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Use the form on the right to contact us. This form will allow you to send a general inquiry to Carolina Performance. We will do our best to respond to you within two business days.

To contact any of the individual practitioners at Carolina Performance directly, click on CONTACT US or the tab above.

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8300 Health Park Suite 201
Raleigh NC 27615


At Carolina Performance in Raleigh, our mission as psychiatrists, psychologists, and therapists is to enhance the performance of our clients, resulting in a smarter approach to sports, a more effective work life, and an improved general well-being. We use mental training techniques to build upon existing skills, develop mental game plans, achieve individual and team goals, and maximize potential. 


At Carolina Performance in Raleigh, our mission as psychiatrists, psychologists, and therapists is to enhance the performance of our clients, resulting in a smarter approach to sports, a more effective work life, and an improved general well-being. We use mental training techniques to build upon existing skills, develop mental game plans, achieve individual and team goals, and maximize potential.

Stress & Injury

eric morse

Exercise is good, right? Whether you are an Olympic athlete, a weekend warrior, or just a casual walker, exercise has been shown to have all sorts of beneficial effects on our health and well-being. (Need convincing? Check out here, here, and here!).

One of the biggest ways that stress can impact our performance is when it takes us out of the game--when we sustain an injury. Injuries can take away all of these positive effects, causing physical, psychological, and even financial harm. And there’s more: researchers have found that there are psychological and social causes of injury, too. Stress, certain personality characteristics, and poorly developed coping abilities have all been shown to contribute to an increased risk of injury.

One of the primary models used in this area of sport psychology is the Stress and Injury Model. Looking at the model, think of each of the arrows in the model as an interaction between factors. The core of the model is the “Stress Response” and is made of two major components:

1.     Our perception of a situation and our ability to respond to the situation (the cognitive appraisal), and
2.     How our mind and body react to our perceptions (physiological/attentional changes)

These two components—perception and response—make up our immediate response to any given situation. The boxes above and below also exert an effect on the stress response.

In our last blog, we talked about two of these factors: stressors and interventions. Stressors include the major life events, daily hassles, and even past injury history; things that weigh on one’s mind and distract from the task at hand. The cognitive, somatic, and other relaxation exercises are just a few interventions that can assist with reducing stress levels.

Personality and coping resources make up the rest of the model. Through research, we know that personality traits like anxiety, anger, dominance, and competitiveness have all been linked to heightened injury risk. These personality traits may serve as distractors to performance or they may cause an athlete to put their body in more risky situations. Rather than view these traits as negatives, it is important that we recognize our own personality traits and keep them in mind as we are participating in exercise or sport. Finally, coping resources come into play; these factors include mental skills, stress management, and social support. For anyone undergoing stress, it is important to have a support system—someone to chat with or a teammate to work through problems with. You don’t always have to deal with stress on your own!

Injuries aren’t the only way that stress can inhibit performance. While they are a problem for athletes and exercisers, they may not be the biggest problem for stress at work or school. Next time, we’ll talk more about some other ways that stress impacts our performance!

Identifying & Eliminating Stress

eric morse

Stress: unless you live a truly blessed life, everyone suffers from it. While stress is a different experience for everyone, sport psychologists have had a long interest in how athletes encounter, feel, avoid, and cope with stress. Although stress most definitely isn’t limited to athletes, much of the research done in these studies can be used by anyone!

It is important to consider the more common root causes of stress. One popular model in sport psychology is the stress and injury model from Andersen and Williams (1988). This model splits everyday stressors into two main categories: major life events and daily hassles.

Major life events are significant, often life-changing experiences like a divorce, the death of a loved one, or possibly a lost job. Research has shown that these events can play on our minds not only through anxiety and depression, but they can narrow our attention, contribute to sleeping problems, and even deplete our coping resources over time.

Daily hassles includes situations like spilt coffee, that annoying coworker, and even bad traffic. While certainly not as serious as major life events, the additive effect of these minor stressors throughout our day can have similar effects: anxiety, depression, and an inability to concentrate (which can lead to even more frustration through the day!).

The real question: How can we better cope with this stress, reducing our risk for these harmful effects? Sport psychologists have identified a few important ways we can decrease our stress levels and our body’s response to that stress. The best part is that anyone can use these strategies!

Cognitive techniques can help you manage stress by targeting your thoughts and perceptions like worry, anxiety, or pessimism. These strategies often help us react more calmly to stressors. Visualization and imagery are two popular cognitive techniques, and positive self-talkcognitive restructuring, and refocusing can also help calm your mind!

Somatic techniques attempt to calm the body’s response to stress. Classic examples are deep or rhythmic breathing. More recently, progressive muscle relaxation and biofeedback training have seen an increase in popularity.

There are also more advanced techniques, like Benson’s relaxation response and cognitive affective stress management training, which target both the cognitive and somatic aspects of stress.

Decreasing stress can have a huge effect on your performance, whether you are trying to improve results at work, in sports, in public speaking, in school, or in any other area of life! In our upcoming posts, we’ll talk more about how stress can impact your performance.

Jordan Long
Carolina Performance Intern
Master’s Student, Sport & Exercise Psychology at UNC-Greensboro
Correspondence can be directed to:

Where it all Began: The History of Sport Psychology Research

eric morse

Sport psychology is a relatively NEW discipline! The idea of practicing sport psychology didn’t gain much momentum until the 1960’s, but some researchers were starting to think about studying the way performance is affected by mindsets before 1900.

Where it all Began

Norman Triplett conducted a study in 1898, now considered the first research study in sport psychology. He found that cyclists competing against others in races were faster than those who competed alone for a time-trial, even when the distance was the same. I’m sure the concept of being pushed by competition is familiar to everyone reading, whether it’s athletic competition, a board game, or an academic course, but no empirical evidence was offered until this study.

The Father of Sport Psychology

Triplett broke some ground, but Coleman Griffith is considered the founder of sport psychology, as the first researcher to specialize in the area. He taught a course called “Psychology and Athletics,” and in 1925, opened the first research lab specializing in sport psychology topics. Many of his topics are still being researched today, including methods of teaching psychological skills in football, the effects of fatigue on performance, the persistence of errors, and mental variables associated with excellent athletic performance. Sound familiar?

Griffith was also the first practicing sport psychologist, who was hired by the Chicago Cubs to work with the professional baseball team until 1940. Unfortunately, after he left his lab, his work was not readily continued. It was not until the late 1960’s that sport psychology began to emerge as an independent field of study. The International Society of Sport Psychology (ISSP) was founded and the International Journal of Sport Psychology created soon after. Around the same time, North American leaders in sport psychology began the North American Society for the Psychology of Sport and Physical Activity (NASPSPA). This was a huge step for the field, having journals and conferences devoted to only research related to sport psychology.

From Smocks to Jocks

At this time, however, the research was mainly dedicated to social psychology in the context of physical activity. An article by Rainer Martens, “From Smocks to Jocks,” called for researchers to conduct more applied studies in the field and look at sports specifically, beyond just physical activity as a whole. In the 1980’s, SEP had shifted toward the psychological skills training of elite athletes. This shift led to the formation of the Association for the Advancement of Applied Sport Psychology (AAASP) in 1985, which heavily focused on applying psychological knowledge to help athletes in their sport environment. The word “Advancement” in this title was later dropped, and the association is now known simply as AASP. As research expanded, the American Psychological Association (APA) added an official Division 47, which was the Exercise and Sport Psychology division in 1986. This addition of exercise psychology was an important marker, as the Journal of Sport Psychology became the Journal of Sport and Exercise Psychoogy in 1988. Soon after, the United States Olympic Committee also established a sport psychology committee and registry and hired their first full-time sport psychologist. By the 2000’s, the field of sport and exercise psychology was a fully independent research field with its own textbooks, academic degree programs, journals, and conferences. The importance of AASP, APA 47, and the USOC is discussed in my next blog post: How to choose a sport psychologist

Where are we now? Sport Psychology Practice.

These days, sport psychologists can specialize in research or application. Although the practice of sport psychology is much more popular now, it still lacks the commonplaceness of counseling and therapeutic psychology (aka clinical psychology). This is likely a result of both psychology’s history of being associated with mental illness and the lack of awareness that sport psychologists exist and are helping individuals achieve their goals every day. Articles recently posted to our social media (e.g. illustrate athletes’ reluctance to seek help from a sport psychologist or psychiatrist.

Nonetheless, more and more universities and athletic programs around the world are hiring sport psychologists either full-time or as consultants to work with their athletes. In fact, the top employer of sport psychology professionals is the United States Military, where masters and doctoral level graduates train soldiers to perform under pressure.

More commonly, you’ll see sport psychologists, sport psychiatrists, and mental skills trainers working independently through a private practice. Carolina Performance is unique because it is a single practice with a variety of practitioners specializing in all realms of performance-related psychological training. The The United States Olympic Committee (USOC) provides a great list of registered consultants who have a certain degree of expertise in the area.

If you're interested in speaking with a sport psychology professional, start here at Carolina Performance!

Coming soon... "Wading your Way through the Sport Psychology Waters: How to find the Performance Psychology Professional that's Right for You!"

Lauren Becker
Carolina Performance Intern
Master’s Student in Kinesiology at UNC-Greensboro
Correspondence can be directed to:

"Drop and give me 50!" Using Exercise as Punishment

eric morse

"Drop and give me 50!"

Athletes, soldiers, police officers… all these groups understand that if you do something wrong – show up to practice late, talk back, slack off – you might hear that dreaded phrase. Pushups, running laps, and other strenuous activities are commonly used as punishments in these domains. But, given the current obesity epidemic, can we afford to let people associate punishment with physical activity? How could this strategy affect later motivation to exercise?

Punishment involves imposing an undesirable consequence to someone after a “bad” behavior in an effort to reduce the behavior. However, research tells us that punishment is pretty much across-the-board something to avoid if one really wants to reduce the frequency of a behavior. It leads to undesired consequences like learned helplessness and the avoiding of the SOURCE of the punishment. For example, a child who was spanked for bad behavior will now ADAPT such that they only engage in the behavior when the spanker is not present. Instead, psychologists promote the use of reinforcement. Read more on this here:

What I’d really like to discuss is this idea that punishment via exercise might create an association between feelings of depression, disappointment, or anger with intense physical activity.

Professional Opinions

Professionals vary on their personal opinion on the issue. On one end of the spectrum, elite athletes should not feel discouraged as a result of exercise punishment, as they are already in such great shape. The exercise serves as a chance to improve while being responsible for their mistakes. Further, the idea of punishment in the military has been noted by some to be “motivating” and “a healthy challenge.”

Others claim that over time, as the competition starts to fade, all athletes are left with is the same type of exercise they only did as a punishment. That is, with the competitive basketball ending, all they're left to do are more push-ups and lap sprints – the exact kind of exercise they’d been trained to avoid. Still other sport psychology consultants claim that the exercise-related punishment has very little impact on an athlete’s later fitness, claiming that the bigger issue is that the exercise shifts from “training to win” to “training to stay fit,” a far less motivating outcome.

But perhaps the punishment depends on the “cause.” Are sprints more discouraging when presented as an individual punishment for being late to practice or as a group punishment for losing a game? My guess? A group punishment like that would foster anger, helplessness, and an environment of blame – definitely not ideal for an athletic team. Using the same reward or punishment for a group or team who have all individually engaged in different behaviors leading up to a loss makes no sense. Winning and losing are not behaviors.

For punishment to work, it is necessary that the individual is able to understand its connection to the right behavior. It is well known that punishment becomes less effective after a delay. Kids that get punished at home for a tantrum at the grocery store may not see the relationship between the unwanted behavior and the punishment. It is best to give punishments right after the behavior occurs and include an explanation of why the punishment is being imposed.

Nonetheless, punishment is still used, often as an attempt to provide “motivation.” After running multiple sprints, the last thing the athlete wants is to run another one due to being slow, so they attempt to run faster. In this situation, though, this coaching style could also be seen as negative reinforcement. A fast runner gets to stop running sooner, the upsetting situation gets taken away as a reward for performing well. Note how different this example is from, “Drop and give me 50!” in response to a late arrival to practice.


In the end, as with all of psychology, individuals assume that their personal experience is representative of a general rule of behavior, and this is often false. In fact, intuitions OFTEN lead us astray. But that is for another time. Regardless of anecdotal stories of punishment by physical activity, the research has time and time again stated that extrinsic rewards and punishments are insufficient at increasing an individual’s intrinsic motivation.

Rogers, Maslow, May, et al, Ryan and Deci (2000) (Self-Determination Theory) present a strong case for the belief that humans are intrinsically motivated and that extrinsic rewards and punishments actually demotivate a person. A book by Deci cites abundant studies supporting this idea.

“The Competitive Ethos and Democratic Education” by J. Nichols in 1989 demonstrates that a mastery motivation leads to greater persistence of training efforts when external rewards are scarce than an ego motivation.  Coach administered rewards and punishments for winning and losing, thus, would seem to undermine mastery, intrinsic motivation, and self-determination.

Behavioral reinforcement has been studied extensively for over one hundred years since Edward L Thorndike first introduced the Law of Effect in 1905: “responses that produce a satisfying effect in a particular situation become more likely to occur again in that situation, and responses that produce a discomforting effect become less likely to occur again in that situation."

NASPE Statement

The conversation is fascinating, but in the end we must look to research for evidence of what works. In fact, the National Association for Sport and Physical Education (NASPE) created a position statement to address this issue that reads: “Administering or withholding physical activity as a form of punishment and/or behavior management is an inappropriate practice… The core issue is that administering or withdrawing physical activity as punishment is inappropriate and constitutes an unsound education practice” and finally, “the absence of support for using physical activity as punishment renders its use by a teacher or coach indefensible, from a legal liability standpoint.”

Wow. These statements are incredibly strong and do, indeed, discourage the use of physical activity (or the removal of physical activity) as any sort of punishment.

This NASPE position statement further informs its readers that the National Standards for Sport Coaches (2006) also specifically states, “…coaches should ‘never use physical activity or peer pressure as a means of disciplining athlete behavior’ (NASPE, 2005, p. 17).

I wonder how many coaches follow that guidance! Nonetheless, we can all start following the evidence right away and STOP USING PHYSICAL ACTIVITY AS PUNISHMENT.

Until next time…

Lauren Becker
Carolina Performance Intern
Master's Student in Sport & Exercise Psychology
University of North Carolina, Greensboro

Goal Setting: Are you doing it right?

eric morse

Goal-setting may bring up memories of boring workplace orientations or cheesy teamwork exercises, but in reality, goal setting is one of the most widely-researched performance-enhancing strategies in the field of sport psychology and has been proven to be successful if done right. It sounds so simple, “Write down a goal.” But, people do this wrong ALL THE TIME. I saw it all the time in the classes I taught. Goals like, “I want to get in shape,” were abundant. But, what does this person mean by that statement?

Perhaps they mean they want to lose weight – To accomplish this goal, this person might start walking more to burn calories and eating fewer calories each day. Will their health improve? Yes! Will they lose weight? Yes! Will they increase their fitness? Probably not. They won’t run faster, jump higher, or get much stronger.

But maybe this person wants to become more “fit.” But how so? Do they want to run longer, run faster, stretch further, or increase their strength? Maybe all of it? Well, that’s a lot to keep track of in one goal sentence.

To run longer, this involves progressively overloading one’s large muscle groups such that they adapt to have better aerobic capacity via cellular changes within muscle and nerve tissue in response to the stress of exercise. Or to increase one’s strength, the person will want to lift heavier weights than is comfortable, but only for 3-6 reps at a time, exhausting on the final rep, in order to build more Type IIx muscle fibers, which have a higher anaerobic capacity. Phew!

These training programs are all very different! The way that individual would approach all these different goals is different. Without a clear direction, what should this person do?

This example demonstrates how important it is REFINE your goal statements, and I'm going to tell you how. Start with knowing what result you want or at least a goal for where you want to be a couple months from now. Using SMARTER goal setting strategies can help you write down a goal that will actually help you pinpoint what you need to DO to accomplish that OUTCOME.

Your goal statements should follow a formula that satisfies all of these guidelines. Your goal should be SMARTER:

S – Specific – Goals should describe the exact activity you’d like to improve upon, and how you will test your success. “Fit” becomes “aerobically fit” which becomes “running-fit,” which means your goal involves RUNNING. “Lose weight” becomes “lose pounds” or “lower body fat percentage” or “Lower risk of diabetes.”

M – Measurable – Avoid vague terms like “more” “better” “improve”, and use computable terminology. Drink 8 glasses of water per day. Lose 4 pounds. Walk for 20 minutes per day. Increase muscle endurance by 20 squats. Reduce run time by 20 seconds. Touch my toes with proper stretching form. Run the entire mile without stopping.

A – Attainable – Set goals within physical limits. If you are new to certain exercises, do not expect to become elite by the end of this week. If you are not a runner, do not expect to run a mile and a half in <10 minutes anytime soon. Know where you are already, and ask for help assessing what is realistic growth, and get help to plan how you would have to get there. Is losing 10lbs in 10 weeks attainable? Sure, but it will be easier than losing 15lbs in 10 weeks and harder than losing 5lbs in 10 weeks. Know what it will take to get you there.

R – Realistic – Related to above. It has to be possible and probable. Quitting smoking cold turkey is unrealistic goal, whereas goals to start using nicotine patches may be more applicable. Don’t set a goal so unrealistic that anyone would likely fail or probability is far against you. You can always set a goal for a week from now, and then set another for a week from then. Keeping some short-term goals will help your success seem closer.

T – Time-frame Specific – Give yourself a reasonable amount of time to reach your goal, but give yourself a time limit. “This goal will be achieved by December 1st.” On that day, you will plan to assess yourself using your planned measurements, and you’ll know precisely whether or not you’ve achieved your goal, and by how much you exceeded it.

E – Evaluate – Consistently evaluate the progress you’ve made on your goals and adjust them as needed. You might find that you’re reaching your goal much sooner or later than anticipated! Maybe you need to change your strategy or adjust your timeframe expectations.

R – Recorded ­– Make sure to WRITE GOALS DOWN in a place where you’ll see them regularly! Try a a bathroom mirror, refrigerator, or front door.


  • Set goals for practice as well as competition. How many free throws do you want to make in practice?
  • Set reminders for yourself. Want to make sure you go to the gym later today? Keep your gym shoes in front of the door so you have a reminder of what to do. Maybe even keep a pair in your car to cut down on the excuses!
  • Develop goal-achievement strategies or plans (Do your research – For example, know that 1 lb of human fat is equivalent to 3,500 calories. Over the course of a week, can you burn an extra 3,500 or eat 3,500 fewer calories? Adjust your plan and your goal accordingly!)
  • Prioritize process, performance, and outcome goals.
  • Find social support for goals. Tell friends who will hold you accountable – they might even join you!
  • Make the goal-achieving FUN! However you can, fun and exciting goals will be achieved faster than boring ones. Make sure you work them positively and remind yourself all the exciting changes that will occur when you reach your goal. This should be a fun, rewarding experience!


  • Set too many goals and have difficulty tracking them all.
  • Fail to recognize individual differences. (Not all goals are appropriate for all people; set them based on your current level of ability).

Lauren Becker
Carolina Performance Intern
Master’s Student in Kinesiology at UNC-Greensboro
Correspondence can be directed to:


eric morse

Depression: we’ve all heard of it. It’s a clinical mental health concern that manifests as a depressed mood or loss of interest or pleasure in daily activities for at least 2 weeks. Other symptoms include disturbed sleep, suicidal thoughts, and reduced concentration. The World Health Organization predicts that depression will become the leading cause of death and disability by 2030. So what can we do to treat and prevent depression?

Substantial research has shown that physical activity levels are associated with the prevalence of depressive symptoms in adults of all ages. Further, studies have shown exercise interventions to be successful in both preventing and treating depression! Could it be that simple? Let’s look at the data…


  • The U.S. National Comorbidity Study (Buckworth et al., 2013) conducted a nationally representative survey and found that those who participate in regular physical activity had 25% lower odds of being diagnosed with depression. In fact, for each categorical increase in physical activity (never, rarely, occasionally, regularly), there was a corresponding decrease in the prevalence of mood disorders overall.
  • The CARDIA study controlled for variables like age, education, BMI, smoking, and alcohol use and found that for each depressive episode, individuals averaged 28 fewer METs of physical activity per year.


Studies have tracked individuals over time to establish the temporal relationship between the onset of a change in exercise and the onset of depressive symptoms.

  • Out of 30 prospective studies from 12 countries, nearly all showed that depressive symptoms decreased with increases in physical activity, showing that exercise does indeed help prevent depressive symptoms (Buckworth et al., 2013).

    The case for using physical activity to prevent depression is supported if the data shows a “dose-response” relationship. This means that a greater “dose” of physical activity should correspond with a greater decrease in odds of developing depression. Less active people should have lower odds than nonactive individuals, but super active people should have even lower odds than moderately active people, and so on.
  • The Australian Longitudinal Study on Women’s Health looked at over 9000 women and found that you get the largest bang for your buck when increasing your activity level from “no exercise” to “very little exercise.”
  • Further, they found that the women who were inactive at first and became moderately active by 3 years later reduced their odds of developing depression by 25%. Those who became highly active cut their odds in half during the 3-year span.

These results suggest that the exercise need not be highly intense in order to benefit.

  • Another study (Bernard et al., 2014) targeted postmenopausal women who were at risk for depression due to being inactive. These women completed a six-month, three-session per week, moderate-intensity walking intervention. They found that the simple, widely accessible walking intervention was successful in reducing depression in their sample.


  • A study by Blumenthal et al. (2007) found that exercise interventions were AS SUCCESSFUL as the medication at treating depression!
  • Dunn et al. (2005) found that individuals with depression who burned 250-400 kcal/day during exercise 5x/week improved symptoms by twice that of any other dose/frequency combination.
  • Singh (2005) found similar results in their study of resistance training rather than aerobic training, with higher-intensity exercise producing twice the efficacy of low-intensity training.

According to these studies, any kind of exercise is better than none, and if you’re completely inactive, you’ll see a huge benefit in depressive symptoms by just becoming minimally active.

This research is strong enough that one day, doctors could be prescribing exercise instead of traditional pharmacological treatments.

How active is “minimally active?”

The ACSM recommends 30 minutes of moderate-to-vigorous physical activity per day. This doesn’t have to be RUNNING or SWIMMING, but can simply be WALKING. Is there a trail or sidewalk near your home or workplace you could stroll down during your lunch break or while you wait for rush hour to end? Whatever it is, you’re best off picking something that is fun for you. Hate running? Don’t do it! We know that individuals who don’t enjoy an activity are far less likely to continue doing it. In the long run, it’s the habits that matter, so go ahead and start! See how much you won’t miss by walking 30 min/day! You can improve your physical and mental health greatly in the process!

…Until next time!

Lauren Becker
Carolina Performance Intern
Master’s Student in Kinesiology at UNC-Greensboro
Correspondence can be directed to:

Sport Psychology: Not Just for Athletes!

eric morse

Once you’re physically capable of winning a gold medal, the rest is 90 percent mental. ~ Patti Johnson

Sport Psychology is a relatively new field that results from a new paradigm in modern psychology: positive psychology. Although psychologists and psychiatrists in the past have developed a reputation for focusing on “fixing” an individual and returning them to a “normal, functional” state, positive psychology is the practice of building individuals’ strengths so that they can become exceptional. While some sport psychologists and psychiatrists still specialize in helping individuals overcome sport-related mental health issues, others focus exclusively on performance enhancement techniques. That is, they aim to take someone’s current strengths and give him or her even more strategies to use to become mentally stronger. This idea of developing mental strength may seem new, but athletes have been referencing the value of this mental edge for decades.

Golf is a game that is played on a five-inch course – the distance between your ears.  ~ Bobby Jones, former professional golfer.
It’s amazing how much of this is mental. Everybody’s in good shape. Everybody knows how to ski. Everybody has good equipment. When it really boils down to it, it’s who wants it the most and whos the most confident. ~ Reggie Crist, 1992 olympic skiier, pioneer and 2x winner of Ski Cross X Games.
Football is 80 percent mental and 40 percent physical. ~ Steve Emtman, former NFL star.
The mind is everything. What you think you become. ~ Buddha


Yes! Sport psychology involves the study of mental factors that influence participation and performance in contexts ranging from physical activity and athletic competition to the workplace and performing arts.

For years, athletes did not take advantage of mental skills training, instead relying on strength and conditioning training, and physical practice. Still, the best athletes likely had a good grasp on the skills and techniques used by sport psychologists today. As Reggie Crist said above, everyone is in shape and physically capable. What sets you apart is the mental side: attitude, confidence, mental toughness, and more. Although a lot of what athletes do is physical, mental skills are still enormously important to develop in order to excel in competition. Knowing what we now do about the effectiveness of mental skills training, everyone can practice mental skills just like they practice physical skills. And it doesn’t stop with sports. Think of how much an individual could gain from using mental skills when the goal requires almost no physical training. Imagine a business person about to give a big presentation or a student preparing to take the SATs. The challenge they are about to experience is hardly physical, meaning mental skills training is at least AS important to them as it is to an athlete, if not more! The idea that sport psychology is only for athletes is fading, as the many uses for performance psychology are showing up in the medical field, performing arts, and any other context in which a person or team wants to perform their best.


A sport or performance practitioner uses evidence-based techniques to help you:

Improve performance using a variety of performance enhancement techniques including goal setting, imagery, focus/attention strategies, stress management, and much more!

Educate coaches and leaders about effective coaching practices to optimize the experience of athletes in terms of their satisfaction and their sport/personal development.

Cope with changes in your performance environment. Injuries can negatively affect an athlete’s attitude. A person who identifies with their ability to be physically active may need assistance with the mental rehabilitation required to make a full recovery. Other athletes may need help coping with the pressures of competition and demands placed on them (e.g. a student-athlete balancing school and practice, a professional athlete afraid of letting down her team, a parent balancing work, life, and training).

Develop workshops and programs to help cultivate team cohesion within a workplace, to encourage weight loss, to motivate exercise adherence, or to train a group of surgeons to deal with the mental challenges in their profession.

While many sport psychology professionals work in academic institutions and conduct research on these factors, others specializing in taking what we already know from research and applying it to help individuals better themselves. At Carolina Performance, we acknowledge the breadth of situations that demand optimal performance and mental health, so you will find a variety of practitioners and experts to help people like you.


Just as athletes practice their physical skills regularly, mental skills require practice too. This is so important to understand prior to meeting with a sport psychologist for any reason. Of course, the techniques given to you may not come naturally; if they did, you would probably be an expert already. Nonetheless, they will help if given time and attention, just like learning a new yoga pose, a new golf shot, or a new dance move.


It is imperative that you seek guidance from those who are properly educated to use evidence-based practice. That means your practitioner has sought out information from journals, conferences, and research studies about what has been shown to work and not work. Sport, exercise, and performance psychology practitioners can come from a variety of backgrounds, including Counseling, Clinical Psychology, Psychiatry, Kinesiology (Sport & Exercise Science), and Sport, Exercise, and Performance Psychology! These people should have at least a master's degree, if not a doctoral degree.

If you have mental health needs (or are not sure!) you should first and foremost see either a licensed counselor, licensed psychologist, or licensed psychiatrist. A licensed psychologist who "has experience applying psychological principles in sports settings" may also be APA Division 47 affiliated. These individuals are the only ones termed "Sport Psychologists."

If you are simply looking for a mental skills coach or sport psychology consultant, start with the USOC Sport Psychology Registry, which lists qualified professionals by geographic area. These people should all be certified consultants by the Association for the Advancement of Sport Psychology (AASP), signified by CC-AASP.


At Carolina Performance, we have experts who are capable of helping anyone with a range of desires. We have psychiatrists, psychologists, and coaches who specialize in children & adolescents, couples, groups, military personnel, athletes, and individuals going through life transitions.

The experienced and skilled professionals work to help their clients with performance enhancement, stress management, life coaching, business coaching, mediation, team building, and addiction.

No matter what you’re looking for, Carolina Performance is here to help! Contact one of our wonderful providers today:

Not sure who you’re interested in working with? Contact us through:

If you're looking for more detail on the qualifications needed to become a sport psychology professional, keep an eye out for an upcoming post that describes the differences in detail!

Lauren Becker
Carolina Performance Intern
Master’s Student in Kinesiology at UNC-Greensboro
Correspondence can be directed to:

Why we CHOKE when it matters MOST

eric morse

Many important moments in life require individuals to perform their best under pressure. Placement exams, game-winning free throws, live performances, and important speeches may all have implications for person’s future path like whether a person gets into college, makes the cut in a big tournament, receives a scholarship, or earns a promotion.

Leading researcher on the topic, Sian Beilock, describes choking as subpar performance outcomes given a person’s skill level when the pressure is high. For example, a professional basketball player missing free throws when they usually demonstrate a high free throw percentage in practices and other games. Baumeister and Showers (1986, p. 361) describe this occurrence as “inferior performance despite striving and incentives for superior performance.” In this description, the situation not only has to be demanding, but the performer has to care about the result. A professional golfer who you might expect to excel at mini golf may not care about their score; therefore, a bad putt would not indicate a choke. However, the importance of choking is not limited to athletic situations. Beilock has found these choking patterns to be present in school or workplace settings as well when demands to perform are high and the student or employee does not perform up to expectations.

The theories to explain choking behavior are divided by whether we choke due to the physiological changes resulting from the stressors (e.g. mental arousal, increased heart rate, etc.) or our maladaptive attempts to alleviate our stress (e.g. we start focusing on the wrong things).

“Drive Theory:” Cusp Catastrophe Model.
(Beilock & Gray, 2007)

It is well-established that too little “arousal” results in suboptimal performance. Think of a time you had barely anything to do at work – How long did it take you to get something small accomplished? Probably a lot longer than it would take you on a busier day. But we also know that too much arousal is harmful as well. When you’re too busy at work, you struggle to get anything done because there’s too much stress in the way. This leaves an “optimal zone of functioning,” which occurs right before a quick drop in performance. Being even slightly past that optimal zone puts you right on the cusp of experiencing a catastrophic “choke.”

Attentional Theories

Theories that address what the athlete is thinking about and focusing on during a choke are referred to as attentional theories.

Processing Efficiency Theory (PET).
(Eysenck & Calvo, 1992)

When you are in a high-pressure situation, you’re probably having a lot of thoughts (“What if I fail/succeed?”), and those thoughts take up space in your working memory. With a finite amount of space in our working memory, something has got to give. Too many thoughts lead to processing inefficiency. The performer needs to sacrifice mental resources dedicated to performing the task and experience a decline in performance.

Explicit Monitoring Hypothesis (EMH).
(Beilock & Carr, 2001)

Long ago, Fitts and Posner (1967) demonstrated that experts in a task have developed that skill to the point of automaticity, characterized by the lack of conscious processing during task execution. They do not require the use of their working memory to complete the task, but rather their procedural, implicit memory system. Since experts do not use their working memory to complete a task in the first place, then PET is probably not the cause of their choking, as their working memory has more free space.

EMH states that experts become self-conscious in high-pressure situations and attempt to deal with it by thinking explicitly about the task. Explicit focus includes rule-based thoughts (e.g. “keep the arm straight, rotate the shoulders”) and involve consciously monitoring how the skill execution feels. Ironically, this coping strategy is commonly encouraged by coaches who say, “just focus on the stroke,” or “make sure you follow-through on this shot.” By calling attention to the imminent task, athletes will focus on the parts of their movements they usually do not think about and process their actions through their working memory, just as a beginner would. Novice performers are able to maintain performance under highly self-conscious and self-focusing conditions because this systematic, rule-based thinking is common when one is first learning a task (Masters, 1992).


Beginner performers think explicitly about their skill execution because they are learning a new task, so adding extra thoughts or a second task can overwhelm their working memory and lead to a drop in performance. On the other hand, experts may do well in this same condition because they do not need to use their working memory to execute the skill, so their mental resources are free to use to complete an unrelated task. But once that unrelated task becomes stress-inducing, an expert is in danger of focusing too hard on the parts of their skill (shot, swing, voice, body movements) that normally come naturally. This is commonly understood as “forcing it,” and can lead to a true choke.

What can you do about it? Keep an eye out for an upcoming post on how to deal with choking under pressure and contact Carolina Performance providers today!

Lauren Becker
Carolina Performance Intern
Master’s Student in Kinesiology at UNC-Greensboro
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