The relevance of psychiatry to top-level performance is increasingly apparent, and nowhere more so than in the world of athletics. For years athletes have tried to gain a competitive edge by finding ways to directly enhance their performance. In the new era of sports, with its increased pressures of public scrutiny and demands, it is equally important to eliminate distractions. Psychiatrists and therapists who work with athletes play key roles in helping athletes calm the emotional and social storm that could potentially hinder athletic success.

The NCAA states that out of every 10,000 high school senior boys playing basketball only 3 will make it to the NBA (0.03%). This statistic reveals the enormous talent of those who make it to the top; they are extraordinarily gifted, and they often must pay extraordinary prices for their success.

Many people laughed when Ron Artest thanked his hood, his wife, his doctor, and his psychiatrist, after his championship performance with the LA Lakers winning this year's NBA title. But what his acknowledgements bring to light are the valued connections that make it possible for star athletes to survive, thrive, and achieve lasting success.

The personal ability that gets one to professional ranks is not what is going to keep them there. The athlete's talent can take them places that their character may not be prepared to keep them. The signing of a multimillion dollar contract does not make one an instant professional, especially if the athlete is a teenager who just finished high school.

Therefore, it is often the quality of healthy connections that provide a crucial sense of security in the chaotic world of sports. Because there are so many people focusing attention, making requests, and asking for time, trust becomes a central issue. People make decisions based on the advice of those they trust.

Sometimes, however, the person the athlete trusts is not actually qualified to make appropriate decisions. There is a high level of trust, for instance, in the friend who had your back on the playground or who protected you from gangs, but is this the person who should be advising you on business matters?

The spotlight of success brings with it a barrage of complex decisions, as well as constant demands from family, friends, and fans. The resulting magnitude of responsibility and influence is not always well understood by those surrounding the athlete. The star may be weighed down with a sense of responsibility for managing his or her own emotions and expectations, as well as those of other people.

For most athletes, the field of play is their sanctuary, where things are predictable and for the most part make sense. But the longevity of an athletes career is not only about what happens during games but also how they manage the unpredictability of life off the field. The true key to healthy athletic success is appropriately and profitably managing the social and psychological impact of their performance.

Professional athletes have unique abilities that lead them to equally unique circumstances and pressures. While much of the experience is positive, there are threats and stumbling blocks as well. Developing an ability to work through challenging issues with maturity and professionalism is essential to the star performer's continued wellbeing.