Here on the West Coast, our own Vancouver Canucks made it into the National Hockey League’s Stanley Cup playoffs for the 2011 season as the #1 seed, a monumental accomplishment whose significance is easy to understand, even for non-hockey fans (and we’ve heard that these do exist). Since 1952, when the legendary Foster Hewitt started broadcasting live play-by-play of NHL games on television, generations of us have grown up watching Hockey Night in Canada every Saturday and cheering our hometown teams. Ironically, more hockey teams from California made it into the 2011 playoffs than from Canada.

And by the way – no Canadian would ever call this game “ice hockey”.

During the February 2010 Olympic games in Vancouver,  almost 17 million Canadians – well over half our population – watched Canada beat the U.S.A. in the men’s hockey gold medal final. Compare that to barely 7 million of us who watched that year’s Super Bowl XLV. We are a hockey-mad country indeed. Go Canada!

But getting too excited about our Canucks in the playoffs could actually be psychologically and physically damaging. A new UCLA study warns that a loss by the hometown team in an important game can lead to “increased deaths in both men and women, and especially older patients.”

Researchers reporting in the medical journal Clinical Cardiology* found that total and cardiac mortality rates in Los Angeles County increased for both men and women immediately after the city’s 1980 Rams’ Super Bowl loss, but there was an overall reduction in total mortality – especially in older people and females – after the 1984 Raiders’ win four years later.

But winning or losing may not be the only factor worth considering. An earlier study published in the New England Journal of Medicine** examined heart attack trends among Germans during the 2006 World Cup compared to other times of the year.

This study concluded that on days the German football team played, cardiac emergencies more than tripled for men and nearly doubled for women. How the team played, the overall importance of the soccer match, and whether the winner was determined by a shootout all affected fans’ heart risks.

Dr. Ursula Bertrand, a psychologist from Green Bay, Wisconsin (who ought to know, having watched her own Packers beat the Steelers in Super Bowl XLV) explained:

“Many sports fans, it needs to be said, will be self-medicating. This can be helpful, but in excess it can also make anxiety attacks more likely.”

One of the UCLA study authors even said in a press release that “stress reduction programs might be appropriate in individual cases.”

Enter Benedict Carey, writing in the New York Times, who has recommended these brilliant preventive home treatment guidelines for over-anxious sports fans – easily adaptable to fit our Stanley Cup playoff “patients”:

1.  Establishing a Therapeutic Alliance (Pre-game)

Patients often arrive on the couch well before the first face-off, agitated and highly resistant to treatment. Proceed with care. Attempts at small talk or queries about their mental well-being may at first be met with an irritated stare, a gesture toward the flat screen and insensitive remarks like “Do you mind?” or “The game’s about to start, okay?”

This is the disorder talking, not the person.

It also provides an opportunity to establish trust, by sitting with the sufferer and his or her feelings.

2.  Evaluating the Severity of Impairment (First Period)

The severity of the disorder will usually reveal itself early in the first period of the game. Some patients will exhibit physical symptoms, including flushing, heart palpitations, chest pain, even a choking sensation when their team chokes. Others may show psychological signs, like disorientation, a numbed trancelike state, or disordered vocalizations like “What the…,”   “How in the name of…,”  “Oh, lord, no.”

“Tell me that didn’t just happen!” is another characteristic rhetorical reaction to an undesired play, almost always followed by this remark: “I can’t watch this anymore.”

Caution: Do not approach patients in these moments. They are fragile and prone to hurling nearby objects, including chicken wings and Timbits – even themselves, in extreme cases – to the floor.

3.  Formulating a Treatment Plan (Second Intermission)

Patients ritually leap to their feet and disappear at this time. This break allows the therapist time to develop an intervention for the third period, when symptoms are most severe and disabling.

The goals of treatment are the same for all patients:

• to reduce anxiety
• to eliminate avoidance behaviors
• to soothe physical symptoms like sleep loss, chronic groaning and cursing at the TV and pets

Yet each individual suffers at different times and for different reasons, and the treatment plan must be tailored accordingly.

4.  Administering Therapy (Third Period)

The first commercial break after the third period face-off is the time to explain to the patient that his or her suffering is rooted in cognitive misconstruals, automatic assumptions that do not stand up to scrutiny.

The notion that the world will end if the patient’s team loses – catastrophizing, as this sort of thinking is known – does not stand up to the evidence. Remind the patient: life did resume after each previous loss that the Canucks suffered. And, in time, taste returned to food, colours became visible, feeling returned to extremities.

Breathing exercises are highly recommended and become increasingly important as the game nears the end of regulation time, when events on the ice are likely to prompt strong physiological reactions, like a pounding heart, hyperventilation, even dizziness. These internal cues, as they’re called, can escalate the feeling of panic, a self-reinforcing cycle resulting in groans and cries that can be frightening to small children, pets and sometimes neighbours.

In the final minutes of a close game, be forewarned: many patients will move beyond the reach of therapy. Their faces may change, their breathing appears to stop. Once in it, patients may fall back on primal coping methods, behaviours learned in childhood within the cultural context of their family. Like emitting screams. Or leaping in an animated way, as if the floor were on fire.

Benedict Carey’s important note to therapist:

“At this point in the game, if you are rooting for the same team as the patient, it will not violate ethical standards to join in.”

This video was created by 13-year old Canucks fan Tammy Yang from Vancouver

• * Clinical Cardiology, Volume 34, Issue 2, February 2011
• ** New England Journal of Medicine, Volume 358, Issue 5, January 2008

2011 Canuck-o-meter: 

1.  The Vancouver Canucks made it through the first round of the Stanley Cup playoffs by eliminating the Chicago Blackhawks in seven games. They face the Nashville Predators in Round Two.

2.  The Canucks moved through Round Two by eliminating the Preds in six games.  They will play the San Jose Sharks in the third round.

3.  In double overtime in Game Five, the Canucks beat the Sharks in Round Three to win the Western Conference title and moved on to the Stanley Cup finals against the Boston Bruins.  GO CANUCKS GO!

4.  In the Stanley Cup finals (best of seven games series):

• Game One: Canucks beat the Bruins on home ice, 1-0, with just 19 seconds left in the third period of play
• Game Two: Canucks came from behind to once again beat the Bruins in Vancouver with a score of 3-2, about 11 seconds into the first overtime period
• Game Three: Bruins humiliated Vancouver with an 8-1 score in Boston
• Game Four: More humiliation tonight from Boston – the B’s beat the Canucks 4-0
• Game Five: Redemption! Canucks won against the Bruins 1-0 back home in Vancouver to lead the series 3-2
• Game Six:  We needed a seventh game after all: the Canucks lost to Boston by a 5-2 heartbreaker tonight. The series was now tied at 3-3.
• Game Seven: BOSTON BRUINS WIN THE GAME and the 2011 STANLEY CUP!  Congrats B’s and ‘Nucks for such an exciting run!

NOTE:  As if it weren’t bad enough to lose the Cup in Game Seven that night, drunken thugs burned, looted and attempted to destroy downtown Vancouver as fans poured out of the arena to engage in the infamous Stanley Cup riots.

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