THE anxiety disorder that has Chuck Knoblauch throwing wildly – forcing the Yankees to move him from second base to the outfield – is an affliction that haunts people in high-stress professions.
And sometimes, the consequences are much worse than losing a game.
When a surgeon gets a dose of Knoblauch’s “yips,” and his fingers go herky-jerky, people die.
Jim Loehr, a Florida sports psychologist, recalls a phone call he received a few years ago from a prominent Northeast-based heart surgeon.
“He said he wanted to ask me a question,” said Loehr, who promised the doctor anonymity.
“He asked, ‘What happens when an athlete chokes?’ I said, ‘Well, I guess when someone can’t play well, they typically lose.'”
“Right,” the surgeon said. “They lose – a game.”
He then asked Loehr: “What do you think happens when a surgeon chokes?”
Before Loehr could answer, the doctor began to sob uncontrollably.
He went on to describe how he couldn’t control his hands when making delicate cuts in his patients’ chests. He felt paralyzed in front of the nurses and other doctors who stood around him in their scrubs. As the renowned surgeon’s confidence plummeted, he avoided doing operations, and patients were backed up.
“The result was complete devastation,” Loehr said. “When this doctor got the ‘yips,’ lives were lost.”
Worried, Loehr referred the surgeon to another medical doctor. Now, he says, the stricken surgeon is operating “brilliantly” again after a top-secret, three-month sabbatical for intensive psychotherapy.
“For people in critical-care work, failure is not an option,” Loehr said. “Their stories are very vivid – much more compelling than someone who loses his golf game.”
PERFORMANCE anxiety results from a sudden and uncontrollable fear of humiliating oneself in public, say doctors. The mental lockup can cause involuntary shakes. It frequently strikes people whose jobs combine high stress and repetitive, precise, physical tasks.
John, a 44-year-old anesthesiologist from Pennsylvania, performed impeccable epidurals and spinals for 15 years. Two years ago, he was suddenly hit with “the shakes.”
John had begun a weight-training program to get in shape. One day, on the job after his time in the gym, he noticed his hands shaking.
“It was a result of my rigorous exercise,” John said. “But having the slight tremor was embarrassing. I was thinking, ‘Gee, this must not look so good.'”
John was sure the other people in the room – the patient, doctor, nurse and medical students – were eyeing him with horror as he handled small needles and made pin pricks in veins as his hands trembled. The more he imagined himself being the focus of their glares, the more he began to shake.
“At first, I used to joke about it,” he said. “Somewhere along the line, it occurred to me how devastating it would be if I had this problem all the time. That’s how it started.”
John claims he never endangered anyone’s life. But he does admit his anxiety fluctuated depending on the situation.
“If I was in a hospital that wasn’t familiar or if there were a lot of people watching, it would increase,” he explained. “Also, if it was a particularly difficult job, such as a procedure on a small baby, I would get extra nervous.”
John initially sought
help from a local psycho- logist and then attended a workshop last year in Connecticut run by performance-anxiety expert Janet Esposito. There, he was encouraged to give demonstrations about his profession to large groups. He was also videotaped.
“It was interesting to get the feedback,” John said. “A lot of them said, ‘Well, we don’t see anything wrong with what you’re doing. You don’t look nervous to us.’ Even though I thought I looked horribly nervous, the class couldn’t see anything.”
AND when John reviewed his own performance on video, he realized he didn’t look so bad after all. That confidence was a big step toward squashing the “yips.”
John also used Inderal, a drug in the beta-blocker family, to calm his nerves as he worked on boosting his confidence. He says he still takes the drug “occasionally.”
For Nancy McMillan, losing control over her hands was not a matter of life or death. But she did consider throwing away her career as a professional pianist.
As the Poughkeepsie native began to perform in increasingly prestigious recitals, her fingers began to “lock up.”
“I used to have nightmares three months ahead of time,” said McMillan, 47, who now lives in Bethlehem, Conn. “Right before I’d go on, I’d feel complete dread. There were times when I felt I couldn’t continue playing. It was pretty scary.”
Like John, she watched and listened to herself on videotape at Esposito’s workshop and realized she didn’t appear as chaotic as she felt. Slowly, she said, “I regained control of my mind.” What helped was shifting the focus off herself and onto what she was trying to communicate with her music.
“You have to remind yourself what your real purpose is,” she explained. “It’s not all about you.”
Experts say negative self-obsessed thinking is the common thread for all victims of the “yips.” When sufferers feel certain all eyes are upon them, they envision failure and monumental humiliation.
“Their perception of themselves becomes very distorted,” Esposito said. “In this self-absorbed state, they put themselves under a microscope and imagine everyone else is doing the same thing.”
The solution, Esposito says, is focusing on “the big picture.” She suggests shifting attention to teammates or fellow performers.
“See yourself as the vehicle, not ‘The Show,'” she explained.
“Even if you are the star and the stakes are high, you have to focus on the larger picture. Nobody, by himself, holds everything up.”