The Effectiveness of Ego State Therapy in the Reduction of Athletes’ Stress Levels

Athletes are required to always perform optimally.1 Optimal performance is achievable through physical readiness, technique, tactics, and psyche. This situation can also lead to increased stress, as a poor performance on the field is assumed to affect the individuals’ mental state.2,3 This is the body’s reaction when faced with a threat, placed under pressure, or subjected to a change. This reaction is accompanied by physiological, emotional, cognitive, and behavioral responses to these activities.4 According to Feldman, stress is an evaluation process to threats, which challenges an athlete’s perception of power.5,6 This originates from both internal and external sources, including the characteristic physiology, time, and social and academic demands.7,8 Hence, the stress experience affects performance during training and competition. Adler reported on the ability of stress to influence the immune system, thereby increasing an individual’s vulnerability to chronic diseases, which leads to a consequent reduction in performance.9,10

Stress is the overall condition of the emotions and thoughts of a person.11,12 The symptoms of stress are identified by examining the physical, psychological, social, and interpersonal changes to the body that affect the overall health (eg, joints).13,14 In addition, stress leads to other health problems, such as obesity, due to an increase in appetite, thereby, leading to irregular eating habits.9,15,16

Stressful conditions occur due to pressure, demands, being overburdened, or due to restrictions on the mental capacity of a person. According to Lamotte, stress appears when individuals experience violence.17 Last, environmental factors also lead to the emergence of symptoms of stress such as workplace noise, an unfavorable atmosphere around the house, difficult academic situations, and the pressure that arises from a broken home.18,19 Therefore, it is necessary to administer treatments to decrease the stress levels of athletes with assistance from therapists. This research, therefore, used ego state therapy to reduce the stress levels of athletes.

Ego state therapy is short, extraordinary, and focuses on the premise of the personality being comprised of separate parts.16,20 It is also considered to be a psychodynamic approach with groups and family therapy utilized to resolve conflicts between the various “ego states” within a single individual.5,21 Ego state therapy uses individual, family, and group therapy approaches to access and deal with this state to release and overcome the occurrence of conflicts.3,22 This is also part of a group with equivalent emotions, differentiated on the basis of specific tasks, moods, and mental functions.9,23,24 The aim, therefore, is to locate the pain, stress, anger, or frustration, in order to facilitate the expression, release, comfort, empowerment, functional communication, and understanding of possible benefits.25–27

Ego state also increases one’s understanding of personality and provides an avenue for rapid and lasting change. It allows therapists and clients to have a clearer view of their personalities and discover from where most psychological problems originate.28,29 It also demystifies the “unknown subconscious,” thereby making it more accessible in the context of therapy. Ego state provides a process capable of connecting a problematic symptom to the causal stimulus, without guesses or misinterpretations from the therapist or client. This connection thereby facilitates empowerment, and prevents unwanted symptoms from unresolved states.4,30,31 An understanding of their ego state allows clients to possess a richer life experience, with the ability to be assertive, fragile, angry, logical, and caring at preferred times. Internal turmoil eventually leads to cooperation and the respectful acceptance of various roles. These 2 features improve physical health and overall internal communication. Some of the benefits of the ego state therapy is improved psychological and physical health.15,32

This research utilized the resistance and bridging deepening technique to access the negative physiological emotions of athletes.33 This provides easy ways to access the ego state that needs resolution.20,22 Resistance Bridge is a hypnosis technique for the promotion of movement, especially after performing deepening resistance on the surface to address the main problem. This approach is used to better ascertain the principal challenge19,34 through the application of memory psychology,where each datum or experience with a certain emotional charge is resurfaced by washing the emotion.3,23,30 However, there is some ambiguity as to whether ego state therapy is effective in reducing athletes’ stress levels.35

METHODS

This investigation used a single-subject research method, and 6 athletes with very severe stress levels were selected on the basis of an assessment result. The design adopted was an ABA [Baseline (A1)—Intervention (B1)—Baseline (A2)]36 approach, where the first step involved the acquisition of data related to target behavior at the first baseline state (A1), using the Mini Stress Scale (MSS) adaptation from the Depression Anxiety Stress Scales and an observation sheet.28 In addition, the MSS categorized athletes according to 5 levels that include the following (and they are): normal (0 to 7); low (8 to 9); medium (10 to 13); high (14 to 17); and very high (17 to 20). An intervention (B1) was provided after data stabilization.25 Therefore, the collection of information under the intervention state was performed continuously up to the point where a trend and clear levels were reached. This was followed by a repeat of each baseline state (A2) on the same subject.29 Wilcoxon signed-rank tests and visual evaluations were used for data analysis and interpretation.

RESULT AND DISCUSSION

The stress levels were measured 3 times at the baseline phase (A1), 2 times at the intervention phase (B1), and 4 times at the subsequent baseline phase (A2). The tendency of direction showed that the baseline phase (A1) had a median value of 12 at the beginning of observation with an increase in baseline observation (A1) and a decrease in the intervention phase (B1). With the median value of 10 to 7 at the baseline phase (A1), the trend showed a steady decline to 5. Furthermore, the stress level at the end of the baseline was 12, and gradually decreased to 5 at the second baseline (A2). Therefore, an increase in interventions leads to lower target behavior.

Data were collected through observation, and the MSS was used to measure their overall stress level. A total of 6 athletes with an extremely severe stress were analyzed using the ego state therapy treatment. However, after treatment, the athletes showed an anemic-lowering level. Furthermore, the Wilcoxon signed-ranks test was used to obtain data before and after the treatment and the level of stress in an athlete. On the basis of the pretest and posttest MSS, the results at different levels of athlete stress also supported previous evaluations. These assessments provide a Z value of −1789, P=0.03. Hence, H0 was rejected. In addition, a significant difference was observed in terms of the client’s stress level between the pretest and the posttest, suggesting that the stress-reduction capacity of ego state therapy is significant.

The baseline state (A1) in the last and first session of measurement (12) under the intervention state (B) (10) was used to obtain the difference between the baseline and the preliminary treatment. These changes tend to reduce the target behavior, with an improved meaning (+) or effectiveness, capable of lowering stress level. Conversely, the results of graphical analysis further ascertained the efficiency of ego state therapy.

The findings showed that the 6 respondents experienced decreased levels of stress after treatment due to an imbalance between the situations that tend to meet their various needs.12,31 The high demands of coaches and team members continuously increase the stress in athletes attributable to the feeling of tiredness, pessimism, a lack of enthusiasm, and low fighting power.23 The stress in athletes arises due to their inability to deal with demands related to competition, which also proves to be a significant factor in the stress that they report.37 Ego state therapy is a psychodynamic approach where a group and family are utilized to resolve conflicts between various intrinsic states of an individual.20,26 This is a relatively quick technique, based on the premise that an individual’s personality is consisted of separate parts.27,38 Furthermore, individual, family, and group therapy approaches are used to access and deal with the ego state of athletes.10,26 The goal of this process is to first locate the pain, stress, anger, and frustration of an athlete. Thereafter, the goal is to subsequently facilitate the expression, release, comfort, and empowerment of an athlete and client. Conversely, resistance is used to deepen the technique and resistance bridges, resulting from the ability to accommodate the direct access of negative emotions and accompanying physiological sensations.37,39

CONCLUSIONS

Ego state therapy is an effective method of reducing stress in athletes, based on the significant differences we observed here after an ego state therapy treatment. Before therapy, stress levels were classified in the very heavy category, which was then reduced to the more simple and light stress categories, providing additional evidence for the therapy’s effectiveness for athletes.

ACKNOWLEDGMENTS

The authors are very grateful to the therapists and the cotherapists working at the Indonesian Institute for Counseling, Education, and Therapy for their performance and implementing the treatment to aid in the completion of this paper. This paper can be useful for future psychotherapist services. This approach is, therefore, recommended to be applied in counseling and psychotherapy.

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