Experts praise Olympic gymnast Simone Biles' mental health honesty: 'Conversation is critical'

Simone Biles stepped away from Olympic competition and into a debate about what it requires to thrive at a high level of athletics.

Biles, citing mental health concerns, withdrew after struggling on her vault Tuesday. Support came from all corners, but Biles has also been forced to explain and defend her decision.

On Friday morning, the most talented gymnast in the world used her Instagram account to further explain her decision.

“For anyone saying I quit … I didn’t quit,” she wrote while answering questions on her Instagram story. “My mind & body are simply not in sync.

“I don’t think you realize how dangerous this is on hard/competition surface. … nor do I have to explain why I put health first. Physical health is mental health.”

And that’s at the center of Biles’ decision. Her sport requires peak concentration. Any psychological or emotional disruption can result is disastrous — even dangerous — results.

Biles, 24, has talked about the pressure associated with being the face of her team, her sport, and the Tokyo Olympics. The four-time gold medal winner at the 2016 Olympics, Biles carried enormous expectations into Tokyo.

She has also dealt with trauma. Biles shared three years ago that she was abused by former USA Gymnastics team doctor Larry Nassar.

The other component? The Tokyo Olympics, delayed for a year because of the pandemic, are unfolding in empty venues. Athletes accustomed to performing before large crowds and with the support of nearby family are competing in isolation.

However the factors mixed, Biles was not in an optimal mental or emotional place.

So she stepped away.

“She made a very common sense decision,” said Stamford clinical psychologist Reid Daitzman, who has worked with athletes for more than 40 years. “Her mind and body were just not prepared for what she wanted to do. And she could have really hurt herself. I really respect her for the decision. I can’t imagine what it was like making that decision. But you really have to be aware of your body. A good athlete is always aware of their body.”

Daitzman said an athlete’s “optimal level of arousal” is the unique place where emotions during performance and competition are high — but not too high.

Biles, Daitzman speculates, knew her OLA was off.

“She made the correct decision not to proceed even though people who have never been exposed to that level might have said no, you’ve got to keep doing it,” he said.

Greenwich sports psychologist Amy Tardio, who works with college athletes at all levels, said athletes who reach Biles’ level recognize when they are mentally or emotionally distracted.

Athletes competing in a team sport can rely on others to compensate when they are not at peak form. But gymnastics, in particular, is a lonely venture — and it’s unsafe to compete if the mind and body are not aligned.

“You have a sport where the consequences and the degree of difficulty of her performance have catastrophic consequences if she’s not mentally there,” Tardio said. “So I think we have to respect her as an individual, as well. And I think that’s one of the issues with mental health — each individual, each individual athlete … everyone’s different. Everyone is human.”

How do athletes recognize when pressure and stress is unbearable?

Dawn Shadron, UConn’s director of student-athlete counseling and mental health services, said the school’s staff works to identify signs of distress.

“Our work focuses on identifying the source of their anxiety or stress and breaking it down into manageable chunks of information and examining what is and what isn’t in one’s control,” Shadron said. “We work to develop effective coping mechanisms to use ‘in the moment’ and identify additional supports the athlete can utilize while taking those next steps.”

Daitzman began working with athletes in an era when sports psychology was in its infancy. His client list has grown from high school and college athletes to professional athletes and those training for the Olympics.

Fast forward from his work in the late 1970s to a time when the conversation about “sports psychology” extends beyond performance. Mental health — the impact of competition and preparation and pressure — is very much part of the conversation.

“We’ve come a long way,” he said.

Said Tardio, “The conversation is critical. And I think the athletes and their peers are embracing it … the conversation alone is probably a first. These are very strong, successful, accomplished, determined athletes that are opening up these conversations and they’re willing to stand there and even feel the backlash of what that means.”

Shadron said that while the focus on mental health has increased over the past decade, the sports world remains at the “earlier stages of this discussion.”

“Fortunately the voices of these prominent athletes has amplified and advanced those discussions in important ways,” she said.

Indeed, Biles is just the latest high-profile athletes to speak about mental health. Naomi Osaka, one of the top tennis players in the world, cited her emotional health when she withdrew from the French Open and skipped Wimbledon. Michael Phelps, the most accomplished swimmer in Olympic history, has talked openly about depression.

Former UConn basketball player Breanna Stewart, among the best in the world, praised Biles for speaking out.

“Mental health is real and making sure that you’re in a good mental state of mind isn’t always the easiest thing,” Stewart said. “And especially here at the Olympics, you see that everything is heightened. The pressure is heightened, the pride is heightened, the wanting to represent your country and do everything you possibly can do to win is everywhere. I think for us as athletes we feel that and it’s making sure we have a happy balance.”

The change is immense, especially among the best of the best — Biles, Osaka, Phelps and Stewart have reached the highest level in their sports.

“Simone Biles has recognized her power and utilized her voice and her visibility on this world platform in a way that is inspiring and empowering others,” Shadron said. “The more that professional athletes can lead and live by example reduces stigma and promotes the importance of attending to one’s mental health as we do our physical health.”

The shift is generational. Shadron works with a population of athletes comfortable speaking about mental health, people who prioritize the emotional component of athletics.

“Discussion of mental wellness, good nutrition, coping mechanisms for managing stress, having a good sleep plan, good study habits, creates a sense of normalcy and supports a cultural of well-being,” Shadron said. “The earlier we engage in healthy discussions about thoughts, feelings, and behaviors, the better.”