Sport & Performance Psychology (SPP) for Injured Dancers

Written by Arianna Shimits, MA & Persistence Psych Co-Founder

What is Sport and Performance Psychology (SPP)?

“Doing therapy with a person who happens to be an athlete is not sport psychology” (Aoyagi & Portenga, 2010; Swann, Morgan, & Piggott, 2015).


There is an analogy that I think captures the nuance of sport and performance psychology: “a square is always a rectangle, but a rectangle is not always a square.” Similarly, SPP is a specialized practice in the field of psychology, but psychology is not always considered SPP.

SPP is usually defined by the population we are working with instead of its foundational concepts. SPP applies psychological principles to help athletes perform well and perform well consistently, but the athletes we work with define those goals themselves.


Counseling and clinical psychology can have similar goals, wanting to help individuals learn coping skills and “perform” consistently in life.


However, these branches of psychology are focused on helping individuals with more immediate concerns like developmental challenges or psychopathology. Outside of the three branches of psychology mentioned, there are dozens of different sub-fields that work with specific populations and their specific needs!

Now, back to SPP and injury…

Injury is a complex topic. Dance medicine and research have come a long way in the last few decades, however, there is still a lot we don’t know about injury and recovery, especially on the psychological side. In this article, we will focus on 3 concepts about injury: 1. Injury is inevitable, 2. Injury is still viewed in a binary, you're either hurt or you aren't 3. Even as your body recovers, your community, psyche, and confidence all need to heal as well (even if you don't realize it). When performers experience injuries there is an immediate need to fix what is physically happening, but what about our psychological experience? SPP has been utilized as a treatment modality for injury and recovery in athletic domains for decades and SPP interventions have been associated with positive outcomes including, “increased adherence, reduced stress and anxiety, and enhanced recovery rates” however, this practice is less common in the performing arts (Swann, Morgan, & Piggott, 2015).


**Below is a case study highlighting the importance of performance psychology during injury and recovery. Details have been altered to ensure the performer's confidentiality**

Scene One:

The performance season is quickly coming to an end and Ben is excited for the off-season and all the opportunities he has lined up. He has been working hard to show the artistic staff his growth and push for promotion. Two weeks before the company moves into the theater Ben was taking company class when he rolled his ankle during petite allegro. Shocked and flustered, Ben stood up quickly and went to the side of the studio to “shake it off” as he had done many times before. By the end of class Ben’s ankle was feeling slightly better, and he walked into the next studio to begin the rehearsal day. After the ballet master specified that Ben’s cast was going to run the piece, Ben walked to stage left to practice his entrance. The music started, and Ben ran in to take his first soutè and fell to the floor again. The ballet master, who also taught class, sent him up to the PT to get his ankle looked at. By the time Ben sat on the PT table his ankle was swollen and tender. Shortly after, the PT confirmed that he had sprained his ankle. As the PT went through instructions for the next few days (no dancing for 5 days and then we reevaluated), Ben felt himself become very anxious. Soon after Ben sent me an email.

SPP Session 1

After Ben explained his situation, we used our first session to explore his thoughts on the injury and the emotions that it triggered. Ben described feeling angry, frustrated, incompetent, and relieved and we explored these emotions one by one. Ben was angry at himself for not being able to push through the pain, and we reflected on how this is often an expectation of dancers… to be resilient… no matter what. Ben reported feeling frustrated because he felt this was his last chance to “prove himself” …and we poked holes in this idea. He had performed well all season and this injury wasn’t going to change that. As we explored Ben’s feeling of incompetence, he reflected that he often focuses on the moments of “failure” instead of on his “success”. At the end of the session, Ben disclosed that part of him felt relieved. Ben realized he felt relieved because this injury finally gave him the break he needed. At the end of the session, Ben was given “homework” to notice his emotions throughout the next few days and reflect on them.

***Homework is occasionally given to help performers focus their attention on one of the concepts discussed during a session. In this example, Ben was asked to notice and become more mindful of his emotions. Some individuals like to do this by journaling, and others prefer to reflect internally. (Personally, I like to leave this up to the performer. Ben did not enjoy journaling, so he decided to engage in a moment of internal reflection instead of making this a formal written practice.)***


Summary:

  • Goal: Debrief Ben’s accident and become more familiar with the cognitive and somatic experiences he was having.

  • (Desired) Result/Progress: Ben developed a better understanding of his situation and was provided a space to speak freely about the cognitive and somatic experiences mentioned above.

SPP Session 2

During our second session, we reviewed Ben’s homework and highlighted themes that emerged from this experience (negative emotions he experienced when he was watching class or rehearsal and was feeling more motivated when he was away from the studio and focusing on something else). At this point, Ben was 1/3rd of the way through his 5-day rest period, and we began to shift our focus. First, we developed goals for the rest of the recovery time using the SMART goal format. Those goals were:

  1. Reflect on his emotions more throughout the day and utilized each meal as a reminder to check in with himself.

  2. Engage in social activities to take his mind off his situation.

  3. Practice PT exercises and communicate with the physical therapist if something doesn't feel right.

  4. Review the choreography by listening to the music once per day.

  5. Watch class and rehearsal and focus on what he could be learning instead of comparing himself to others.

Summary:

  • Goal: Create an action plan based on reasonable goals for both his physical and psychological experience.

  • (Desired) Result/Progress: Creating these goals helped Ben focus his energy on the “controllables”. He had action steps to focus on which could help alleviate some of the feelings of anxiety and a general lack of control.

SPP Session 3

During our third session, we explored mastery imagery so that Ben could mentally rehearse his choreography to implement corrections, focus on form and artistry, and most importantly focus on using his foot and ankle as if they weren't injured. Once he became more comfortable with this concept, we started to integrate cue words into his imagery scripts to help him focus on the strength and alignment of his ankle. At the end of the session, I asked Ben to create an imagery script and record himself reading it and listening to it while imagining the scene.


Summary:

  • Goal: Learn about imagery, specifically how it can be used during injury and recovery.

  • (Desired) Result/Progress: Learn and practice a new skill that could aid in Ben’s recovery.

SPP Session 4

During our fourth session, we discussed Ben’s return to the studio. Ben reported feeling insecure because all eyes were on him, and he knew that he wouldn’t have much time to show the artistic staff that he was stage ready. Ben found that the imagery work was helpful for choreography, but he noticed that he was having difficulty focusing on the present moment because he was scared he would fail or re-injury his ankle. We spent much of the time focusing on acceptance as an attentional focus strategy. While pushing away negative emotions can be an effective strategy for some it wasn’t working well for Ben, so education was provided on acceptance and the importance of experiencing our emotions without judgment.


Summary:

  • Goal: Debrief his imagery practice to offer feedback and suggest improvements and introduce the use of acceptance.

  • (Desired) Result/Progress: Continued focus on his internal experiences and the further development of coping skills that foster performance.

SPP Session 5 & 6

During the show week, we had two shorter sessions where we explored his emotions around his injury, created contingency plans (detailed coping plans for when obstacles and challenges arose), and continued practicing imagery and acceptance.

After the last show, Ben and I met to debrief the performances before he took some time off and he reported feeling accomplished and content with the way he performed and stayed focused. When I asked Ben about what was most helpful during this session, he reported that having space to explore his emotions and learn how to accept them was most helpful. Ben mentioned that he hopes to use imagery and cues in the future, especially when he is less comfortable with the choreography. Ben and I have continued to work together processing several mental and physical injuries together this last year.


Summary:

  • Goal: Offer continued support and maintenance. At this point, new interventions were not utilized.

  • (Desired) Result/Progress: Development of imagery and acceptance skills to better understand his cognitive and somatic state.

Why was performance psychology effective for this athlete?

Performance psychology takes a holistic approach to performance, psychological wellness, and recovery. The sessions with Ben were successful because he had the space to reflect and process his experience while additionally creating action steps to move forward. In this situation, Ben faced many challenges that could’ve escalated without intervention. At the beginning of our work together Ben described the emotions around his injury, and as we worked together it became clear to him that he was setting impossible standards for himself and his situation. We were able to defuse some of these emotions which allowed him to refocus his attention on recovery. Over the next few sessions, Ben defused other unproductive internal experiences and entered the studio feeling more confident and competent in his abilities and strength. While these interventions seem simple to implement, changing our thought patterns and perspective is a difficult and lengthy process that takes time, energy, and persistence.


Courtesy of Persistence Psych

About Persistence Psych Co-Founder: Arianna Ciccarelli Shimits, MA is a current PsyD candidate at Springfield College. She completed her Master’s degree in Sport and Performance psychology at the University of Denver and her bachelor’s degree in Psychology at the New College of Interdisciplinary Arts and Sciences at Arizona State University. While working towards her BA and MA she danced professionally at the Washington Ballet, Ballet Arizona, and the Colorado Ballet. After retiring from ballet Arianna pursued an MA in Sport and Performance Psychology (SPP), believing that the performing arts could benefit from the skills and training offered by SPP. Additionally, Arianna is pursuing a PsyD in Counseling Psychology so that she can provide well-rounded care for performers who are experiencing mental health concerns. Throughout her graduate school education she has worked with dancers, musicians, runners, basketball players, soccer players, cyclists, surgeons, first responders, and adults with eating disorders. She is passionate about helping people perform at their best and believes that complementing rigorous physical training with SPP will help performers of all ages achieve exactly that.

 

Connect with Arianna via:

Website: persistencepsych.com (directly ashimits@persistencepsych.com)

Instagram: @persistence.psych