Seek Couch Time for Hafner, Cano, Jones, Howard

April is in the record books and May is well underway. About this time of the year, sportswriters, pundits and sports book aficionados begin to draw conclusions about this season's players and what they will, or won't to, for the balance of the season. There are always new stars on the horizon who nobody guessed would be in the limelight along with other players who just can't seem to get off the mark. What is wrong with Travis Hafner, Robbie Cano, Andruw Jones and Ryan Howard? How could Cliff Lee have been sent down last year and this season he is reaching for the Cy Young trophy? Some will speculate that those who are faltering are hiding injuries which are affecting their performance. We have an alternate explanation and recommended therapy.

Major League Baseball is a head game, perhaps like no other in sports, in which extraordinary emotional as well as physical pressures placed upon the athlete. The vast majority of us go through our day-to-day activities with some acute or chronic pain. So is true for professional athletes -- more so. Baseball players, especially pitchers, seem as fragile as potato chips with a low threshold for heading for the trainer's table with established injuries. Other players who are reported to be 100% physically still must deal with the head game -- the fans, the media, and the clubhouse, knowing there are a bevy of hot-shot rookies breathing down their necks. If it's not physical, how does a professional athlete break out of the slump?

Doctors Thomas Newmark and David Bogacki have described the use of relaxation, hypnosis, and imagery in sports psychiatry (Clinics in Sports Medicine, 24(4):973-7, Oct 2005). Hypnosis is a procedure during which a mental health professional suggests that a patient experience changes in sensations, perceptions, thoughts, or behavior. The purpose of this report is to briefly describe the use of various methods of relaxation, hypnosis, and imagery techniques available to enhance athletic performance. The characteristics that these techniques have in common include relaxation, suggestibility, concentration, imaginative ability, reality testing, brain function, autonomic control, and placebo effect. Athletes can use many characteristics of hypnotic trance to benefit their performance. The techniques described herein facilitate learning new information that can be applied in competition, provide general relaxation to enhance performance, and assist in the rehabilitation of injury or pain. The characteristics that these techniques have in common include relaxation, suggestibility, concentration, imaginative ability, reality testing, brain function, autonomic control, and placebo effect. Hypnotic trance allows access to different functions of the brain. Two different aspects of brain function are of interest. First, hypnosis increases the opportunity to understand unconscious motivations of athletes The unconscious motivations of the athlete are more accessible in a trance than in ordinary mental consciousness. The writings of Freud and his collaborators suggest that gaining a greater understanding of the unconscious motivations of patients facilitates treatment goals. In this context, hypnosis is only part of an overall psychotherapy treatment plan. Hypnosis also permits greater access to the functions associated with the right side of the brain. Gaining greater access to the functioning of the right brain is useful in the mental training of athletes. The imaginative skill of the right brain can help make hypnotic imagery sessions more powerful and performance-enhancing. It must be stressed that hypnosis is a tool with techniques.

Hypnosis is not itself psychotherapy. Hypnosis has its limitations, and will not transform an average athlete into a superstar. A substantial amount of research supports athletes' reliance on imagery. Imagery training has been used to increase time practicing, to set higher goals, and to increase adherence to training programs. Generally, research on imagery in sport performance enhancement has been positive. Another characteristic of the hypnotic trance is the ability to assist in the control of autonomic function, including blood pressure and blood flow. This control is important in recovery from injury, as well as in blocking the adverse reactions to anxiety. Athletes can be taught how to control autonomic functions through trance, and can apply the positive effects to enhance performance. Hypnotic techniques, biofeedback, and autogenic training may all be employed to facilitate the rehabilitation and healing process. Recently the power of the individual for self-healing is becoming increasingly recognized. Much of contemporary psychosomatic medicine focuses on enlisting the aid of the patient in mobilizing the healing process, and hypnosis has a long history of energizing the healing forces within an individual.

Sports psychiatry experts emphasize that the body and mind are in constant interaction. In summary, hypnosis and visual motor behavior rehearsal can sharpen an athlete's focus and enhance performance or stop a slump. This mental rehearsal of success can give the athlete a mental edge in real competition. So get on the shrink's couch, Mr. Cano, Mr. Jones, Mr. Hafner, and Mr. Howard -- you have some work to do. You still have over 400 at-bats left in 2008.