11. Sleep disturbances
  12. Overuse injuries.

There is a growing body of research that speaks to the issue of burnout in young athletes. I work with teens that come to me complaining of reduced performance, loss of interest/enjoyment in training/competition, and physical/emotional exhaustion. We come to realize that part of what lead them to this state was a lack of balance in their lives. For example, one male high school athlete reported that he averaged 15 training hours per week, 1-2 competitions per month, and was enrolled in Gate classes which required 8-10 hours of weekly homework. In doing the math, the athlete/parent realized that his sport and academics entailed 40-45 hours per week. Competition out of town added the additional stress of traveling. The athlete felt isolated from his non-sport peers and felt exhausted and annoyed most of the time. I also find that young eathletes and/or their parents are focused on the outcome which creates a great deal of pressure to train and win. One female athlete was led to believe that her college education was dependent upon an athletic scholarship. As a result, she developed a sense of entrapment and began to doubt the value of her sport. Some athletes feel guilty for the amount of money and time their parents have invested and continue to participate despite loss of enjoyment.

Many of the dynamics described above can occur among adult athletes as well. With my adult population, I see burnout manifesting in a wavering commitment to training/competition, physical injury/illness, and exhaustion despite the same training regiment, decreased performance, delayed recovery from injury, and an increase in relationship/work issues. The condition of burnout, if left untreated, can lead to dropout from the sport.

I believe that stress doesn’t have to lead to burnout nor be responsible for 80 to 85 percent of all illnesses and disease as reported by the American Medical Association. One line of thought is to work on eliminating exposure to stress such as John Travolta‟s character, did in the 1976 movie, “The Boy in the Plastic Bubble”. The main character, Todd Lubitch, is born with a deficient immune system and must live out his life in an incubator to protect him against unfiltered air which has the power to kill him. In other words, air is stressful and Todd’s body lacks sufficient resistance (strength) to fight off illness.

An alternate perspective involves using stress as a means to build emotional, physical and mental resiliency and strength. Weight training is a good example of this notion from a physical perspective. The exercise stresses (breaks down) the muscle tissue fibers for the targeted muscles. The actual building of the muscle occurs during the rest and recovery period. Research shows that exposure to new learning can help prevent age-related cognitive decline, in other words, keep you strong mentally.

I view burnout, illness, and/or injury as the result of excessive stress without adequate recovery time. Burnout can be prevented in both athletes and non-athletes by balancing stress with appropriate recovery time. The model, based upon James Loehr’s book,  “Toughness Training for Life”, involves viewing stress from three perspectives, emotional, mental and physical, and then designing adequate recovery to address each area for building toughness. I take a mind/body approach to stress and believe that that excessive stress in one area can have asynergistic effect on the other two areas. For example, one athlete I worked with believed her inability to access her full power on the bike was due to overtraining. We took a look at what was going on in her life at the time and discovered she had an overabundance of mental stress with insufficient recovery time. Her physical performance was suffering because she was unable to concentrate during training. She became frustrated with herself which was displaced on her husband during a discussion over where to go for dinner. An argument ensued, thus depleting her emotional stores which then affected her physical training the following day.

Stress management from the outside in entails the implementation of a stress/recovery program where energy is expended and replenished in the mental, emotional, and physical realms. I agree with Loehr who believes that the first step in recovery is to meet your basic needs for adequate sleep, nutrition, and water. You must have these in place before you can perform at an optimal. The next task is to work on identifying activities that serve to replenish versus deplete each area. For instance, you might balance high mental stress with reading light material and for emotional stress, engage in nurturing activities such as relaxation exercises, guided imagery, or massage. Incorporate recovery time during your workday (i.e.take a lunch break away from the office)rather than attending to yourself at the day‟send. This latter pattern can set you up for late night overeats and drinking, both being insufficient ways to replenish your depleted stores.

The stress/recovery model can be applied to young athletes as well. For example, I worked with the male athlete described above on creating a foundation of adequate sleep, hydration and sports nutrition. I found that he was getting 5-6 hours of sleep per night and eating junk food 1-2 hours prior to competition. He rarely hydrated during and following his game. We then looked at incorporating recovery time into his schedule, including time with friends. I also provided parent education about symptoms and prevention of burnout to foster their support.

Stress does not have to be destructive if you create space in your life for adequate recovery. It‟s up to you to make yourself worth replenishing. As Ernest Hemingway said, “Life breaks everyone, but some people become stronger in the broken places.”

1. Loehr, James Ed.D, Toughness Training For Life.New York: Penguin Books, 1993.

Susan Farber is a Licensed Marriage, Family Therapist and Sports Psychotherapist in private practice and can be contacted at (805) 886-5538. Additional information can be found at and

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