Anxiety and the professional tennis player

A year ago, I wrote about my concern that professional tennis players' mental health issues may be under-addressed. One of those issues, anxiety, is worth a more thorough exploration, since its prevalence is obvious among many players.

We see it all the time--choking, getting tight during a match, losing successive "winnable" matches, alternating between firing aces and hitting a series of double faults. Dinara Safina, aka Thrill Ride (on this blog), perhaps the WTA's most quotable player, once said, when asked about her failure to be mentally tough: "If I would know explanation, then of course I would do it on the court." She also said: "...First to find the reason what's going on, what are the mistakes, and then to work on them. Not to go blindly on the court and killing your ass for like five hours. Sometimes it makes no sense."

And it does "make no sense" until a player addresses the anxiety that is behind repeated errors, choking and erratic serving. Anxiety is natural to all of us, but--like every other emotion--too much of it creates problems. Anxiety among tennis players (and the rest of us) has many causes:

1. Childhood trauma
This is undoubtedly the main cause of excessive anxiety.  A child who feels unsafe because of emotional, physical or sexual abuse, or because of poverty or war or constant re-locating, will grow up to be an anxious adult.

2. Adult trauma
Living through traumas such as accidents, assaults, natural disasters and war is likely to create posttraumatic anxiety. Having unresolved past trauma (such as childhood trauma) makes someone more likely to develop symtoms.

3. Poor coaching
A coach is like a parent. If s/he manages the player through constant criticism, harsh words or lack of praise, the player will respond with anxiety about her performance. (Safina knew a thing or two about that.)

4. Left-handedness
Left-handed people, as a rule, feel more fear than right-handed people. The "fear" part of the brain, on the right side, is reversed--and therefore dominant--in left-handed individuals, who are more apt to be afraid of making mistakes.

5. Cultural expectations
Certain expectations are placed by our cultures on various groups. These expectations can involve gender, nationality, profession, etc. Not "living up to" these expectations can create anxiety. To make things worse, these expectations tend to be very unhealthy, and ignore the individual's right to evolve at her/his own pace. They also tend to reflect values that are harmful to human psychological growth.

The good news is that anxiety is fairly easy to reduce. The bad news is that people often do not seek treatment, or the only treatment they receive is from medication. I don't know how much (good) anxiety treatment pro tennis players are getting, but I suspect it isn't enough. There are a number of treatment modalities (I use them in my own practice) which can significantly reduce anxiety and create the relaxation response in its place.

Limerick for Indian Wells

There was a director named Ray

Who chose a press conference to say

Lady players should please

with their looks (on their knees).

And he's still the director today.

Back in the desert

Perhaps our favorite pic from Wednesday: Welcome back, #Venus #BNPPO16 pic.twitter.com/3zyKInJ0BT

— BNP Paribas Open (@BNPPARIBASOPEN) March 10, 2016

In the desert you can remember your name
'Cause there ain't no one for to give you no pain 

From "A Horse with No Name," by Dewey Bunnell

Maybe. The BNP Paribas Open comes at a time when many questions abound, and some may have painful answers. The biggest one, of course, concerns a player who isn't even there, but whose name has dominated the headlines for the last several days. More about that later.

If it weren't for the Sharapova controversy, we might be hearing more about defending champion and world number 5 Simona Halep, who--not that long ago--was world number 2. Halep has faltered repeatedly at big moments for much of the past year. As defending champion, the pressure is on, and Halep's recent history indicates that she doesn't buy into pressure being a privilege.

Halep is now working with coach Darren Cahill, but her propensity to change coaches makes me wonder how long that relationship will last. Since the season began, the defending champion has been dealing with a chronic illness and an achilles injury. She canceled her scheduled surgery in order to play for Romania in Fed Cup competition, and then later declared herself free of pain and injury. Whether she had the good sense to avoid an unnecessary surgery, or whether the inevitable is just being postponed, is something we cannot know.

If Halep is illness- and injury-free, then she has a chance to turn her career around. But there's something mentally fragile about the Romanian star, whose talent on a court is stunning. And then there's the reality of having had an incredible season (2014) and having to face one's new celebrity and all the expectations that go with it. Here's hoping 2015 was Halep's season to make that adjustment.

Meanwhile, the new world number 2, Angelique Kerber, steps into the desert as the Australian Open champion. In a recent interview, Kerber said that, after her early Doha loss, she took some time off to relax, and that she feels ready and confident at the BNP Paribas Open.

World number 1 Serena Williams has returned to Indian Wells, and this year, Venus Williams has also returned after a 15-year absence. Unfortnately, in 2015, Serena's long-awaited return to the event ended with her retirement in the semifinals because of a knee injury. That gave Simona Halep a walkover, and then Halep beat Jelena Jankovic in the final.

Of interest in the draw: Serena and Venus could face each other in the quarterfinals. There's also a potential meeting between Kerber and Johanna Konta, which could be good, and it's also likely that Doha champion Carla Suzarez Navarro will be waiting for Kerber in the quarterfinals.

There could also be a quarterfinal clash between Agnieszka Radwanska and Petra Kvitova, though there are some pesky players in their part of the draw who could cause trouble. Chief among them is the eternally unpredictable Svetlana Kuznetsova. Under "normal" conditions, Lucie Safarova would be considered a major threat in that section, as would Dominika Cibulkova. They still could be, but both players have been recovering from physical challenges. I'll add Madison Keys to that list, too.

Also of note: Ekaterina Makarova and Lucie Safarova formed a team to play in Indian Wells. They are already out of the tournament, but should they continue to play together, they have the potential to do well. Makarova and Elena Vesnina were a successful team, but upon Makarova's return from a long injury layoff, the pair did not reunite.

I'm now going to be the laziest blogger ever and say that my sentiments about the Maria Sharapova issue are summed up beautifully by Todd Spiker, so I'll just let him speak for me. I'll add, however, that while I expect so-called tennis fans to speak from positions of ignorance and prejudice, it still distresses me (though I expect this, too) when the news and sports media do it. The amount of misinformation and distorted information that has been spewed by tennis writers and commentators has been really disheartening. Equally disappointing have been a couple of the player reactions--one full of pompous self-righteousness (not to mention hypocrisy), and the other just plain vicious and crazy.

We will never know all of the facts behind this situation, nor will we ever know all of the motivations--from all parties involved.  Historically, as I see it, Sharapova certainly has a better character rating than the ITF, but that doesn't mean she didn't do anything wrong. I hope for a fair accounting and a fair judgment. In the meantime, thank goodness, we have Indian Wells.