René Holten Poulsen is a Danish sprint canoeist, three-time Olympian and multiple world champion, whose mental health spiralled after a poor performance at Rio 2016.

He has worked through those challenges with the help of talking therapy, research and journaling, and now wants to raise awareness among athletes about the prevalence of PTSD in elite sport.

Find out how Athlete365 can support you with your mental health through our #MentallyFit campaign.

I believe there are more athletes than we think who have suffered from this, and that we have a chance to help them.

René Holten Poulsen

As a two-time Olympian, with a silver medal from the Olympic Games in 2008, and double World Championship gold in 2015, I came into Rio 2016 as a strong favourite to win gold. But after several problems, including illness, I ended up in sixth, missing out on a medal altogether.

While trying to qualify for Tokyo 2020, I found out that I suffered a trauma, or PTSD reaction, from that experience. I would be going down the course in a race, and if I found myself in a similar situation to the 2016 Olympic final, I would just stop. And until I was diagnosed, I had no idea why.

I don’t wish for anyone to be one of the best in the world at your sport, and to keep training at a high level but have no idea why you’re not performing at all for almost four years.

I’m working it out now, and I feel almost 100 per cent. But the damage is done, and the journey back to the podium and to your absolute best takes time – not to mention the healing process of the mind from the stress and depression that comes with it.

I believe there are more athletes than we think who have suffered from this, and that we have a chance to help them – whether that’s through specialists, athlete ambassadors, or a combination of both. I think there is something to be done, and that we need to take a much more serious look at this issue.

I’m René, and this is my story.

Disappointment in Rio

In 2015, I reached my goal at that time, when I won the K1 500m and 1,000m double at the World Championships. After that, there was a lot of media stuff, then I went to Russia for a few days for a competition, then home to Denmark for the nationals, and then to Brazil for the pre-Olympic test event. So less than eight days after I won my World Championship titles, I had done two more competitions and was standing in Rio de Janeiro ready for the third.

I didn’t have time to sit down and process what I had achieved, and so I basically started training for Rio 2016 without having reset my goals. This, I think, was the beginning of what would become my trauma – and in the end, my PTSD reaction.

Going into Rio 2016, I was the favourite and everybody in my country was wondering what colour it was going to be, rather than if I was going to win a medal. But then I got ill on the way over to Brazil on the overnight flight. It wasn’t much, but it was enough that I needed penicillin antibiotics, but which I didn’t end up taking until after the semi-final.

I was in the outside lane for the men’s K1 1,000m final, and even though I was a bit tired, I knew physically that the year before I had been winning medals on days when I was not feeling great. But this time, I remember looking at the finish line with 400m to go, thinking: “Just another 400 metres and then it’s over, no more pressure”. And that is not how you should be racing an Olympic final if you want to win.

That in itself was a terrible experience. My girlfriend at the time became Olympic champion a few days before, and as much as I wanted to be happy for her, I was just completely gutted. I’d have moments where I’d be like, “OK, it’s fine – I can tough it out”. But then I’d have moments where I would just stare into the wall, because I was so disappointed with what had happened.

And over the next two or three months I didn’t actually sit down once with a piece of paper and write out what I was thinking, what I was feeling, what had happened, what was next, or whether I wanted to continue competing for another four years. I just did nothing; zero. I wasn’t happy, I wasn’t unhappy; I was just numb.

Call us, we’re here for you

Beijing Olympians, Paralympians and Entourage, get free access to a confidential mental health helpline. Available 24-hours a day in 70 languages.
Impact on performance

This kept going until it got worse and worse, and I had a few experiences where I would stop or give up in a race because it reminded me of the Olympic final. Competitors would be in a certain position in the race in front of me or beside me, and something would happen or I’d have a feeling in the body which would remind me of it, and then I’d stop – or have the feeling that I wanted to stop.

From Rio 2016 until the 2019 World Championships, which was the qualifier for Tokyo 2020, I’d improved over two per cent on the physical test, and I got faster. We have an indoor ergometer test, and I delivered more watts at a higher VO2-max.

So I was improving physically, but at the same time I got at least another two per cent slower. At the 2017 World Championships, I couldn’t sleep for four days during the competition and I didn’t know why. At the 2018 European Championships, I was so far behind in the B final, and I couldn’t explain what was happening. And then in the 2019 World Championship semi-final, I was sitting in a good position with 250m to go, and I just stopped.

Normally when you’re a competitive athlete, if you give up you’d have remorse, but on this occasion I had none of that. I didn’t stop for anything; I didn’t know why I stopped paddling, and I knew something was wrong.

The next day, our sport director, who is also sports psychologist and a former special forces solider with experience from Iraq and Afghanistan, pulled me aside and said: “You said something after the race, and I’ve had my suspicions for a while. I’m sure you have a trauma and a PTSD reaction; it’s the only thing that makes sense.”

What I apparently had said when I came off the water was that the race reminded me of the 2016 Olympic final, and that it was all I could think about. So after that, he was certain something was completely off.

It was kind of a relief to hear, because I had been wondering why I was not improving; it was such a contradiction. I could see my physical tests getting better, but I was feeling worse and worse, and my performance was declining.

Writing the diary, and finding out what I felt, why I felt it, how it had affected me and how I felt about it, was a process that I went into and just had to trust that at some point I was going to get out on the other side. And I don’t know for sure if this is the reason why, but I just started feeling better and better.

René Holten Poulsen

The road to recovery

Finally, I actually got an opponent. And from there, I started writing diaries, reading books, and working with a sports psychologist we have at Team Denmark. Writing the diary, and finding out what I felt, why I felt it, how it had affected me and how I felt about it, was a process that I went into and just had to trust that at some point I was going to get out on the other side. And I don’t know for sure if this is the reason why, but I just started feeling better and better. Journaling is great because you can be completely honest with all of your feelings. And then you close the book and you go: “That’s it. I won’t think about it until tomorrow”. It’s like you’re unloading all of the negative feelings.

Check out our article on how journaling can help you stay positive.

During all the research I did on trauma and PTSD, I didn’t know what to call it – and I still don’t know what to call it. I checked all the boxes for PTSD, but no psychologist is going to confirm that that’s what it is, because there’s an idea that PTSD only affects people who come home from war or something. But that’s not the case; that’s not what it is. I think all people have traumatic events in their lives, and some handle it with no problems, but there are also a lot of people inside or outside sport who don’t know why their body is reacting in a certain way.

I don’t think you really ever get over trauma. But I think you can learn from it, and you can learn to live with it. It’s an on-going process, and you just get better and better at balancing it. On bad days in training, I still see that moment from Rio 2016, and I can still have that feeling. But at least now I know what it is, which makes it so much easier.

All my research says that the more you know and read about trauma, then the more you understand it, and the easier it is to cope with it or to get through it and work with it. I probably spent 10 hours a week studying how to be present in the now, and that research, combined with journaling and someone to talk to about it – a psychologist – are the three tools I used. I would say they are pretty basic tools that help you mentally, and a sports psychologist or any psychologist would probably advise the same.

Steps to improve sport

I think what’s important is that all athletes should be more aware of this issue, and that sports organisations and companies should take a bigger look at it. For me, the joy that I can come down to training with now has a positive impact not only on my own training, but also my training partners – and this is something that we also see happen in the world of work.

I hope in the future that we can find ambassadors and build a gateway to inform more athletes and people in general. If we took Olympic champions, Olympic athletes or anyone with a great story, and use them to teach the younger athletes, that would be a great place to start. It’s great to have a sports psychologist, but you look at other athletes and you listen to them for some reason. You just have this kind of respect for athletes in a different way that you do for someone who’s just a psychologist, because athletes have been in your shoes.

I know it would have been good for me, and I know it would make a difference to someone who’s going through something similar to what I went through. It might be a 20-minute conversation with that athlete, but that might help you make the decision to talk to the sports psychologist.

Ultimately, the dream scenario is that there is a sport psychologist or mental coach so that – say specifically for the Olympic Games – every athlete who participated has to sit down afterwards to get an evaluation. And if anything is picked up, they can keep working on it with that coach or psychologist until it’s better.

Just like we’re screening for injuries when we go to the physiotherapist, maybe there’s a way to screen athletes for mental injury or mental trauma. And once you exit the Olympic Village, you have to go through it. I think if that was possible, that would be major.

Looking forwards

My perspective is that the athletes who struggled the most with the postponement of Tokyo 2020 were the ones who were only focused on winning, or on the result. And the athletes who struggled the least were the ones who were focused on the process, and who actually just enjoy doing their sport.

For me, I used it as an opportunity. It’s like I was given a one-year free pass to work on myself, work on my technique, work on my physical ability and get my body one hundred percent again, relaxed and ready to perform.

Find out how Athlete365 can support you with your mental health through our #MentallyFit campaign.