Psychotherapy with David: Football as helping to cope with life and manage emotional ill-health

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Football is growing exponentially as a global entertainment and as a participant/spectator sport, arguably reflects life and its vagaries. However, football can be used in other ways, which offer reason and insight to aspects of living and are potentially therapeutic. To illustrate, I recall sometime back working with a young man I will call David. The story is true: only David’s name and some circumstances have been changed with his consent.

David’s story

David was 22 years old and suffered severe social phobia and anxiety disorder. Growing up as an only child and in a single-parent family, David had learned to live without his estranged father and the company of siblings by developing an intense internal world. His sense of identity was concerned with thinking of himself as his mother’s protector. Accordingly, he was anxious to gain approval by endorsing her attitudes towards others.

This state of affairs, however, prevented David from developing an identity which was separate and distinct from that of his mother and forming his own views about the world. Subsequently, at times of difficulty, he did not have the necessary skills or sense of self to affiliate with others in ways which would bring about self-assurance and feelings of personal equanimity.

David had recently become emotionally unwell because of difficulties in work. He became excessively preoccupied with pleasing others and worried about failing to live up to expectations of him. The situation caused him to feel angry and shameful for his inability to assert himself in ways that would allow a sense of personal integrity.

He also became concerned about previous occasions when life did not go his way, including discontinuing his university education. David stopped seeing the few friends he had kept since leaving university. Consequently, instead of looking to others for support and comfort he isolated himself in his bedroom occupying his day with computer football games.

While this method of coping with his difficulties permitted David some control of his world, he continued to feel tormented by endless ruminations concerned with personal and professional failure and life being unjust. These circumstances served to perpetuate David’s unhelpful self-stigmatizing and shaming views about himself.

Emotional isolation and self-harm

David ultimately tried to kill himself with an overdose of painkilling medication and was admitted to the Accident and Emergency Department of the local hospital for treatment. Following a detailed mental health assessment, David was later referred for psychological therapy at which time he described himself as a failure and his life as purposeless.

Football as a metaphor for living

Working together in psychotherapy, we were, able to harness David’s imaginative qualities to bring benefits to his life. Football, he revealed, was his great passion and one, which promised him a hope of recovery from his current experience of mental ill-health. Football as a metaphor for living and a methodology for psychotherapy permitted us both to discover new ways of exploring the connectedness of the world and relationships as well as address matters related to the importance of personal identity to health and happiness.

E-football games

Initial work concerned David’s preoccupation with e-games and ways that we might harness this interest in extending his social activities. We discussed how football league tables might help David assess his own position in the world as well as identify resources needed to progress in satisfactory ways.

Subsequently, we were able to consider David’s personal needs as an imagined football player along with developing an infrastructure, which would benefit his imagined team as a whole and facilitate movement through his league table.

Shared language

Because of developing a shared language and identifying with certain values and techniques relating to the game of football, while eschewing those he deemed inappropriate, David’s future began to look different. Football offered David a means of personal evaluation and therapeutic growth, using, allegorically, the football league tables and current club form to assess his own progress in life.

Using football as a means of exploring life’s difficulties, our discussions included issues concerning dignity, fraternity, separateness, belonging and the sometimes unfair nature of life. Living for others, David concluded, does not bring about satisfaction or personal composure.

David also recognised that his own personal fitness – physically and mentally was critical to his advancement and that becoming a team player, while retaining elements of personal solitude, would contribute to his advancement in his personal league table.

As such, David eventually joined a football supporters’ organization locally and took out a subscription to the nearby gym. Subsequently, during psychological therapy, he was able to think about the benefits of having caring friends and associates, all of whom shared a common interest in football, health, and happiness.

David also began to develop a sense of pride associated with belonging to different groups and as a result of his new experiences, he reflected on the significance of identity. He also considered the integrity of maintaining relationships and the importance of his emergent friendship in ways different to the usual.

David disclosed a sense of movement from his imagined UK lower leagues to Championship levels with a hope of reaching the Premier League. E-football league tables provided David with a more attractive means of assessing personal progress -replacing more orthodox psychological outcome measures.

The importance of viewing the world differently

In addition, we were able to think about where he situated himself in the football stadium to view football matches and how this might be varied in order to gain a different viewpoint – linking this to social situations. These strategies proved invaluable to David managing his life enabling him to step back a little and take stock when faced with difficult situations.

Pleasing others

David was becoming less concerned with pleasing others and began viewing life and relationships in a more balanced way. David acknowledged that at times in life as in football, things don’t always work out as planned. Each of us has to accept that success and failure including periods of instability, being off-form or personal injury are inevitable.

Personal anger and feeling trapped

Because of thinking about life indirectly through football, David was able to consider his own predicament, including his relationship with his mother and the lack of opportunities to develop a secure personal identity in his childhood. David discovered that some of his fears concerned with displeasing others were related to his own anger because of his life situation.

He also recognized ways in which this situation maintained his feelings of low mood, anxiety and a sense of isolation, preventing him from gaining any sense of achievement or personal comfort.

Finally, some absurdities, which define success for young men in Western societies, were rendered open to our mutual scrutiny. Among other topics of concern, David revaluated his contributions and moral obligations to his family and society and subsequently felt much less of a failure as a young person. As far as was possible, he addressed difficult issues concerning the absence of his father in his formative years by making contact and building up better relations with him.

David eventually became efficient at monitoring his mental health and overall well-being. He took seriously his obligations to continue supportive relationships with family and friends and recognized the importance of sustaining a balanced life so helping him become aware of the relevance of a moral framework for healthy living.

He also began to view his friendships in ways different to the usual. Because of developing a shared language and identifying with certain values and techniques relating to the game of football, while eschewing those he deemed inappropriate, David’s future began to look different.techniques for regulating his potentially disabling anxiety.

Working with football similes encouraged David to engage in regular psychotherapy and so gain maximum benefits. Successful psychotherapy assisted not only David’s recovery from emotional ill-health but also his sense of renewal as a young man.

David regained his sense of dignity and self-respect allowing him to enjoy social acquaintances in ways he was previously unable to do. Regular contact with friends and re-establishing good relations with his father contributed to protecting David from becoming preoccupied with harmful negative ruminations.

Postscript and conclusion

I have no further knowledge of David’s life at this time, although we did have opportunities to discuss, his progress, consolidation and relapse prevention. Notwithstanding likely difficulties, I have no reason to believe that he is anything other than well and getting on with living in a more socially connected way. There were, of course, other therapeutic factors which contributed to the benefit of psychological therapy for David.

Nonetheless, because of talking about football as an allegory for life and taking time in therapy to think about relationships, including his relationship with himself. David regained his sense of dignity and self-respect allowing him to enjoy social acquaintances in ways he was previously unable to achieve.

Regular contact with friends and re-establishing good relations with his father contributed to protecting David from becoming preoccupied with harmful negative ruminations and also helped him develop techniques for regulating his potentially disabling anxiety.

Working with football similes encouraged David to engage in regular psychotherapy and so gain maximum benefits. Successful psychotherapy assisted not only David’s recovery from emotional ill-health but also his sense of renewal as a young man.

Footnote

E-football games initially contributed to David’ social exclusion. Nonetheless, the judicious use of this method of coping allowed David to widen his horizons and become more socially engaged. Football is not the only novel method of psychotherapy. Other sports, such as basketball, rugby, cricket all can provide an organising framework for discussions taking place in therapy sessions.

In fact, harnessing the interests of a person, much like education, is probably the most important indicator of positive change. In my own professional practice, I have used art, poetry, rock music and ecology as metaphors for everyday life.

Notwithstanding important transcultural issues, as in many aspects of life, it is the relationship established between both psychotherapist and the person undertaking psychotherapy that promotes successful outcomes.

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