Part I broke down what actually happens in your brain and body under pressure. Now for the part you can use. In Part II of the Performing Under Pressure series, Dr. Kelsy Vick walks through the real science behind the things we reach for to perform better under pressure: breathwork and meditation, prayer and rituals, exercise, visualization, and naps. You will learn the 30 second physiological sigh that beat mindfulness in a 2023 Stanford study, why a lucky ritual can genuinely boost your performance through self efficacy, how consistent exercise trains your body to handle stress, the visualization method elite athletes use to rehearse pressure in their heads, and the short nap length NASA research linked to big gains in alertness and performance. Smart, science backed, and fun, with a clear here is what to do with this for every single tool.

Wellness Big Sis: The Pod is expert led, science backed wellness girl chats for women in their 20s and 30s, hosted by Dr. Kelsy Vick, a board certified orthopedic Doctor of Physical Therapy and women's health PT.

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RESOURCES:

Cyclic sighing beat mindfulness meditation for mood and lower arousal, five minutes a day for a month. Supports the physiological sigh segment. Balban, M. Y., et al. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine. https://www.cell.com/cell-reports-medicine/fulltext/S2666-3791(22)00474-8 Plain language write up from Stanford: https://med.stanford.edu/news/insights/2023/02/cyclic-sighing-can-help-breathe-away-anxiety.html

Lucky charms and rituals can improve performance through self efficacy, with the honest caveat that replications are mixed. Supports the ritual and superstition segment. Damisch, L., Stoberock, B., and Mussweiler, T. (2010). Keep your fingers crossed! How superstition improves performance. Psychological Science. https://journals.sagepub.com/doi/abs/10.1177/0956797610372631 Replication caveat worth reading before airing: https://replicationindex.com/2016/01/31/too-good-to-be-true-a-reanalysis-of-damisch-stoberock-and-mussweiler-2010-keep-your-fingers-crossed-how-superstition-improves-performance-psychological-science-217-p-1014-1020/

Visualization and mental rehearsal improve performance. Supports the visualization segment. Driskell, J. E., Copper, C., and Moran, A. (1994). Does mental practice enhance performance? Journal of Applied Psychology. 2020 replication and extension: https://www.sciencedirect.com/science/article/abs/pii/S1469029219301530 The PETTLEP model and functional equivalence framing comes from Holmes, P. S., and Collins, D. J. (2001), The PETTLEP approach to motor imagery, Journal of Applied Sport Psychology. Verify the exact PETTLEP citation before airing if you name it on mic.

A short planned nap improved performance and alertness in NASA pilot research. Supports the NASA nap segment. The 26 minute nap improving performance about 34 percent and alertness about 54 percent traces to NASA work led by Mark Rosekind. Rosekind, M. R., et al. (1995). Crew factors in flight operations 9: Effects of planned cockpit rest on crew performance and alertness in long haul operations. NASA Technical Reports. https://ntrs.nasa.gov/citations/19950006379

Welcome to Wellness Fixes the Pod, a

by Maven Media production, where we

2

believe you deserve real education

from real experts, delivered

3

in a way you can actually use.

4

I'm Dr.

5

Kelsey Vick, your board-certified

orthopedic doctor of physical therapy, and

6

this podcast was built for the girl who

is done feeling overwhelmed and frustrated

7

by conflicting health noise and is ready

for something she can actually trust.

8

Every week, we have honest, science-backed

conversations about your health,

9

your hormones, your brain, your

body, and everything in between.

10

No fluff, no fear-mongering,

just the truth.

11

Because understanding your

body is the most powerful

12

thing you can do for yourself.

13

A table full of experts built for

the curious girl who wants the truth.

14

So welcome.

15

Your seat is waiting for you.

16

Last episode, we watched the

whole world hold its breath as

17

grown men took penalty kicks

18

with millions of people staring at them.

19

Today I wanna talk about the

thing that no one puts on the

20

highlight reel, the breathing

21

The pregame ritual, the little nap The

quiet prayer, the boring looking stuff

22

That is actually the reason some

people fall apart under pressure

23

And some people kick it into another gear

24

So welcome to our part two of

this Performing Under Pressure

25

miniseries, where we start to build

your own pressure toolkit Welcome

26

back to Wellness Big Sis The Pod.

27

I'm your host, Dr.

28

Kelsey Vick, a board-certified

orthopedic doctor of physical therapy

29

and a pelvic floor physical therapist

30

If you caught part one last week,

you already know what happens in your

31

brain and body when the stakes go up

32

Your amygdala hits the alarm, cortisol

and adrenaline flood your system

33

Your heart rate climbs and your

prefrontal cortex, the area of the brain

34

in charge of execution and planning

and working memory or muscle memory

35

gets a little hijacked

36

That is the what part of the equation,

and this week we cover what to do about it

37

We're gonna go through the

real science on breathwork

38

prayer, rituals and superstitions

39

exercise, naps, and all the things

that a lot of people rely on when it

40

comes to better preparing theirselves

for these high-stakes moments And I'm

41

gonna tell you exactly which ones are

worth your time and how to use them

42

The first thing in your

toolkit is the 30-second reset

43

And breathwork, meditation, both of

those things can fall under this tool

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Last week we made the metaphor of what's

happening in our brain during a high

45

pressure environment as a group chat

amongst friends where the amygdala is

46

sending alarm signals and the friend

that usually helps to talk her off the

47

ledge left their phone in another room

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So in this situation, our

nervous system is like a group

49

chat that won't stop blowing up

50

Breathwork is that one friend

that can walk in, read the room

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and tell everyone to calm down

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In five seconds flat.

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And it's not that annoying sort

of friend that says, "Calm down,"

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and you don't listen to them.

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This is one where all the girls

in the group chat actually listen

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As a physical therapist, I use

breathing a lot in my practice,

57

especially as a woman's health and

pelvic floor physical therapist.

58

Breathwork is one of the tools

that I feel like we should have

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in our existing toolbox, just

like being a functioning human.

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It helps with core work.

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It helps with regulating

our nervous system.

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It helps lengthen certain muscles.

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It acts as like an internal

mobility technique.

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There are so many ways I use

breathwork in my practice.

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So breathwork is a great, I call it

bang for our buck tool when it comes

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to mobility and movement, but it's also

a great bang for our buck tool when

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it comes to performing under pressure

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It is the only part of our stress

response that we can actually

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grab the wheel and take control of

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You can't just will your stress

hormones down or your cortisol down.

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You can't just think about

it and will it to come down.

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But breathing and breathwork,

you can actually choose to do.

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It's in your control

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You can change your breath,

And that breath communicates

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directly with your nervous system

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One of the standout techniques

for performing under pressure

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is called the physiological sigh

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or cyclic sine

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Two short and quick

inhales through the nose

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Followed by one long slow

exhale through the mouth

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The extended exhale is what

actually flips you towards that

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rest, digest, parasympathetic,

calming part of your nervous system.

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And you can combine meditation and

breathwork, but it's truly breathwork

84

in that physiological sigh that has

been shown to help calm your physiology,

85

especially in a high-stakes environment,

not necessarily the meditation alone.

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It's okay to combine both, but the

research is behind the breathwork

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and actually gripping the steering

wheel on that breathwork, not

88

necessarily on the meditation.

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A 2023 study out of Stanford

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had 111 people do five minutes a day of

one of several practices for an entire

91

month cyclic sign, so that double inhale

followed by that long exhale through

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the mouth beat mindfulness meditation

for lowering stress, reducing resting,

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breathing rate, and improving mood

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We can think of that long exhale

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that increases activity in our

parasympathetic nervous system

96

as that sort of brake pedal,

the reins on our nervous system

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So your heart rate and arousal come

down on purpose instead of by accident

98

So next time you feel the

pressure start to spike

99

Do one round of the physiological sigh

100

Two sniffs in through the nose,

one long exhale through the mouth

101

Repeat for about a minute

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And if you want the

mood benefits long term

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Do five minutes a day,

not just in a crisis

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So the second thing a lot of

people have in their toolkit

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is what I call the lucky ball.

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This can be superstitions or certain

rituals that people have to do.

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It can also be prayer

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It's the Taylor Swift

wears the same bracelet

109

On tour energy The athlete who

always has to put their left sock

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on first Your friend who will

not go on a first date without

111

listening to that specific playlist

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Let's talk about if any of this

is real or it's all in their heads

113

I feel like superstitions and

rituals oftentimes get mocked,

114

especially the crazy ones.

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The crazier, the better.

116

We all love to hear them

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But for performing under pressure,

they can actually help And it's

118

not magic, it's actually psychology

119

The lucky charm The pregame routine,

the prayer that someone has to say

120

What they help do is to give the

person using them a sense of control

121

And a little hit of confidence

122

right when their brains feel most out of

control Prayer specifically overlaps with

123

contemplative and meditative practice

for a lot of people It slows you down,

124

focuses your attention and gives you a

moment of steadiness before the storm

125

So the confidence boost

for some people is real

126

But it's not necessarily a guarantee

127

So this is a tool, not necessarily a

crutch that you can rely on for helping

128

you perform better under pressure.

129

There were a few experiments done in 2010

130

that showed people who were told

131

They were using a lucky golf ball

132

sank noticeably more putts

133

Then people told it was just

a regular golf ball 65% versus

134

48% in one of the studies

135

The mechanism behind it wasn't

luck it was self-efficacy

136

Your belief that you can

actually pull this off

137

Activating a little bit of that

superstition by calling it a lucky ball

138

raised confidence, and that increase

in confidence improved performance

139

Rituals seem to work by giving your brain

140

a predictable sequence to hold onto

141

which can lower anxiety when

everything else feels uncertain

142

So consider rituals a confidence primer

143

rather than something that is guaranteed

to give you results under pressure

144

So if you wanna use this tool, try

building yourself one pre-pressure ritual

145

and use the same one every

time, a specific song, a mantra

146

A prayer, a quick hand gesture

147

It doesn't need to make

sense to anyone else

148

What matters is that it's consistent

and makes you feel a little bit

149

more in con- and it makes you feel

into that room or high-pressure

150

environment with more confidence

151

The third tool is exercise or movement

we can think of exercise like the friend

152

who's already seen you cry, so nothing

you throw at her will be a surprise

153

Regular training is basically allowing

your body to be in this stressed

154

environment in a safe way So that

when you experience real pressure,

155

it feels a little bit more familiar

156

So there's two different

benefits with exercise

157

There is the in-the-moment mood lift

158

from a single workout

159

And there's the long-term

game where exercise

160

And exercising consistently changes

how your whole stress system responds.

161

I always think of that Legally Blonde

quote "Endorphins make people happy, and

162

happy people just don't kill people."

163

It's like she's exercising, she's

releasing endorphins, and endorphins

164

make people happy, and happy

people just don't kill anyone.

165

So I always think of that quote

when something like this pops up

166

So zooming into acute exercise or

that one session of exercise and

167

the benefits that come with it

168

A single exercise session can burn

off some of that jittery energy

169

and create mood benefits

for hours afterwards

170

However, the bigger prize

is stress inoculation

171

Exercise is a controlled dose of

physical stress Your heart rate

172

spikes, stress hormones increase

173

and then your body recovers

174

Do that regularly and your

system gets more efficient

175

at turning the stress response both on

and crucially better at turning it off

176

This is how you play

the exercise long game

177

Yes, you can cram in exercise or

movement to burn off some of that

178

jittery energy, but it's really that

investment in the long game that is better

179

gonna help you perform under pressure

in a lot of high-stress environments

180

When you exercise, your

body runs a smaller scale

181

controlled version of the stress

cascade that we talked about in part one

182

Over time, regular aerobic exercise

183

is associated with a more regulated

cortisol response and better recovery

184

back to baseline So that the same stressor

produces a smaller, shorter spike.

185

Exercise also supports that

prefrontal cortex the planning

186

and decision part of your brain

187

that pressure tends to hijack

188

Which is part of why people who train

regularly and exercise regularly

189

Often stay in control a little bit

better when the stakes start to climb

190

You can think of every

workout as a rehearsal

191

that teaches your body

pressure is survivable

192

So keep a consistent movement

routine, exercise routine

193

as your baseline pressure insurance

194

Aiming for regular aerobic

sessions throughout the week

195

And on a specifically stressful day

196

Do not skip movement.

197

A brisk 10, 20-minute walk

198

before the big moment

can genuinely settle you

199

The next tool is what I'm calling the NASA

NAP, and it consists of naps and recovery

200

A nap is the underrated it

girl of the pressure world

201

Not glamorous, but quietly

running the whole operation

202

And if it works for astronauts and

pilots It's good enough for your Monday

203

A short nap is one of the

fastest ways to buy back

204

The alertness

205

and clear thinking that pressure

and poor sleep drain out of you

206

The key word here is

short, the power nap per se

207

not a two-hour nap that leaves you groggy

and worse off than before Timing matters.

208

10 to 20 minutes is that sweet spot

and earlier in the day so that it

209

doesn't wreck your night's sleep

210

This can help in a variety of ways,

but when you feel sleep-deprived and

211

when you haven't gotten very much sleep

212

Your prefrontal cortex is

already running on fumes

213

So pressure hits harder and judgment slips

214

A nap tops the tank back up

215

So why the NASA nap?

216

There was a famous NASA-

217

research on pilots that

was done in the '90s

218

that found a planned rest

averaging about twenty six minutes

219

improved performance by about 34%

220

and alertness by about fifty four percent.

221

Short naps clear out some of the adenosine

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the sleepy pressure chemical that

builds up the longer you're awake

223

which restores alertness and reaction

time, which is very important for pilots

224

Keeping it under about 20 minutes usually

means you wake up before a deep sleep

225

So you skip the groggy fog and get

the sharpness without the hangover.

226

So if you have a high-pressure event

and the option and capability of doing

227

so, Take a 10 to 20-minute nap earlier

in the day to help fill up that tank

228

If you don't have time

or a place to lie down

229

Even resting with your eyes closed for

a few minutes gives your overworked

230

brain a small recovery The last tool

is one that I feel like a lot of

231

you guys have probably heard about.

232

I used to use it as a gymnast,

but that is visualization

233

This shows the manifestation

girlies were onto something

234

They just needed a little bit of

a sports scientist in the group

235

chat Visualization is not woo-woo.

236

Maybe a more appropriate

term is mental rehearsal

237

When you vividly imagine doing something,

your brain lights up some of the same

238

circuits that are required to do that task

239

So you're quietly practicing

without actually moving a muscle

240

So the reason it works in these

high-pressure situations is

241

that you get to run the model

242

and run possibly a scary moment

in easy mode first by the

243

time the real thing happens

244

your brain has a version of it

that ended well So it feels more

245

familiar and less threatening

246

The key with mental rehearsal is to

make it very detailed and first person

247

Do not watch yourself from the stands.

248

Sit inside it

249

What do you see, hear,

and feel walking in?

250

And then visualize

yourself handling it calmly

251

not just the end result of perfection.

252

Walk through the process.

253

Visualize through the process

254

The other thing with mental

rehearsal and visualization is to

255

add the imperfections on purpose

256

Add the wobble on purpose.

257

The pros don't only picture perfection

258

They picture something

going a little wrong

259

and then themselves recovering So

Pressure Day is not the first time

260

they have seen a little hiccup.

261

I believe I heard that Michael Phelps used

to visualize a lot of different things

262

going wrong whenever he got in the pool.

263

He'd visualize his goggles falling off

as one example, and I believe there

264

was a very important race, and I can't

remember if he ended up crushing a

265

world record during that race, But his

goggles fell off in the pool, and I

266

don't think his time was affected too

much, and he might have even gotten

267

the world record during that race.

268

And I believe a reporter had

asked him "What happened?

269

How did you do so well?"

270

He was like, "I visualized it.

271

I visualize a lot of things going wrong.

272

That way, when I'm in the moment,

it doesn't shock me or scare me.

273

I just know how to move through it

274

So this is called motor imagery

275

Imagined action and real action

276

share overlapping brain activity

277

Reviews of mental practice

consistently found that imagery

278

Improves performance

279

strongest when you already have some skill

280

in the task and when the

imagery is vivid and specific

281

It is a staple of Olympic and elite

sport prep for exactly this reason

282

But to be completely honest

with you, imagery sharpens and

283

refines a skill you already have

284

It does not install one that

you haven't built yet So pair

285

it with actual preparation.

286

this comes back to our episode on

lucky girl syndrome that I'll link

287

below for you guys if you missed

it, but it talks about visualization

288

and what some call manifestation

with actual action and preparation.

289

You have to visualize with action

290

So the night before or the hour

before a high-pressure event

291

Spend two or three minutes running

your mental movie First person,

292

full sensory detail See yourself

walk in, feel steady handle one

293

small hiccup and then finish well

294

You're giving your brain a dress rehearsal

so the real deal feels like a rerun.

295

So there's your pressure toolkit,

and none of it requires you to

296

be a completely different person

297

Here's what to actually do.

298

One, when the pressure spikes, name it

299

Reach out to your pressure people to

bring them in with you on the journey.

300

We covered both of those two

things last week on our part

301

one episode if you missed it

302

But the first action in your

toolkit is a physiological sigh

303

Two inhales through the nose,

one long exhale through the

304

mouth, repeated for one minute

305

Two, build one pre-pressure ritual or

prayer that you say consistently before

306

every high-pressure circumstance or event

307

It helps to prime your confidence

308

Number three, keep a steady exercise

habit So your body can treat stress

309

like something that has been rehearsed

and something that you have also

310

shown your brain and body that

you can recover from Number

311

four, protect a short nap.

312

10 to 20 minutes, that's it

313

And number five, run your

mental movie beforehand.

314

First person, super detailed, include

a little hiccup that you successfully

315

handle In part one, we talked about what

pressure does to your brain and body, and

316

in part two, we learned how to handle it

317

I hope you guys enjoyed this

episode, this little series.

318

I need to dive into each of

these components a little more.

319

I love the research on

visualization, on motor imagery.

320

I'd also love to research how it pertains

to skill-based, so like a penalty kick

321

versus public speaking, something that's

maybe a little bit less motor planning

322

going on and just in a crowd speaking.

323

So I might have to dive into

that for another episode.

324

If you enjoyed this episode and

got something from it, send it to

325

a friend, share it with a friend.

326

As women, we definitely move

more towards that connection,

327

especially in times of stress.

328

So maybe that friend that you send it

to can be part of your pre-pressure

329

group chat that hypes you up

right before you're about to go do

330

something that's a little bit scary.

331

I'd also be forever grateful if you

wouldn't mind rating and reviewing

332

Wellness Fixes the Pod on whatever

podcast platform you're listening on.

333

That way, this can get out to more people.

334

I hope you guys enjoyed this episode,

and I'll see you guys again on the

335

next episode of Wellness Fixes the Pod.