The very real psychological condition known as the “yips” was on display in the brightest of spotlights: Game Seven of the World Series last fall. The Indians tried to fluster Jon Lester, whose troubles throwing in any direction other than toward home plate had become well known.

After making 98 pick-off attempts in 2010 and 70 in 2011, Lester made just five in 2012, seven in 2013, and none in 2014, according to SportingCharts data. He didn’t make a single pick-off attempt over the course of 66 consecutive starts until this one on April 13, 2015:

The issue isn’t only tied to pick-off attempts. Lester has also struggled when fielding his position, as seen on this throw from April 17, 2016:

Lester’s issue is the most well known and publicized in recent years, but it’s not the only case. This spring, Blake Swihart has struggled throwing the ball back to the mound, though Swihart is reportedly making some progress on that front.

Blake Swihart getting better with throwing back to the pitcher, but still has occasional issue. #redsox #wbz pic.twitter.com/5tJZr5X4Wj — Dan Roche (@RochieWBZ) February 19, 2017

I personally watched and reported on Pedro Alvarez’s 24 throwing errors in 99 games at third base in 2014, a development that necessitated a move down the defensive spectrum from third to first base.

In 2013, Alvarez hit 36 home runs and played an above-average third base, according to defensive runs above average (1.8). He recorded 3 WAR. But after his struggles with throwing in 2014, after he moved to first and struggled there in 2015, he was then viewed largely as a DH last offseason. He had to wait until March to sign a one-year deal with the Orioles last spring. This spring, he remains unsigned in a market that values bat-only players less and less. Baltimore attempted to play Alvarez at third base in spots in 2016, but he was still not over the throwing issues: he recorded two throwing errors against five assists in 53 innings at the position.

The yips have cost Alvarez millions and might play a role in prematurely ending his career. The condition did end the career of Pirates broadcaster and former Pirates pitcher Steve Blass. The yips played a role in derailing the pitching career of Rick Ankiel, who said in a recent interview he drank vodka before a start in 2000 to “tame a monster” that “didn’t fight fair.”

There’s something inherently tragic about an otherwise healthy athlete failing to fulfill one of the most basic obligations of his profession. It can be uncomfortable to watch a pitcher such as Lester become vulnerable in the center of the infield. To watch a player like Alvarez inexplicably lose the ability to make routine throws is difficult to comprehend. While I had explored the issue as a newspaper reporter, I wanted to understand more about the condition and how teams might be able to ameliorate it. So last week I spoke to one of the few players who has suffered through the condition and beat it: Steve Sax.

Triggers and Psyche

In the ninth inning of the Dodgers’ 1983 home opener, Andre Dawson tripled to right field and Sax made an errant — and unnecessary— relay throw home, the ball skipping off the shin guard of catcher Mike Scioscia. Dawson scored. It was the trigger for what became known as “Steve Sax Syndrome.” The second baseman made 30 errors that season, as he became unable to execute routine throws to first base.

“It’s amazing when you talk to people, it doesn’t matter when they played or where they played, all the symptoms are exactly the same,” Sax told FanGraphs last week. “Something triggered it. They hit somebody. They threw a ball away to end a game. ‘I hit somebody when I was pitching in batting practice.’ Something triggers it. It’s a horrible thing.

“I started thinking about it [after the error]. Basically, I just lost my confidence. Over the course of the season, I started a campaign of negative thinking.”

What’s so unusual about the condition is that, in practice, away from game competition, athletes struggling with the yips can complete the tasks at issue without problem. Symptoms disappear. As his struggles persisted, the Dodgers had Sax take early infield work when the stadium was empty of even teammates. Sax said he showed up for infield work as early as 12:30 p.m. at an empty Dodger Stadium prior to a 7:00 p.m. game.

“They would have me throw the ball to first and I would hit him in the chest every time,” said Sax, who is now a motivational speaker and author of Shift. “They would blindfold me, and I would hit him in the chest blindfolded. It was absolutely crazy.”

But when the lights came on, when stands filled with fans, the condition returned. Fear crept in. Sax would become more mechanical in his throwing, and more throws were off the mark.

“I would come off the field and just excoriate myself, screaming at myself ‘You fucking idiot! You stupid fuck! Just awful. I was going to bed with this thing. I was waking up with it. I was losing weight… Five to 10 pounds… It’s so perplexing.

“When [players] are going through this, all they have is this self-loathing, this angst they carry around in their heart about themselves. They hate themselves for putting themselves through this. One thing they have to know is there is nothing wrong with them. Let yourself out of jail… But players are so hard on themselves.”

Patrick Mooney of CSN Chicago observed last spring as Lester tried to work through his issues:

The Cubs are trying to attack the problem head-on, even if it meant Lester pitching on Field 1 during Tuesday morning’s controlled scrimmage against minor-league players at Sloan Park. It left beat writers comparing notes on how many times – at least three – Lester’s pick-off throws to first base wound up near the chain-link fence. In this intimate setting, you could hear the frustration and listen to the guttural noises as he finished his pitches in front of dozens of fans. “God damn it!” Lester screamed after one of those wild throws.

What exactly is happening with Lester and Sax and Alvarez? How do they lose the ability to perform such routine tasks? There’s some agreement in the psychology community.

In a piece titled “The Art of Failure”, written for the New Yorker back in 2000, Malcolm Gladwell explored the difference between choking and panicking. Gladwell described choking as a phenomenon when a person under stress replaces “explicit” with “implicit” learning.

According to Daniel Willingham, a psychologist at the University of Virginia …. when you are first taught something — say, how to hit a backhand or an overhead forehand — you think it through in a very deliberate, mechanical manner. But as you get better the implicit system takes over: you start to hit a backhand fluidly, without thinking… Under conditions of stress, however, the explicit system sometimes takes over. That’s what it means to choke. When Jana Novotna faltered at Wimbledon, it was because she began thinking about her shots again. She lost her fluidity, her touch… The same thing has happened to Chuck Knoblauch, the New York Yankees’ second baseman, who inexplicably has had trouble throwing the ball to first base. Under the stress of playing in front of forty thousand fans at Yankee Stadium, Knoblauch finds himself reverting to explicit mode, throwing like a Little Leaguer again.

Back in 2014 for my piece on Alvarez, I spoke to Sian Beilock, a University of Chicago psychology professor and author of Choke, who said the yips phenomenon is tied to a switch from unconscious to conscious thinking, similar to Willingham’s appraisal. Said Beilock:

“(Our mind) is a limited-capacity system. We can only pay attention to so much at one time. As we get better and better, some of what we do becomes automated so we can use our (consciousness) for other things. The issue is when we are in a stressful situation and working under pressure to perform well or had a poor performance in the past, those tasks that were automated before become un-automated. We start consciously attending to them… When people are watching you, you start watching yourself.”

The issue is perhaps tied to environment, it’s a matter of self-awareness.

The low point for Sax was at the 1983 All-Star Game, when he collected a ground ball off the bat of Manny Trillo and threw the ball away before a sold-out Comiskey Park crowd and a national TV audience. After the game, a despondent Sax returned to his hotel room of the Hyatt on Upper Wacker Dr. in downtown Chicago.

“I almost gave up. Everyone has a breaking point. I got tired of hating myself,” Sax said. “After the game, my mom was with me, in the room, and she said ‘One day, you are going to be glad you went through this thing.’ I never thought my mom took part in the smoking of hashish or anything like that, but I started to wonder if she had after she said that. But she was right. She was absolutely right. It made me a better person. It made me a better player, for sure. I guess God picked me to be the person to get the hell tested out of them.”

Taboo

Since Sax’s playing career ended, sports psychology has become more accepted and widespread in athletics. Most, if not all, major-league clubs employ a sports psychologist. In college baseball, the South Carolina Gamecocks, which won two straight College World Series (2010-11), are perhaps the first team of any kind to house a sports psychologist in the dugout during the season. And maybe it made a difference for Jackie Bradley Jr. and his teammates.

But there’s still a taboo associated with psychological issues relative to physical ones.

For instance, when Alvarez was going through his throwing issues in Pittsburgh, the Pirates refused to disclose whether Alvarez was working with the club’s “mental conditioning” team. Pirates infield coach, Nick Leyva, declined to talk about the work being done to correct the issue. Alvarez ended one interview session when asked about his struggles. When addressing physical injuries or ailment, however, the club was typically much more open.

Sax said that, a couple times every month, he’ll get a call, often from amateur coaches, asking him about a softball catcher who cannot throw back to the pitcher, or a high-school first baseman who can’t make a routine throw back to the mound. Some major-league teams have even reached out to him.

“I’ve had a conversion in a broom closet in a major-league stadium because the team wanted me to talk to this guy but they didn’t want the press to see me talking with him,” Sax said. “So I went in this little closet and was talking to him about this.”

Sax said the game has made strides in dealing with psychological matters.

“It’s like anything else in our society,” Sax said. “People become more accepting of it.”

But treating these situations differently, and handling them differently, might only make the situation more of an issue. Players only become more self-aware. Perhaps sports psychologists should have a frequent or permanent presence in a clubhouse. In my experience covering the Pirates, members of their sports-psychology team were only occasionally around the major-league team.

Perhaps there’s a better way to help and approach players like Lester and Alvarez.

A Way Out

In August of the 1983 season, Sax took a phone call in the visiting clubhouse at Fulton County Stadium in Atlanta. It was his father. Then conversation was the last he would have with his father, who died hours later from a fatal heart attack.

Sax grew up on a small farm outside of Sacramento, complete with cows, chickens and a hayloft. The family had little money. His father had lived through the Great Depression. They had to be resourceful. Sax’s father, John, was a “tough dude,” according to his son.

“To become vulnerable, or say he’s sorry, never came out of his mouth. He was like John Wayne, who had a tough day,” Sax said. “About six hours before he died that day [on the phone], he told me I’m going to wake up and this throwing problem is going to be over because he went through the same thing when he played. My dad was a really good player. I thought ‘If this big, tough dude can go through it, then certainly it can happen to me.’ He told me the way you get over it is practice. It’s just temporary loss of confidence.

“[After the conversation with my dad], I was flooding my thoughts with all positive stuff… I started building confidence back just like he told me.”

After 24 first-half errors, Sax committed only six in the second half. While Sax made 21 errors in 1984 and 22 in 1985, he never committed more than 16 errors in a season from 1986 to 1991. He was able to conquer the yips.

“Two years after I retired, I was having this conversation with my mom about this conversation with my dad that changed everything for me,” Sax said. “My parents had been together since the fifth grade. So my mom knew my dad very well. She kind of laughed and said ‘I want you know that your father never had a throwing problem. He never did.’ He knew the reverence I had for him. He knew if I thought he went through it, it wasn’t odd that I was going through it. It saved my career. If he had not told me that, I don’t know if I’d ever had gotten my confidence back.”

For Sax, that’s what he believes allowed him to overcome the yips, a psychological trick courtesy of his father, allowing the condition to seem more “normal” to him, that it could happen to anyone. Sax found a way. But can baseball help the next Sax, and Alvarez, and Lester find their way? Some careers will depend on it.