Scand J Med Sci Sports 2010: 20 (Suppl.

2): 78–87 & 2010 John Wiley & Sons A/S

doi: 10.1111/j.1600-0838.2010.01188.x

Review

Psychological skills training as a way to enhance an athlete’s

performance in high-intensity sports
D. Birrer, G. Morgan
Swiss Federal Institute of Sport Magglingen, Magglingen, Switzerland
Corresponding author: D. Birrer, Swiss Federal Institute of Sport Magglingen, Alpenstrasse 16, 2532 Magglingen,
Switzerland. Tel: 141 32 327 62 63, Fax: 141 32 327 64 05, E-mail: daniel.birrer@baspo.admin.ch
Accepted for publication 31 December 2009

The importance of psychological skills training (PST) in the gical skill. Considerations based on our model and the
development of athletic performance is widely recognized. limited HIS-related literature available revealed self-skills,
This paper is a comprehensive review of PST in elite sports, personal development and life skills, arousal-regulation
with a special focus on high-intensity sports (HIS). The skills, volitional skills, motivational skills and recovery
reviewed literature showed a lack of convincing evidence and skills as the most important skills to address in order to
theoretical underpinning concerning traditional psychologi- enhance performance. Development of harmonious passion,
cal skills to enhance performance in HIS. Therefore, a in-practice integration of volitional strategies, use of asso-
model with three conceptual levels (psychological demands, ciative attentional techniques, pain management techniques,
skills and techniques) is presented. The model facilitates the use of the mindfulness-acceptance approach and the facil-
identification of the psychological demands of a specific itative interpretation of cognitive and somatic sensations are
sport, which in turn enables distinguishing which psycholo- regarded as suitable to meet the psychological demands of
gical skills are required. This allows an expert to choose HIS. They are recommended for systematic application by
psychological techniques to improve the athlete’s psycholo- athletes and coaches.

In today’s professional and semi-professional sports, should be adapted to the psychological and physio-
the thin line between winning and losing is becoming logical demands of each discipline. Therefore, it
progressively thinner. At the Beijing Olympic Games introduces the systematization of PST and proposes
in 2008, the difference between first and fourth places a model for the identification of the psychological
in the men’s rowing events averaged 1.34%, with the demands of a specific sport. With this focus and the
equivalent for women being a mere 1.03%. This few available research findings, this review addresses
increasing performance density creates massive pres- the psychological demands of HIS and describes
sure. Thus, it is not surprising that in recent years, how these specific demands can be met through the
the importance of psychological skills training (PST) systematic development of different psychological
has been recognized, and the number of athletes skills and the application of psychological techniques.
using psychological training strategies has increased.
This paper aims to address the effect of PST on an
athlete’s performance progress, with a special focus
Systematization of PST
on a group of sports involving a high-intensity load.
High-intensity sport (HIS) is characterized by an ‘‘Psychological skills training (PST) refers to the
impact duration between 1 and 8 min, with a very systematic and consistent practice of mental or
high-impact intensity and a continuous power output psychological skills for the purpose of enhancing
throughout the performance phase. Typical examples performance, increasing enjoyment, or achieving
of HIS are rowing, swimming, 800 and 1500 m track greater sport and physical activity self-satisfaction’’
and field running, track cycling and flat-water canoe- (Weinberg & Gould, 2007, p. 250). Therefore, PST
ing. While some authors (e.g. Mujica, 2009) state that should be systematic, goal-oriented, planned,
high-intensity exercise is also crucial in team sports, controlled and evaluated (Seiler & Stock, 1994).
this paper focuses merely on individual sports be- In recent years, the literature on the use of psycho-
cause the psychological demands in these two sport logical skills has become rapidly available. Most
forms are very different. This paper argues that in literature on PST use the expressions ‘‘psychological
attempting to achieve outstanding performance, PST skills’’ and ‘‘mental techniques’’ more or less

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interchangeably, whereas some authors (Seiler & imagery and relaxation) (Patrick & Hrycaiko, 1998).
Stock, 1994; Vealey, 2007) differentiate between Although triathlon is not regarded as HIS, this study
psychological skills as the desired outcome (e.g., is reported here because the performance investi-
increased self-confidence and enhanced attentional gated had the characteristics of HIS. Additionally,
focus) and psychological methods or techniques (e.g., literature searches using different search engines
imagery and self-talk) as the means to promote the (PsycINFO, Psyndex plus, SPORTDiscus) with
desired outcomes through the systematic application ‘‘PST,’’ ‘‘mental skills training’’ or ‘‘HIS’’ as search
of these techniques. In this context, a skill is the terms detected no articles. We found only six related
learned capacity (or ability) to carry out a specific studies (one for rowing and five for swimming), when
task. A technique is the procedure used to enhance using HIS-identified sports (rowing, track cycling,
that capacity in order to be able to complete this swimming, canoeing and 800–3000 m track and field)
task. Imagery, goal-setting, self-talk and physical combined with ‘‘PST’’ or ‘‘mental skills training’’ as
relaxation techniques are named as the four basic search words. One of the studies was not reported in
mental techniques predominantly used in sport psy- the Gardner and Moore analysis. Sheard and Golby
chology interventions, supplemented with multimo- (2006) showed with 36 young elite swimmers a
dal PST, which incorporates a combination of these significant post-PST performance enhancement after
basic techniques (Vealey, 2007). However, there are a 7-week PST training program (goal-setting, ima-
numerous additional techniques used to enhance the gery, relaxation, concentration and thought stop-
psychological skills of an athlete, e.g., cognitive ping) in three separate swimming strokes, each over
restructuring. Sometimes, the term ‘‘psychological 200 m. The 200 m swimming distance would be
strategies’’ is used for the application of psychologi- defined as a typical HIS discipline. Unfortunately,
cal techniques. In this paper, the term ‘‘strategies’’ is the study lacks a control group.
used to refer to the means or the plan of action used Nevertheless, the reported scientific evidence pro-
to achieve the enhancement of psychological skills by vided by studies using randomized controlled be-
using one or more psychological techniques. In this tween group design or single-case design with
context, it is important to note that the same psy- intervention comparison and the target population
chological technique can be used for the development (competitive athletes) is sobering. It has to be recog-
of different psychological skills, depending on the nized that information concerning the utility of PST
specific application. for skilled elite athletes in general and in HIS remains
limited.

Current state of knowledge regarding traditional PST

in HIS Psychological demands of HIS
Psychological skills are posited as effective for attain- Although numerous applied sport psychology books
ing optimal athletic performance (Hardy et al., 1996), are available today, the recommended training pro-
and the benefit of PST is widely reported (Vealey, grams usually are quite generic in form, and sport-
2007; Weinberg & Gould, 2007). Although consider- specific PST programs are more the exception than
able scientific evidence is available regarding the the rule. This is remarkable, bearing in mind that the
efficacy of traditional psychological performance- performance-relevant tasks of say a soccer player and
enhancement methods, some authors claim that a 200 m breaststroke swimmer are very different.
sport psychology interventions have not been criti- However, to systematically support the performance
cally examined, and most studies investigating the outcome in a specific sport, it is important to know
efficacy of PST do not meet the criteria for evidence- what demands an athlete has to meet in order to
based empirical support (Gardner & Moore, 2006). choose the most promising and best-adapted inter-
Gardner and Moore analyzed 104 empirical studies vention. However, the literature addressing the psy-
investigating the efficacy of PST by using objective chological demands of HIS is very rare. Kellmann
measures of athletic performance. Of these, only four et al. (2006) discussed the psychological aspects of
studies involved HIS, met the criteria for adequate rowing. In their discussion, they proposed that the
design and methodology, used competitive athletes critical skills are motor skills (the ability to balance
as participants and therefore enable generalizing the the boat and pull the oars and skulls in an efficient
results onto skilled or elite athletes. Only one of these and effective manner), volitional skills (to overcome
studies showed performance enhancement. fatigue and maintain the rhythm of the boat despite
This study was conducted with triathletes high fatigue and lactate concentration), regulation of
and showed a performance increase in two out of stress and pressure (anxiety – the fear of being
three participants in a 1600 m run by using a multi- replaced by highly motivated rowers and the anxiety
modal psychological intervention package (self-talk, of performing in the competition and being able to

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Birrer and Morgan
maintain the rhythm of the boat), coordination/ functions and motor control. Additionally and in
communication skills (to proactively avoid potential relation to the various self constructs in Vealey
sources of conflict) and recovery (to speed up recov- (2007), e.g., self-awareness, self-efficacy, self-worth,
ery process and being open to new training impulses). self-confidence, personal development and life skills,
Elbe and Wenhold (2009) report that training and coping skills, communication, and leadership skills and
competing in HIS require specific motivational and finally recovery skills that are important for many
volitional demands. It appears that elite HIS athletes sports are integrated in the expanded model.
differ from non-elite athletes in their understanding Figure 1 depicts the adapted model. The two
of the motivational concepts hope for success and fear above-described conceptual levels (demands and
of failure. From the perspective of volitional de- skills) are complemented with the most used psycho-
mands, the authors further report that elite HIS logical techniques to enhance psychological skills.
athletes appear to have a lower loss of focus and a The most important hypothesized demands and skills
lower lack of activation compared with non-elite are hallmarked in boldface. The following sentences
athletes (Elbe & Wenhold, 2009). Apart from the will try to identify the demands of various HIS.
reported literature, there is little knowledge available Movement patterns and movement complexity differ
about psychological demands in HIS. from sport to sport, sometimes even between dis-
Another way to identify demands of a specific ciplines in the same sport. With the presented model
sport is to systematically gain insights based on in mind, rowing can be considered as a quite techni-
theoretical considerations using a comprehensive cally demanding sport, compared with the 800 m
model. Unfortunately, the models suitable for sys- track and field running. In swimming, the movement
tematic analysis of the psychological demands of a pattern of 200 m freestyle demands a highly opti-
specific sport are limited. Therefore, the following mized movement pattern, whereas the movement
sections will try to outline a preliminary model pattern of 200 m breaststroke requires the same
suitable for the systematic identification of psycho- optimized movement pattern in addition to a very
logical demands of a sport. The sections will also demanding movement complexity. Although there
identify the most important psychological demands are differences, most HIS are cyclic sports, with the
in HIS based on this model and suggest which motion being repeated many times. Therefore, task
psychological skills might have a performance-en- complexity and variability of HIS can be regarded as
hancing effect. The suggestions will be based on these low (competition always occur in the same or similar
theoretical considerations as well as the sparse litera- environmental conditions; distances are always the
ture addressing psychological requirements of HIS. same and the only variability in action is tactical in
Schnabel et al. (2008) presented a framework to nature). The impact duration differs from 1 to 8 min;
identify the psychological demands of a specific intensity and continuity of the impact are very high
sport. This framework is one of the few attempts to throughout the performance phase, which involve
summarize the psychological requirements in a sport, near maximal energy supply for the sustained period
which we found worthwhile to develop further. In (Laursen, 2009). The required cooperation for world-
their model, demands such as duration, intensity and class performance is low in most of these sports. The
continuity of the impact; complexity and variability of exceptions are rowing and canoeing (team boats) and
the action; movement pattern and movement complex- some track cycling disciplines. Generally, injury and
ity and cooperation between the athlete and all mem- death risk in HIS competitions can be viewed as low
bers of the party dictate the psychological skills (no impact from opponents and no objective risks,
required for successful competing in the relevant with the possible exception of track cycling), whereas
sport. We complemented their model with the fol- the overuse injury (and overtraining) risk due to very
lowing demands: training scope, training intensity and high training volumes and very high training inten-
training years [keeping in mind the 10-year or 10 000- sities can be considered as high. The objective re-
hour rule in Ericsson et al. (1993)]; psychosocial quirements for training and lifestyle of HIS persons
development (that each sporting/non-sporting indivi- are mostly influenced by the necessary training scope,
dual needs to fulfil) and finally the injury and death training intensity and training years. Ericsson et al.’s
risk a sport can pose, because we believe that these (1993) rule of thumb can be regarded as relevant for
demands are important for thorough analyses. Con- all HIS, with tough, extensive training schedules and
trary to the original model in Schnabel et al. (2008), very high training intensities. Psychosocial develop-
psychological skills (instead of unspecific psycholo- mental tasks can provide the background for failure,
gical terms) are hypothesized to help to regulate in conjunction with performance pressure and ex-
the athlete’s behavior to meet the demands of the tensive training requirements.
specific sport. Following Baldasarre et al. (2003), the In summary, taking into account theoretical con-
psychological skills addressed are attention, motiva- siderations about the psychological requirements and
tion, volition, arousal regulation, perceptual cognitive the shortage of literature regarding the psychological

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 PST in high-intensity sports

Fig. 1. Potential psychological skills to cope with the psychological requirements for world-class sport performance
(hypothetical example for a high-intensity sports is in bold type: 1500 m running) and the psychological techniques to develop
them (adapted from Schnabel et al., 2008).

demands of HIS, we have revealed the following Therefore, the following paragraphs will focus
psychological requirements. (1) Athletes training and mainly (with the exception of the few studies we
competing successfully in HIS have to be able to cope found) on potentially important psychological re-
with very high training volumes and training inten- quirements of HIS and how they can be supported
sities over a period of several years. (2) Despite the by a systematic application of psychological pro-
high training volumes, they have to accomplish cesses based on theoretical considerations. Further
normal developmental tasks. (3) The complexity the paragraphs will explore scientific evidence for
and variability of the action are low, but the move- interventions stemming from other HIS-related
ment pattern can be quite complex. (4) HIS athletes sports or general psychology. Although motivational
have a high overuse injury and overtraining risk due skills have been identified as important to meet the
to very high training intensities and volumes. (5) The demands of HIS, we have largely left them out,
impact duration, intensity and continuity demand a because a thorough discussion of them would have
maximal energy supply, which is linked with the gone beyond the scope of this paper. Nevertheless,
rapid development of muscle fatigue. (6) The perfor- motivational issues are addressed in several paper
mance density evokes a high performance pressure sections and a summary of motivational training
and the potential for fear of failure. We suggest that forms can be found in Birrer and Seiler (2006).
the summarized psychological demands of HIS ne-
cessitate the systematic use of the following psycho-
logical skills: (1) self-skills, personal development Self-skills, personal development and life skills
and life skills (to fulfil the normal developmental The development of various self-constructs appears
tasks and to cope with high training demands); (2) to be a key issue in an athlete’s career. Self-efficacy
arousal-regulation skills (to regulate stress and pres- (Bandura, 1997) has been one of the mainstream
sure); (3) volitional skills (to overcome pain and issues in psychology for the past 20 years. It describes
fatigue due to specific performance demands); (4) the appraisal of a person for his capability of
motivational skills and (5) recovery skills (to cope executing a specific task. Self-efficacy appears to be
with high training and performance demands and associated with performance success, and a lack of
minimize the injury and overtraining risk). self-efficacy or self-esteem is associated with under-
performance and unhealthy behavior such as eating
disorders and drug abuse (Petrie & Greenleaf, 2007).
PST to meet the requirements of HIS Self-efficacy is closely related with other self-
constructs such as self-awareness, self-consciousness,
Scientific proof for the efficacy of traditional psycho- as well as self-concept and should be facilitated
logical techniques in HIS appears to be limited. systematically. For an athlete to be aware of his or

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her own strengths and weaknesses, desires and flaws activity they like. Harmonious passion promotes
are key factors in this process. Literally, to be aware healthy adaptation, whereas obsessive passion pre-
of oneself is the first step in enhancing self-conscious- vents it by causing negative effect and rigid persistence.
ness, and as a result, self-efficacy. To influence one’s Findings with high-school basketball players, synchro-
self-efficacy, multiple strategies are recommended. nized swimmers and water-polo players suggest
Many PST programs aiming to enhance the self- (Vallerand et al., 2008) that harmonious passion is
efficacy of athletes are predominantly using goal- conducive to high levels of performance and well-
setting techniques. Eberspächer (1995) suggested a being. Obsessive passion can facilitate or inhibit
psychological-oriented training method for the de- (when related to performance-avoidance goals) perfor-
velopment of self-efficacy, where athletes have to mance attainment and appears unrelated to happiness.
predict their performance in a task during training. Consequently, the development of harmonious pas-
These sessions aim to improve self-efficacy through sion could have an influence on both personal devel-
the development of realistic goals. opment and performance enhancement.
Self-concordance refers to the feeling of ownership
that people have with regard to their goals. It des-
cribes goal congruency with implicit personal inter- Arousal regulation: overcoming pressure and fear
ests and values (Koestner et al., 2002). Findings Arousal is defined as the cognitive and somatic reac-
suggest that people with high self-concordance are tion to an internal or external stimulus. It is generally
better able to attain their goals, leading to an supposed there is an optimal state of arousal for high
increased psychological adjustment. Consequently, performance. The optimal level of arousal is defined
it is important that athletes’ goals match their im- through situational factors, the combination of cogni-
plicit interests and values. Enhancing self-awareness tive and affective sensations (Hardy et al., 1996),
can help to explore one’s implicit interests and values individual preferences (Hanin, 2000) and the require-
and identify a possible mismatch with personal goals. ments of the particular task or sport. Therefore, the
Unfortunately, no research is available that explores state of arousal can be influenced through control of
the influence of self-concordance or the use of goal- the situation, appraisal of situational factors, and
setting on the performance of elite HIS athletes. transformation of cognitive and affective sensations
Teaching life skills to young athletes recently came (Seiler, 1992). What appears to be crucial in this
in the focus of applied sport psychology. There are two context is the presence of fear of failure (Kellmann et
studies reporting the effectiveness of a life skill-training al., 2006; Elbe & Wenhold, 2009). The psychological
program. In a randomized controlled between group and physical impacts of fear are numerous. It affects
design, the effect of a predominantly goal-setting- athletes’ affective state, can reduce athletes’ motivation
based intervention of eight 15-min sessions on perfor- to train and compete, affects athletes’ self-confidence
mance and self-beliefs was shown (Papacharisis et al., and their volitional and attentional skills, produces
2005) with 32 young female volleyball players and 32 feelings of anxiety and increases muscle tension, which
male soccer players. In another study, Curry and can lead to loss of coordination.
Maniar (2003) investigated the effect of a semester- A number of strategies have been proposed for
long life skills education program, using a non- performers to modify their arousal state: psych-up
randomized control design, on 62 student athletes psych-down techniques involving self-talk, imagery,
playing various sports. The course was a combination physical activity, short or cued relaxation; pre-
of the practice of classic performance-enhancement performance and performance routines; mental
strategies, including arousal/affect control, goal-set- rehearsal strategies; stress management and mood-
ting, imagery and flow and a life skill training program enhancement strategies (Hardy et al., 1996). Most
targeting confidence, trust, on-/off-field problem sol- research shows that these strategies can reduce anxi-
ving, sports nutrition, transitions and drug/alcohol ety or reduce the interpretation of symptoms of
issues. Performance, measured by the coach’s rating, performance anxiety as debilitating (e.g. Page et al.,
significantly improved in the life skill group but not in 1999). Almost all studies have failed to show a clear
the control group. The effect size was moderate to impact on performance (Gardner & Moore, 2006).
high, suggesting that a life skill program is helpful in One reason might be that it is still not clear whether
increasing the performance of university athletes. An- and when anxiety or fear exerts a beneficial effect,
other worthwhile concept is the approach of harmo- what arousal level is performance facilitating and
nious and obsessive passion (Vallerand et al., 2008). under which conditions the same level might be
Obsessive passion refers to controlled internalization debilitating. Hardy et al. (1996) commented that
of an activity in one’s identity that creates an internal the ‘‘early recognition and control of anxiety symp-
pressure to engage in the activity. Harmonious passion toms were associated with superior performance in
refers to an autonomous internalization that leads elite athletes’’ (p. 171). This statement indicates that
individuals to choose freely to get involved in an two factors are important for competitive athletes:

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(1) athletes have to know their individual perfor- processes. Stimuli that enter awareness are observed
mance-facilitating state of arousal before and during but not judged, and internal experiences (thoughts,
the competition. (2) Athletes have to be aware of feelings and sensations occurring through internal or
their current state of arousal and how they can influ- external stimulation) are instead accepted as natural,
ence it in the direction of the performance-facilitating transient facets of human existence.
state. Both notions highlight the importance of self- Numerous studies support the effectiveness of
awareness processes. mindfulness-based interventions with clinical and
However, considering the amount of research that non-clinical populations (e.g. Grossmann et al.,
has been conducted in this area, there is surprisingly 2004). Again, these studies are rare in sports. Never-
little sports-specific knowledge regarding the indivi- theless, the use of the mindfulness approach appears
dual optimal level of arousal. Studies by Hanton et to be fruitful for HIS athletes, because it supports the
al. (2005) might represent a considerable advance in need for meta-cognitive attention to external cues,
the understanding of competitive anxiety and per- performance-enhancing openness to options, as well
formance-facilitating arousal state. They found that as contingencies. Therefore, it can be hypothesized to
athletes can interpret the intensity of anxiety-related have an impact on several psychological skills, for
symptoms or arousal as either facilitative (athletes example, arousal regulation, attentional skills, voli-
are termed ‘‘facilitators’’) or debilitative (athletes are tional skills, personal development and life skills. The
termed ‘‘debilitators’’) toward performance and that first promising research findings regarding mindful-
this differentiation might be critical in the coping ness and athletic performance are available (Gardner
efficacy before a competition. Facilitators and debil- & Moore, 2006; Kee & John Wang, 2008), but
itators experience more or less the same feelings in unfortunately, not regarding HIS.
phases before a competition, but the intensity is less
in facilitators. Facilitators appeared to be capable of
using a repertoire of psychological skills, which Volitional and pain management skills: overcoming
enabled them to reinterpret negative cognitive and fatigue and pain
somatic sensations as performance facilitating. In Athletes normally possess high performance motiva-
contrast, debilitators tried to use the same psycholo- tion. In duels or very exhausting activities, there are
gical skills but were not able to internally control often unexpectedly high psychological and physical
these skills and experienced a loss of control (inabil- inner and outer resistances to overcome. Then, high
ity to attain a positive pre-performance state), lower motivation is frequently inadequate. In these situa-
confidence and an ongoing debilitative interpretation tions, it is helpful to possess implementation inten-
of the sensory input (Hanton et al., 2005). Thomas tions (Koestner et al., 2002) and shielding intentions.
et al. (2007) showed that it might be possible to Implementation intentions dictate when, how and
restructure athletes’ interpretation of anxiety and where activities should be implemented. Shielding
confidence symptoms with a multimodal intervention intentions are used to conquer obstacles that occur
(imagery, rationalization, cognitive restructuring, during activities. In dependence on implementation
goal-setting and self-talk), with positive effects on intentions, shielding intentions’ (Birrer & Seiler,
their confidence and anxiety appraisal as well as their 2006) purpose can be understood as an ‘‘if-then’’
performance. Unfortunately, the limitation of this relationship, e.g., ‘‘If someone attacks me, then I will
research is the lack of a control group. easily enhance my step-rate and will orientate myself
Despite these promising results, there appears to forwards.’’ This means that possible obstacles that
be a great number of athletes who experience could occur during an activity are anticipated and
difficulties in controlling their cognitive processes. linked with a specific activity plan to overcome them.
This might be explained by ironic mental processes The goal of implementation and shielding intentions
(Janelle, 1999). In the last two decades, intervention is to maintain a pursued activity or even enhance
techniques that target acceptance instead of the effort despite the inner (pain) and outer (headwind)
direct control of cognitive and affective processes resistance. According to Mathesius (1993), conscious
were suggested. They have been recommended as and purposeful intervention is thereby the crucial
alternatives to change-based traditional cognitive- criterion for volitional regulation processes. By
behavioral treatment. Mindfulness-based cognitive focusing on performance-relevant processes, the
therapy (Segal et al., 2002) and his sport-specific performance becomes actively aligned, and the dis-
adaptation, the mindfulness-acceptance-commitment traction of performance obstacles is reduced. Self-
approach (Gardner & Moore, 2006), are two of the talk, imagery and relaxation techniques can be used
proposed interventions. These mindfulness techni- separately or in combination to control the focus on
ques emphasize the non-judging awareness and ac- relevant processes during sporting activity. These
ceptance of present cognitive, affective and sensory techniques are used during tough training sessions
experiences, including external stimuli and internal in terms of psychological-orientated training, e.g.,

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Birrer and Morgan
through neck-and-neck races or in sessions where the moderating perceived exertion and managing pain
athlete reaches his limit. They are also embedded into have been addressed since the late 1970s (Morgan &
tapering and pre-competition routines. Pollock, 1977). Most research was conducted with
The ability to manage pain with psychological endurance sports, e.g., marathon running. The gen-
processes has been of interest since the 1970s (Flor, eral findings are more or less consistent: associative
2009). Pain is defined as an ‘‘unpleasant sensory and strategies, where the athlete focuses on bodily sensa-
emotional experience associated with actual or po- tions (such as muscle tension and breathing) and
tential tissue damage or described in terms of such performance-specific cues (such as stroke rate in
tissue damage’’ (International Association for the rowing or the round treadle in cycling), relate to
Study of Pain, 2009). Pain during physical effort is faster performance. Dissociation strategies, where
often not pathologically contingent. It can be inter- athletes focus on say music or the landscape in order
preted as a threat to the individual’s somatic integrity to distract themselves from say muscle pain, relate to
and is associated with increased arousal and anxiety lower perceived exertion and possibly greater endur-
(Flor, 2009), which makes it even more uncomfor- ance (Masters & Ogles, 1998). In their review, Masters
table. The body tightens, which makes the physical and Ogles (1998) claimed a lack of definitional clarity
effort even less effective and more painful. However, of association/dissociation, and crude dichotomies
what HIS athletes experience during training and appear to be too simplistic to account for the full
competition can be regarded as discomfort and not spectrum of an athlete’s cognitions. Therefore, Ste-
pain. They can always control pain by slowing down vinson and Biddle (1999) proposed a two-dimen-
or stopping the physical activity. Findings from pain sional system to classify the thoughts of (competi-
research show that exposure to pain can directly lead tive) endurance athletes, including task relevance
to habituation through decreased surprise, insecur- (task-irrelevant/dissociation vs task-relevant/associa-
ity, and threat. This implies that an athlete can tion) and the direction of attention (internal vs
prepare himself for pain. The predominant thoughts external).
are very important in this process. Negative thoughts Studies investigating the effect of associative and
such as ‘‘I am not able to sustain it’’ accompany less dissociative strategies in HIS confirmed the findings
pain tolerance, whereas managing thoughts such as from other sports. Internal as well as external asso-
‘‘I can do it’’ enhance pain tolerance and minimize ciative strategies resulted in a higher rating of per-
the pain sensation (Flor, 2009). There is also a close ceived exertion levels (Stanley et al., 2007). Couture
relationship between the self-efficacy beliefs regard- et al. (1999) showed that swimmers using an asso-
ing pain tolerance and the release of endogenous ciative strategy (thinking the word air when inhaling)
opioids. The first findings in the field of exercise swam significantly faster than the control group.
psychology with cycling ergometer tasks could con- Two further supporting studies were conducted in a
firm this proposal (Motl et al., 2007). rowing task (Scott et al., 1999; Connolly & Janelle,
The findings of pain research suggest that the 2003). In Scott et al. (1999), the mean performance
appraisal and interpretation of pain sensations are enhancement between pre- and post-intervention
crucial to pain tolerance. Athletes can actively de- tests was 3.76% for the internal association strategy
velop their pain tolerance. Therefore, the strength of (‘‘feel the burn’’ and ‘‘listen to your breath’’) group,
the pain stimuli should be increased very slowly, and in Connolly and Janelle (2003), the improvement
enabling the athlete to gradually habituate to the was 1.9% for the internal association strategy group.
increasing pain. The volitional strategies identified
above, linked with shielding intentions, appear to be
suitable to overcome pain. In a randomized control Recovery skills
study, Whitmarsh and Alderman (1993) showed that One of the important requirements of HIS is the
athletes in a stress-inoculation training program combination of high-volume and high-intensity
showed significantly better performance times and a training (Laursen, 2009). This necessitates very
higher pain tolerance while performing a physical good recovery capabilities in order for the training
task. Unfortunately, research exploring pain man- to be most beneficial. Harmonious passion (Valler-
agement among athletes is rare. However, there is a and et al., 2008) and high self-awareness should have
research body (Masters & Ogles, 1998) investigating a positive impact on athletes’ recovery. Furthermore,
associative or dissociative attentional strategies in in general sports psychology literature, relaxation
athletes, including pain. techniques are highlighted as being helpful to hasten
the recovery processes after training or competition
(e.g. Kellmann et al., 2006). However, so far, there
Associative and dissociative attentional strategies has been a lack of convincing evidence that relaxa-
Associative and dissociative attentional strategies for tion techniques are really effective in enhancing
influencing performance, enhancing endurance, the recovery quality, reducing recovery time or

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 PST in high-intensity sports
enhancing athletes’ performance. Moreover, differ- proach. In this context, the concept of ironic mental
ent relaxation techniques [e.g., progressive muscle processes (Janelle, 1999) should be considered.
relaxation (PMR), autogenic training, and self-hyp- A third cornerstone might be the in-practice inte-
nosis] are usually recommended for athletes, without gration of psychological techniques, carefully chosen
taking into account individual differences in person- to meet the requirements of the task at hand.
ality and the requirements of the particular sport. Psychological techniques must support the automatic
Indeed, relaxation techniques have their own unique engagement of developed athletic skills, respond to
effects (Lehrer, 1996), which should be considered. contextual cues, and help athletes focus on the
PMR might have an influence on immunoenhance- necessary aspects of competition or training. These
ment (Pawlow & Jones, 2005). However, preliminary include focusing on the present and coping with
results from an intervention study with long-distance internal and external experiences. Again, the mind-
runners suggest that PMR is detrimental when used fulness approach can be valuable in this endeavour.
directly after training in the attempt to enhance Although some scientists have raised the notion
the recovery quality, whereas the use of self-hypnotic that research on the effectiveness of PST revealed
relaxation might have the desired recovery- only low treatment effects, if at all (Gardner &
enhancing effect (Schneider, 2007). Moore, 2006), a minimal performance enhancement
of 3% can make a significant difference at the elite
level between winning a gold medal and not winning
Implications and recommendations even an Olympic diploma. Therefore, the systematic
and purposeful application of PST can make an
This paper reviews the current knowledge on the important contribution. In this attempt, sport psy-
effective use of PST in HIS. Convincing scientific chologists and coaches are advised to reflect on the
evidence from the widely used PST programs and following considerations. One of the targets of PST
theoretical underpinnings regarding the psychologi- should be to initiate small improvements or progress
cal demands of HIS are not available. Research on in small steps, and it should aim to enhance training
HIS has provided limited empirical evidence, and quality as well as competitive performance. Addi-
hence, this paper’s reflections are largely based on tionally, PST techniques are not universally applic-
theoretical considerations and research from other able without considering individual differences
areas. We present a preliminary model that appears between athletes and the specific function of the
suitable to systematically determine the psychologi- technique used. For example, self-talk can be used
cal demands of a sport. This model can be used to in different forms and functions and therefore also
identify the psychological requirements of HIS in has different effects (Hatzigeorgiadis et al., 2007).
competition and training such as, e.g. the capability Most importantly, before implementing a PST pro-
to maintain maximal energy expenditure despite gram, applied sports psychologists should first ad-
rapid increase of muscle fatigue and muscle pain. dress the psychological requirements of the sport as
Based on the identification of the relevant psycholo- well as the level of the athlete. Furthermore, to be
gical skills, we suggest that PST programs in effective, the intervention should be adapted to the
HIS focus on the following psychological skills: specific training and competition phase of the season
self-skills, personal development and life skills, (as, e.g., demonstrated in Thomas et al., 2007).
arousal-regulation skills, volitional skills, motiva- Therefore, the concept of periodization could also
tional skills and recovery skills. be adapted to PST (Holliday et al., 2008). Finally,
PST should help athletes train hard, compete although associative attentional strategies are con-
aggressively, maintain or sophistically adjust strate- sidered to have a performance-enhancing effect, the
gic plans and choices and take care of the ‘‘self.’’ question of when an athlete should associate and
Therefore, establishing life skills programs, including dissociate in training and how much time to spend on
the development of harmonious passion (Vallerand this or whether the excessive use of associative
et al., 2008) and a thorough elaboration of per- strategies is associated with the risk of the athlete
sonal goals along with the enhancement of self- over-reaching himself and over-training is not clear.
concordance, might be a cornerstone. In this context,
Birrer and Seiler (2006) proposed the systematic use
of multiple goal-setting strategies in order to change Perspectives
avoidance motivation into approach motivation.
Another cornerstone appears to be training voli- There is a lack of scientific research on PST in HIS.
tional skills, which would integrate the findings Knowing this, some additional points should be
concerning associative and dissociative attentional borne in mind and addressed here. Future research
strategies, the findings from pain management should focus on the relationship between the specific
research, as well as those from the mindfulness ap- demands of HIS and specific PST interventions.

85
Birrer and Morgan
These interventions should be designed especially for the highest scientific standards, the difficulty of eva-
HIS. Particular attention should be given to newly luating the efficacy of an intervention with a target
established interventions such as, e.g. the mindful- group of elite athletes must be recognized and
ness approach or the periodization of PST. The considered.
outcome variable of interest should be preferably
performance. A further important consideration is Key words: mental skills training, mindfulness, row-
related to the research requirements of applied sport ing, cycling, swimming, elite sport.
psychology, especially when high-performance
athletes are involved. It should be agreed upon
which research design is regarded as appropriate to
identify empirically supported interventions for elite Acknowledgement
performers. Although it is important that an aca- Conflicts of interest: The authors have no potential conflicts of
demic discipline show empirical support that meets interest.

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