Mental Health Awareness Week: Retirement – Game Over?

Posted by on May 15, 2017 in Mental Health Awareness | No Comments
Mental Health Awareness Week: Retirement – Game Over?
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As part of my piece on mental health and elite football posted on this site on Tuesday, I outlined some of the key stressors characteristic of the tough, intensely pressurised and volatile world of the professional game. However, my analysis largely skirted around arguably the most significant stressor – though it did so deliberately, with this post (and Rob’s review of Alan Gernon’s Retired) in mind. My intention today is to afford the subject of retirement the explicit and serious consideration it deserves.

Over the course of this article, I’ll examine why retiring proves to be such a challenge for so many players, explore the impacts and consequences that it can have on individuals’ mental health, assess the provisions and support currently available to former players, and suggest what more can be done.

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Among psychologists and academics, retirement is often referred to as a “transition”; it is, however, only one of many different transitionary periods in an individual’s life. As Mark Nesti, Martin Littlewood, Lisa O’Halloran, Martin Eubank and David Richardson note in a 2012 paper, research into transitions within football does tend to focus primarily on retirement, but players actually experience transitions almost continually – from winning their first senior contract, to suffering an injury that means a long spell on the sidelines, to being dropped to the bench after a run of below-par performances.

Nesti and his colleagues quite reasonably take issue with the term “transition” on the grounds that it “could easily be interpreted as signifying something that is rather smooth, steady and relatively easy to negotiate”; their preference is for “critical moments”, a “more useful and dramatic phrase” that comes much closer to encapsulating the stress and trauma usually involved. In a different paper, co-authored with Noora Ronkainen, Nesti uses another alternative formulation, “boundary situations”, borrowed from Karl Jaspers’ book Way to Wisdom, but the phenomenon in question is the same. These situations can be either associated with one’s job or completely non-work related; in this regard, it’s worth recalling academic Dan Parnell’s point in my previous piece that, quite apart from all of the stresses of their profession and “workplace”, players are also subject to the same day-to-day stressors (for instance, relationship breakdown and money worries) as the rest of us, and that these can also trigger mental health problems.

Nevertheless, regardless of whether it is best described as a transition, a critical moment or a boundary situation, retirement is arguably the most significant such moment in an athlete’s life – a fact reflected in the mental health statistics. A 2013 survey of more than 1,200 retired sportsmen and women, including footballers, conducted by the Professional Players Federation revealed that almost 20 per cent had suffered depression, anxiety, stress or low self-esteem in the two years after the end of their careers, while 32 per cent reported that they “did not feel in control” of their own lives. Focusing exclusively on footballers, a pilot research project led by Vincent Gouttebarge, Chief Medical Officer of the World Players’ Union (FIFPro), found that 39 per cent of the retirees who responded had experienced anxiety/depression and 42 per cent reported adverse nutrition behaviour; the comparable figures for respondents still playing the game were 26 per cent for both conditions.

In some cases, admittedly, retirement exacerbates pre-existing issues rather than precipitating new ones. When former Burnley defender (and chairman of the PFA from 2010 to 2013) Clarke Carlisle, for instance, attempted to take his own life by walking in front of a lorry in December 2014, he did so while in the midst of a depressive episode that was at least partially brought on by the end of his career. However, he had previously revealed a long private battle with the illness and indeed had made a prior attempt to kill himself, as a 21-year-old professional at QPR devastated at a long-term injury and its potential consequences. Similarly, when Dean Windass was consumed by depression after retirement and brought to the brink of suicide, he was not battling an unfamiliar foe but an old enemy that he had just about kept in check during his playing career.

However, the fact remains that retirement appears to have a harmful impact on a vast number of players, whether they have a prior history of mental health problems or not. As such, it more than merits its status as a critical moment, a significant stressor and (in the words of Mind’s 2014 report Performance Matters) a “mental health pressure point”.

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This, of course, begs an obvious question: retiring is a fact of life for all of us, so why does it seem to have such a damaging effect on footballers in particular?

There are, I would suggest, six prime reasons for this.

First, the idea that a player “hangs up his boots” is, in most cases, a myth. That clichéd phrase implies that retirement from the professional game is something that is actively and consciously chosen by footballers, rather than something all too often imposed upon them. Only a small proportion of players are able to retire entirely on their own terms, and at a time of their choosing; for many, an opponent’s malicious or clumsily mistimed tackle or an accidental collision suddenly cuts short their career. The decision is also taken out of the hands of those whose contracts are not renewed, or who are cast out of academies each summer. It is, I think, understandable that players can find both their lack of agency with regard to a life change of this magnitude and its abruptness to be traumatising. Furthermore, the fact that a career-ending injury can be sustained at any time ensures that retirement can be a psychological stressor for players of any age, not only those moving into the natural twilight of their careers (which, of course, occurs by their mid to late thirties, not their mid sixties).

Second, footballers effectively become institutionalised at their specific clubs, and within the world of the professional game more widely. Over the years, they grow accustomed to adhering to a rigid routine, to observing a strict code of conduct and to being micromanaged (told what to do, wear, eat, etc) on a daily basis. Some players, like Blackburn’s record goalscorer Simon Garner, find this structure imprisoning and a stressor in itself; retirement, then, comes as a blessed release: “Having more freedom was very welcome. When you’re playing football, you can’t do anything for the eight months of a season.” For many more, however, the loss of structure is not liberating but deeply troubling. Such was the experience of Steve Harper, Newcastle’s longest-serving player: “To go from the regimental routine of football, to having nothing to do with your days … It’s like being in the military without the risk to your life. The structure, everything is provided and done for you. To come out of that, overnight, it’s horrible.” After retirement, the scaffolding supporting footballers’ lives falls away and they are left to fend for themselves, burdened with a weight of personal responsibility that they have never had to shoulder before. As ex-Middlesbrough and Blackburn winger Stuart Ripley has put it, “Football’s not real life … [After retirement the] rhythm of your life changes completely.” Little wonder, then, that many recent retirees report not feeling in control of their own lives and that retirement can induce culture shock and, potentially, mental health issues.

Third, as implied above, a career within the surreal bubble that is the world of professional football is hardly ideal preparation for the realities of life outside it. Steve Mellalieu, Professor in Sport Psychology and the Associate Dean for Research for the Cardiff School of Sport, notes that the nature of elite sport – specifically the intensive focus on training and performance and the eternal demand for complete commitment – means that players have little opportunity to contemplate what might lie beyond; Garner has confessed, “I never thought about what I’d do after playing. I’d not trained for anything.” Having been within the football system since childhood, professional players know nothing else, and many lack the qualifications and indeed the basic life skills to find new employment. Footballer-turned-academic Seamus Kelly considers himself “blessed” to have had “a degree in my back pocket”, while former Arsenal midfielder David Hillier has recounted the difficulties he encountered in becoming a fireman: “I failed the interview three times. I’d had no experience of interviews; I’d been a footballer who’d been looked after all his life. You don’t understand what’s required to get a job.” Even if a retired player is able to establish a post-football career, Mellalieu points out, the experience can still be fraught with anxiety; after all, in such a case, he has made the leap from a world in which he is comfortable and demonstrably talented to one which is unfamiliar and in which he must prove himself.

Fourth, retirement – especially when sudden and enforced – results in a loss of earnings that is significant regardless of the exact size of the player’s pay packet. Lower-league professionals who earn modest amounts have little opportunity to build up a financial cushion over the course of their career to protect themselves in retirement, while those on high salaries face the sharpest drop-off, and therefore often need to accept a correspondingly dramatic adjustment to their lifestyle. Upon learning that his career was over, former Norwich and Leicester striker Darren Eadie’s first thoughts were that “money would be an issue and I’d have to sell everything to get by. It was unrealistic to be driving around in a Porsche any more.” If the necessary adjustment is not made, the outcome is often bankruptcy (a fate suffered by the likes of ex-Villa pair David James and Lee Hendrie) – but even if it is made, it can be potentially problematic in psychological terms if a player has too much of his self-worth invested in the status symbols with which he’s surrounded himself.

Fifth, footballers regularly describe getting an enormous “buzz” out of playing the game, which poses a problem when their careers end. Stuart Ripley has commented: “When you’re playing, you’ve got two potentially very big highs within a week – you play on a Tuesday or Wednesday and then at the weekend. That’s a huge adrenaline rush. When you retire, that’s very difficult to replace. You’ve got to find another goal in life.” For Ripley, that goal was becoming a qualified solicitor; for David Hillier, it was firefighting, which provides him with “an adrenaline buzz” not dissimilar to football. However, some who continue to crave that rush or buzz after retirement end up indulging in addictive thrill-seeking behaviours that are ultimately ruinous to both physical and mental health, not to mention their bank balances. For instance, Kerry Dixon, who is third on Chelsea’s all-time goalscorer list and has experienced divorce, bankruptcy and jail since retiring, sought to fill the void with drugs and particularly gambling: “I believe it’s in my DNA. It is something in me, I would argue, that maybe made me the footballer I was. It was the drive, the will to win, the need to score goals. When I gamble, it’s wanting to win because of the buzz I get from it.”

Sixth, and arguably most significantly, while in some cases retirement can allow former players to truly be themselves (think, for instance, of Thomas Hitzlsperger only feeling able to reveal his sexuality once his career was over), more often it does the precise opposite: it precipitates a fundamental crisis of identity. In a recent Guardian interview, Coventry’s FA Cup-winning captain Brian Kilcline stated that he refuses to be defined by his profession: “the footballer is not who I am. It’s something I did.” Such an attitude, while very healthy, is unusual because – for reasons mentioned above – players often know nothing other than the inside of the football bubble and have few interests or educational qualifications outside it, and so define themselves almost exclusively with reference to their job. Furthermore, while some players find that the scrutiny that goes with performing at the elite level induces anxiety, others actually thrive on the attention that their status brings and/or use it to prop up their self-esteem.

It is obvious, then, why retirement can have profound and devastating consequences for players’ mental health. For many, it removes the cornerstone of their identity (something explored in a forthcoming paper by Conor Curran and Seamus Kelly). Additionally, for those with a fragile sense of self-worth, Gouttebarge and colleagues observe, the fact that “public and media interest generally stops … may be an additional psychosocial stressor”. Ex-Derby and Leeds midfielder Seth Johnson has spoken of his own problems in making the transition, which appears to have left him directionless and without a purpose or prospects: “Early on, I really struggled with [not being a footballer] because to go from something you’d done all your life pretty much every day to suddenly not doing that was difficult. Even now, I want to do something, but I still don’t know what.” Clarke Carlisle found it equally difficult to adjust to life after football, and felt the loss of identity particularly keenly: “I missed a sense of belonging, a sense of worth and value in life. You see someone in the street and they’d say ‘Didn’t you used to be Clarke Carlisle?’ I laughed the first few off but after a while it eats at your core.” Thus began a downward spiral into depression that culminated in attempted suicide.

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To whom, then, can retired players suffering from common mental disorders (CMDs) turn?

Gouttebarge and colleagues have argued that mental illness is especially problematic for retirees: not only does retirement appear to provoke psychological trauma, it simultaneously deprives former players of structure and many sources of provision and support. With no need to report to the training ground every morning and less day-to-day contact with people (including mental health professionals), the recently retired can easily retreat into social isolation or drift into self-harming addictions.

You would expect (or at least hope) that retired players might be helped through tough times by the clubs they served, often with distinction and loyalty over a number of years. That has been the experience of Mark Ward, for whom retirement brought financial ruin and ultimately a prison sentence: “There aren’t many people in this world who give you a second chance, especially in football, but West Ham have welcomed me with open arms. I work there in an ambassador role a few times in a season.” Similar roles have been offered by Chelsea to Kerry Dixon and by Crystal Palace to Kenny Sansom, the left back capped 86 times by England whose descent into alcoholism and gambling addiction led to divorce and homelessness. So far, so heartwarming. However, the cynic would point out that in each of these cases the ex-footballers apparently had to hit rock bottom in a very public way before the clubs became involved in their rehabilitation – perhaps sensing a good PR opportunity.

One of the key recommendations of Mind’s Performance Matters report concerned the moral obligations of clubs: “Individual clubs have a responsibility as employers to proactively support the mental health and wellbeing of players and support staff, mitigating the impact of the changeable and uncertain characteristics of this unique working environment.” Yet, as Clarke Carlisle has emphasised, the absence of a formal legislative framework means that clubs can merely pay lip service to the commitment and easily shirk the actual responsibility. Furthermore, given that they fail to display much concern for the mental health of current players – not even self-interested concern in the well-being of valuable assets – then it’s no surprise that they exhibit even less consideration for those no longer in their employ. Seamus Kelly is scathing on this point: “Clubs have a duty of care, yet discard players once their value, in terms of contribution to results, diminishes. Clubs have no problem discarding young players when sacked or deselected from academies. Few clubs provide post-career training or advice. … Few clubs really care.”

Carlisle has expressed bafflement at this state of affairs, noting that instead “the onus rests with the union”. However, such a situation might actually be for the best. In the conclusion of their paper, Gouttebarge and colleagues recommend the provision of support and interventions primarily through unions because players “remain affiliated to their union after retirement” in a way that they often do not to their former clubs. For many, the PFA have proven to be a vital lifeline: Kenny Sansom, for instance, has said that the union “have helped immensely”, and Kerry Dixon has benefited from counselling sessions they have arranged for him. Gary Speed’s death in 2011 prompted the union to extend the circulation of copies of The Footballers’ Guidebook – a publication designed to raise awareness of mental health issues, outline the symptoms of CMDs and signpost sources of help – to include former players as well as those still lacing up their boots. Bobby Barnes, the PFA’s deputy chief executive, has claimed that significant strides have been made, not least in the recognition that supporting players through retirement should start long before they stop playing: “Footballers were very ill-prepared. There is a lot of work now being done, particularly in terms of our education programmes, to try to ensure that transition from being a player, to being able to carry on with the rest of your life and do something meaningful.”

The PFA are not, however, beyond reproach. In a candid interview with The Daily Telegraph in February last year, Steve Harper opened up about both his own mental health issues and his frustrations with the organisation explicitly set up to meet players’ needs: “I was at a dinner recently and the PFA had a table there. As a former PFA representative, I tore into them. I said: ‘You do a lot of fantastic work for players when they are playing, but too many people of my age, a year or two older, are either getting divorced, going bankrupt or struggle with depression’.” Whether or not this criticism was fair and justified, it did not deserve the rather scornful and dismissive response it initially received from Pat Lally, the PFA’s director of education, who belittled Harper as “probably a bit emotional”. The apparent absence of sympathy and understanding shown by a PFA representative to someone suffering from depression recalls the experiences of Leon McKenzie and Darren Eadie, as reported in Tuesday’s piece. Meanwhile, the lack of support given to Nobby Stiles – the former Manchester United and England midfielder who has been struck down by Alzheimer’s and vascular dementia – is a damning indictment of the PFA as well as of the club to which he gave the vast majority of his career.

While the PFA perhaps primarily exist to represent the interests of current professionals, there are other organisations specifically dedicated to supporting those whose playing careers are over. XPRO, for instance, offer support and guidance on a range of issues that commonly affect retirees, including employability, relationship and financial difficulties, and physical and mental health. Membership is open to anyone who has ever held a playing contract.

However isolated players might feel, then, there are sources of support out there. Much as with similar organisations within the world of music, though, the key is in ensuring that they are both sufficiently prominent/visible (which requires concerted efforts to publicise and raise awareness) and sufficiently well funded to be able to help all of those in need of their services (which demands substantial investment from within the game).

Ultimately, however, arguably the most effective support network is that created by family and friends. As Steve Mellalieu notes, having such a structure to call upon (and fall back on) is of enormous value when it comes to negotiating a tricky transition phase such as retirement.

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Given the profound and detrimental impact that retiring can evidently have on the mental health and well-being of professionals, it seems abundantly clear that significant effort should be made to ensure that they are adequately prepared for life after football. The critical word here is “prepared”. Only offering support to a player after he has already retired is too late; advice and guidance are needed well in advance of retirement, to enable him to make the psychological adjustments necessary for a relatively smooth transition. Indeed, returning to a point made earlier in this piece, retirement from football can be suddenly enforced at any time, so it makes good sense to start the preparatory work at a young age.

But what form should this work take? As I argued in Tuesday’s article, identifying and developing effective solutions and best practices with regard to anything is dependent upon detailed knowledge of the problem at hand. Only through rigorous academic research – something to which football has been stubbornly resistant historically – can this knowledge, and therefore the validity of the strategies that spring from it, be firmly established.

Nevertheless, we already know enough about the difficulties that retirement can cause to make some tentative proposals. These broadly divide into practical suggestions and psychological approaches.

Principally, players should be equipped with the necessary tools to be able to survive and indeed thrive after leaving the professional game. For youngsters, this includes a scholarly education and/or vocational training alongside their footballing apprenticeship. Conor Curran and Seamus Kelly mention claims that such educational programmes appear to be increasingly common, though those claims are yet to be substantiated.

Meanwhile, Steve Mellalieu argues that clubs should emphasise the importance of skill sets within academies and appoint player development managers who can work closely with individuals to ensure that they have other skills and interests outside football. With regard to employability, he talks about instilling players with confidence so that they can go on to achieve success in an unfamiliar environment beyond the football bubble. In part, this might be through formally teaching new skills, such as interview techniques (something that David Hillier would have found helpful); but it might also involve convincing players of skills such as leadership or communication that they already possess but that have been learned “on the job” rather than formalised in an official qualification.

Both the enormity of Premier League salaries and the frequently catastrophic impact of retirement on a player’s finances – as exemplified by the likes of David James, Mark Ward and Kerry Dixon – mean that sound independent financial advice is also essential. John Blavo, an FA-registered lawyer, has outlined three strategies for avoiding bankruptcy; such lessons could be taught to young players in the hope that they might show prudence and give some thought for the future.

Turning to consider the more psychology-focused strategies, Mellalieu flags up the need to ensure that players do not define themselves too rigidly in relation to their status as professional footballers because, as we have seen, this can make retirement particularly challenging. The key, he says, lies in getting players to acknowledge that their identity is actually multi-faceted or that they have other identities. In other words, a footballer should be made to realise that he is not simply a footballer; he is also (potentially) a husband, a son, a father, and so on, and that those different identities/roles also give his life meaning.

This is where the “existentialist” or “phenomenological” approach to sports psychology endorsed by Mark Nesti comes into its own. Retirement truly is both a critical moment (defined as one when “we must confront the anxiety associated with an important change in our identity”) and a boundary situation (defined as one in which “there are profound and personally significant changes to self”). In this view, identity is never fixed (no matter how we perceive it), but rather permanently in flux, challenged and reshaped in each critical moment. Retirement and the psychological trauma that it can provoke exemplifies the existentialist view “that it requires courage to construct or accept a new identity for ourselves … since it involves movement from a secure and known place to something yet to unfold”.

However, a vital tenet of the existentialist/phenomenological position is that this process, painful though it may be, is ultimately a positive one – an opportunity for self-development and self-discovery, “for personal growth and developing a more authentic self”. If this mindset could be instilled in players confronted with retirement, and if they could be convinced that retiring is merely another surmountable transition or critical moment that is little different to any other, then perhaps the stressfulness and anxiety surrounding this phase of life could be dramatically reduced.

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While Tuesday’s piece necessarily ended on a gloomy note, then I think cautious optimism is possible here. While many players struggle to come to terms with retirement, at least initially, most do eventually adjust to “normal” life. The experience can be scarring, but the likes of former Man City midfielder Jeff Whitley, whose career was curtailed by alcoholism, appear to be happy to bear those scars for the benefit of others: “I’d like to give something back, to give a little hope and strength to somebody else. I’ve done work with Sporting Chance, going to football clubs, educating younger players. Not necessarily about drink or drugs – it could be about anything: peer pressure, girlfriends, family, gambling. Things like this are hushed up in football clubs.”

The bleak conclusion to my other article was that it is hard to see how good mental health could possibly be compatible with participation in professional football or in elite sport in general, with all its competitiveness, intensity and volatility. The situation for retired players is markedly different. As we have seen, many regard the sudden absence of structure to be a significant stressor, and it can certainly lead to serious problems – but it is the very fact that they are no longer constricted within a world inimical to sound mental health that means that, with the right preparation and support, they can potentially make a full recovery.

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Thanks to Steve Mellalieu, Seamus Kelly, Mark Nesti and Simon Whitmore for their help and contributions to this article.

Ben
Ben is a long-suffering Newcastle Utd supporter (is there any other kind?) who co-founded and co-wrote Black & White & Read All Over, a blog that, over the course of a decade, chronicled the ups, downs, chaos and calamity of the club he has the misfortune to follow. Since the blog hung up its boots in May 2014 (note: not as a mark of respect for Shola Ameobi leaving St James’ Park), he has contented himself with sporadic, splenetic Twitter outbursts and shamefully rare contributions to The Two Unfortunates. He is currently haunted by visions of Joe Kinnear returning to the club for a third spell and pondering whether he’ll live to see another victory over the Mackems, but at least has a cardboard coathanger with Robert Lee’s head on it for consolation.

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