Chapter 1: Mental Fitness

Almost every professional athlete we see at The Stone Clinic has a solid fitness program involving CrossFit-like extreme training and cross-training in the off-season. They know all about how to get strong, and have access to trainers and coaches who aim to eliminate specific physical weaknesses that can lead to injury.

The pros also know about nutrition. They know that protein is necessary for muscle building and that a balanced diet is more important than the huge carb-laden training tables of the past. All, especially long-distance athletes, know about fueling during sports. Hydration has become a commonplace science with access to electrolyte replenishment everywhere—even poured over the heads of successful coaches.

In addition, the pros know about massage and soft-tissue mobilization as practiced by superb physical therapists. They use the latest in yoga and Pilates along with novel stretching techniques to help them remain flexible. The “wimp” fears of the old days—i.e., an aversion to spending time in Lycra-filled stretching classes—has given way to a useful realization: it is better to spend time in Lycra than in hospital gowns.

And the pros know about coaching—who is good for them and who is not. They know enough to seek out individual coaches if the team coach is not a good fit. They use the resources of the web to find out about the latest strategies that other teams and athletes are employing.

All the pros use technology on both a personal and a team level to monitor performance and strategize about moves, feints, forms, and styles: the choreography of winning performances. These interconnected athletes represent not just local wisdom but the global skillset of the world’s best.

And yet, even with all of these components in place, professional athletes can implode. When Serena Williams was penalized during the 2018 US Open, she turned her anger against the umpire rather than remaining focused on her opponent. She lost. At the same event, when Roger Federer suffered from high heat and humidity, he couldn’t wait to get out of Arthur Ashe tennis stadium. He lost.

The obvious lesson? We defeat ourselves far more often than our opponents defeat us. Unforced errors in tennis are not just the problems of novices; they pervade sports. Despite the best coaching, phenomenal physical training, fitness, vast sums of money, and even decades of experience, we often remain our own worst enemies.

The patterns that serve or obstruct even great athletes are often learned on children’s playgrounds, on youth teams, and through parenting. The phenomenal successes of players, such as Roger Federer, Tiger Woods, and Serena Williams are brought to a stop by psychological weaknesses—distractions that cause them to lose their swing, their temper, or their confidence, despite seeming at the top of their game. Federer, Woods, and Williams were coached to stunning physical success—but left mentally exposed.

Consistently, the one weakness that is most difficult to fix in athletes lies in the mind itself. Mental conditioning, the approach to an injury and its recovery, the overcoming of psychological blocks that prevent a physical superstar from being a winner—these are so ingrained that they remain the most difficult weaknesses to fix.

Yet it is not impossible to change. We can work on these issues, and many doctors and mental empowerment coaches are successful at it. The first step—a simple but crucial one—is to understand that the body and mind are irrevocably linked. This doesn’t only apply to competitive athletes, but to everyone, whether they’re dealing with a changing body, playing amateur sports, or simply living. A brain is attached to each body I repair. This is obvious, but in treating the whole patient, I am cognizant of the importance of mental processes as they relate to treatment. The mental health of an injured patient brings another dimension both to their healing and their ability to excel. In short, our daily mental health defines what our body is able to achieve. Naomi Osaka poignantly brought this to light in her refusal to undergo the ritual press conference drilling in the 2021 French Open. Over decades of practicing medicine, I have identified particular mental qualities that enable people to shine—not just athletically, but in all they do. This is a good place to start this book: in the unseen and often underappreciated aspect of fitness and health that can ensure you play forever and play well. These eight mental fitness objectives are:

• Competitiveness
• Grit
• Attention
• Fantasy
• Patience
• Acceptance
• Grace
• Kindness and competency

While these qualities are what take supreme athletes to the top, they are applicable to all aspects of your life. So pay attention to your own mental game—on the court or the playfield or the racecourse, and in day-to-day interactions at work and home. Strengthening each of these qualities is the cornerstone of fitness.

Mindfulness from Day One

If you knew that your child was going to be on the world stage, performing before millions of people, and that their success depended on their response to adversity, how would you start training them? My advice is to start early.

I believe that the mental fitness required for success as a top competitor is largely formed in childhood. As children, our errors of both judgment and action are met with a wide range of responses. Our teachers and parents may exhibit love or disdain for our actions. They may respond with a teaching moment or with severe discipline. What may be needed, instead, is training in the skillsets that enable young people to control their emotions and their thoughts—skillsets that empower them to become tactical when faced with adversity, to become calculating when surprised by unanticipated events, to become cunning when attacked, and to be mindful at all times.

This is possible. We enroll our children in all kinds of after-school activities, from religious schooling to arts and crafts, from sports camps to computer programming sessions. But where do they go to get the type of mental training that allows them to respond skillfully? Apparently not from team sports, which are often filled with violence and exhortations to hit harder and get “psyched up.” Coaching in individual sports certainly addresses the mental game, but it often comes too late.

The mature athlete brings to the game his or her life story of success and failure, which often needs to be accommodated rather than built upon. What is needed is the recognition early on that developing mindfulness—often expressed as the ability to put a pause between the brain and the tongue—may determine our overall success in life. Mindfulness deserves formal early training, which should continue throughout one’s life.

The lesson I take from observation of professional athletes’ equanimity (or lack of it) is the importance of sophisticated, intuitive, and careful coaching of children. Their approach to sport will be imprinted in their psyches forever. When done well in the beginning, all else is coachable.

Competitiveness

Competitive. That’s how the vast majority of four hundred female corporate executives, the subjects of a recent research report,1 see themselves. They consider competitiveness an asset to their leadership skills. The study revealed that executive women are more likely to have played competitive sports and are more likely to hire candidates who have also participated in sports. Almost all of the respondents (94 percent) said they participated in at least one sport, and close to three-quarters agreed that an athletic background can help accelerate a woman’s leadership and career potential. Approximately two-thirds said that past sporting involvement contributed to their current career success, and that a background in sport was a positive influence on hiring decisions.

For girls, it seems, the race to the top of the corporate ladder begins well before their first job. It starts with competitive sports. Yet if you ask parents to describe the traits they are trying to teach their children, they typically mention compassion, teamwork, politeness, and diligence—but never competitiveness. Why is this quality not mentioned?

The skillsets needed by executives, civic leaders, entrepreneurs, doctors, and other professionals—both female and male—overlap with those that make great athletes. Determination, grit, focus, teamwork skills, and the ability to drive oneself and overcome adversity come to mind as the most obvious traits. These are often learned while playing team sports. Fortunately, competitiveness is a skill that also can be honed and encouraged.

How can competitiveness be learned? I can think of seven ways.

1. Remind yourself that success is admirable, that it is within reach, and that it is the pinnacle of achievement.

2. Study what competitiveness means and how it can be utilized.

3. Reward competitive skills. (For children, this means eliminating some of the “participation” trophies and making winning important. It matters. Teaching children to win helps them understand their potential and helps them to find their strengths.) Encourage competitiveness by bringing more age-appropriate awards to sports and academics.

4. Develop mental skills required to be a great athlete and/or executive, including the ability to find the mental flow that characterizes the supremely successful...