Sport, Mental Illness, and Sociology: Volume 11

This chapter responds to calls to “reclaim” the work of Erving Goffman, and specifically his conceptualization of stigma, arguing that Goffman’s ideas can inform a critical social theory of mental illness in sport. The analysis pays particular attention to the challenges to social identity for those experiencing mental illness stigma, the role of personal identity in negotiating mental illness stigma, and strategies for stigma reduction including the adoption of stigma symbols.

The first section of the chapter revisits the concept of stigma, before proceeding to relate this to mental illness stigma as applied to sport. The second section overviews several high-profile cases of mental illness stigma of elite athletes, before presenting some examples of campaigns to address the perceived stigma related to mental health issues in sport.

The chapter proposes that Goffman’s work maintains relevance when related to social contexts other than those directly observed by him, and that the conceptualization of stigma helps understanding of, and challenges to, mental illness stigma in sport.

While sport continues to be proposed as an arena for positive character development, analysis informed by the work of Erving Goffman demonstrates that the culture of sport provides a context within which athletes experiencing mental health issues may be stigmatized. This, in turn, undermines the potential for them to secure the health care that they need, with participation and performance often taking precedence over well-being, even in the campaigns ostensibly designed to address mental illness stigma.

Pain is demonstrated as a complex, multi-dimensional phenomenon that is interdependent and connected between people. The author proposes that social scientists use a “total model” of pain to better understand pain epistemologically and ontologically and people’s “pain lives.” Through this model, and drawing from the author’s own research on mixed martial artists, new ways to conceptualize, study, and talk about pain within the sporting context have been outlined.

In the first part of this chapter, pain is discussed with respect to how it has been researched and understood within the fields of medicine, sport psychology, and the sociology of sport. In the second part of this chapter, the total pain model developed by Dame Cicely Saunders is explored as a revolutionary development for the ways in which pain is understood and treated within the health field. Lastly, the author proposes a reconstructed methodology for the study of pain.

Pain should be studied not from one tradition, but using an amalgamation of the medical, sport psychology, and sociology of sport traditions and perspectives. In this way, the many dimensions of the phenomenon, social, cultural, political, material/physical, spiritual, existential, emotional, and cognitive must be explored from all systems and languages of pain in order to achieve a more robust understanding of pain in sport.

The dualistic relationship between theory and method currently present in most qualitative research does not fully account for the complexity of bodies in pain. Therefore, it is critical to adopt an interwoven methodological and theoretical approach that enables scholars to relate to, and feel with, people in pain.

To examine the exercise experiences of women with obsessive-compulsive disorder (OCD) in order to highlight the complex relationship between mental illness and physical activity, as it intersects with other identities and social locations (e.g., gender and sexuality) as well as other mental health conditions (e.g., eating disorders and exercise addiction).

Semi-structured interviews were conducted with 14 women who self-identify as having OCD. A thematic analysis was conducted to understand the role of physical activity in the participants’ lives.

The participants experience holistic benefits from being physically active. At the same time, however, their symptoms of OCD and related disorders (e.g., eating disorders) make it challenging to be physically active in meaningful and healthy ways.

Public health messages promoting exercise as a form of therapy must take into account the complex relationship between physical activity and mental illness. Additional research and programing is also needed in order to help women with mental health issues be physically active in safe and enjoyable ways.

To outline the critical role of the sporting context in traumatic experiences, exploring sport as a catalyst to traumatic experiences and as part of the recovery process. In doing this, the chapter also aims to review the qualitative literature on trauma and provide recommendations for future research directions.

The chapter begins by asking two key questions: what silences some stories of trauma in sport and what stories are valued above others? In answering these questions, the qualitative literature is discussed with particular reference to how voice is given to stories of trauma.

Trauma may be silenced by the particular norms and values that exist within sport, creating a culture in which athletes and coaches alike fear to speak out. As a consequence, trauma stories are not voiced but avoided, a strategy that is not conducive to good mental health. The difficulties in coping with trauma may then become ameliorated by the dominance and expectation of stories of growth through adversity.

Creative strategies for allowing athletes to voice stories of trauma are discussed, including the use of visual and written methods.

To examine some of the complex relationships that exist between sports work and mental health and illness.

This chapter draws upon prevalence data, athlete testimonies, and theoretical works to examine: (1) the prevalence of depression and suicide in professional sport and the wider society; (2) athlete experiences of depression and suicidal ideation, particularly among men; and (3) some of the key sociological ideas which might help to explain experiences of mental health and illness in professional sports work.

Although there are plentiful data on the societal prevalence of depression and suicide, increasing interest in the mental health of professional athletes (and other types of sports workers) has occurred largely in response to individual or clusters of often publicly known, sometimes high profile, cases rather than in response to systematic empirical grounded data. Athlete experiences of mental illness are shown to be related in complex ways to various constraints associated with their public and private lives, to the constraints of their interdependency networks, and to experiences of shame which can have a series of deleterious acute and chronic health costs.

Since much of what is currently known about the links between sports work and mental health and illness is derived from largely psychological studies and media-led or autobiographical accounts, more sociological research is needed to better understand the costs of mental health of working in often very public and highly pressurized, medicalized, scientized, and performance-focused performance sport settings.

This chapter describes the disordered eating in sport problem and provides a critical overview of research in the area. It offers specific insights into how cultural practices in elite sport may be implicated.

In contrast to dominant medical perspectives, disordered eating in sport is discussed as a product of high-performance cultural contexts. The ways that practice commonplace in elite sport might contribute to disordered eating onset and maintenance are described. In turn, I also consider the experiential struggles of athletes with eating disorders and how this relates to dominant discourses in elite sport.

Elite sport culture, with its emphasis on surveillance, sacrifice, and success, reinforces disordered eating practices. Much of what is conventionally considered disordered eating, can be normalized when situated in the context of high-performance sport. Nevertheless, when functional disordered eating slides into mental illness, the mental toughness ethos works to silence and stigmatize athletes.

Research must broaden its focus to explore how social practices in elite sport normalize disordered eating and how prevention approaches can become more culturally informed and less individually driven.

To outline the paradoxes and contradictions inherent in debates about sport, alcohol, and addiction. It appears that a growing number of sportspeople suffer from addiction to alcohol and other drugs while at the same time alcohol use is widely sanctioned and celebrated in sport. The high-profile falls from grace are a public display of a more insidious, problematic relationship to drugs and alcohol in sport, yet cultural change is often difficult given long standing associations between sport and alcohol.

In the first part of the chapter, the key themes in the drugs, alcohol, and sport debate (notably health and ethics) are discussed. In the second part, some of the relationships between sport and alcohol, such as sponsorship and the cultural sanctioning of particular forms of drinking and masculine identities are examined. In the third, the issues of drug and alcohol addiction and recovery, and the implications for sport and sporting identities are discussed.

The chapter reveals the tensions that underpin the social contexts of drug and alcohol use and misuse in sport. The chapter suggests that a recalibration of popular understandings of masculinity in sport may provide a safe space through which to share battles with alcohol and addiction.

Discussion of the paradoxes and contradictions inherent in the relationships between sport and alcohol have important implications for a discussion and analysis of addiction and alcohol in sport, and for sport and social policy, health promotion, and social care more broadly.

To outline the experiential nature of hidden mental illnesses (or “invisible disabilities”) in sport and physical cultures. A sociological account is given of how people living with a hidden mental illness or disorder manage their identities in physical culture.

The chapter begins by addressing the role of social stigma as a barrier to sport and exercise participation for young people living with hidden mental illnesses. From there, and venturing beyond typical sociological tropes about social stigma, the chapter presents ethnographic findings from a study of people living with epilepsy and their tactical uses of a range of physical cultures to craft their selves in innovative ways.

People living with so-called simple or nonmajor “hidden/invisible” disabilities are often overlooked as a differential needs population with sport and health zones. The people in this study identify how the desire to be mobile, self-expressive, and authentic through the physical activity pursuits is important yet unavailable to them in a wide range of sport, leisure, and health fields because of the ways in which these places privilege particular types of brain and bodies. Through their own self-styled physical cultural involvements, however, these people challenge the dominance of sport-based model of health promotion in broader culture and disrupt dominant ideological frames that privilege the normative, rational, calculating, and predictable brain in athletic zones.

The importance of identifying persons who may not participate in sport and physical culture due to perceived and felt stigma is highlighted. In addition, developing creative strategies and programs for these populations is underscored.

This chapter outlines the paucity of media research attending to mental health and mental illness in sport. As such, the purpose of this chapter is to encourage critical reflection and further research on the mass mediation of mental illness in sport.

In the first part of the chapter, we review the extensive literature addressing the mass mediation of mental illness and mental health in order to provide key reference points for future scholarship. We then suggest to potential avenues for sociological study of this topic: Talcott Parson’s sick role and Guy Debord’s spectacle.

The authors find that the notion of the sick role provides insight into the assumptions underpinning athlete disclosure of mental illness as well as encouragement of help seeking behavior in relation to mental illness specifically. From a broader perspective on mental health, the authors identify a central challenge of the spectacular presentation of mental health and well-being and the lived experience.

The central limitation of the field currently is the dearth of research. Similarly, in providing a broad overview of key considerations, this chapter does not undertake primary media analysis of mental illness in sport. Nonetheless, the authors outline key considerations and lines of inquiry for the field.

This chapter draws on qualitative data and observations from a range of projects seeking to use football to support mental health recovery. The authors conceptualize recovery as a fluid ongoing process that while supporting individuals to manage and deal with mental illness, may not result in the reduction or remission of clinical symptoms.

The research discussed in the chapter is drawn from interviews with male participants aged 18–40 years, who participated in four different football and mental health projects.

The chapter outlines three key ways in which participants perceived that football contributes positively to their recovery. Participants discuss football as providing a “safe space,” free from stigma, and as a setting where they can develop productive and engaging social relationships with medical professionals, support staff, coaches, and peers. Finally, they perceive football as a context in which they can begin to rework and redefine their identities, to move away from identities constructed around illness and vulnerability.

The chapter concludes by considering both the value and limitations of football as a mechanism for supporting recovery.

In this chapter we share some lessons we have learnt through doing research with – rather than on – people experiencing a range of mental health problems.

Our work has taken place within social, cultural, economic, and political contexts which create several problems or challenges. Through an extended dialogue, we explore how we have critically responded to each of these challenges across three phases of our projects: accessing and witnessing experiences of mental illness; understanding experiences of mental illness; and communicating mental health research.

Our aim is to stimulate creative responses to the question of how to do and disseminate research that is most likely to be helpful to people experiencing mental health problems.