Psychological Responses to a Sports Injury (Kubler and Ross)
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The 5 stages of grief
The Psychological responses to negative events has been studied and documented, most significantly by ‘Elizabeth Kubler-ross’ who in her book (Death and Dying, 1969) outlined what she determined as the ‘The five stages of grief’, also known as ‘The Kubler-Ross model’, the five stages are; Denial, Anger, Bargaining, Depression and Acceptance. It’s important to mention that not all five stages are necessarily experienced, it doesn’t have to be in the precise order and there is no guarantee that the individual will ever move on from a given stage.
Though the Kubler-Ross model was originally designed to outline the Psychological responses to grief and dying, it was expanded to cover personal losses of virtually any kind, therefore the loss of ability to perform and participate in Sport is likely to evoke these same responses, Kubler-Ross specified that whereas not all five were experienced, a minimum of 2/5 stages will be experienced; therefore I will now look at three Psychological responses to injury, two of which are stages from the model and the other is a response I feel is also relevant. The three responses I will look at are;
An athlete’s initial reaction to injury is often anger, think of the footballer who thumps the ground in anger after pulling his hamstring, it’s an illogical outburst of anger with no positive outcomes or benefit to performance or recovery. The individual is angry that it happened, angry at the circumstances in which it happened, perhaps angry at themselves or another individual for causing the injury or not doing everything they could do to prevent it, angry that they are feeling immediate pain and most significantly is likely to be angry at the repercussions they anticipate the injury will have upon their lifestyle and their sporting endeavours.
The most common cause of frustration due to injury is likely to come as a result of the rehabilitation process, either frustration at having to do it or more commonly frustration at the lack of progress, this may sometimes be due to it actually taking longer than expected or simply the individuals impatience and eagerness to get participating in their sport again, any good rehabilitation schedule will follow S.M.A.R.T principles (Specific, Measurable, Achievable, Realistic and Time based), particularly that it should be time based and that this be of a realistic time frame, for instance setting a target for Arsenals Aaron Ramsey to return to top flight football in a time frame of 1 month after breaking his leg would have been unsuitably unrealistic. Setting an unrealistically optimistic target is likely to frustrate the individual when they fail to meet it.
Take a Hockey, Football or basketball player or any team based sportsman for that matter, training is done together as a team and has a rewarding social aspect, teams do a significant amount of team bonding in training, this principle may still transfer to an athlete involved in an individual sport, as Olympic runners still train with other runners for added competition and the social aspect.
When a player is injured, they are often made to train separately, this may even be at separate times to the other athletes, this removes the social aspect from their sport and this is a key component of why some injured athletes enter depression. They are likely to miss out on any in-jokes, events that occur within training, training developments and strategy developments. All these factors may lead to the isolation and introversion of the individual, as they become secluded from the rest of the players both professionally and socially.
The lifestyle of an elite athlete is often centred around their Sport, the rigorous training and match routines shape their week and exclusion from this changes the structure of their entire week, any serious athlete abstains from alcohol and fast foods but without the incentive of competing within their sport on a regular basis they maybe become demotivated to follow the strict adherence of the exclusion of such substances, take away the main component of their life (Their Sport) and an individual is likely to become depressed, just as likely as an individual who has been made redundant from any non-sporting context occupation.
Players may lose their sense of identity, the source of their self-esteem, the outlet for their stress and the activity which brings the majority of their endorphin and adrenaline rushes.
Depression is often linked to a lack of motivation, so it may perhaps be that it is a follow on symptom of a loss of motivation from a failure to hit aforementioned rehabilitation targets.
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