Erin Strout: The Mental Health Crisis in Women's Sport

From DreamRun Camp, I'm Matt Fitzgerald, your host. Behind the camera, as almost always, is Lauren Clement, valued assistant coach here. Um, so we are in Flagstaff, Arizona at DreamRun Camp. We've got all kinds of exciting stuff going on here, so at some point we're going to be interrupted by a bunch of elite British runners who are training in Flagstaff right now. They're, uh, Coach Andy Hobdill is staying here at Dream Run Camp. Kind of neat. Also have a blast from the past friend, Erin Beresini. I love it. I love it. It's just great to see you again, Erin. And this is the night of Erins. I am very excited to welcome my guest for this evening, our guest for this evening. Erin Strout.

Thanks for having me.

Right on. I didn't give you a title. Do you want to give yourself a title?

Writer, freelance journalist. That about covers it, probably.

I'm sure you're asked to do this every now and then, right? Just say, yep, what do you do?

Or like, yeah, sometimes I don't know what I do.

Yeah. So you and I are not meeting for the first time. No.

That's true.

Yeah, you guys just be yourself. Yeah, we're live, but this is how we roll here at DreamRun Camp. All good. Just do your thing. Yeah, don't be shy about it. Like, if you want to sit here, here, here. Um, and if you get bored and want to leave, you can just leave. It's like, yeah, it's like, yeah, yeah, this is not, you know, whatever, David Letterman. Almost. Almost. Yeah. Heading that way. We'll be very buttoned down within 15 years. So you and I are not meeting for the first time.

We are not.

How do we know each other?

Probably mostly through bumping into each other in media rooms at marathons across the country. I would imagine that's probably how we originally met. Just small world of people who write about running.

Right on.

Yeah.

Yeah. And then I think it— when I was here in 2017, that's the first time I like really got to just get to know you better, like have a conversation. And I remember you telling your story of like how, like just moving to Flagstaff and like falling in love with it. And, you know, it resonated with me so much because like, that's exactly the experience I was having then. Yeah. So tell us the story.

Yeah, so I came here for an adult running retreat, not unlike what you do here, for about a week in, I think it was 2008 or 2009, probably 2009. And it was just kind of at a point where I was diving into freelancing instead of a full-time position, and I was living in D.C. at the time and kind of realized that I didn't have to, I'd lived on the East Coast my whole life, came out here and saw the mountains and all the people outside all the time and just a completely different lifestyle. And I was like, I could get into that. So yeah, I, I came back with all of my belongings and signed a 6-month lease and that was 15 years ago. So here I am.

And I'm going to be hazy on the details, but like, I think the way I remember it, and it could be wrong, it's like initially you felt a little bit isolated, like you you hadn't found necessarily like your people and what, did you bump into someone at Whole Foods who invited you to a barbecue and it was all runners? Oh yeah. Something like that?

Yeah, something like that. I was, yeah, I think it's, you know, when you move anywhere as an adult and you're also working from home, I think, you know, it's just hard to meet people no matter what you're into or what you're doing. So yeah, I was, just kind of volunteering to do anything. I was volunteering at one of the summer series races and met a few people there, and they were having a barbecue that night with a whole bunch of—

I had the barbecue part right.

Yeah, that's right. Yeah, they invited me to come, and at that point I was, I was like Little Miss Awkward going to everything not knowing anyone, which is like a really terrible period, but it's like necessary if you want to meet people. So yeah, I went to the barbecue and I'm still friends with all of those people.

Yeah, all of them. Yeah, yeah. That's just how it is here, right?

Yeah, you just got to dive right in.

Yeah. Um, so the, uh, the occasion— I mean, we would have welcomed you as a guest here anytime, but the occasion for this, you know, the timing, um, is, uh, a book that you have coming out now. It's complicated. There's like co-authors. Hey, Betsy! Hi, Betsy's here, everyone.

Welcome.

Yeah. So there are two authors and we'll get into them. And then you were kind of like the amanuensis or, you know, you were the wordsmith.

I was the writer.

Yeah. Yeah.

Yeah. So two therapists. One is on the faculty at University of Oregon and the other one has a private practice in Bend, Oregon. Both of them, you know, see a lot of athletes, help a lot of athletes, and came up with this idea of what they wanted to do, which is write about female athlete mental health in particular. And yeah, so they, they wanted a writer to write what they were envisioning, and so we all just sort of came together by connections and all those fun things, and that's how we ended up with the book.

Right on. The title of which is The Price She Pays. And you were kind enough to share like a PDF, like uncorrected. I get it.

You noticed how I emphasized this is an uncorrected proof.

Believe me, I know.

I know you understand.

Yes. But yeah, so I dived into it. I mean, I think I just got it yesterday, right?

Probably.

Yeah. And so I dived into it today. I went for a— it's a beautiful day here in Flagstaff, everyone. And I went for a 5-mile walk and I just put it on my phone and started reading it. And, you know, like, I don't— I don't say this to flatter you, but like, like already, like, because I'm like 2 and a half chapters in.

All the dudes are like, thanks boys, we just did a gym session.

Like, oh good, no, I told you, leave, leave anytime you want.

Yes, it was nice meeting you.

Yeah, nice to meet you. Likewise, look forward to reading your book.

Yeah, thank you.

Yep, um, where was I?

You were reading the book.

Oh yeah, reading the book. Yeah, but it's like, you know, I, I, I mean, it, it sounds trite But I mean, it's true. Like, I think that like this is like essential reading, definitely for coaches, but, you know, definitely for more than just coaches. So like, yeah, it just seems like an incredibly important and timely book and it's very well done as far as I've gotten. It could all fall to shit in chapter 5. I don't know.

Let's hope not.

You bonked in chapter 5?

Yeah, I'm sure I did bonk somewhere along the way. You can let me know, right?

Um, but, uh, yeah, so like, could you just like, um, I, I do want to hear more. We want to hear more about the, um, how it came together, but like, just like, what's the synopsis?

The synopsis is, um, so we're concentrating on female athlete mental health because for a variety of reasons, but, um, I think, you know, there are a lot of factors that female athletes encounter that are unique to them. Primarily, you know, we get into eating disorders, anxiety, depression, sort of what the root causes of those can be or how they manifest in sports. Suicide. At the time that we were putting together the book proposal was a really like bleak period in NCAA women's sports. There were, there had been 5 athletes who had, female athletes who had died by suicide in one semester. And so we, it just kind of reinforced the fact that we needed to look into it and see what was going on and what was contributing to that. And I think, you know, that seems so long ago now. It wasn't that long ago. But so much has happened in women's sports since then that I think even more people will be focused on the topic of this book.

Yeah. Yep. Cool. So yeah, before we dive into the guts of the book, tell me about— I mean, that was like— I mean, I was hooked very quickly because you have kind of personal statements, mini biographies of the two authors. And, you know, harrowing, you know what I mean? Like, that's not an exaggeration.

Yes.

Like, like to describe your experience just as a woman runner who's pretty good at running is like a harrowing experience.

How it can go wrong so quickly.

Yeah.

Yeah. If you're not in the right hands and your career isn't being guided in the most ethical ways.

Yeah.

Yeah. Without giving away too much, we'll just say that Katie Steele ran for the University of Oregon and had a pretty treacherous experience. And yeah, we, we start the book off with her story.

Yep. So yeah, just tell us a little bit about both, both of them.

Yeah. So Katie, as I said, she was a D1 athlete and she had a pretty pretty terrible experience as a D1 athlete. Wrestled with a lot of things that, you know, today's runners still wrestle with, with, you know, a little bit of— I don't think she was diagnosed with an eating disorder, but she did, you know, dip into the, you know, relative energy deficiency in sports territory. Was told, you know, when she didn't have when she wasn't menstruating that her body fat was probably right where it needed to be. Instead of seeing menstruation as a sign of health and strength, it was seen as, you know, something where, well, perhaps you've gained too much weight if you're getting your period, you know. And to be clear, she was not an athlete that long ago. And these things still happen.

Right.

So, yeah, she went into psychology and became a therapist. And now, like, her sole mission is really to make sure that other athletes don't have the experience that she did. And then, so Tiffany Brown is, she's a PhD. She's on the faculty at the University of Oregon. She works with a lot of athletes at Oregon. And she just kind of came into sports in a completely different way. Was not a D1 athlete, but like, Yubi, like, you know, as a child found a lot of joy in playing different kinds of sports. She tells a story in the book about how, you know, her access wasn't kind of what other kids had around her. She didn't have transportation to get to practice. She didn't have, you know, caregivers that were supportive of buying the equipment and those kinds of things. And so, she comes at it a completely different way and can see just sort of sports in a completely different way than Katie does. And I think the two of them together combined with their expertise is pretty fascinating.

Yeah, it is. Yeah, they kind of came to the same place from different directions.

Yeah.

Yeah. Yeah. And so, like I said, like, I mean, I know I saw the table of contents that's right up front. So like, I know the territory ahead. But yeah, say a little bit more about the structure of the book and really like who it's for and what the desired effect is.

Yeah, so I think when we were originally thinking about audience, first came parents and we got into sort of the introduction into sports and what that looks like. Sort of how to make that a healthy experience for a young girl and how to like sort of help her continue through periods of time where girls are known to drop out of sports, like puberty. So that's how we sort of get started. I think parents will get a lot out of that sort of first section of the book. I think coaches, as you were saying in the beginning, can get a lot out of all the entire book. We do get into a lot of just sort of where it can go wrong or the support that coaches don't actually get to navigate some of these issues with or even identify or understand them. Some have more background in that than others, but universally, there's there's just no training or education for coaches on any aspect of mental health that we get into. So we think that coaches would benefit from reading it. And athletes themselves, I mean, we get into NCAA level, we get into pro level. So it kind of runs the gamut from that first initial introduction up until the You know, if the Olympics are something that, you know, somebody's legitimately striving for, we touch on also retirement from, you know, whenever that retirement comes, whether it's like after high school or after college, or if you do go into the pros and end up retiring, you know, they all retire at some point. And that transition can be really troublesome too.

Yes. Yeah. And then for athletes who read it, I would imagine that like in terms of like, I mean, it could be a good reading experience, but in terms of like practical benefit for an athlete, I would think it would— they might be just in a better position to self-advocate.

Yes. Yeah, I agree with that. Yeah. And I think a lot of times athletes aren't altogether sure that what they're feeling or experiencing is normal, right? Or if it's expected or accepted, or, you know, there's a lot of confusion about what's, you know, what's normal to experience as an athlete versus what maybe isn't great, and maybe it's accepted but shouldn't be.

Yeah. Like normal but not healthy.

Exactly.

Yeah, yeah, yeah, for sure. Like, I know I'm going to be recommending the book to like, you know, I do a lot of coach mentoring, coach education these days. Like, and I think, you know, it's trite to say required reading, but I really think, I really think it is like it's so, so important. I have a couple of questions I want to tee up, but wanted to open the floor to anyone present who wanted to chime in. You don't have to. It's like you're not spotlighted. You're just like, this is what we do. Like, yeah. So usually I just tee it up that way and then I come back around later and I get it. But, you know, like, like a book like yours, I, always read through the lens of who and what I am, like a coach. It's like, for me, I'm in that coach camp. It's like, all right, how am I changed by this reading experience? Couple of questions that are like really just for my benefit.

Sure.

But hopefully someone else's. But one thing like I, you know, I find myself not— I don't want to say wrestling with because like I feel like I act very intuitively in my relationships with athletes, but like I can still like just like conceptually wrestle with things. And, you know, as I kind of like take in this dialogue, you know, the broader dialogue that your book is a part of, like— so I had a— this is going to be a long question.

Okay.

Hang in there.

All right.

You're going to get to talk. But like, I really want to know the answer. Like, I really want to know.

I hope I have an answer.

I mean, it's just like, whatever is true is all I care about. So yeah, in, in college I had this sociology professor who taught me the difference between equality and equity. So equality is treating everyone the same. Equity is recognizing that not everyone's the same and trying to treat everyone in a way that gets fair outcomes. And the example that he gave is like, well, you know, a better example actually is like cash bail. Cash bail is equal because, you know, certain offense, certain arrest, it's the same for everyone. It's not equitable because for some people, $50,000 bail is pocket change, and for others, it's more money than they've made their entire lives. So you're actually not getting the same outcome by treating everyone as if they were the same when they're not. So for me, like as a coach who coaches people of all genders and like, you know, for me, like, well, like I want, I want to be equitable, right? Like I want to get the same outcomes, but like, okay, so, but then like, you know, like man, woman is like, that's, that's pretty broad brushstrokes. Right. Right. And so I don't want to treat everyone as if they are the same because they're not. At the same time, I don't want to make the wrong assumptions about differences. It's like, you know what I mean? Like starting off differently with a female athlete just because she's a female athlete. It's like, well, that may not be true of this particular athlete. And like, again, like, I think it all works out fine practically. My heart's in the right place. But like conceptually, I have not resolved this. This. Can you help?

Can I help? Well, no, I think you, you're doing it the right way. I mean, let's— from the outside, just, um, I think every athlete, no matter what their gender, probably needs something different, you know? And it doesn't matter if they're man, woman, or otherwise. It's— you just, you treat people like individuals. And I think the other thing is to treat people like people and not just like robots and athletes. And I think if you start with that, you really can't go wrong and realize that people are complicated and running might be simple, but the way that we all come at it is always complicated.

Yes. That wasn't a wrong answer. I don't know why you felt you were on trial. Like, I'm seriously, like, I'm honestly like, you know, like as a coach, like there's quite a bit at stake, you know, for me, you know, like, and yeah, I mean, the older I get, the more I realize like, like I need, I need to be informed by other people's perspectives in order to serve the people I'm trying to serve.

So, yeah, yeah, that's not—

that wasn't just like an interview question. Like, I'm really—

I hope it helps.

Yeah, I'm trying to get somewhere. Yeah, of course it helps. And then the other one, which is like just definitely like just a Matt question, is so for me, like, you know, I love coaching every type of, of person. And but I do find like I am actually like, as I put it, a friend, like, like, men are great, women are better. And so, like, I am especially more in mentoring than coaching. Like, you know, Lauren behind the camera here, like, we— I jokingly refer to Lauren as my fake daughter. But like, but like, you know, like, I am just like, I am naturally drawn, like, I don't know, for whatever reason, like, I want— I am drawn to helping women, like women, women athletes. And again, like more of like the the mentoring type of role. So this is another really long question, but we're gonna get there. We're gonna get there, I love it, I promise. So, um, you know, so I, I'm involved in, um, uh, a program called the Coaches of Color Initiative. I think you know about it. It's like an apprenticeship program that is just aimed at increasing diversity in endurance sports generally, but specifically, you know, at the coaching level. And, you know, just like being involved in that has got me thinking about like, what's the endgame here? It's like, we know there's a problem, right? You know, like we're addressing the problem, but like, what's at the end of the rainbow? Like, what's nirvana? You know what I mean? What does it mean? Like, our work is done, you know? No more need. And for me, like, again, similarly, I mean, part of what we're trying to do for sure is like give every athlete of color an opportunity to be coached by a competent coach, coach of color. Right. You know, it's like, like that doesn't exist now. And it's very difference-making. Like, there are people who would not get into the sport sport if they didn't see themselves represented. But at the same time, like, I as a white person love coaching athletes of color. And so like the endgame for me is not like the sort of like kind of situation where like every athlete of color is coached by a coach of color. It's like, but I want to coach some of those people too. And I think there's actually like, there's something in it when it's like, everyone should have the opportunity, but it should almost like on a different level, like just be less of a consideration. So just like looking at it from like a coach's perspective, like I get it, like we need some major correction, but it's like, I sure hope I'm not deprived of the opportunity when we get to the end of the rainbow to coach people who like aren't the same race. And so like now I think we're getting back to like, you know, girls and women athletes. It's like, I think like, you know, there's, you know, a female coach can be more than just a coach to a female athlete. They can be like a role model in a way that a male coach can't. So it's like, you know, that is super important, super valuable. But like, like, is for me, like, I want, I want you to say yes, but like, you know, is there also like a place for, you know, like male coaches? Because like, you know, the world is half men, half women, right? So it's like, it's good to have relationship, good relationships, you know, across the board. So like, like what's the role for like, you know, coaches like me in the future when we get to a better place, when like there, there's just you put— you have some of those statistics in the books like, you know, just there are not enough female coaches. So when we get to when it's like 50/50 or even, you know, 45/55, whatever it is, like what, what's it like for, for me then? Do I still get to coach women and like, and what does the value add? You know, just like, what are we adding? Yeah.

Yeah, those are some big questions.

I know, like I'm—

I would say, so I forget what story this was that I was writing quite a while ago. It was about the lack of female coaches. But it's just like when you think about, any room where decisions are being made or people are being led or guided, you want different perspectives at the table. You don't want just the white male perspective. And I think, you know, as you said, like women tend to understand what other women are going through as athletes. And I think that's a valuable perspective to have whether they're the head coach, they have a voice at the table. I'm thinking NCAA, like you wouldn't want the sprint coach coaching the jumpers, you know, like they don't probably, or the distance coach coaching the jumpers.

God forbid.

Like, you know, I think there's a seat at the table for all kinds of people. It's just like inviting them in. And I think, you see performance increase. You see people being happier in their athletic careers when there are more people that they can go to and identify with and see themselves in, or find the, the, you know, the help that they need, or the, you know, understanding and empathy that they need at any given time. And so I do think that there's there's room for everyone. It's not that men can't coach women. That's obviously not true. But I do think there's, there's way more room for, for women to be, you know, doing the same jobs and, and being invited in and, you know, having their careers flourish in a way that they're still not able to do.

Yeah, yeah. Something I actually did not think of this until I was hearing that answer. Like something I think that I am, I am doing when I'm like, like coaching or mentoring women is like trying to like almost like set a standard just like, like to, to behave in a way and to like develop a relationship that like shows like this is possible, like, like a very, very, very healthy relationship is possible.

Oh, for sure.

And then like, you know, then like presumably, hopefully you won't forget, you know, it's like that should, that should be your standard. And like, it's very helpful to me to think that way. It's just like this can ramify, you know, it's just like, you know, I coach Betsy, like our relationship is just me and Betsy, but it's also, it's a little bit more than that, you know, as far as I'm concerned. So I think like, I think that's, that can be sort of additive where like for sure, like, you know, women are going to have lived experience as coaches, you know, that male coaches don't have.

Right.

And, you know, at the same time it's like, all right, well, but it can, there can also be like a complementarity where especially with younger women. Like, I, you know, I've seen so many examples of it where like just the right male influence at the right time, it does— it's like standard setting. It's like, don't settle for less than this, you know, this level of healthiness. And now you've seen it, right? So it's real. And then as you move on in life, you know, don't just like— remember that, like, don't— don't— do not settle for less than that. Yeah, I was just lecturing. Yeah, sorry.

No, that's fine.

But no, really, I mean, quite honestly, like, you know, like, your, your book has really just got me thinking.

I'm glad. That's what it's meant for.

Yeah, yeah, yeah. And when it's printed next week, hopefully Couple more weeks.

Comes out June 18th, but you can preorder it now.

Yeah, we should be brandishing it. So let's rewind before we have pasta. So we have pasta on the menu. Thank you, Nataki, pasta queen back there. Yeah, but before we get to that, we haven't actually talked a lot about your relationship with running, like how you got into it and what the journey's been like.

Yeah, so, well, I grew up swimming, competitive swimming, and so, um, yeah, the parents wanted us to be doing something in the fall, and the one little, you know, few weeks of the competitive swimming year that was empty. Um, it's, it's a year-round endeavor, so, um, so I chose cross-country, um, and that's, yeah, in middle school, I think, and ran cross-country. I was you know, super slow, but I loved it. Um, ran through high school, did not run in college. Every now and then I would be inspired to take a jog around campus, but that was about it. Um, and then when I moved, um, after graduation to New York, um, got really involved in the running community there. Um, you know, ran my first New York City Marathon, ran my first marathon, and yeah, that's how I I sort of got back into it and, um, I've been doing it ever since.

Right on. And, uh, and so like what, uh, where are you now with running?

Um, we have not— running and I have not been in a great place in the last, I would say, 5 years.

I feel you.

I would say, um, we're trying to repair the relationship right now. Um, Yeah, I just, I got busy with other things and just, you know, wasn't interested. I think I trained really hard for many years and, you know, did all the PRs and the Bostons and all that kind of stuff and just burned out. Was not all of a sudden just was not interested in doing it. And if it's not fun, I don't believe as an adult who's not getting paid to run, I don't think you need to do it. Um, So, um, yeah, in the past, I would say year or so, I've been getting more consistent, um, but just when I feel like doing it. I just don't put the pressure on myself anymore. But yeah, I, I ran today, so that was good.

Nice. Yeah, sweet. Uh, yeah, well, as I like to say, it's not a tragedy to fall out of love with running, it's a tragedy to fall out of love with running and keep running. I mean, like, it's a freaking hobby.

Exactly.

You know what I mean? Like, for me, like, I didn't burn out. I just had it taken away from me, right? It's like, well, I damn well better not need running to be happy, you know what I mean? And that should be all of us, right? No matter how much it means to you, no matter how much you're getting from it, like, it can't be everything, right? So you can get to a time in your life, it's like, you know what, I can come back to it whenever, just not feeling it right now, right?

Yeah, exactly. Yeah, so that's where we're— that's where we're at.

Right on. Do you know about my comeback journey?

I know some parts of it. I don't know where you're at right now.

Yeah, yeah, deep in— deep in post-exertional malaise today.

Yeah.

Yeah, but it's like, yeah, there's no other way, you know? Just like, yeah, you just, yeah, there's no playbook, no playbook for this. But that's part of the fun.

Right.

Yeah.

Fun, I guess, but.

Yes, yeah. Cool, well, you ready for some pasta?

Sure.

Sweet. Well, It's been an absolute delight. Like, I'm really, again, like, not just telling you— it's not flattery. Like, it's a really, really excellent, important book.

Thank you. I really appreciate that.

Yeah. And I will be sharing it far and wide.

Great. That's what we like to hear.

Yes. Yeah. Well, you know, it is a product.

It is.

It is. Yes. So, yeah, but it deserves commercial success.

Thank you.

Right. And I, again, like, I'm only 3 chapters in, so much more to come. All right. And when you write your next— but you're never gonna write another book, are you?

We'll see. It's a lot of sitting, which is not good for you.

Yeah. Oh shit, now you tell me.

I don't know how you do it, cuz that's—

yeah, yeah, that's, that's a topic for another time.

Yeah, yeah, that's a whole other podcast.

Yeah, but thank you very much, really appreciate it.

Thanks for having me.

Appreciate you. Right on.

All right, thanks.

Peace.