*Note: I am not a mental health professional or doctor. I’m sharing what I have been helpful in my own coaching practices, and what has been helpful for me as an athlete. As always, individual mileage may vary. See a mental health professional if you’re struggling with anxiety!*
Coaches encounter a wide variety of people on a daily basis who all have unique backgrounds, histories, and ideas about what they want exercise to mean to them. For many, exercise is about getting healthy, providing an outlet for emotions and mental struggles, and bettering themselves in a tangible way. Awareness about the positive impact exercise can have on mental health is growing, and as such, more people are turning to the gym and coaches to help them better their lives. As the dialogue around this topic increases, coaches are more likely to work with clients with a variety of considerations, including anxiety.
Anxiety is considered to be a bit of a nebulous term and there are several different types of anxiety that manifest in different ways. For example, some individuals may be more anxious in social or group situations (social anxiety), some may experience anxiety as a result of a traumatic experience (post traumatic stress disorder), and others may have specific things that trigger panic attacks. It is important to remember that anxiety is not something that just happens in isolation. For someone experiencing anxiety, anxiety is like elevator music that is always running in the background - sometimes it is really quiet and almost unnoticeable and other times, the volume gets turned way up and it is all consuming. This is not meant to be an overview of clinical and/or subclinical presentations of anxiety, since there are far better and more qualified resources for that.
Exercising as a person who experiences anxiety can be complicated. For coaches and athletes, learning how to navigate this mental landscape is more than saying “ignore it” or “get over it”. It is a process of learning how you/the client experiences the world with this background music and how exercising can impact this. On one hand, it is greatly beneficial since there is ample evidence to suggest that exercise can greatly help with mental health and anxiety. On the other hand, a lot of people with anxiety are reluctant to exercise because their anxiety can be greatly triggered by it and the spaces and experiences that go along with it. My goal with this article is to provide you, the coach, with salient considerations and tools that you can implement with your clients who experience anxiety. These considerations will be broken down into that relevant physiological, psychological, and environmental topics that can training can have on clients with anxiety and vice versa based on my own experience and research as a coach and an athlete with anxiety.
Increased heart rate, sweating, and that pit of your stomach nervous feelings are all feelings associated with the physical experience of anxiety. They’re also feelings that occur when someone exercises. If you’re coaching someone, or you are someone for whom anxiety has a very physical presentation, the physical experience of training can trigger panic and increase anxiety symptoms. It becomes a feedback loop of where the physiological status change while exercising gets interpreted as anxiety, since that is the most salient reference, which makes the client more anxious. For this reason, it is important to check in with your client often. Ask clients how they feel. Reframe these feelings as a consequence of their activity and provide a space for them to exercise their autonomy over these physical sensations. Provide positive reassurance and also teach them physical tools that can help with recovery during exercise and lessen those sensations.
Tools and solutions:
Adjust training accordingly: Anxiety can be an incredibly exhausting experience which can leave yourself or clients feeling less than stellar while training. If needed, reduce intensity or autoregulate to match what is going on that day. Adjusting training based on the overall accumulation of stressors in a client’s life is also an important consideration. For example, if someone is in college and has finals week coming up, some training adjustments may need to be made to ensure their recovery is optimal and they still get in the work they need to get in. As stress piles up, the need to be smart and strategic with training increases. Having the adjustment conversation with your client before the event(s) occur can be extremely helpful for you as the coach and for setting expectations for the client.
Learn how different types of training impact your/your client’s anxiety: Anecdotally, it seems that higher intensity (i.e. higher percentage) training is more exhausting and has more detrimental impacts in the following days than higher volume (lower percentage) training, but each person is unique. Communicate and elicit feedback.
Physical training environment:
Trauma is an embodied experience and does not exist in isolation. Seemingly unrelated things, to you, may correlate strongly with how a client felt before/during/after a traumatic experience and it is not your job to tell that client how they should feel in that moment. Provide a space for the client to feel their feelings and provide what they need. What they need may vary - it can be continuing the session and joking around, it may be lifting something heavy, or it could be calling it a day. Let your client lead here and listen to them.
Tools and solutions:
Noise sensitivity: If someone is highly sensitive to loud noises or feels triggered by those noises, take this into consideration if they seem distracted, jumpy, or agitated during times when noise is high or they are performing a more noisey exercise (i.e. deadlifts). Provide reassurance or even accommodations if necessary.
Scheduling: If you have a client who expresses hesitation or anxiety related to exercising in front of others, try to schedule them at a time when the facility is mostly empty. This may be something that changes over time, but it is especially important to consider this for brand new trainees who have social anxiety or anxiety about their appearance and proficiency to others.
Exercise selection and preparedness:
It is not uncommon for clients to have anxiety or fear around certain exercises that they have either had difficulty with in the past or that others have told them are harmful. For example, squats seem to be one of the more anxiety inducing lifts due to the nature of having a bar on your back and the potential perceived “scariness” of failure. Similarly, things like box jumps and deadlifts also have a high incidence of fear associated with them due to fear of injury. Rather than telling your client to “get over” or that “it’s not scary”, acknowledge the reality of their fear and use it as an opportunity for education.
Tools and solutions:
Regressions and modifications: As a coach, it is your job to implement modifications and regressions to help the client feel comfortable and proficient in movements that they may be fearful of. Remember, even if the capable is physically capable of executing the standard movement, it may be more beneficial for their buy in and mental health to ease into things in a slow manner. For example, step ups, box squats, and elevated deadlifts can be helpful tools to use with new clients. If you don’t know a regression or modification that would be appropriate for the client - ask and seek more information. There is nothing wrong with saying “I’m not sure what the best course of action is here, let me do some research and consult with some colleagues and we will return to this next week”.
Language and presentation:
The importance of being mindful, thoughtful, and critical of how you speak and present to clients cannot be overstated. Paying attention to the language you use and the way in which you use it can be a major pivot point for client-coach relationships. For clients with anxiety, it can be a huge accomplishment for them to even come into a gym and doing something that makes them uncomfortable, all while being watched and talked to by a stranger. There are several things you can do to help ease this anxiety for your client, and while this is a small sampling, the take away point is give some thought to how you communicate.
Tools and solutions:
Present yourself in a supportive way: Let them know you are not there to “punish” them or make them puke (if you are, then I honestly don’t know why the hell you’re still reading this). Use supportive language and provide reassurance and feedback in a way that is most effective for them. This will differ from client to client, so take your time noting how each client responds to feedback, demonstration, and instruction.
Communicate expectations: Tell clients what your role is and is not, what your expectations are of them, and ask them what their expectations are of you. Having this clarity upfront can ease a lot of anxiety surrounding the logistics of the coaching experience and also gives you, the coach, insight into some key points for that particular client.
Communicate intentions: Talk to clients about the intention of their training sessions, why you’re doing what you’re doing, and what the overarching plan is. This can ease a lot of anxiety surrounding “the plan” and also encourages participation and buy in from the client. Clients are much more likely to continue showing up and being honest when they know that they have an active role in their training.
Encourage feedback and questions: Allow clients to tell you how they feel versus telling them how things “should” feel. This gives you insight into how they verbalize things and also gives them an active role in the coaching relationship. Encouraging autonomy through education and feedback is incredibly empowering for clients, especially those who experience anxiety.
Ask for consent: Always, ALWAYS ask for consent from the client before touching them for a correction. Some individuals may be triggered by touch so asking if you can, and explaining what you are going to do, is critically important. Along these same lines, always ask clients for expressed consent before you post them on social media. Again, you are there to be a member of your client’s support squad - they don’t need to feel additional anxiety by the prospect of being nonconsensually touched or posted on the internet.
All of these considerations boil down to one thing: coaching is a practice of communication. Give a shit about it. As a coach, it is your job to troubleshoot and communicate. If the client is not understanding something, that is your fault. You need to find some different tools to communicate what you’re trying to say to your client. Taking responsibility and putting the onus on yourself is not only doing your job, it is very helpful for clients who are nervous about doing everything “right” or who are preoccupied with pleasing you. Fostering an environment of open communication that encourages questions and disclosure will do more for your coaching-client relationship than almost anything else. As coaches, we know how beneficial training can be for our clients, especially those with anxiety. It’s our job to ensure that we do everything possible to make training a positive experience for them that adds to their life.