Why Mental Health Matters To Athletes With Dr. Justin Ross

Topics Covered In This Episode:

• Cultivating mental health
• Concepts for a model of resiliency
• Skills that help improve performance through mental health

Guest Bio:

Dr. Justin Ross is a licensed clinical psychologist specializing in athlete mental health and performance – addressing issues such as anxiety, depression, disordered eating, insomnia, and stress to developing high-performance sport psychology skills on the chosen field of play and managing the psychological impact of injury or transition in sport. He has been a longstanding resource for CTS Coaches, works with athletes of all ages and abilities, and is vetted as a psychologist for the NBA and NFL players associations.

Guest Links:

Website: https://www.drjustinross.com/

Twitter: https://twitter.com/PsychDenver

IG: https://www.instagram.com/drjustinross/

Show Links:

CTS Article: Mental Health and Skills for Sports Performance, with Dr. Justin Ross

Model for resiliency: https://pubmed.ncbi.nlm.nih.gov/18181708/

 

Listen to the episode on Apple Podcasts, Spotify, Stitcher, Google Podcasts, or on your favorite podcast platform

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Episode Transcription:

Please note that this is an automated transcription and may contain errors. Please refer to the episode audio for clarification.

Adam Pulford (00:07):

There is no health without mental health, an optimal performance demands, both. That’s a quote from Dr. Justin Ross sports psychologist, who has been long vetted by athletes in the NFL NBA pro professional and amateur athletes alike, as well as a wonderful resource for CTS coaches. You may have read a recent CTS newsletter article featuring Dr. Ross about mental health and skills for sport performance. We’ll touch on a few topics from that article today, but more deeply explore what mental health is, why it’s important and how to cultivate it in your life. We’ll then learn specific techniques that you can apply to your own training, to decrease anxiety, discover trust in the process and develop a daily practice for a healthy mindset as an endurance athlete. This is also part one of a two part series. So be sure to join us for that second as well, which will come out in a few weeks, uh, if you’re listening right now. So with that said, let’s meet our guest and start learning Dr. Ross, welcome to the train right podcast.

Dr. Justin Ross (01:12):

Hey, thank you so much for having me. It’s great to be here.

Adam Pulford (01:15):

Yeah, this is, this is wonderful to have you here. Uh, again is, well, um, in my recent episode, I did it allude to the fact that we had this, um, two part series coming out, but, you know, the, the, the podcast gods deemed that one, not to be as worthy as this one is gonna be Dr. Ross. Yeah, I think so. Thanks for taking the time again to do it.

Dr. Justin Ross (01:37):

No, yeah, man. My pleasure. I think that the technology gods tossed that first one aside. So I, you know, I’m excited to be back,

Adam Pulford (01:44):

But you know what though, like we had a great conversation and only you, me and, uh, Aspen really will, you know, ha have been a part of it. Uh, so if Aspen, um, Dr. Ross’ cat wants to join us again, you can join us, uh, for all the cat lovers out there, join on our YouTube component of the train right podcast, otherwise, uh, listen in for all the good stuff.

Dr. Justin Ross (02:07):

Yeah, that’s right.

Adam Pulford (02:09):

Yeah. All right. Uh, so Dr. Ross, I gave you, I gave our listeners a brief background on your work and kind of what you’re up to today, but could you tell our listeners a bit more about yourself, your practice and where you’re talking to us from? Yeah.

Dr. Justin Ross (02:25):

Uh, be happy to, so, uh, yeah, my name’s Justin, I’m a clinical psychologist in Denver, Colorado, and you know, the work that I do is really related to health and wellness and human performance. Um, I’ve long been interested in, in these areas that overlap the mind, the body and, and optimal wellbeing, and really love playing in the playground, work, working with athletes from all levels, from literal league baseball teams, to those performing on the world stage and a lot of amateur recreational adult folks, just getting after it, uh, for their own reasons. Um, so I, I love the work that I do. I’m deeply interested in all of these topics related to mental health and human performance and excited to talk about it with you guys here today.

Adam Pulford (03:06):

Right on, well, this is just kind of a curiosity question, Dr. O but I, I’m curious what got you into the field of sports psychology and why do you do what you do today?

Dr. Justin Ross (03:18):

Yeah, great question. So I’d always been an athlete growing up, right. Loved sport as a little kid and was always playing something. And back then it was, you know, you played the sport based on the season, right. That’s how we grew up. So you got to play a lot of different sports as a kid and as a teenager, and was always coaching and, and volunteering and, and working with, you know, kids younger than my myself, and really thought I was gonna go into sort of the physical side or the medical side, uh, working with athletes and went to college with that idea in mind, right. Whether that was pursuing like an athletic training, physical therapy, medical type of approach, and really just kind of fell in love with psychology as I was taking undergraduate psych ecology classes. And it kind of peaked my curiosity and kind of drove me in a, in a new direction. So after college, um, you applied to grad school in the areas of, of clinical psychology with an emphasis on health and wellness and performance. And, uh, and here I am all these years later, you know, really spending my, my year and a lot of my personal and professional time in these spaces.

Adam Pulford (04:25):

Yeah. It sounds, it sounds like you are one of those who have truly found what you love to do, and you’re just doing it daily.

Dr. Justin Ross (04:31):

Yeah. I think I got pretty lucky with that. Right. I, you know, yeah. A lot and support and privilege and opportunity. It all kind of co-mingled and just really found a nice niche. And, you know, I think really recently in the past five years, maybe a little bit longer, there’s been such an emergence of athletes understanding the importance of mental health and the importance of performance psychology skills, and are really invested in, in learning how to make the most out of their mind to get the most out of their performance and whatever sporter domain that means for them.

Adam Pulford (05:04):

Yeah. That re that reminds me, I’m gonna probably, uh, weave that into some of our later topics, but that’s an interesting point to bring up is just how I, I think more accepted sports psychology or psychology in general is right now in especially sports psychology. So we’ll get there. But first I wanna talk about mental health and when, when I say mental health, I mean, for me anyway, is like, the first thing that comes up is, is COVID and all the implications that, um, that has had in our society. And so, however, when I was making this outline and I was like, oh, mental health, health, and COVID, and, and all these words that will clearly define here later, I was like, but what is mental health? Cause I couldn’t come up with a, I was throwing a lot of words down, but I’m like, well, I’m talking to an expert, so I’ll just ask him. So Dr. Ross, what, what is the working definition? What is mental health?

Dr. Justin Ross (05:59):

Yeah. So I always start with this general idea around health in the first place, which is health is more than the absence of disease, right? And so I think often when you hear about mental health, what you hear about is sort of quote unquote mental health problems, right. And really what I think about their, there really, aren’t not as many mental health problems as there are deep human reactions to the situations, to the lives, to the relationships that we find ourselves in. So my take on mental health is it’s the physical, psychological, cognitive, emotional relationship experiences that we have based on being a human being. And sometimes those things can really point us in a place of optimism and vibrancy and wellness and living a life in alignment with values. And sometimes those things can really point us in a place of disruption, distress, DISE, not feeling well, hopelessness. Right. So mental health really just captures that human experience that is tied to so many different facets of our lives.

Adam Pulford (07:06):

Yeah. That’s a, that’s a great definition all encompassing, but there’s a lot to it. Right? Absolutely. And yeah, and there’s, there’s a lot to it, which is why I think we determine that, uh, having a two part, so to cover all of that in a way and, and how to actually create mental health or cultivate it, um, is, is, is important. So I’d say let’s, let’s first, you know, if it’s not say an absence of a disease, let’s, let’s swing kind of in the opposite direction, cuz there’s disease going around. COVID right. Let’s talk about how that disease has really impacted us. Anything from like politically to socially and this kind of environmental unrest. Um, I wanna talk about that with COVID and, and you know, maybe not even like the COVID impact, but then like you’ve got you talk about environmental unrest, you’ve got the, world’s changing at a rapid rate, right. So we have all these severe weather events happening more than ever. And recently, I mean, this is even sadly between when our podcast, uh, for the first podcast happened and, and now, um, all the unrest in Ukraine, like there’s a war raging, so man, I just threw a ton of at you, but uh, let’s talk about COVID and, and, and how you’ve seen that impact. Um, some people on your end, as it, as on your end, as it pertains to mental health.

Dr. Justin Ross (08:32):

Yeah. All great points. And I think in a way like the starting point could be, could be very overwhelming, given all those layers from the political, to the social, to the environmental, to, uh, to the fighting on a global scale to this virus, that’s continuing to ebb and flow. I, I do think a, a starting point from my side of things is COVID has allowed us, it’s given us an entry point to sort of normalizing the conversation around mental health in general, because how so well, so, okay. So there’s a saying, right? That I’m gonna, I’m going to take down in a second, but the sayings we’re all in the same boat, which I hate, hate that saying, I think what we’re in is we’re all in the same storm, but we’re in different parts of the storm. And we have very different boats depending on our privilege, our opportunities, our access to care, our health equity, uh, our socioeconomic status.

Dr. Justin Ross (09:28):

But what it’s done is it’s said, it’s given us this, this talking point to say, let’s identify what this experience has been like for, for us understanding that there is data that shows anxiety, depression, burnout, substance use relationship problems have really impacted a significant portion of our population just through the COVID layer. So COVID for all the disruption and all the distress has allowed us the opportunity to talk about these things because there so deeply human, right? Very few of us have gotten through the past few years without being, you know, impacted in some way. There there’s been disruption for all of us in some way, shape or form. And one of those layers is on our emotional, psychological health and wellbeing. So it’s allowed that talk point. One of those biggest factors that we’re seeing is this conversation around burnout, right? Burnout is this, this thing that is getting talked about, and it’s often discussed from this position of it’s sort of your problem, right?

Dr. Justin Ross (10:27):

Adam, we gotta fix your burnout. Right. And it gets blamed on the individual. And yet what we fail to recognize is that burnout comes first and foremost from external drivers, right? The reason that people are individually experiencing burnout is that they’re in an environment where pressures exceed capacity to cope. Right? So the analogy I always use with that is, you know, if you’re in the middle of a burning building, you don’t need more flame resistant clothing, you need to get the hell out of the burning building. Right. And, and that’s where we’ve been like we have, we have a duty to take care of ourselves when we’re in distressing situations, but we’re not gonna be optimally healthy physically or mentally until we can be in a SI a situation where we’re physically safe.

Adam Pulford (11:10):

Yeah. No, that’s, that’s great. I’m, I’m taking a few notes down here too, but burnout where pressures exceed outside.

Dr. Justin Ross (11:18):

Yeah. So external pressures, whatever external pressures that’s right. Continue to exceed our capacity to cope with them. Yeah. Right. So burnout that’s awesome. Comes from this external driving factor and or factors. And one of the areas like there’s the, the personal experience of burnout is really three different pieces. It’s first exhaustion, which makes that right. We’re, we’re exhausted physically, emotionally, spiritually. And we can’t really catch back up to our baseline. The, the second is what’s called depersonalization, which is just a fancy word. That means we get kind of irritable with others and we lose our empathy and compassion. And we start to see their needs as just another thing that we have to deal with another to-do list item. And the third is this reduced sense of satisfaction. Right. We just, we don’t feel like we’re doing a good job. We’re not living up to our standards or we’re not contributing in a meaningful way. That’s the personal experience of burnout that so many people have been, uh, have been experiencing the past few years.

Adam Pulford (12:19):

Yeah. That’s I mean, I would say from the athletes I work with, that’s probably, um, one of the main things that I hear from them in terms of burnout coming from, coming from work, coming from family, coming from training, you know, if, if we’re not, uh, um, kind of seeking balance and we’ll get into that, what that means, um, as we go to, uh, and it comes from so many different directions, but I think that the way you framed it up makes, makes a lot of sense. Um, and that burnout, when you, when you continually have these, you know, influences in, in, you know, trauma and stressors coming from all these different sources, you know, you can’t even, you know, if you look to the news for relaxation, I don’t think that’s helping you any right. Especially right now. And so that burnout can come from so many different areas and it’s, and it’s absolutely incredible. So, you know, or I guess the sake of this conversation, I, I think that there’s some more key terms that we can build off of, you know, from burnout and, and I think burnout probably touches a lot of those key terms. Um, but to help frame the rest of the conversation up, can you talk about what like moral injury has to do with mental health and like the COVID implication, everything else that we talked about as

Dr. Justin Ross (13:39):

Well? Yeah. It, it’s another word that’s getting a lot of attention these days, moral injury or moral distress. And at its core, that idea is our connection to human suffering. Right? And it, we really think about moral distress or moral injury is having three ways that, that builds the, so the first could be your own personal experience, right? I am exposed to human suffering. And what we’re seeing that a lot is in our healthcare professionals who have been working on the front lines and, and seeing COVID firsthand and the disruption on their individual patients, but also on their families. So personal experience is, is layer one. The second is sort of, it’s called bearing witness two. So seeing maybe not your personal experience, but right next door, right. Somebody that you’re, you’re interacting with a colleague, a friend you’re seeing the situation for them. The third is learning about right. Learning about hearing, about reading about the news is a major factor there. These situations that relate to human suffering, and what we’re seeing right now is we look at this situation unfold in the Ukraine is it’s absolutely devastating. And so many people have they’re burned out. They have moral injury, and it’s really hard to be paying attention to that because they’re already morally distressed, right? So this, an offshoot of this is often called you know, compassion, fatigue, right?

Adam Pulford (15:06):

And that’s, that’s another kind of buzzy buzzy

Dr. Justin Ross (15:08):

Term with you. Yeah. Compassion, fatigue. If you look at it, it’s gonna tell you it’s the cost of caring. Well, in a lot of ways, compassion is actually a, a key factor in human vitality, compassion towards others, towards other beings, really, for the most part fills us up. It, it recharges our battery compassion is somewhat draining, but it’s more rewarding. The problem with caring. And this is what often gets missed. It’s not the caring. That is the problem. It’s when we’re caring for something and hopelessness and hopelessness are tied to it. Right. And this is what we’ve seen in, in COVID, especially for healthcare workers, they’re caring so much. And yet for years it’s felt hopeless. It’s felt helpless, right? This doesn’t, we don’t have an end inside. We’re not sure when it’s gonna get better. There’s nothing I can do about it. When we look at situations like, like what’s happening in the Ukraine, those factors are very much at play for us, at least here in the states, right. We don’t have a lot of hope for what’s gonna happen next. We certainly don’t have any immediate control factors to make this better. So it’s not the caring. That is the cost that burdens the us. It’s when that caring is attached to things that have hopelessness and hopelessness associated with them.

Adam Pulford (16:18):

Got you. And so it’s, it’s not to say that you shouldn’t care about your, your fellow man and, and, uh, I don’t know, um, go against any, um, local call it mask or vaccine end date, because you just don’t care anymore. It’s more, more about genuinely caring about why you would want to do that in, in what disassociating from, I don’t know, uh, a, a hopelessness or a helplessness aspect of it, or do I got that, right? Yeah.

Dr. Justin Ross (16:50):

I think it’s, it’s hard, right? Because I think part of it is we want people to care, right? It’s, it’s a show of humanity and connection. And I think it’s an important recognition to, to know when, when that care has those elements connected to it, because those are the elements that are gonna come back and be distressful to you in the long run. Right. Not having the ability to have hope, not having the ability to, to have help or control. Those are the areas that really provide us a lot of distress.

Adam Pulford (17:22):

Gotcha. So it’s a, you know, two other, two other words, cuz they kind of, all of these kind of play off each other too, because where I was going with that compassion, fatigue aspect is like, well, do you just focus on the things that you can control or can’t, or, you know, and, and don’t deal with the stuff that you can’t control then. But then I, I believe that that brings in some like anxiety, right. And anxiety can lead to depression. So can you, can you give us a little bit more context of what anxiety is and, and then we’ll also talk about depression.

Dr. Justin Ross (17:54):

Sure. Yeah. And, and you’re right, Adam, they’re all kind of woven together and have overlapping areas and a lot of similarities. So I, I do a lot of outreach and give a lot of talks and often what I’ll I’ll do when I talk about anxiety is I’ll say to the room, like all a quick show of hands, if you’ve ever felt anxiety in your life, raise your hand. Right. And yeah. Right. So most of the time I have a room full of honest, genuine people and everybody raises their hand. But once in a while, you know, somebody, you know, stoic and doesn’t wanna admit it. And the, the reason I do that is again, anxiety is a very normal human reaction. Right. I, I haven’t met anybody in my life that hasn’t felt anxiety in some way, shape or form related to something. But it’s important to understand the building blocks of anxiety.

Dr. Justin Ross (18:39):

Right. And there are three. Totally. Yeah. So the first is uncertainty, right? When we don’t know when we don’t have clarity, when we can’t predict, that’s the first thing that builds anxiety. And again, if we just look at the past two years, it’s been a lot of this, gosh, I don’t know what’s gonna happen. Right. I don’t know what the direction of COVID is taking. I don’t know what this means for my health, my family’s health. What’s gonna happen with my kids’ school. How is this gonna be? Right. But we don’t have predictability thoughts, spirals start to happen. The second is that control piece, right? We need to have influence over our own safety. Right? We need to feel as though there’s something I can do, right. In response to, or in pro action to right here are my steps I can take. And again, that layer has been very Rocky.

Dr. Justin Ross (19:25):

The past few years, the last building block of anxiety is a threat to something of value, right? A threat to something you care about. So the, the nice thing, if you will, the silver lining of anxiety is it really does point us to values. Right? If you didn’t care about something, you wouldn’t get anxious about it. If it were threatened. Right. So silly joke, you know, I’ve got my nice cup of coffee here. Somebody was gonna threaten my cup of coffee. I’d say, go ahead, man. Take it. It’s yours. Right? No anxiety about my coffee being threatened. But if you threaten my kids, like, all right, that’s, that’s a whole different situation. Like now, now I’m defending, I’m getting anxious. I’m figuring out a response. So the back door way to play with anxiety is to look at what values it’s pointing to, because that’s a really important element in that whole, um, constellation.

Adam Pulford (20:14):

Yeah. Yeah. That’s that three prong approach or the, the three elements to anxiety I think is really good to help shape that up. And then I think for our listeners, I think they can then see how like a broad aspect, like anxiety can then lead to more specific compassion, fatigue, that moral injury, and maybe this all encompassing umbrella, burnout or something.

Dr. Justin Ross (20:36):

Yeah. And you could layer that, right? You could think about your own personal life. You can think about your community. You could think about the world at large and they’re gonna have different elements of, of all of those components, but really challenge people. If you’re, if you’re feeling anxious, when you’re feeling anxious to go back and, and think about those three layers, what feels like it’s unpredictable right now, what feels like you don’t have control right now? And what value do you own that’s being threatened in this moment?

Adam Pulford (21:06):

Yeah, exactly. So where do, where does depression fit in some of the, in all of all of that I should say.

Dr. Justin Ross (21:13):

Yeah. Again, depression, there’s some overlap, there’s a unique experience. It’s uh, again, very, uh, a very high level concern right now. And again, some of the, the development of depression usually comes first and foremost with a sense of loss. Right. And we can think about loss in a number of ways. So for anybody listening, who’s ever lost a loved one family member, friend, pet patient. When somebody, you care about passes away, we process that as grief, right? There’s sadness there. Well, we can experience loss in all kinds of ways that are not wrecked loss of life, but psychological. Right. And these could be things like loss of meaning, right? Loss of purpose. Those are two huge elements of depression building. Right. And that could mean very different things based on your individual circumstance, uh, loss of relationships, right. Loss of like getting your identity needs to at right. When we go back to the beginning of COVID, one of the things that really impacted athletes, mental health was loss of events. Right. You know, we, we compass our lives in direction to events that are deeply meaningful for us. And when you took them all away, people were really struggling. Right. I don’t know what yeah. To do. I feel directionless and lost loss is huge that when you factor in hopelessness and helplessness on top of it, those are really the major building blocks that we see impact the development of depression for people.

Adam Pulford (22:41):

Yeah. That all, um, that all makes sense. It’s a little heavy, but makes sense. Right. Yeah. And you know, I’d be Remis to, to talk about, you know, we’re talking about athletes, right. And, and anything from, you know, the Tokyo games being, uh, moved around and having, you know, elites have to shift a lot of things. There was a lot of people that, um, experienced a lot of that. A lot of those elements leading up to that in the, you know, competitive setting, but the, your missed to talk about, you know, the, some of these specific groups that are just dealing with this since day one of COVID, right? Like the healthcare workers, the, the, uh, working mothers, you know, the, the peop you know, families with kids, like, I mean, that’s a whole other element too, that I have not had to deal with. Right. And so, uh, people at the grocery store, so talk a little bit about how some of those groups have been experiencing this. And I, I mean, I shouldn’t, I shouldn’t even say to tell us how those people have been impacted. I think a lot of people understand how, how that is, but can you talk about how some of like, even compassion fatigue would, would work into how we’re experiencing this as a society? Like how these terms kind of worked. Yeah.

Dr. Justin Ross (23:57):

Yeah. I, those are all really important groups to think about right there. There’s a large scale meta-analysis study published last year, March of 2021 that looked at 65 studies, 97,000 healthcare workers across 21 countries. So very broad sweep. Yeah. Yeah. That’s huge. And they were interested in depression, anxiety, and posttraumatic stress disorder concerns in those healthcare workers and the number there is staggering. So low, 20% in moderate range for anxiety, depression, and PTSD. Those are the moderate band is the band of clinical significance. It’s gonna get you a diagnosis and recommended treatment. More importantly, in my opinion, was anxiety and depression in the mild category was scoring around 36%. So greater than one in every three healthcare workers was walking around with a mild level of anxiety and depression. And often when it’s mild, nobody knows about it. We’re suffering in silence. We’re we don’t feel like, ah, nobody, people are gonna get this.

Dr. Justin Ross (24:55):

I can’t share this. Other people are struggling way more than I am. So I have guilt about sharing my struggles. And so we know that there’s just a lot of people in that setting healthcare workers who are struggling greatly gonna see post traumatic burnout, post traumatic, moral injury, posttraumatic compassion, fatigue in completely new ways that we’re gonna be dealing with in treating and helping support for years, if not decades, to come for those in a healthcare space. That’s part one, working mothers is, is another group that we need to give a lot of attention to. And there’s data that shows that compared to working dads, working mothers through the pandemic have had higher levels of stress, anxiety, and lower resiliency compared to working dads. And the reason is it’s not their fault. So we need to start there. The reason is they’re taking on what’s called more cognitive load than working dads.

Dr. Justin Ross (25:46):

So moms have disproportionately taken on more of the household duties. More of the safety checks, more of the thinking through about social relationships, more of the navigating text chats with their friends and their moms and the social network. And it’s creating this cognitive load space that is becoming burdensome. It’s a silent layer that often doesn’t get talked about. It’s one of the most important factors in the development of burnout is the nature of cognitive load. So those two groups specifically are just getting decimated, and we’re not often talking about it the way that we need to. I worry about this idea of, you know, a new normal right, where there’s gonna be this pressure from a big part of the, was in the storm on yachts, sip and martinis, the past two years, not recognizing that people have been at the front of the storm, getting battered by rain and wind and lightning, and they’re down to one or, and their ship is falling apart. It’s gonna take those folks a long time to recover, and we’re gonna do a disservice to our global humanity if we don’t find a way to help support their recovery.

Adam Pulford (26:53):

Yeah. Um, completely agree with that. And it’s, you know, we’re still in the thick of this too. A as you said, I mean, we’re gonna be healthcare workers or dealing with that for decades to come. Um, where my mind goes with that. And we haven’t like laid this out in the outline, but I was, I’m curious too, which is like kids in, in school, kids in their developmental states being, you know, and that goes from anything from, I don’t know, uh, preschool early grade school, all the way through, you know, the, the kind of that graduation, trying to find a job. I mean, there’s generations here that will, I mean, everybody’s been affected, right. But like what, what is your take on say kids going through this and potentially what the outcomes, or how does that end, you know, is something that we haven’t dealt with before what’s, what’s Dr. Ross’s

Dr. Justin Ross (27:47):

Take on yeah. It, what it’s challenging. Right. And give you a little, little story. So my kids are 10 and seven and this morning getting them ready for school. Uh, just yesterday, they, the, our school district, um, let go of mass mandates. And so it was the first day, today’s the second day where they’re not able, they, they don’t have to wear masks. Our kids wear mask yesterday. And they were like one of the only kids that did. So, and so our conversation this morning was around like threading the needle between recognizing and understanding that there’s a social element. If they’re, if they’re the only kids wearing masks and we’re, is that gonna feel like, right, they’re gonna be called out. They’re gonna feel alienated. There’s a safety component that we’re still trying to figure out. Is it safe? Is it not safe? They’re vaccinated.

Dr. Justin Ross (28:35):

You know, what happens if they catch it? How do they feel about it? And so my kids are old enough where we have the ability to talk this through and really working to sort of empower them to understand both sides of it and make good decisions collectively. Now, one of the hardest hit groups is the well, a lot, right? And developmentally different, those younger kids who have known nothing but social isolation in some respects, due to safety, physical, distancing masks, right. That we see that some of these kids may feel, you know, this little social delay in terms of those kind of normal interactions, those older kids, right? Those teenagers, young adults, who’ve missed so many rights of passage. Right. You know, I think about like prom, homecoming graduation, those important things that happen in our, on our teenage years have been missed for a lot of these kids. Those things are gonna leave a mark, what that means long term remains to be seen. But again, we need to be finding ways to, to be responsive to this and helping get our kids, you know, to those developmental normative stages.

Adam Pulford (29:42):

Yeah, absolutely. And I, and I think that, you know, one of the primary reasons I bring it up is a lot of people listen to this podcast, have to have kids and have to deal with that. Right. And it, and it plays a huge part in their cognitive load because what my athletes and especially my athletes with kids, you know, have to deal with is very different than my athletes who, you know, don’t have kids in that regard, if you just like separate it out, no matter what you think of COVID and masks and all this kinda stuff, it’s just like, you have to understand, like, the cognitive load is way different than in 2019. Right. And kind of where, where I work say in a, a performance setting is working with athletes to get them more resilient, to physical and mental stress or fatigue, if you will.

Adam Pulford (30:31):

And, uh, say distractions in life that take us away from achieving our goals. Right. Or navigating all the rest of life stuff like we’ve been talking about, um, we’re talking about all this stuff that like, hold like puts us down, right? Compassion, fatigue, moral injury, burnout, anxiety, depression. Right. So in, in the notes that you sent me there, you know, there’s a model for resiliency and, and where my brain goes with that is like, well, I’m trying to develop resiliency in an athlete, be as nearly physical. And there’s a lot of mental that goes on with it, but there are tools that I use in order to get an athlete performing very well, to withstand outside forces coming in to handle stuff. Right. And I, I think that there’s some similarities there. I don’t know. I’d say let’s get into that model of resiliency that you talk about, especially to the trauma I’m informed care. Um, however, I’m gonna kind of play off of that, where I see it kind of working in, say in coaching and with athletes as well, because I do think that there are some similarities with

Dr. Justin Ross (31:34):

That huge. Right. And I know like, let’s just take the lens of flow for a minute. And I know you love the idea of flow as much as I do and flow is

Adam Pulford (31:44):

Flows.

Dr. Justin Ross (31:44):

My G yeah. It’s so good. Right. And in the endurance space, flow is really important. Now I often I think about this idea, I call ’em flow robbers, right? What are the, what are gonna be the anti flow things that, that allow us not to get into flow? The biggest flow robber that we have is distraction, right. Not totally being present. And if you think about all the elements that allow us to not be present, cognitive load is a big one. Right? So even as I’m thinking about this conversation with you, I could have one part of my mind going through, okay. I wonder, okay, this is the first day we’re trying to nuance this mask situation with my kids. How’s it going? I don’t have any predictability. I don’t have any control. I could spend a lot of time dancing around anxiety questions that creep up about that situation, because I care about them.

Dr. Justin Ross (32:34):

It’s a threat to something I value. So a flow robber that we’re seeing in the past two years, cognitive load anxiety, exposure to moral distress, all of those things are gonna impact our ability to be deeply focused and deeply present. Right? So we have to start there, whether you’re an athlete or not an athlete that applies to humanity in general. So I think one of the, one of, of the ideas around developing a resiliency framework, the, the first and foremost thing is awareness, right? One of my favorite sayings, you cannot change what you are not aware of. So we need to bring awareness and attention to this. One of the most important pieces, I think about the initial part of this conversation is we have to outline it. We have to talk about these things. We have to give them labels and, and names so that people feel comfortable identifying them like, yep. That’s, I’m experiencing that. That makes sense. Right. So that we can understand then how it impacts your life as a human being first and an athlete. Second.

Adam Pulford (33:32):

Totally. And within that, I mean, awareness awareness is a, that’s a huge one. And we, we’re gonna spend a ton more time on awareness. So I’d say we’ll get to that here kind of in a minute, but in terms of, I like that term flow robbers. I mean, that’s man, we could go, we could go a lot of different ways on that too. Um, but anything that does distract from, um, the attention I think is huge. And when, where we’re, when we’re looking at what it takes to even start, I think like in a camp setting for us, for example, if we got athletes that it’s, you know, 20 athletes that come to a road training camp, we always start with safety first because no, no is gonna want to ride their bike, let alone be able to do a, a time trial uphill for 20 minutes.

Adam Pulford (34:26):

If they don’t feel safe, if they feel like they’re gonna get pegged by a car, sorry, I ain’t going right. And so when it comes to that, um, resiliency or developing the ability to stave off some of that and focus, uh, you know, on flow or anything else, I mean, it kind of starts with safety and the other kind of bullet points to that resiliency safety capacity to be calm, connection and belonging self-efficacy, which I think is huge with athletes. Right. And that future orientation, like where we’re going. Um, could you break down those as aspects just a little bit more, and then we’ll transition into like that balance and awareness aspect.

Dr. Justin Ross (35:06):

Yeah, absolutely. And, and you’re right. Safety has to come first and, and physical safety first more than anything, right? None of those other resiliency skills matter if you’re in an unsafe building, right? Like the whole idea of burnout. If you’re in the middle of a burning building, you don’t need to focus on mindfulness or deep breathing. You can get the hell out of the building. Right. And again, one of the disservices I see is so much of this. You’re gonna read it right about resiliency is take a deep breath, go outside, eat salads, not candy bars. Right. Well, great ideas. They only count if you have the opportunity to engage in them. And if I’m gonna harp on the storm analogy, again, it’s easy to do when you’re on a yacht, in a sunny part of the storm, harder to do when you’re in a broken down boat with one, or you’re getting pounded with rain.

Dr. Justin Ross (35:56):

And so again, we have to start there opportunity for the stuff matters. Most the first thing is physical safety and whatever capacity that means we need to get to a place where physically we’re unharmed and we can predict and have control that we’re gonna remain safe. The psychological safety then is the second piece. Once we’re physically safe, we need to be able to have the psychological mechanism to have prediction like, okay, I’m safe now. And I’m gonna continue to be safe. Right. I’m gonna continue to have control over my wellbeing. And then within that is we need not only transparency. We need to continue to understand and have data. That’s gonna suggest that we’re gonna continue to be in this place, but this is where we need communication. We need the opportunity reflect on what we’ve been through. We need the opportunity to, to share those experiences in a, in a way that we feel the other person’s gonna understand support and validate and not judge or criticize or tell us to do something different. That’s all so critical and safety first.

Adam Pulford (36:57):

Totally. Yeah. And that safety, I mean, it, it allows you to build from there, right. Call it the kinda a pyramid for, uh, NA’s hierarchy. Right. That’s where my brain goes in terms of, um, how you can achieve, um, self-actualization self actualization is kind of his thing, um, or flow as it pertains to, uh, the athlete context or happines just pure happiness, um, right. Where some people, you know, maybe listening here and say, yeah, sports are great, but I just wanna be happy. Well, it all starts with that kind of, that context of being safe and then builds from there.

Dr. Justin Ross (37:34):

Absolutely. Yeah. And, and from there really the second step is understanding. We have amazing capacity to regulate our experiences in mind and body, usually through breathing. Right. And, and my take on breathing is it’s old as dirt, right. And we’ve heard this forever, right? Like we’ve said it, we’ve heard it when you’re upset, just take a breath, right. It’s woven in our DM and a, in our collective conscious that breathing helps. And we have a lot of data that shows now that just one minute of regulated, slow breathing is gonna turn off any of that sympathetic nervous system activity. We have cortisol, adrenaline stress, anxiety, and it’s gonna move us into this parasympathetic type of approach. Right. That’s kind of the rest and digest system. It gets us to a place where we can improve our sense of calm, improve our focus. And when you can do that one minute, just try it one minute, slow, deep breathing brings our bodies down. It slows down the treadmill of thoughts. And when you put those two things together, reduced physiology, slower thinking, we can then really approach whatever comes next in our day with a, a more proactive, productive sense of agency.

Adam Pulford (38:49):

So I’m a huge, huge proponent of breathing. Okay.

Dr. Justin Ross (38:55):

Pretty good for you. If you’re not breathing, you’re having a rough day.

Adam Pulford (38:59):

That’s right. But, uh, full transparency aside, I do nothing in the way of, uh, like a framework of breathing or, uh, there’s a lot of like even certifications out there on rework meditation, all this kind of stuff. However, I do it, I implement it with athletes, whether I’m on the bike next to ’em or I’m talking to ’em or, you know, in the training peaks, uh, portal, dialogue, this kind of thing. I’m cur where I’m going with this is curious if you have some sort of, kind of context framework that our listeners can use with that. If there’s more to talk about it, but my approach to it is like, as you just said, you described kind of like physiologically what happens. Say even at a, um, like a hormonal level, why breathing is good and why it brings you to a place where you can be calm or more grounding, but it effectively, um, I mean, people are probably gonna like, R me over the colds, like Jason coop, but it’s gonna make you more efficient because when you’re stressed out, you’re over breathing, you’re wasting energy. Your brain’s going in all these different directions. But if all of a sudden you start breathing more deeply and I come up alongside someone, I say, okay, wiggle your fingers, breathe. Right. So just like, cuz it gets ’em to relax their hands with they’re normally like death gripping their hands, climbing up a hill climb, for example breathe. All right. Deep breath. Here we go. Yeah. In, in, in it just takes that. Yeah. You know, in, in the moment. Absolutely.

Dr. Justin Ross (40:33):

Yeah. I mean there’s my whole approach on that is emotionally intelligent athletes are gonna be more away, more aware and they’re gonna make better decisions. And in the landscape that, that we play in endurance sports where we’re out there for, you know, sometimes minutes, but sometimes hours and sometimes days making good decisions is gonna be critical to not only enjoying the experience, which I, I think is a huge part of why we do this in the first place. It’s gonna allow you to perform better. There’s a great saying, right? Mindfulness, which another buzzword mindfulness isn’t difficult. What’s difficult is remembering to be mindful. So we, we need to find a way to cue totally cue this up in our lives so that we don’t have to spend 15 minutes on a meditation cushion, but we do need to check in daily and think about our breathing. Oh, we’re I haven’t been paying attention to my breathing. Let me just take a minute. The more we do that in the cadence of our regular day, the better able we’re gonna be able to do it when we’re on the bike, on a trail out there for hours and we’re, we’re, you know, maybe lost in some type of performance, something right. Having something to come back to is critical and the breath is a great place for that.

Adam Pulford (41:45):

Yeah. Um, in the last word I’ll or the last thing I’ll say about that is, uh, having a, you said come mean back to having something to come back to. Right. I think mantras are a pretty good way of doing that. Especially in the moment in competition, all this kinda stuff. It’s part of your self talk, but it cues us to come back to the breath. So it could be as simple as breathe.

Dr. Justin Ross (42:08):

Yeah.

Adam Pulford (42:08):

Focus. Yeah. Or, I mean, you can come up with that and slogan you want, that’ll bring you back to that, but having a mantra to cue the mind in order to do the physiological thing to calm, then you can return back to that flow state. Totally.

Dr. Justin Ross (42:23):

One of, one of the challenges I’ll put athletes through that I’m working with is every time you change your clothes, I want you to use changing your clothes as a, for paying attention to your breath and working to settle it down. And there’s a couple reasons. I like it. You know, for most of us, especially on the athletic side, we change our clothes several times a day. And again, going back to flow robbers, distraction, having a lot of things on our mind impacts our performance. And often if, if folks out there or like me, I’m often working out, I find a way to make it happen in the middle of my day, especially this time of year. And so I’m working and then I’m often letting go of something at work that I’m thinking about or working on. And then I’m moving into working out training.

Dr. Justin Ross (43:09):

And if I’m still thinking about the last thing or the next thing, while I’m on the bike or in my running shoes and it’s gonna impact my ability to be present. So I love that idea as it’s a transition, right? We’re transitioning identity, we’re transitioning behavior and we’re transitioning approach, right. So we’re putting on our bike shorts getting on our running shoes. Oh, that’s my cue. All right. I can take slow, deep, rhythmic breaths as I’m moving. I don’t have to stop. I don’t have to take time outta my day. That is good for you. Don’t get me wrong, but it can be this cue to help us start to train that muscle of, of awareness of focus of breath work.

Adam Pulford (43:45):

Totally. Yeah. And that’s, I mean, I’m glad you brought that up cuz as soon as I throw some spandex on it’s go time like done. However, I do procrastinate quite to bit with I’ll answer that last email. I’ll take that last call, but, but as soon as the spandex are on man game time. Yeah,

Dr. Justin Ross (44:02):

For sure.

Adam Pulford (44:04):

Okay. So just to kind of rip through the last, um, couple bullet points here, how does connection and belonging play into this and then we’ll get into that self-efficacy and then a future outcome or orientation.

Dr. Justin Ross (44:17):

Yeah. So, so yeah, going back to the trauma inform care model connection and belonging is, is really then kind of that third step. And if you think about those building blocks, right safety first down, regulating our system in body in mind and then we need to reach out and have support. Right? And so connection of belonging is kind of, it’s an intuitive piece for most of us. We know that we need connection and belonging. And one of the biggest hardships at the start of the pandemic was physical distancing and not being able to be around our people. Right? So connection of belonging is important for few reasons. One it’s that of being able to actually get validation and support, right? People around me can understand my experiences that they, you know, they recognize them as deeply human. And I feel as though they get it right, that part is critical. But then we, we often forget that we’re doing that for other people as well. That’s compassion, right? This urge to help this urge to act. And that passion is often, you know, really recharging for us. It really helps us. So connection and belonging is a, is a critical element in that process of trauma inform resiliency.

Adam Pulford (45:22):

Totally agree. How does, how does self-efficacy play into it?

Dr. Justin Ross (45:28):

Yeah. So then after that you get into these sort of cognitive models, right? Once you’re physically safe and you feel connected to people, then you get into being able to, to work on higher order thinking. Right? And if we just go back to connection and belonging again, like think about my, you know, my role as a dad, you know, when my kids are up upset or stressed about whatever, what do they want more than anything. They don’t want me to solve their problems. They want to touch me, me. They want be, they wanna cuddle. They wanna hug. Right. Daddy cuddle me. You got it. Right. We need to feel that sense of safety. And you can almost feel this, like the, the breath comes in. We have that deep reflex and relaxation. Sometimes if you get into the weeds on it, what we’ll often recommend people do is it’s called a 22nd hug. Right? When you’re feeling stress, you go to your partner, community member, not a community member, somebody that you love, that you feel safe with hug em for 20 seconds. You don’t, we don’t usually hug that long hug for 20

Adam Pulford (46:22):

Seconds. Yeah. It’s

Dr. Justin Ross (46:22):

A long hug. It’s a long hug. But watch what happens right around the ten second mark, 12 second mark. There’s this big side that happens. It’s really important. Self efficacy is thinking, right. And it it’s belief system on what you think is possible. Right. And it’s really shaped first and foremost, by your own personal experiences. What you’ve been through in your life in general, what you’ve been through in a micro level the last year to two years, Henry Ford is the greatest cliche quote on this. Whether you think you can or you can’t you’re right. That’s, self-efficacy in enough shell, it’s your belief system and what you think is possible or what you think your limits are.

Adam Pulford (46:59):

Gotcha. So, I mean, I can definitely see where that self view has for future orientation. Uh, but talk to that, uh, just for

Dr. Justin Ross (47:09):

A minute. Yeah. So then future orientation is where we go next. And again, if we go back just to the COVID layer, one of the biggest disruptions, physical distancing was one. The second was the cancellation of so many things, right? I didn’t have a thing to look forward to. My race was canceled. My travel was canceled. I couldn’t connect with people that I cared about. All of those elements in this model were threatened and taken away. Future orientation is two things. One we need to look forward with things that we’re excited about. Things that provide us meaning, right. Identity, meaning engagement, so important, but optimism is a big part of that as well. It’s really easy for us, you know, to look back at the negative. I screwed this thing. I didn’t say that. Right. I wish I would’ve done that differently. And we have this rumination of those things. We need to build an optimism about, you know, one that we’re doing okay. Right. And two that things are gonna get better. Right? There’s that hope level. We, we need to find real hope. It can’t be unicorns and rainbows. It can’t be made up. It’s gotta be anchored in, but we do need to find ways to think about finding hope optimism in our daily lives.

Adam Pulford (48:16):

Well, that’s, that’s a great summary of that, that model of resiliency, Dr. Ross, that you were, that you were talking about. And, and as I said, you know, there’s, there’s a lot that I can see on that end of how I, I work with athletes to kind of build, build the athlete, to become more resilient for a specific performance outcome. Right. Um, but the, the cognitive side, or kind of the emotional side that goes into safety capacity to calm connection self-efficacy and future orientation. I think a lot of that, um, plays into just all of humanity. Right. And so an athlete is a human. Um, and so there’s, there’s super big parallels there. Uh, we also talked about, you know, those key terms, that’ll set us up for our part two coming. That’s a burnout, moral injury, compassion, fatigue, anxiety, and depression. The reason I wanna spend so much time on that is like the, their buzz words, their, the words that I’ve heard and athletes have heard out there and even like probably using, but are we using them properly, you know, um, to we fully understand them.

Adam Pulford (49:19):

So I think having a better understanding of that is, is really important with where we’re going with this conversation. And, you know, with COVID looming here in year three, um, changing climate, it now the war in Ukraine, there’s, there’s a lot of stuff going on in the world. So I think that, you know, mental health is never been more important to start to cultivate, uh, Dr. Ross, we talked a lot today about mental health. Is there anything kind of in summary of part one that you want our listeners to make sure or they, they remember from this part one series?

Dr. Justin Ross (49:54):

Yeah. Yeah. I, I think a couple things stand out. So the trauma-informed resiliency model is really based on the idea of what has happened to you, not what is wrong with you. And I think we need to take that to the mental health later. Mental health is what is going on with you, not what is wrong with you. We all have mental health, all of us. And it’s our way of relating to ourselves and the world and how we regulate our emotional experiences. And it, it is shaped by environmental factors. And the reason I think these conversations are so important is it’s a starting point to recognize that those environmental factors right now can be extremely distressing. You, you don’t need to have a personal experience with COVID to have distress or trauma or anxiety in the past two years. So many people I’ve talked to felt guilty.

Dr. Justin Ross (50:44):

Like I shouldn’t be feeling the way I’m feeling because cause so, and so is working on the front lines and I’m relatively safe. Doesn’t matter. You’re a human being and, and you have a right to have those experiences. So I think this whole idea around mental health is really understanding. We all have mental health and we all have these experiences. They’re deeply human in nature, giving awareness and attention to them allows us to then figure out exactly we, what we need to live in an optimal way in alignment with our values, with our meaning, with our purpose and to perform optimally. And for athletes performing optimally is such a meaningful part of our, our identities, both in and out of sport.

Adam Pulford (51:22):

Couldn’t agree more, couldn’t agree more and we’ll get into, uh, that element even more so in part two. So Dr. Ross, uh, thank you for joining us today, uh, for part one for our listeners, uh, make sure to catch part two and, uh, we’ll be cultivating mental health as we do.