By Marvin Zauderer
In last month’s Sport Psychology column, on Assessing Your Mental Fitness, I explained steps you can take during this off-season to evaluate and improve your mental skills. This month, we add to the Advanced Skills of the mentally fit cyclist covered in past installments of this column, and begin to explore how to recover – mentally – from crashes, in Part 1 of a two-part series.
It was May 20, 2007. Dr. Prentice Steffen, Garmin-Chipotle Team Physician and Medical Director, had just watched the peloton start a rainy stage 3 of the Tour of Picardie near Paris. Since the team was headed to Spain next for the Volta a Catalunya race, Dr. Steffen figured he’d get a headstart. He swung his car onto the autoroute and headed for Barcelona. Within minutes, he realized that he was in the worst possible spot: stuck behind the peloton, with no good alternate route. He pulled off the road, and decided to wait until the race cleared. He turned on his race radio. Suddenly, the news crackled through: Garmin-Chipotle rider Steven Cozza had crashed. Dr. Steffen sped to the scene, and found Steven face down, unconscious. Calling on his expertise in emergency medicine, Dr. Steffen stayed with Steven as he was loaded into the ambulance and taken to the hospital.
Steven had a bad head injury and serious neurological symptoms that persisted upon his return home: loss of memory, difficulty focusing, trouble perceiving hot and cold temperatures, an altered sense of taste, and problems with coordination and depth perception. He picks up the story:
I wasn’t sure how long the symptoms could last – maybe even years. With a head injury, you really don’t know how long it will take to heal, or if it will. I was really depressed. One week, I was competing with the best athletes in the world and doing well at it, and then I went to not being able to get out of bed. I didn’t know if I would ever be normal again.”
A head injury is bad enough. But research has also shown that the brain can change as a result of emotional trauma – experienced during and after the traumatic event – and depression is a common consequence.
In her landmark book, Trauma and Recovery, Dr. Judith Herman writes,
Psychological trauma is an affliction of the powerless. At the moment of trauma, the victim is rendered helpless by overwhelming force. When the force is that of nature, we speak of disasters. When the force is that of other human beings, we speak of atrocities. Traumatic events overwhelm the ordinary systems of care that give people a sense of control, connection, and meaning.
“The first principle of recovery is the empowerment of the survivor. [He] must be the author and arbiter of [his] own recovery. Others may offer advice, support, assistance, affection, and care, but not cure….Trauma robs the victim of a sense of power and control; the guiding principle of recovery is to restore power and control to the survivor.”
According to Dr. Herman, recovery from trauma unfolds in three, often-nonlinear, stages. The key task of the first stage is establishing safety. In the second stage of recovery, the trauma survivor tells the story of the trauma “within the realm of what is bearable.” (Perhaps with others’ help: note that it’s possible to create a story without having any memories of the event.) In the third stage, “the survivor is ready to engage more actively in the world. From her newly created safe base she can now venture forth. She can establish an agenda. She can recover some of her aspirations from the time before the trauma, or perhaps for the first time she can discover her own ambitions….She is ready to take concrete steps to increase her sense of power and control, to protect herself against future danger, and to deepen her alliances with those whom she has learned to trust.”
In beginning to assert some control over his recovery, Steven turned to a natural source: the Internet.
“I did a lot of research online, because none of my friends or family had experienced this. I typed in ‘frontal lobe injury,’ and saw all of my symptoms. It made me feel so much better – my symptoms were totally normal. I found that some could go away quickly, but some might never go away….I slept a lot, drank a lot of water….after 3-4 weeks, I started to feel much better.”
He also turned to his coach, Dario Fredrick. Dario recalls that stage of Steven’s recovery:
“Some of the symptoms, such as being disoriented, were very disconcerting for him. Mood swings and depression are very common in these cases, and he’s not prone to that kind of thing; he’s always been a very positive person. Things we take for granted were thrown into disarray…..My whole approach was to emphasize that these things are temporary, to focus him on the things he could do, and to emphasize that his body was healing itself….Mindset is so important to healing.”
But Steven got back on the bike too soon. Dario continues:
“Steven is a very, very proactive kind of guy….he tried to ride, and realized he couldn’t do it yet. I told him as soon as he felt ready, he could ride easy loops with me. [In the meantime,] he started on a trainer.”
“I put too many expectations on myself. I rushed back into training too soon, and wanted to race too soon. My team was very supportive: no one was pressuring me, and my [personal] doctor was in touch with Dr. Steffen regularly….It’s more important to recover to 100% – or 110% – before returning. But, not training was depressing. Training was helping my mind – just spinning was great. I couldn’t even do an hour at first.”
Once Steven could get back on the road, he started by doing short, flat rides side-by-side with Dario. After Steven felt comfortable with that, Dario had him ride on his wheel, “re-learning the proximity of riding with another rider,” according to Dario, who picks up the story:
“Then, he had difficulty with descending and cornering: his visual-spatial ability had decreased. So, I’d shepherd him down the descents. I told him I’d pick out the line; he just needed to follow my wheel. Gradually, I picked up the speed. Then, as soon as his visual-spatial ability started to come back, I had him lead, and we gradually picked up the speed. It helped him to be doing something that contributed to his recovery.”
Says Steven of working with his coach,
“Working with Coach Dario – I could tell him how I felt, and he could design my training program around that. He really helped me with cornering and descending – I’d just follow him. That helped my skills and my courage.”
Clearly, Steven’s relationship with Dario was critically important to his recovery. This fits with another of Dr. Herman’s central points about trauma:
“The core experiences of psychological trauma are disempowerment and disconnection from others. Recovery, therefore, is based upon the empowerment of the survivor and the creation of new connections. Recovery can take place only within the context of relationships; it cannot occur in isolation.”
According to Dr. Herman, the central task of the third stage of recovery is “reconnection with ordinary life.” Steven began to race again. He remembers:
“It was stressful to race in Europe: more cyclists, more obstacles, the rains – I was having a lot of crazy thoughts about what might happen to me. I set a goal for each race. I told myself that for the first hour, I’d ride near the front. Then I’d put myself on the back for the next couple of hours, and try to go to the front for the end. I’d try to increase the time I was spending near in the front in every race….My physical capabilities are just like everyone else’s, so I have to use my mental strength to get through these races.”
“It’s taken me 15 months to finally feel normal again in the peloton….The most important thing is that I truly believe I’ve fully recovered, so I could crash again [and be OK].”
I asked Dr. Steffen what he saw in Steven that contributed to his recovery. His view:
“When you reach the level that he’s at, the guys are really motivated to do what you ask them to do – when their livelihood is on the line….He listened very well and really wanted to learn as much as he could….He really wanted to be an active member of the planning team. It was very important for him to be in a supportive environment: his family, his team, JV [Garmin-Chipotle CEO Jonathan Vaughters], and everyone else.”
I asked Coach Dario the same question:
“He’s incredibly tenacious: if he feels he can accomplish something, he will. The key was that he had tangible goals to be back riding again. Also, his general positive outlook, his optimism. He’s always been good at seeing the positive in anything.”
In Part 2 of our series on Recovering From Crashes, we’ll look more in depth at what slows recovery down, and what you can do to speed it up. In the meantime, some closing words from Steven:
“I’ve learned a lot. You only live once, so do what you really want to do in life. I learned how much I really love to race by having to sit out. When I got back to racing, I enjoyed every moment of it. I don’t regret any moment of what I went through; it’s made me a better cyclist, that’s for sure.”
Marvin Zauderer, in his sport psychology practice, coaches athletes from all sports on the mental skills needed for success. He works in person and by phone, and frequently speaks to groups about the mental side of sport. Marvin leads the Mental Training program at Whole Athlete, a performance center in Marin County, California that provides a comprehensive set of coaching, testing, fitting, and consulting services to amateur and professional athletes. He is a licensed psychotherapist, USA Cycling Level 2 coach, and Masters road racer for Taleo Racing. Having had a 20-year career in high-technology R&D, sales & marketing, and management, he also coaches business professionals on improving their performance at work. Marvin welcomes email at firstname.lastname@example.org. His website is www.marvinz.com.