England play Uruguay tonight in a crucial match that, if lost, could leave the team with one foot already on the flight home. It’s for situations like these that Steve Peters, England’s sport psychiatrist, was invited to accompany the team to the World Cup.

It’s worth considering why England’s manager Roy Hodgson has chosen Peters over the more traditional sport psychologists who have been regularly employed by England football teams in the past.

Peters does have a great track record – he worked with the British cycling teams who enjoyed huge success at the 2008 and 2012 Olympics, as well as snooker great Ronnie O'Sullivan. But psychiatrists are nevertheless more commonly associated with mental illness. Hodgson will have found himself getting a different service from Peters than his predecessors will have had from psychologists.

Psychology vs psychiatry

Sport psychology is still a relatively new discipline, having only been around since the 1950s. Its aim is to understand the mental factors that underpin successful performance and influence them positively. Among other things, a sport psychologist will help people to think and act in different ways by constructing skills (or interventions) that can be used in sports environments. Skills such as relaxation to control anxiety and stress, self-talk to promote positive thinking and imagery to mentally rehearse skills are all commonly taught. Sport psychologists will also work with coaches to help build cohesion and systems of leadership within a team.

Sports psychologists and psychiatrists are educated in different ways. The term “sport psychologist” is protected by the Health and Care Professions Council (HCPC) and anyone claiming to be one will need to have an MSc in sport psychology and be a member of a professional body, such as the British Psychology Society.

A sport psychiatrist, on the other hand, is first and foremost trained as a medical doctor. They will have qualified in psychiatry and then chosen to work with sports people. Peters calls himself a consultant psychiatrist, perhaps because sport psychiatry is not recognised as a speciality in the UK. He describes himself as being a doctor who specialises in looking after the human mind.

Psychiatry in sport does not necessarily look at treating illnesses but it recognises that thoughts and thought patterns developed by athletes can be detrimental to their performance. A main difference with psychology is that sport psychiatry is not aimed at producing performance enhancement, rather it focuses on how the brain is working and any problems that the brain is causing. It may produce performance enhancement but unlike the interventions of a sport psychologist, this is not the primary aim.

The Chimp Paradox

Central to Steve Peters' work is a system he has developed of mind management, which he presents in his book, “The Chimp Paradox”. This concept is used to present a simplified view of how the brain works. He explains that thoughts are generated in two parts of the brain. The frontal lobe is responsible for rational thinking based on facts and the limbic system is responsible for emotional thinking.

The “chimp” sits in the limbic system and has the first opportunity to process what is happening around you. The chimp produces what are described as catastrophic thoughts, such as “this is terrible”.

Take the example of a footballer striding up to take a penalty kick. He may experience anxiety and tension due to the pressure of the situation. He may have thoughts like “I have got to score or I’ll be a failure” and “I’m going to let everybody down”. He should feel confident about taking the kick, but his thought processes have been hijacked by his chimp.

England currently face the looming prospect of exiting the World Cup at the first group stage for the first time since 1958 – high potential for catastrophic thoughts to thrive in players' minds. Peters will be working with players to overcome these and maintain positivity.

If athletes can bypass their chimp then they will start having rational thoughts, which will aid their performance in these situations. Peters explains that the anxiety produced by the chimp gets the better of people, but once they recognise that these feelings are unwanted and are stopping them performing at their best, they can start to manage their chimp.

Sport psychologists and psychiatrists have both been successfully used by sports people. Ultimately a professional’s title or chosen field of study matters little if they can deliver the support needed by England footballers. Let’s hope Peters can help England’s footballers to replicate the success of the Olympic cyclists and produce their best performances on the world’s biggest stage.