Game On!

Bringing the locker room into the consulting room

A basketball on a court with players in the background | Photo by Bk Aguilar/Pexels

This article first appeared in the May/June 2010 issue.

In the parlance of the game, the guy is brutalizing me under the boards. When Lou, a burly 19-year-old, whips his elbow into my chest, I lurch backward like a drunk. When he swings his rump against my hip, I go spinning out of bounds into the wall. He lays the basketball through the rim and glances back at me with teeth bared. I curse under my breath. At age 50, I shouldn’t feel the need to prove myself against some brash, buff kid. As I hustle down to the other end of the court, however, I call for the ball.

This isn’t just about hoops. It’s about answering the questions that press on me daily: What am I capable of doing? Will I make a mark or leave no trace? Will I help my team or feel humiliated? After 40 years of dribbling and driving, dishing and shooting, I have few illusions about being a superstar, a.k.a. “the man.” I aspire to just being a competent man. Some days, even that seems unattainable. In my middle-aged years, in the twilight of my playing, my career as a psychotherapist is a slow grind and my family life is built on compromises. The game of basketball, with its stark, decisive moments, seems a surer test of my worth.

My teammates swing the ball from side to side before hitting me with a bounce pass to the left of the foul lane. Twice before in this game, I’ve sunk 17-foot bank shots from that spot; Lou will expect me to shoot another. Instead, I fake the jumper and dribble quickly past him before extending my right arm with the ball on my fingertips to scoop in a layup. But young reflexes are cat-quick: Lou pivots around to smack the ball out of the air in an orange blur against the white backboard, and then snatches the rebound and starts rumbling back down court. I bolt frantically after him. When I get my body between him and the basket, he turns his back and shoves me out of the way again with his big butt before scoring his team’s winning point.

Watching him amble triumphantly off the court, I remain doubled over with exhaustion and shame. Then I feel two hard slaps on my back. One of my teammates, nearly as old as I am, says empathically, “The guy’s a monster.” Another adds, “You did your best to stop him.” Their redemptive words surprise me. They recognize my effort; I failed, but still have their respect. My eyes, already stinging from perspiration, start welling with tears.

By all sound reasoning, I should have outgrown this game. My loved ones, physical therapists, and orthopedic surgeons have pleaded with me for years to give it up. But after every injury and operation (thumb, back, knee—and, soon, elbow), I’ve limped back to the gym and struggled to get back into playing shape. I’m not the only one. Sitting with my male clients nowadays, I hear their reluctance, too, to relinquish their favorite athletic pursuits, to abandon the “glory days” about which Bruce Springsteen sang. I see us all as men moving through life as a prolonged sports season, infused in our heads with infield chatter and locker-room rituals, punctuated by flashbacks of grandstanding feats and the roar of cheering crowds. Like me, my male clients spend hours clicking through all-sports cable channels, gaping at the highlights of home-run blasts and rib-smashing tackles, gazing at the latest LeBron and Shaq product endorsements. Each spring, we snap up the new crop of nostalgia baseball books, featuring Dizzy, Jackie, and the Babe. Each fall, we hunch over stat sheets, bedecked in our vintage jerseys, trying to get a leg up in our online fantasy football leagues. At work, we speak a language replete with metaphors like “end-run” strategies and “slam-dunk” conclusions. At home, we raise our children to be “team players” but also, first and foremost, “winners.”

I understand and relate to the passion these men have for sports. At the same time, I’m aware of a counternarrative held by many of my psychotherapist colleagues: sports breeds competition, which causes decreased empathy, which foments injustice; game-day get-togethers of sports-crazed buddies are occasions for substance abuse and indulgence in misogyny; aging jocks are frozen in too-narrow definitions of what it means to be a man. I admit there’s truth to these assumptions. And yet, there’s so much more here: rich drama, with which to understand the strivings, insecurities, and identities of many of our male clients. There are also telling lessons with which to deepen clinical reach. Psychotherapists needn’t be weekend warriors or box-score analysts, but they’ll conduct better therapy with many men if they’re cognoscenti of male fandom.

Getting into the Game

My sports initiation was typical. I fell in love with hoops, instantly and irrevocably, at age 10 during a rare family vacation in Miami Beach. Under a scorching December sun, my father and I played in my first-ever pickup basketball game on the hotel’s half-court. My dad, tall and sturdily built, had been a college athlete and moved with swagger and skill. (I relish this virile image of him, rather than as the stumbling, glassy-eyed, brain-cancer victim of only four years later.) I could barely catch the ball—so big and bouncy, unlike a baseball—let alone shoot with it. I felt even more out of place when the ball whipped back and forth among the other players—strangers in life, savvy brethren in the game—but never came my way. I wanted to belong to this sudden community of men, not be a child on the margins. Then, on the game’s last play, my father hit me with a pass where I was loitering underneath the basket, and I miraculously tossed the ball up against the backboard, around the rim, and in. We won. I flushed with pride and was hooked. The next morning, I was back on the court by 7:00 to practice my shooting and begin turning myself into a player.

From that point forward, the sport has taught me many lessons. Early on I learned to savor the game’s textures and physics. In June, the ball bounced off the hot schoolyard asphalt as a spinning, shimmering orb, full of heat and life. When shot errantly, it ricocheted about the orange rim in quick triplets of metallic pings. In December, that orb became slick and cold and landed with sodden, bass tones. I, too, was all material form and rushing sensation: sneakers squeaking, head riveting, red arms and legs gesticulating in bursts of motion without conscious thought. It was both soothing and exhilarating to lose myself in the game’s kinetic flow.

Another lesson was diligence. The more I bounced the ball, the more deftly I could control it with just my fingertips without having to look down. The more I practiced dipping my knees, cocking my wrist, and releasing my shot, the more often the ball arced through the center of the netless rim with nary a sound. My hard work produced skills that allowed me to dominate my ham-handed, middle-school classmates. The more masterful I felt, the more I bought into the gym-rat ethos of practice, practice, and more daily practice in drafty New York City rec centers and shabby playgrounds with faded lines and buckling blacktop.

I learned about trust, relationships, and teamwork. I was taught by a summer-camp coach to lob the ball to a teammate at the high post, and then to expect a return pass when I’d cut hard toward the basket to score a layup. I learned to lead my teammate to an open spot on the floor with a low bounce pass so that he had his chance to spin around and shoot. Whenever I was on pickup squads in which the ball flew precisely up top, crosscourt, and down low from one panting player to another, I felt as if one mind seamlessly linked us.

I learned the power of sports to regulate feelings. When my father died, I spent long hours alone on the schoolyard court, a 15-year-old in focused concentration/dissociation, settling myself into numbness with the mechanical repetitiveness of hundreds of foul shots. When a girlfriend left me a few years later for another guy, I worked out my anger by drilling countless line-drive jumpers from the baseline. My life sometimes felt out of control, but I had the predictability of the ball’s bounce, the reliability of ready teammates, the surety of honed skills. I had game.

Taking the Game to the Office

Sports would one day shape my clinician’s game, too. Not that they gave me a classic therapist’s manner. A lifetime of going one-on-one with opponents elicited the reflex to confront, rather than accommodate. When I arrived in graduate school, in my mid-twenties, one classmate said to me that I seemed like the least likely person she’d ever met to become a clinical psychologist. In the therapy room, I had to remember to turn down my brash garrulousness and feign modest introspection. But from the outset of my clinical training, being a ballplayer gave me distinct advantages over my gently empathic colleagues.

I immediately had a knack for handling male aggression. Actually, I didn’t even recognize it as aggression at first. I was so inured to hostility that it just seemed a normal variant of relating. My athletic experiences had taught me that, for many men, “the best defense is a good offense.” If you could force the other guy into a scrambled retreat, then you were effectively protecting yourself. I’d seen thousands of trash-talking, chest-beating players who’d loudly argued calls (“No fucking way was I out of bounds!”) and swung their arms about in threatening gestures like shrieking simians in an Animal Planet documentary. I’d see through their displays of rage to their vulnerability and fears of failure. I considered the rage to be just the game’s background noise—to be tolerated or even tuned out.

This served me well in my first clinical practicum site while working with Alex, a 16-year-old African-American kid, who’d been court-ordered to undergo psychotherapy after beating another teen unconscious. He sat in my office during the first session with the cold stare and coiled tension of a juiced linebacker. I knew little about adolescent development or building alliances with resistant teens, but sensed a player accustomed to triumphing through intimidation. This was confirmed when, after I’d asked him what happened between him and the other teen, he said ominously, “I don’t get pushed around by nobody.” I assumed that meant me as well.

Without my background in sports, I might have been cowed, but, instead, I felt intrigued, even flattered. Friendly or not, he’d invited me to parry. My instinct was to show I could meet his challenge with cool resolve and then challenge him in return. I said quietly, “I can respect that. I don’t push people and don’t like it when they think they can push me.” His eyes lit up; the game was on. He acted the withdrawn tough guy for the rest of the hour. He then failed to show up for the next two sessions. Like a good one-on-one defender, I had to demonstrate that I’d stick to him like glue and not be shaken off. I wrote to him that unless he appeared for the next appointment, I’d send a report to the judge on his case stating he’d dropped out of his mandated treatment.

Alex returned to therapy the following week angrier than ever. He leaned forward in his chair menacingly at times, and slouched back in sullen silence at others. I didn’t flinch, but instead gave him my full attention, respecting his every move, admiring his gamesmanship. I also was intent, though, to prove that I cared enough about resolving the troubles in his life to hang in there with him and get past his show of rage. Much later on, after he’d settled in, we’d talk about how he felt about being one of the few black guys in his white suburban high school, how he thought his father rode him, how nobody believed he was any good. Today, however, was all about the flailing drama of his aggression meeting a competitor’s calming embrace. It was only at the very end of the session that the rage began to subside and his tone softened to one of mild exhaustion or, perhaps, resignation. I, too, was drained, but felt thrillingly engaged. Even as he sat hunched over with a scowl still contorting his face, I said to him with all sincerity, “I look forward to seeing you next week.”

The Power of Possibility

Another clinical advantage I derived from sports was a kind of transcendental optimism. The Brooklyn Dodgers’ management, in the team’s most hapless days of the 1930s, coined the marketing phrase, “Wait till next year.” It promised fans that the team would deliver league pennants and world championships—a vow it took a decade to fulfill. But the vow helped fill the team’s Ebbets Field seats with hopeful spectators who lived and died with every pitch.

To me, though, the implicit promise of all athletic endeavors is actually closer to the motto Carpe Diem, Seize the Day. Every game is its own new beginning, a fresh starting-line in a dash for victories imagined and unimaginable. Every day is the time to leave everything you have on the field to prove your mettle. This is an action-oriented dictum, on the order of Be Here Now crossed with Just Do It.

Even closer to the essence would be the motto Seize the Moment, for it’s in the smallest fractionated instances—better known as “plays” or, in a contest’s waning seconds, “the clutch”—that players make game-winning shoestring catches, split-second stick saves, and over-the-outside-shoulder end-zone grabs. Even when these moments have been conjured through visual imagery and their skills stamped into muscle-memory through endless practice, they seem to occur abruptly in the game with the surprise and thrill of spectacle. I’ve executed great plays on the basketball court—impossibly angled bank shots, whiplash-inducing spins—that seemingly appeared from nowhere, without my forethought, leaving me and the other players around me stunned. In those rare moments, it was as if I were within and without myself, both caught up in and observing my own sudden actions. I can only compare it to the experience described by Eugen Herrigel in Zen in the Art of Archery, when the master immerses himself meditatively in the rote movements of archery, and then bows to the spirit that has guided his perfectly launched arrow.

In my psychotherapy practice, I try to teach my clients to seize such magically executed moments on all the playing-fields of their lives and to bow figuratively in deepest gratitude and appreciation. (If this sounds like a form of “self-actualization,” then maybe Abe “the Actualizer” Maslow was a ballplayer.) Unfortunately, most anxiety-ridden, anguished male clients are too self-conscious, self-mocking, and therefore self-defeating to believe in the prospect that such moments are even possible. They’re so mired in observing themselves critically, even before the event, that their actions lack the alacrity, spontaneity, or joy of peak performances. They’re the equivalent of a slumping baseball hitter, uncomfortably fidgeting in the batter’s box while ruminating about his stance, awaiting the next wicked curve ball with a sense of doom.

Don was typical in this regard. A lawyer in his thirties, he’d built a successful career in his firm through painstaking attention to writing detailed, persuasive briefs. But when he was assigned to work under a new partner, who put a greater premium on cranking out work (and billing) speedily, Don found his style challenged. In response to his boss’s criticisms, he pressed harder. Rather than speeding up, though, his production slowed down, as doubt, hesitancy, and fears of the partner’s displeasure hobbled him. He started to sweat profusely while in his boss’s presence. He slept poorly at night. After his first panic attack, he made a psychotherapy appointment.

I talked with him about the debilitating impact of becoming too self-conscious. I asked him to tell me about his times of greater ease, when his work and relationships flowed. He’d been a baseball fanatic as a kid, keeping his own statistics on his beloved California Angels. He hadn’t been much of a player himself—peaking at the Little League level as a weak-armed second baseman—but loved his experiences of the game, the smell of his glove, the scratch of the infield dirt beneath his cleats. He loved the smoothness of the tapered, white-ash bat in his hands. He had no trouble at all relating to my symbol of the slumping hitter as illustrative of all uptight, psyched-out performers. When I told him that his most important duty in his law practice was to “swing the bat,” he immediately grasped what I meant—that he had to step up to the daily challenges and take his hacks without overthinking or tinkering too much with technique. He knew that worrying all the time about his new boss was like trying to hit a darting fastball while keeping an eye on the manager’s reactions in the dugout.

Over the next few weeks, Don worked hard to recapture the ease he’d previously felt with writing. But concentrating on relaxing only tightened the grip of his self-consciousness, making him feel like a tense batter, unnerved by the crowd’s catcalls, whose bat is frozen on his shoulder. I suggested a more playful image instead. He now tried imagining that he was watching a beach ball wafting toward him, and that his new boss was just another guy with a hot dog in the stands. Writing the brief was as easy as smacking the large, red-and-white sphere with a long-handled broom. It’d never travel that far, but he wouldn’t strike out either. Soon, he was immersed again in the flow of creating briefs. He wouldn’t be the biggest hitter in the firm, he realized, but was relieved to be swinging freely.

Staying in the Game

The insights gleaned from my sporting life that have most illuminated my clinical practice concern dealing with decline and loss. During two decades as a medical family therapist, I’ve counseled hundreds of men with chronic and serious illnesses who were struggling to live with diminished abilities. The struggle to accept fate, age, and injury has long been part of my athletic experiences.

As a callow teenager, I sometimes played against thick-bodied, sharp-elbowed guys in their fifties, who, lacking the foot-speed to guard me, kneed me in the thigh or gave me forearm shivers to the ribs whenever I dribbled near them. To me, they were pathetic, if dangerous, old sluggards, better suited for bocce than basketball. I had neither love nor empathy for them. The more they’d hit me, the more I’d revel in driving past them to score and show them up.

Then, in my thirties, as my own knees began to creak, I got a different view of the aging male ballplayer while playing regularly in an unusual pickup game in a small-town, elementary-school gym. At the time I joined in, neighborhood players had been gathering on the stained, palely lit court two nights a week for more than 35 years. Some of those who’d originally started the game—guys not in their fifties but sixties, seventies, and eighties!—were still hoisting up hook shots beside teammates young enough to be their great-grandchildren. The game was more age-diverse than any I’d ever played in; a five-man team might have representatives from five different decades ranging from the twenties to the sixties. I’d throw a bounce pass with trepidation to a knobby-kneed, hollow-chested 70-year-old, barely able to propel his stooped body on his thin, varicose-veined legs, and then watch him fake a shot and dribble at a walking pace toward the basket. After making his layup, he’d slap hands with me as he labored back up court. On defense, he’d throw a well-aimed elbow at the man he was guarding and then bellow hoarsely in protest when called for a foul. I’d observe him and feel appalled by what time had done to him physically; he was a slowly moving shadow of a once-capable athlete, but his sheer nerve to will his body to play this game struck me as an inspiration.

More than a dozen years later, as my age has risen and the height of my jumps declined, I’ve taken my place in this gym’s circle-of-hoops-life as one of the more senior players. Though I miss the old spring in my step and the eyesight to shoot as accurately as I once did, I still challenge all comers—19-year-old powerhouses like Lou, but also 40-year-olds who lack the legs or stomach to go near the basket and hug the court’s perimeter—adjusting my game to their strengths and limitations. Occasionally, I’ll play the role my father did on that long-ago Miami Beach day, of ushering young initiates into the game with easy passes under the basket. At other times, I’ll tutor youth in the giving and receiving of sharp elbows. All the skills and athleticism I’ve lost over the years could be cause for overwhelming rue. Instead, I concentrate on achieving minor victories doing what I still can when I can—the crisp pass, the well-defended sequence, the perfectly banked jumper—to make some small difference in the game’s outcome. I’m hoping to dribble out my days, taking my best shot at being the best man possible in whatever playing time I’ve been allotted.

This has translated into a psychotherapy style bent on encouraging ill and disabled male clients to get back into the game. When 77-year-old Bill suffered a major stroke, severely weakening the entire right side of his body, he was an inconsolable lump, lying motionlessly in his hospital bed. He’d been a vital, powerful man throughout his adulthood, but now he was in shock about having to depend on others for such needs as grooming, dressing, and toileting. I told him I knew he felt devastated, but he must rise up and get moving. I said that sitting on life’s sidelines is enervating, in and of itself. Disability is only compounded, I argued, when men avoid trying to resume cherished activities for fear of humiliating themselves through facing what they can no longer do. Playing a diminished role, in contrast, is psychologically better than having no role at all. Swing the bat, I said. Take the shot. Find out what contribution you can still make.

Bill gazed up at me with an incredulous look. He told me he was afraid there wasn’t any game left. He said he didn’t believe he could play any role that related to the person he’d been. His three daughters voiced support for his viewpoint, carefully explaining to me that it was better now for their father to sit out than to flounder.

When I returned to his room the next day, I found him still staring at the ceiling. His daughters still sat silently around his bed as if on some deathwatch. I started off talking gently to him about seeing the scope of his life as its own well-worn playing-field, upon which he could still hustle and strive, regardless of the deterioration of his skills. I described for him the hoary picture of the 70-year-old basketball player, broken down but proud. I talked about stroke-hobbled men I’ve known who struggled to get back on their feet. I worked myself into the fervor of a fourth-quarter pep talk, imploring him to have hope, grasp purpose, and take action. To the daughters, I urged a different approach—creating the means by which their father could still be an active, if limited, player.

Bill looked at me blankly as if I were daft; the daughters looked away. I left the room unsure of the impact of my visit. Later that day, though, I wandered into the physical therapy gym and saw him standing in the parallel bars with the help of three physical therapists. He was shaky but upright, with severe strain on his face. When he eyed me across the room, he at first glanced away in embarrassment, but then he looked back steadily with a grin that showed pride and a bit of defiance. It wasn’t the time or place for me to go slap him on the back. I bowed my head toward him to convey my sincere respect.

Photo by Bk Aguilar/Pexels

Barry Jacobs

Barry J. Jacobs, Psy.D. is a Philly area-based clinical psychologist, healthcare consultant, and coauthor (with his wife, Julia L. Mayer, Psy.D.) of AARP Meditations for Caregivers (Da Capo, 2016) and AARP Love and Meaning After 50 (Hachette, 2020). He writes a monthly self-help column for family caregivers on