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The Paris Olympic and Paralympic Games are around the corner, and for some athletes, it will be the pinnacle of their career.
But on the world stage, even the most skilled sportspeople can find themselves unable to perform actions they've practised thousands or millions of times before.
They "choke" under pressure.
Loading...And it's not hard to understand why.
Memories of the "overwhelming" Olympic spotlight remain fresh for Caroline Anderson, two decades after she represented Australia in taekwondo, in the women's welterweight division, at the Athens 2004 Olympics.
"It's different from world championships, World Cups, and other world events," Ms Anderson recalls.
"Walking out [into the stadium], it can feel like an incredibly lonely place.
"And there was a specialness about it as well, but absolutely an intensity like nothing else."
The former Olympian is now the Paris 2024 Australian Olympic team's lead psychologist.
Part of her job is to help athletes perform in that special, intense atmosphere.
So how does she — and other professionals — make sure sportspeople at the top of their game don't choke under pressure?
And why does it happen in the first place?
When automatic actions go out the window
The history of sport is littered with examples of choking.
Some of the best-known are from golfers who've gone into the final round of a tournament with a seemingly insurmountable lead ... only to squander it.
For instance, it's hard to pinpoint exactly when the wheels fell off for pro golfer Jean van de Velde on the final hole of the 1999 British Open Championship, but it was well before he took off his shoes and socks to wade into water after his ball.
"This really is beyond a joke now. He's gone ga-ga," BBC commentator and former professional golfer Peter Alliss lamented.
The stakes could not have been higher. If the Frenchman completed the course's 18th hole in no more than six shots, he'd win the entire tournament.
And before he teed off, it was all but in the bag: he'd played the hole three times before, finishing it in four shots once and twice in three.
But in a nightmarish play that put his ball in the rough, then knee-high grass, then into a creek — where he considered trying to hit it out — and then into a bunker, he finally sunk the putt on his seventh shot.
That triple bogey put van de Velde into a three-way play-off for the championship the next day … in which he finished third.
Chris Mesagno, an exercise science lecturer at Victoria University who researches choking in sport, says there are three components to the phenomenon.
"The person must have an increase in anxiety from what is normal, normal being: what do you feel when you're practising?
"[That anxiety] leads to a decrease in performance, which is the second element that needs to occur."
The third part, Dr Mesagno says, is that the person must have a decent level of skill: "Most researchers would argue that novices have too much fluctuation in performance levels to have a choking experience."
For most athletes, that high skill level comes from years of relentless practice, whether that's flinging a discus, kicking a footy or putting a golf ball.
Over time, these actions become automatic. But when that automatic motion is interrupted — without any obvious reason — problems can arise.
We don't know exactly what was behind van de Velde's disastrous final hole of the 1999 British Open, but researchers have identified a couple of broad reasons for choking. One is self-focus, or "paralysis by analysis", Dr Mesagno says.
"In golf, for example, they analyse their swing too much. They try to be perfect."
Instead of letting their body and swing gently propel a ball towards the hole like they normally would in practice, a golfer might think about each step. How far back do I swing the putter? Where are my hands positioned? How hard should I hit the ball?
This interrupts their automatic flow. Their movements become less smooth and more stilted. The golfer is more likely to miss the putt.
Another reason for choking is distraction. Distractions can come from within a person — distracted by their own anxiety and other feelings, for instance — or be external, such as the roar of the crowd or remarks from the opposition.
Whatever the reason for choking, it happens across all sports, and it can happen to anyone, clinical psychologist Mary Spillane says.
She mostly works with elite sportspeople and coaches, and choking is a common reason athletes see her.
"It's something that's so distressing and upsetting for an athlete when it does happen," Ms Spillane says.
"Almost worse than losing, in many instances."
A few "types" pop up in those who seek her help to perform better under pressure, such as over-thinkers, who grapple with paralysis by analysis, and perfectionists, who often have unrealistic expectations for themselves and their performance.
Athletes with a strong athletic identity can be susceptible to choking too, Ms Spillane says.
"These are individuals whose ability to perform — and perform well — and be an athlete are strongly linked to who they are as a person and how they see themselves as a person."
An athlete's mental health and wellbeing is another important factor.
"If an athlete has stressors going on … or mental health concerns in their personal life, then they don't have a lot of psychological resources left to be able to perform under pressure," Ms Spillane says.
The mere act of choking can have profound effects on an athlete's mental health too.
Dr Mesagno and colleagues conducted survey of 165 current and retired athletes, from club-level to Olympic competitors, and found almost 80 per cent had choked under pressure in their last year of playing.
Of those, 7 per cent had suicidal thoughts due to choking.
It was a self-reported survey, and the researchers didn't know what the respondents' mental health or personal circumstances were prior to choking. But Dr Mesagno says it is important to provide psychological help and support services for athletes who do choke.
And while it's all but impossible to stamp out choking entirely, there are evidence-based interventions which can reduce the likelihood of it happening again, and help an athlete better cope when it does.
Exercises to improve focus
Researchers such as Dr Mesagno put athletes through their paces, so to speak, to test various choking interventions.
One potentially beneficial technique is called the "quiet eye". It involves staring at a particular spot before executing a shot, and holding that laser focus until after the hit, kick, or throw is completed.
And exactly where to look changes for different sports. For golf, it's on the ball. For a soccer penalty, look at the top left or top right corner of the net. Basketball free throw? Fixate on the front of the hoop.
It sounds simple, but the quiet eye has been shown, time and again, to boost accuracy. It also slows heart rate and breathing.
Then there's the "left hand clench". Just before serving in tennis, for instance, squeeze a tennis ball hard in your left hand for around 30 seconds.
Our body's left side is controlled by and sends sensory information to the right half of our brain. So when we squeeze a ball with our left hand, the brain's right side is activated a little, psychologist Jürgen Beckmann from Technical University of Munich says.
The brain counteracts this activation by spreading a type of slow brain wave across the brain, including the left side.
Brain scans show right-handed golfers who choke under pressure have more activity in the left side of their brain, which is associated with consciously thinking about an action such as putting.
The slow brain waves calm that activity somewhat. Professor Beckmann calls this a "reset mechanism".
"That does the trick. It inhibits too much thinking in the left brain hemisphere," he says.
His studies into "dynamic squeezing" found it can improve performance in soccer, golf, tennis and more.
Of course it's not guaranteed, he says, and won't be useful all the time. A tennis player can't be squeezing a tennis ball for 30 seconds before serving it.
Plus the effect has only been shown in right-handers.
The situation with left-handers is a bit more complicated, Professor Beckmann says. The region of the brain that processes conscious movement might be on the left side, or the right, or split across both.
This means clenching their left hand may not have the same anti-choking effect.
Techniques before, during and after a match
Different mental health professionals use different tools and strategies to help athletes minimise their chances of choking.
And while it's crucial to uncover reasons for an athlete's underperformance, it's just as important to know what "good" performance looks like, Ms Spillane says.
"When an athlete says, 'I want to stop underperforming, I want to play better, I want to stop making mistakes,' I'll say, 'OK, so we want to step out of that, but what are you stepping in to?"
Ultimately, mistakes will happen. Sportspeople can't perform or play perfectly all the time.
And the best elite athletes, Ms Spillane says, are those who make mistakes, then move on quickly.
So in the lead-up to a game or event, she might talk to athletes about "coping ahead". It's a technique used in therapies like dialectical behaviour therapy, which is designed to help people control their emotions.
"It could be that you're thinking about a key moment in a game that might come up and you're … using a strategy like visualisation and practising it over and over again," Ms Spillane says.
"So when you get into a game, you've thought about these things, you've managed these things over and over in your mind, and therefore they're not as stressful or overwhelming when they do happen."
During a match, breathing and mindfulness can help an athlete refocus their attention and lower stress levels.
And afterwards, thinking about what helped performance — and what hindered it — can be useful should an athlete find themselves in a similar position again.
Nervous? Not confident? No problem
The Australian Olympic team's lead psychologist Caroline Anderson uses an approach called acceptance and commitment therapy.
It's designed to be used in a range of settings, from treating chronic pain to mental conditions to helping military and corporate folk perform under pressure.
"The kinds of skills are about understanding our emotions, why we have them," Ms Anderson says.
For instance, hearing our heart thumping in our chest and feeling a bit sick before going into a match — classic symptoms of nerves — can make us feel more anxious and stressed, sending us into a spiral … which is a recipe for choking.
"Whereas if we understand … this is a natural thing that our body does to protect us, just like it's a type of fight or flight, it is also actually going to enhance and help performance," Ms Anderson says.
"So our heart pumping blood is actually a good thing because it's getting blood to the major muscle groups where we want it. Feeling nauseous is just our digestive system switching off to try to save energy."
While not all interventions will work for all athletes, much of the thinking behind performance psychology and choking have flipped since Ms Anderson fronted up for her taekwondo match in Athens in 2004.
Looking back, she sees the advice she received at the time was probably unhelpful to her.
"The language back then was all around control, how you feel — be calm and confident and have positive self-talk.
"They ultimately didn't work and probably, to some extent, impacted negatively on my performance."
Confidence in athletes is, she adds, now considered an added bonus. If you have it, great. But if you don't, it's not necessarily a problem.
"Confidence isn't what predicts outcomes and performance. It's our actions and ability to focus in the moment that predicts outcomes and performance.
"And so when we free up a bit of space, and not worry as much about how confident we're feeling, we can just focus on our behaviour and actions."
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