Why did USA gymnast Simone Biles withdraw from Olympic competition? A sport psychologist offers insight into athletes’ mental health.

Dr. Tony Kemmochi said athletes seek and need control, and when they’re placed in uncontrollable situations, the mind can shut down.

(Gregory Bull | AP) Simone Biles, of the United States, talks to teammate Sunisa Lee during the artistic gymnastics women's final at the 2020 Summer Olympics, Tuesday, July 27, 2021, in Tokyo.

Simone Biles knows pressure.

The multi-medal-winning 24-year-old gymnast from the United States stepped into the 2020 Tokyo Olympics expecting to dominate. The outside world expected it of her, as well. She was favored to win five gold medals in gymnastics and has become arguably the face of the Games for the U.S. She’s widely considered the best gymnast of all time.

Which is why it came as a shock when Biles withdrew from the gymnastics team final due to what she said were mental health reasons. It turned out that all that limelight was starting give her burnout.

“I have to put my pride aside,” Biles told reporters, per USA Today. “I have to do what’s right for me and focus on my mental health and not jeopardize my health and well-being. That’s why I decided to take a step back.”

Athletes at every level — from preps to Olympic — live in a constant state of having to answer the question “What have you done for me lately?” There’s always an improvement to make, a mistake to correct, a higher apex to reach. In response, elite athletes have to earn honorary doctorates in compartmentalization.

But it’s not the healthiest of mentalities, said Dr. Tony Kemmochi, a sport psychologist for Intermountain Healthcare.

“It’s really hard for athletes to ever feel like they’re good enough,” Kemmochi said Tuesday. “So it just turns into this never-ending cycle of insecurity compared with pressure to bring certain outcomes. And if you endure that for years and years, you can imagine that sometimes the mind just breaks down and can’t take it anymore.”

Biles couldn’t take any more and decided that her mental state was hurting her team. The three remaining gymnasts teamed with fill-in Jordan Chiles and went on to win a silver medal after Biles’ departure.

“I’ll usually persevere and push through things, but not to cost the team a medal,” Biles said.

For spectators that saw Biles struggle, the default conclusion is she was performing hurt. But Biles confirmed that there was nothing physically wrong with her. She was just very stressed and finding it difficult to feel the same amount of joy she usually feels when competing.

“It’s been really stressful this Olympic games; I think just as a whole, not having an audience, there are a lot of different variables going into it,” Biles said. “It’s been a long week. It’s been a long Olympic process. It’s been a long year.

“We’re just a little bit too stressed out. We should be out here having fun and sometimes that’s not the case.”

Kemmochi said athletes are conditioned to “seek and need control.” And when they’re in an environment that doesn’t allow for that, their mind can essentially shut down. He hopes people can start looking at mental health issues as another form of injury, and apply to it the same understanding and empathy.

“When it comes to physical health, we have this understanding that, ‘Oh, you have an injury, [or] you have an illness, it’s OK to take care of yourself,’” Kemmochi said. “When it comes to mental health, all of a sudden we feel like, ‘Well, there needs to be more reasons than that.’ But in reality, as our body can get injured, so can our mind.”

Biles is not the only top athlete to cite mental health as a reason for underperforming or withdrawing from competition. Japanese tennis player Naomi Osaka withdrew from the French Open and wrote an essay for Time Magazine explaining why. U.S. skateboarder Nyjah Huston said on his Instagram page that he has struggled to deal with “all the pressure and expectations.”

Athletes at the highest levels are often treated as commodities and mere sources of entertainment. Kemmochi said he’s worked with athletes who have quit their sport before they reach their highest potential due to these pressures.

“I really hope that one day we can find a way to reduce these expectations and financial pressure so that athletes can continue to embrace their love for their sports,” Kemmochi said.

But Kemmochi sees a lot of good in what Biles and others have done by choosing to be vulnerable and speak out about mental health in athletics. And he hopes it continues.

“Now that athletes are doing that, I hope that we as a society can recognize the value of how important vulnerability is and that is still a great way to be a role model to our younger generations, that sharing expressing our struggles doesn’t make us weak,” Kemmochi said. “In fact, it’s a brave thing to do.”