It is World Cup season, so we are doing a two part series on performing under pressure. Part I is the science: what actually happens in your brain and body the second the stakes spike. We meet your amygdala (the alarm) and your prefrontal cortex (your working memory and calm decision maker), and we find out why pressure can dim the exact system you need most. We break down what choking really is, why it hits the most talented people hardest, and why women's stress wiring, thanks to oxytocin and estrogen, can play out differently. Part II is the toolkit for training through it.

Hosted by Dr. Kelsy Vick, a board certified orthopedic Dr. of PT and women's health PT. Expert led, science backed wellness girl chats for women in their 20s and 30s.

Smart Girl Newspaper, her weekly newsletter and growing media universe, is linked below.

82:: The science of female friendships: https://wellness-big-sis-the-pod.captivate.fm/episode/pod-82/

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RESOURCES:

Stress can sharply reduce prefrontal cortex function and working memory. Supports the "up to 50 percent" blanking claim and the amygdala versus prefrontal cortex framing. The strongest citation is Arnsten's review rather than a single "50 percent" stat, so frame it as stress dramatically weakening the prefrontal cortex rather than a hard number if you want to be safe. Arnsten, A. F. T. (2009). Stress signalling pathways that impair prefrontal cortex structure and function. Nature Reviews Neuroscience. https://pmc.ncbi.nlm.nih.gov/articles/PMC2907136/

Choking is a working memory glitch, and high working memory people choke hardest. Supports Segment 2. Beilock, S. L., and Carr, T. H. (2005). When high powered people fail: Working memory and choking under pressure in math. Psychological Science. https://journals.sagepub.com/doi/10.1111/j.0956-7976.2005.00789.x

Related follow up on pressure reducing working memory and fluid intelligence: Beilock, S. L., and DeCaro, M. S. (2007). Choking under pressure and working memory capacity. Psychonomic Bulletin and Review. https://pubmed.ncbi.nlm.nih.gov/17484426/

Women's stress response can lean toward tend and befriend, driven by oxytocin and estrogen. Supports Segment 3. Taylor, S. E., et al. (2000). Biobehavioral responses to stress in females: Tend and befriend, not fight or flight. Psychological Review. https://taylorlab.psych.ucla.edu/wp-content/uploads/sites/5/2014/10/2000_Biobehavioral-responses-to-stress-in-females_tend-and-befriend.pdf

Welcome to Wellness Fixes the

Pod, a by Maven Media production,

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where we believe you deserve real

education from real experts delivered

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in a way you can actually use.

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I'm Dr.

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Kelsey Vick, your board certified

orthopedic doctor of physical therapy, and

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this podcast was built for the girl who

is done feeling overwhelmed and frustrated

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by conflicting health noise and is ready

for something she can actually trust.

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Every week we have honest science-backed

conversations about your health,

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your hormones, your brain, your

body, and everything in between.

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No fluff, no fear-mongering,

just the truth.

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Because understanding your

body is the most powerful

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thing you can do for yourself.

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A table full of experts built for

the curious girl who wants the truth.

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So welcome.

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Your seat is waiting for you.

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Picture this the 90th minute penalty

shot with 60,000 people watching you

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holding their breath, watching

a player who has taken this

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shot in practice a million times

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But suddenly that player can't

feel his legs It's not that the

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athlete has forgotten how to play

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His brain just pulled the plug

on the exact system he needed

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in this high-pressure moment

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Today we find out why.

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We sprinkle in a little bit of

the World Cup and performing under

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pressure, but this also applies to

pressure in our day-to-day lives.

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Welcome back to Wellness Big Sis the Pod.

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I'm your host, Dr.

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Kelsey Vick, a board-certified

orthopedic doctor of physical therapy.

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and I often find inspiration for these

podcast episodes based on current events.

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And with the World Cup going on, And

actually the game last night that I

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watched got decided in penalty kicks.

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So this performance under pressure

episode that I had planned is coming at

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the perfect time, and I was wondering

how our brains, our bodies handle that

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pressure and why in some moments we

tend to thrive, and in some moments we

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might choke up a little bit, even if

it's something that we have practiced

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thousands and thousands of times.

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You might feel this in a sport, or you

might remember feeling this in a sport,

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or you might even feel it before heading

into a major talk or public speaking

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So today we're gonna chat about the

science behind performing under pressure

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and next week we'll go over some of

the ways and science-backed ways that

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we can utilize within our brains and

bodies to help us better perform under

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pressure and override some of the systems

at play that might cause us to choke.

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So let's understand what actually

happens in our brains when we

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sense a high pressure environment

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So we have two main characters,

the amygdala, which is our

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threat detection center.

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We've talked about the amygdala before,

and then we also have the prefrontal

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cortex, which is in charge of those

higher level decision-making skills

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It's that planner, it's

where decisions are made.

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It's also where our

working memory is stored.

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So the memory of how you used to perform

a task is stored in the prefrontal

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cortex It's the mental note-taking

document or notes app that we use to

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write a plan and then figure out how

to execute it So in a high-stakes

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environment under pressure, our amygdala

starts to sense that as a threat

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It reads high stakes as danger and pulls

the fire alarm, sounds the alarm system

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which floods our system

with these stress hormones

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It's not that the amygdala is evil.

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She's doing what she's meant to do.

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She thinks she's saving your life

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But she just can't tell the difference

between a bear running towards you and a

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penalty kick or a public speaking event

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So when the amygdala sounds the alarms,

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The function of the prefrontal

cortex can drop dramatically.

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So our ability to plan and execute

our working memory, , that system

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in the brain starts to drop once

the amygdala sounds the fire alarm

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So your planning and working memory goes

a little quieter during the times you need

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it the most a study done out of Stanford

found that Stress hormones can cut

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prefrontal cortex activity By up to 50%.

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so this is where an athlete or your

friend might say, "I don't know,

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I completely blanked up there."

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They're not entirely wrong

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So when it comes to the group chat

and maybe what we think of as the mean

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girl in the group chat, the amygdala

is just freaking out a little bit.

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It's sending signals that we are under

attack in some way, even if it is just a

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penalty kick or a public speaking event.

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The prefrontal cortex is the girl who

always tends to back her up off of a

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ledge and start to calm her down although

tonight, the prefrontal cortex left

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her phone in the other room, and so the

amygdala is just going off in our group

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chat, sending the alarms in all caps

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I know we've all been in

this situation before.

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It's just fun to tie it back into

the World Cup and see this play

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out in real time with someone else.

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It's not as fun when we experience

it ourselves, but something we can

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do is we can name it to tame it

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So when you notice that pressure spike,

if you feel it physiologically with a

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increase in your heart rate, name it

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say, "That is my amygdala,

not an actual emergency.

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She's typing in all caps to the group

chat, and the prefrontal cortex might

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have left her phone in the other

room, but it's my job now to step

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in and calm her down a little bit."

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Naming the response switches it from the

alarm system to more of the thinking brain

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And takes a little power back from

that alarm It is the first and maybe

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simplest lever to pull, And we'll

build on it a little bit more in

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part two that we'll do next week

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So now that we understand a little

bit of what's happening in our brain,

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we can now understand why choking

is not necessarily a weakness,

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but it's a working memory glitch

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So for simplicity's sake, let's define

choking as performing worse than

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your skill level specifically related

to that high-pressure environment

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It's not that you weren't ever good

or you didn't have the skill set

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It's that pressure causing the

amygdala to freak out which causes

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a quieting of the system that you

rely on during these situations

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Your working memory

gets flooded with worry

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So there's not as much mental bandwidth

left for the task to remember how you

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used to perform it, to rely on that

muscle memory, even if it is a kick that

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you've taken thousands of times, a speech

that you've practiced multiple times

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You also start overthinking

because of that pressure

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You start consciously monitoring a

skill that typically runs on autopilot

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The counterintuitive part is that

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The people who choke the hardest

are often the most talented

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High stakes has a way of

hitting the high performers

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Research on choking and working

memory found that pressure

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reduces performance the most on

tasks with higher working memory

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demand And that it is often

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the high working memory

individuals who choke the most

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Because pressure starts to consume

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the very strength of what they typically

rely on during high-pressure situations

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The overthinking part

of it also has a name

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Explicit monitoring

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paying so much attention to a movement

or skill that should be automatic that

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you actually disrupt the automaticity

of that skill that is why a striker

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who has scored a thousand times

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can suddenly start to think about how

his foot actually works and kicks the

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ball, and all of a sudden shank it

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The autopilot was better

than the manual controls

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So the second little takeaway we can get

from today that's a precursor to next

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week is we need to externalize our focus.

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We have this concept in

physical therapy as well.

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We call it an external locus of control,

where if we have someone focus on their

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form too much internally, if we say,

"Bend your knee to 90 degrees," that's

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more of this internal focus of control.

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Where if we say, "Bend your knee

towards that wall," that's shifting

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their focus to an external locus of

control, and it actually helps improve

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their ability to perform the task.

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The same happens with this.

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We want to externalize our focus

so that things that are supposed

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to be automatic can stay automatic

without us overthinking it

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giving your attention a small outside job

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keeps the overthinking

brain from taking control

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So all of this system, this pressure,

high stakes environment that causes our

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brain and bodies to do funny things , can

affect us as women differently than men

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It's the same alarm system

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but slightly different wiring

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Our sex hormones shape how the

stress response plays out And that

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means the pressure moment can look

and feel different for us as women

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the bonding hormone, which we've covered

this before, So under stress, we as women

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often go towards this tend and befriend

side of the stress response in addition

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to the fight or flight that we're used to.

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So we like to increase that connection

or bring other people in when

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we experience a stress response

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alongside the fight or flight that's

also happening within our bodies

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So we can use this to our advantage.

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That hormonal response that

happens within our bodies as women

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and that need for bonding can

actually help decrease the alarm.

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If we bring people in when we start to

feel that pressure or that high-stakes

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environment, that's actually feeding

into some of the wiring that benefits

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us as women, especially when it

comes to high-stakes environments

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We've talked about this 10 and befriend

theory before, but it comes out of UCLA

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and we talked about it when it came

to friendship and female friendships.

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So I'll leave the link to that episode

below in case you are interested

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in learning more about that.

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But it's a really cool study

that was done out of UCLA

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that talked about when women

reach for social support because

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of our internal hormonal wiring

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Our heart rate lowers, our blood

pressure lowers, our cortisol

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output is better regulated.

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I won't necessarily say lower 'cause

we want those peaks and valleys.

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So it's just better regulated

when we reach out for connection

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Estrogen enhances oxytocin's effects.

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So the calming payoff of connection

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can be bigger for us as women

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Now a little caveat to this, hormone

levels shift throughout our cycle

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So this science is still trying to

catch up to understand how we might

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experience these things throughout

different phases of our cycle

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But it's cool to start to understand

where women might be able to put

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into action some of these things

that optimize how our physiology

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actually functions to handle those

high-stakes, high-pressure environments

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There's still a lot to learn, but that's

why I also love talking about it here on

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the podcast and sharing new research and

sharing it in the Smart Girl newspaper.

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That way, we can stay on top of what's

new and interesting and fun for all of

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us as women to learn as women's health

just starts to keep pushing and pushing

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boundaries, and as women's research and

women's sports science researchers and

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all of these wonderful women we've had on

the podcast keep pushing the boundaries of

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what is possible for our understanding and

knowledge of female physiology All that

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to say our bodies are built to co-regulate

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borrowing calm from a friend's

nervous system during our own

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high-pressure, high-stakes experience

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can be a real measurable strategy to

help us perform better under pressure

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So build your pressure people.

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If we can name it to tame it, and then

if we can bring others in, whether that's

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through a group chat with our friends

or someone who's in the room with us

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during that experience, those are both

two ways that we can help better override

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our threat detection center, take the

reins back in our control and feel a

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little calmer So that we don't choke or

overthink when that's the last thing we

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wanna do during a high pressure moment

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Quick pause, because if

learning that your brain

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literally dims the lights under pressure

made you feel a little more normal

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I'd love for you to first follow,

subscribe wherever so that next week's

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episode you can also learn about the

actual action toolkit that we're gonna

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use to help us better manage pressure.

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That way all of that

comes straight to you.

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But also send it to a friend.

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that you think might benefit from learning

this about her own brain or body, whether

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or not she's got a big presentation or

game or experience coming up that you

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think she might be under pressure for.

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Send this to her.

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I'd love for

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other girls to understand what's happening

in their brains and bodies when they

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are under pressure, and this was just

a fun way and time of the year to talk

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about it with the World Cup going on.

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Next week we're going over the

actual like toolkit too, so I think

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that will be extremely helpful

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And after you've shared it with a

friend, if you have 30 seconds to

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leave a review on Apple, Spotify,

or wherever you're listening to this

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on, I would greatly appreciate it.

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My goal is to get this education

and information and knowledge

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out to as many girls as possible.

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I have this huge passion for wishing

that I and other girls understood

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things about their bodies far earlier.

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We have so much time to maximize and

to work on some of these things when

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we are younger, but a lot of us don't

actually start caring or get the education

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for that until something goes wrong.

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So I would love for just girls

of all ages, women of all ages

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to find this education and

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to understand more about their brains,

their bodies, their skin, their

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nutrition, their fueling from the

top experts in their fields, which is

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why I started Wellness Fix This Spot.

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So I would greatly appreciate it

if you could also leave a review

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I also feel as like smart, curious

people, we're often smart and curious

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about other things outside of wellness.

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Wellness is my domain.

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I am a physical therapist.

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I've had decades of clinical experience

and education and opportunities that

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have allowed me to learn and fall in

love with the human body, and especially

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sharing this knowledge with you guys.

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But I understand that I am not the

expert in everything, and I like

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learning about other things and

other industries outside my own.

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So that's what the Smart

Girl Newspaper is for.

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It's every week on Wednesdays,, I

curate a list of things that are

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positive, fun, uplifting, , that

maybe provoke conversations about

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industries outside of our own.

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because as women, we're multifaceted, and

we have interests well outside of the one

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podcast you might listen to every week.

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So if you're interested in things

outside of health and wellness

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as well, and are curious about

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marketing and finance and consumerism

and entrepreneurship and business and

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mental health and so

many other industries.

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It's really just a way for me to compile

different articles and podcasts and

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videos that I find very interesting,

and send it out to you guys so that

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we're all able to learn together

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So a little recap of this episode

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One, under pressure, your

amygdala pulls the fire alarm,

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sounding the danger signals

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And your prefrontal cortex, that

place where decisions and plans

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and execution and working memory

is stored, goes a little more quiet

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we can name it when this happens to

take back a little bit of that power

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Two, choking is a working memory glitch

not a talent or skill issue So aim

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your attention at one external cue

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Instead of overthinking it internally

Three, women's stress hormone

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leans on oxytocin and estrogen

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Which means we are naturally

wired for connection

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So build your pressure people,

your pressure group chat

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And use them before the big moment.

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Next episode, we'll build the toolkit.

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We'll talk about the science behind

things like meditation, movement,

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exercise, prayer, superstitions,

all of the things that people might

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utilize to help them under pressure

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The stuff that can actually rewire how

you show up when it counts Thank you

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guys for joining me as we all learn how

our brains and bodies handle performing

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under pressure, and I'll see you guys

on the next episode where we actually

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start to build the toolkit to better

help all of us perform under pressure