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8300 Health Park Suite 201
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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.

Filtering by Tag: performance

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:

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
Correspondence can be directed to:

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