How do the Buffalo Bills and the Cincinnati Bengals recover from the trauma of witnessing Damar Hamlin lifeless on the football field? The Monday Night Football game exposed the NFL organization, along with the players, coaches, and fans to this ever-present mortal risk athletes take playing in the NFL.

For a sport that romanticizes violence, it would be naïve to think an athlete couldn’t be injured while on-field. Injury is so prevalent from elementary school and beyond, that football culture desensitizes athletes to injury. Retired Pittsburgh Steelers safety and Super Bowl champion, Ryan Clark spoke to this reality when he said, “We see hits like car crashes… and the next snap takes place”.

“…for over a hundred grown adult men, who their entire lives have put on pads and understood the risk you take every time you do it… to be speechless, to be in tears, to be gathered in prayer, that tells you how significant this moment was.”
- Ryan Clark, Retired Pittsburgh Steeler and Superbowl Champion

What happened to Damar Hamlin while playing could only be described as “incomprehensible”; a fact evidenced on the players’ faces. Fans watched as their football heroes cried onto each other’s shoulders with shock in their eyes. Players gathered in a circle at midfield, presumably praying against the worst – it was all they could do. This dire situation was clearly palpable to those on and off the field. Hamlin’s teammates and opponents were traumatized by his life-threatening injury.

A psychological trauma is “any disturbing experience (including death) that results in significant fear, helplessness, dissociation, confusion, or other disruptive feelings intense enough to have a long-lasting negative effect on a person’s attitudes, behavior, and other aspects of functioning” (APA Dictionary(opens in a new tab)). While Hamlin’s injury occurred to only one player, other players experienced psychological trauma during the game as proximity to trauma is also a trauma.

Trauma in sports can be split into two categories: out-of-game and in-game trauma. Typically, in-game trauma involves some sort of orthopedic injury for athletes. For example, an athlete can break a bone. The worst of these injuries require orthopedic surgery. Surgeons understand the body’s capacity to mend itself is innate, given the correct environment of healing. Therefore, they surgically create a healing environment: the broken bones are aligned and put into a cast, and the body mends itself over time. Psychological trauma can heal in much the same way.

Every human brain has the innate ability to heal itself – a phenomenon called neuroplasticity. However, like orthopedic healing, the brain can only heal itself within a particular environment that ignites healing. As defined above, trauma hijacks the brain and compels one to act defensively which results in feeling disconnected first from others and consequently from safety. An environment of healing is the counter of this, a space where the brain no longer makes one feel as though they must run, hide, or defend themselves and where it is known they are protected and supported. These environments ensue most readily when one feels connected by the love of a close-other.

Consider a person in your life to whom you never have to explain anything. This person makes you feel simultaneously special and belonging, shares the load you carry, and lets you rest. Our brain is a social-organ developed over millions of years that craves this bond of secure-connection. It expects secure connection to others in the same way our lungs expect oxygen. This feeling of security is paramount when it comes to building resilience healing from trauma.

Sooner or later, everyone experiences inexplicable pain. Attributes such as mental toughness, grit and tenacity can help push one through almost anything. Consider Bills captain, Stefon Diggs. Shortly after Hamlin was taken off the field via ambulance, the players were given five minutes to warm up as play would resume. The NFL is big business, and it stops for no injury. Diggs took responsibility to rally his teammates and inspire toughness within them in an attempt to compartmentalize the in-game trauma they faced so they could win the game. Diggs jumped and yelled, looking each of his teammates in the eyes to reignite passion, but many were too shocked to respond. How could they be expected to perform?

A weariness builds when faced with any trauma – it’s not as simple as pumping oneself up to get one more rep of a bench press or unlocking that “fifth gear” for one last all out sprint. Without appropriate psychological rest, the weariness of feeling fear for a close loved-one aggregates into great psychological risk.

Unfortunately, sports develop athletes to become averse to rest. Even the most hard-nosed coach or trainer will agree muscles need consistent rest to grow strength. However, an athlete’s need for psychological rest is often ignored. Studies show again and again athletes are apprehensive to seek professional help for mental health(opens in a new tab) disorders [This is a study on college athletes which the vast majority of NFL athletes have been]. Clinicians, researchers and mental health professionals everywhere are trying to flip the stigma in sports and reduce reluctance, but progress is slow. Slow progress is not surprising, considering every athlete aspiring to play professionally in the NFL has a less than 2%(opens in a new tab) chance of realizing their dream. It’s easy to see how the fear of missing an opportunity during periods of rest would override an athlete’s need for it. In addition, many NFL athletes use their success to alleviate institutional burdens off themselves and their families. The efforts these players give, along with the punishment they accept unto their bodies, is for something bigger than simply playing a game.

From Ryan Clark’s perspective, Stefon Diggs and the team would have played if told to take the field. NFL players spend more time with their brothers on the field than with their own families, creating bonds that are hard-broken. Diggs understands that they had to play for Hamlin, who couldn’t be there. Clark gave insight to this connection, “This will be the first time they [the players]realize you don’t do it for you…you do it for everybody else… you don’t want to let that dude down; you don’t want to let your family down.” Yet, without rest, the risk remains that their weariness will cause dysfunction.

Clark shared a brief story about his former head coach, Mike Tomlin of the Pittsburgh Steelers. Clark suffered a grave injury, and even though a team of doctors had cleared Clark as recovered, Tomlin would not let him play. Clark said, “I begged coach Tomlin… but he goes, ‘if this is my son, I wouldn’t allow him to go play football.’” Ryan Clark played with tenacity as a safety, and he consistently put his body at risk. Clark, like so many athletes, needed help from his coach to accept his need for rest. Clark continued, “I was relieved… I was as relieved as these players are that (Coach) Sean McDermott and (Coach) Zac Taylor said, ‘you know what, we’re not playing tonight.’”

While Diggs was attempting to rally his team, the broadcast showed the head coaches of both teams, Sean McDermott, and Zac Taylor, speaking directly to officials on the field. Shortly after this conversation, the status of the game went from “on in five minutes” to suspended for the evening. This was unprecedented. Clark speculated the suspension of play could only have happened because of their efforts. Coaches McDermott and Taylor “…understand the gravity of the situation, and they also understand what their players were going through, and also themselves.” The coaches decided protecting their teams from the psychological injury of witnessing what happened on the field involved them preventing their players from having to play while traumatized. Together, they set a boundary against the titan NFL. This action of love proved to their teams (and the NFL) their acceptance of the responsibility to keep their team psychologically safe. These coaches laid the groundwork for the secure connection their athletes need to begin the process of healing from this traumatic event!

Five days later, a news report from The Athletic reported just how this secure connection was building in the Bills locker room. Most importantly, it started from top-down: Coach McDermott demonstrated an honest willingness to show vulnerability with his tears and his unscripted emotions to empathize with his men. These actions opened a door of trust for his players: a door to a judgement free room where players knew they could present themselves in any capacity weak or strong and know they are safe and loved.

Coach McDermott’s vulnerability shows the team they are safe to rest, and they don’t have to run. The response from the players was thankful. “It helped me let my guard down(opens in a new tab),” said Bills Center Mitch Morse. Morse’s guard coming down reciprocates his coach’s vulnerability. (Morse’s “guard up” is the one of the mind’s natural defenses that creates psychological distance when faced with a traumatic event). From this position of open vulnerability, Morse will be able to feel the love and safety created by the connection between he and his coach. Their connection acts as a safe-haven where psychological healing will grow. As Morse’s teammates reciprocate in a similar fashion, the collective system between players and coaches begins to feedback onto itself, enhancing the total environment for healing. The newly erected culture of vulnerability says to everyone, we’re safe, we don’t have to run, and we can face this together.

Ryan Clark appropriately called the NFL to action to also seize the responsibility of these young men’s psychological well-being stating, “if the NFL cares about the players…if the NFL doesn’t send somebody to these locker rooms…to make sure they are alright, they are missing the point.”

Even if the NFL does not send the right people into the locker room to address trauma (while it would be nice), coach McDermott is nourishing the resilience his team needs by fostering a team culture that respects psychological safety for his players. Stefan Diggs and his brothers would have never asked to stop play after Hamlin collapsed – just as Ryan Clark begged Tomlin to let him play. Love empowered McDermott and Taylor to protect their athletes. Never before on a national stage has this statement been so indisputable.

Athletes deserve coaches like Sean McDermott and Zac Taylor who enacts their responsibility as cultivators of psychologically safe environments for their athletes. From this secure base, an athlete’s resilience to any challenge, or any trauma, can only flourish. All coaches have opportunities to allow empathy to inform coaching decisions that protect and respect the mental well-being and physical well-being of their athletes – just as coaches McDermott and Taylor did. It took unprecedented courage to stop the football game from resuming in the wake of Hamlin’s injury. Yet, the coaches’ efforts have set a foundation for their athletes to begin to heal from the in-game trauma of witnessing Hamlin’s life-threatening injury.

-Spencer P. Kilpatrick, MSW, LCSW

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Ryan Clark’s interview on SportsCenter from Jan 2, 2023, can be watched on YouTube here: