I recently attended a symposium at Stanford’s Lucile Packard Children’s Hospital on the adolescent athlete and eating disorders. Four of the hospital’s leading physicians and psychiatrists on the subject (among the top researchers in the field) presented aspects of this issue, including:
- Lifestyle realities of the student-athlete.
- Propensities towards and causes of eating disorders.
- Medical issues that stem from them.
- The female-athlete triad (energy deficit/disordered eating, menstrual disturbances/amenorrhea, and bone loss/osteoporosis that is existent in 1/3 of college Division I female athletes as published by the Olympic Committee).
- Characteristics of the student-athlete that make her vulnerable to become one of the 14% of adolescents with a diagnosable eating disorder.
Dr. Hans Steiner, professor emeritus at Stanford’s School of Medicine and co-founder of Stanford Hospital’s eating disorder program, offered one particularly interesting perspective. He teaches a class to Stanford student-athletes on his research of this demographic – including their strengths, their challenges, and predictable circumstances that might result given each.
Dr. Steiner demonstrated that while student-athletes were better adjusted, happier, and generally more successful than their average non-athlete counterpart, they demonstrated one distinct negative correlation that made them susceptible to eating disorders (in females) and addiction (in males) upon injury or similar career-compromising incidents.
Student athletes, he said, often embody a certain stoicism that prevents them from acknowledging hardship or injury. Biologically, the student-athlete is different. Her lower resting heart rate and blood pressure, lower heart rate and blood pressure after challenging movement, and a far lower delta between the two showed that the student-athlete was prone to non-reaction in challenging situations. The positive aspects of this phenomenon are obvious given the elite athlete’s need to be able to put “mind over matter,” but it can also be the gateway to problems, particularly if the athlete confronts career-altering circumstances.
Injuries, for instance, can be devastating blows to the elite athlete. When injuries prevent student-athletes from participating in the activities they love so passionately, the effect can be powerful and even diagnosable at times as post traumatic stress disorder (PTSD).
Because the student-athlete has a tendency towards stoicism, she does not express “normal” emotional reactions and may suppress or disregard her psychological process until it is too late – i.e., she is severely injured or coping with other behaviors such as unbalanced eating (generally in females) or substance use (generally in males).
If coaches, parents, and doctors observe closely, they might notice a withdrawn affect, detachment from emotions, or an inability to express the impact of challenges.
When I couple this profile of the student-athlete with Rachel Simmons’s depiction of the “Good Girl,” I see a segment that needs our acute attention.
Simmons wrote: “In high school, girls pursue more leadership roles and extracurricular activities than boys do, and they are significantly more likely to see themselves as leaders.
But if their college applications are stamped with 21st century girl power, girls’ psychological resumes lag generations behind. The Curse of the Good Girl erodes girls’ ability to know, say, and manage a complete range of feelings. It expects girls to be selfless, limiting the expression of their needs. It demands modesty, depriving girls of permission to commit to their strengths and goals…The Curse of the Good Girl cuts to the core of authentic selfhood, demanding that girls curb the strongest feelings and desires that form the patchwork of a person.”
The elite student-athlete, who is generally by nature a Good Girl of the highest kind, is not, for the most part, going to show signs and symptoms of emotional distress, or worse, mental illness, often times until it becomes a serious health problem.
We as coaches, teachers, parents, and mentors, MUST be acutely aware of girls’ behaviors, expressions, emotions, and lack thereof. The student who is putting on the most perfect exterior may actually be the one suffering the most.
Girls are masters of putting on the happy face – disguising anything that might harm a relationship, deem them less than, or make them stand out from their peers. Perhaps we need to listen to what they’re not saying at times to really get to the root of their experience.
Simmons wrote: “When girls cannot identify, express, and accept a full range of feelings, they lose critical connections to themselves and their relationships. They are trained to reveal only the parts of themselves deemed Good and to avoid what remains. In extreme instances, when their most painful feelings lack an outlet, girls may compensate by restoring to self-injury.”
When we do notice a girl withholding her feelings, we must support her in reconnecting to her true experience. The splitting of self is very dangerous, and we can support girls in staying connected to their truths by supporting their emotional expressions and real experiences in healthy and safe environments and conversation to help alleviate these factors before it’s too late.
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