Ten Steps To Forward The Action In Your Life

Photo by M. Arloski Glendalough, Ireland

Photo by M. Arloski
Glendalough, Ireland

In the coaching process we listen, clarify and help our clients explore their lives, taking stock of their current life situation and health status. Eventually we have to go beyond our basic listening skills, summarizing and helping our client get very clear about where they currently are. At that point we help them get clear about what they are ready to do (referencing all we know about readiness for change theory) (http://www.umbc.edu/psyc/habits/content/the_model/) and we boldly ask them what they are willing to do. 

In listening to recordings of some of my mentor coaching clients I’ve realized that many new coaches struggle with what we call “forwarding the action”. If all a coach does is summarize, paraphrase, empathize, and reflect the client often continues to tell their story and stay wrapped up in it. One of the most powerful things that coaches do for people is to help them realize that they are not their story! They are much more.

Powerful questions challenge a client to look at things in new ways, to develop new perspectives and try on new ways to frame an old problem. Coaches can still be “client-centered” but share their own perspective on what the client is saying, pointing out observations, helping the client recognize patterns. At some point we ask “What’s one small thing you can do to make progress on that?” or “What’s one small step you can take between now and the next time we talk to work on that?”

Whether we are a coach acting as an ally in the growth process with our client, helping them move forward with their lives, or an individual whose own growth demands some “forward momentum” here are my

Top Ten Ways To Forward The Action

1. Contemplate Well
“Thinking about change” does not necessarily mean you are stuck. We may need to reflect deeper about an anticipated change. Ideally we may use three different methods that help us explore more completely: 1) thinking about it by ourselves; 2) writing about it – which often yields very different insights since we are drawing upon a different part of our brain; and 3) talking about it with someone else such as a coach.

Inadequate contemplation/exploration/research often yields pre-mature goal setting and usually results in failure. Talking it through is important, but of course this wears out its usefulness at some point. If you think you continually need to know more before you act, ask yourself. When will I know that I know enough?

2. Never Make A Decision Just To Relieve Anxiety

This is a phrase I developed in my years of work as a psychotherapist and it’s a good maxim to follow. Research shows that we make 60% of our decisions based on emotion, not logic. Remember that lemon of a sports car your bought on stylish looks alone? When making decisions about how to move forward with our lives we need to acknowledge the emotions, maybe even process them more, but temper them with our rational thinking. This is easier said than done and another argument for processing it with others, such as our coach.

3. Distinguish Between Cautious Wisdom And Gremlin TalkTaming Your Gremlin cover

There is a part of us that has our best interests at heart. This part can caution us to consider changes carefully, to hold back sometimes until we have all the facts. That part is a friend to be listened to. The inner-critic or so-called Gremlin, is not. This part of us is the home of our self-doubt, all our self-recrimination, and in fact is the accumulation of all the untrue statements about ourselves that we, and others, have made throughout our years. If we listen to the Gremlin we will never grow. Maintaining the status quo is the Gremlin’s full-time job so change, even wonderful improvements, is its enemy.

Listen carefully to your self-talk. Distinguish between being cautious and being negative. Does it sound like familiar old recordings being played again? Is your Gremlin hitting you with hurtful thoughts about how you don’t deserve a better life? Or is your self-talk simply asking you to examine your contemplated changes carefully and go forward with your eyes wide open?

4. Link To Motivation By Beginning With The End In Mind

Stephen Covey’s second habit of his Seven Habits Of Highly Effective People (https://www.stephencovey.com/7habits/7habits.php), “Begin With The End In Mind”, helps us remember to start our journey with the destination clearly in mind. Coaches are rightfully notorious for asking “What would it look like…?” Instead of how will I solve the problem or overcome the barriers (which is often where we stay stuck) get clear about what you really want. Visualize, fantasize, imagine, dream. It’s all good.

Align that visualization with your values, with how you really want your life to be. We are talking about you changing your life so you can live in that healthier, more self-actualizing way for the rest of your entire life. Take the time to get clear about “what’s possible”.

Connect a motivational link by seeing how even the smallest action step you take is helping you achieve the goals you have that are part of you living your best life possible, the life that you have imagined. This puts purpose behind even the most mundane action step.

5. Anticipate The Roadblocks And Strategize Through Them

It’s easy to hold ourselves back by fearing the potential consequences of making change happen. Better not to stir the pot. Unfortunately not to decide is to decide. We usually know that our efforts at improving our lives will be met with support from some corners and resistance from others. Anticipate the highly probable negative reactions you may see and come up with effective strategies for how to respond. Anticipate some of the practical barriers like costs, time schedules, etc. You may want to communicate your intentions behind your new ways of behaving proactively to pre-empt potential conflicts. Here is where working with a coach can be so valuable as you work together developing new strategies to insure success.

When you're ready, go for it!

When you’re ready, go for it!

6. Take On The Challenge

Words matter. We may do ourselves a great disservice by dismissing semantics. Reframe your “problems”, barriers, obstacles, diseases, and diagnoses, as challenges. Improving your life, your lifestyle, your wellbeing may be daunting but see it as a challenge that, with the help of others, you are up for!

I always teach coaches that they can challenge a client more when their relationship with them is strong. It’s about conveying your belief in them, in their abilities, capacity, talents, and character. From the individual’s point of view it’s a combination of remembering these qualities and staying around positive and supportive people. This is not a time for hanging out with “dream drainers” and pessimists.

7. Experiment!

It’s easier to “go for it” when we lessen the risk involved. Most of the risk comes at us in terms of our own fear of failure. Adopting an “experimental attitude” allows us to frame our attempt as less risky when we are not putting our entire self-worth on the line. If it doesn’t work we go back to the drawing board. It was an experiment. How can we tweak the experiment to get better results next time? That’s all.

The word “try” or “trying” gets a bad rap from some motivational speakers. “Just do it! Don’t try!” Certainly a half-hearted “Well, I’ll try, if I have to, I guess” is most likely doomed to failure. Yet, I’ve had a number of clients really take to the idea of “trying” something enthusiastically, and yet because they were “trying” it seemed like there was less at risk. They were willing to “try”. One might think of it like trying on a piece of clothing. There is no need for a commitment “to buy”, just see how it fits, how it works for you.

8. Write It Downjournaling

Think it. Dream it. Speak it. Write it down! When we look back over our shoulders at our lives we start to realize that most of the ideas that we birthed and brought to fruition were things that we finally wrote down. Nurturing our thoughts into action works best when we get them outside of our heads. Ideally it begins when we start saying it out loud to others and then when we actually write it down, even if we show no one else, we’ve made a commitment to ourselves. It gets real.

In coaching this is where writing out action plans, wellness plans, business plans, funnel all of our thoughts and ideas into a focused reality. We have a map. We’re actually going to get somewhere!

9. Track it!

Trackers find what they are looking for. Forwarding the action doesn’t just mean getting started. It means knowing where you are on the trail. Coaches ask their clients “How will you know when you are being successful?” Well, I guess I’ll have to keep track of what I’m doing.

It’s always astonished me how often I get a negative answer when I have asked a wellness coaching client if they have ever kept track of their behavior (activity level, what they are eating, any biometric markers, etc.). Never thought of it. People try to make changes with revved up will power, lots of effort and sometimes little else. If they try to keep track of their efforts in their head it almost always becomes a muddle of uncertainty and usually results in abandoning the change process. Use phone apps or even a simple wall calendar but don’t deceive yourself, track it! Seal the deal with accountability to yourself and perhaps strengthen that by sharing that accountability with a coach.

10. Refresh Your Efforts.

Most folks will tell you that maintaining change is the hardest part. The real challenge is usually staying consistent and on your plan for the long run. It’s the smoker getting beyond the point of constant craving. It’s the weight-loss client maintaining through the dreaded plateau phase. It’s any of us staying with our wellness self-care when stress amps up in our lives.

One important part of maintaining action is to refresh it often. Are we following through on the actions we’ve committed to? If not do we need to “Reset, Re-commit or Shift” ? Perhaps we need to reset the frequency of our actions, less walks in one week or perhaps shorter ones. We may choose to re-commit to our existing action steps for another week, or maybe it’s time to shift to entirely new and different actions.

Refreshing may also include adding a greater dose of fun into the mix. Ditch the treadmill and head outdoors for a walk/run every time you can. Perhaps adding a social aspect, including others, will make it easier to get out bike riding, hiking, or walking. A Mediterranean cooking class might be just the thing to recommit to healthier eating and adding the skills to do it easily.

Beach runnerForward Momentum

Merriam-Webster’s Dictionary has a great definition of momentum. Think of this in terms of getting things moving in your life.

the strength or force that something has when it is moving
: the strength or force that allows something to continue or to grow stronger or faster as time passes
physics: the property that a moving object has due to its mass and its motion

(http://www.merriam-webster.com/dictionary/momentum)

With this definition it seems that improving our lives, our lifestyles is all about number one, getting things moving. This is what allows our efforts to gather strength, to gather force. Once moving it will grow stronger over time and essentially take on an energy of its own that is self-sustaining. Physics and psychology seem to complement each other here. Overcoming inertia (objects at rest tend to stay at rest), beating our stuckness, vanquishing our self-doubt, finding the support that bolsters our confidence and accepting the challenge seems to get us moving. Having a clear destination helps us set our course. Then once we are on our path with clear direction and a plan, our movement gets easier and easier (objects in motion tend to stay in motion). Now we’re getting somewhere!

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Forging A New Wellness Path: Leaving Health Risk Reduction Behind

It's time to cut a new trail...innovate wellness!

It’s time to cut a new trail…innovate wellness!

Attending Lifestyle Medicine 2013 (http://lifestylemedicine.org/lifestylemedicine2013) in the Washington, D.C. area this week I was heartened to be around so many enthusiastic people from the medical world who have embraced the realization of just how behavioral health is. The conference was “small but mighty” and had doubled in size since the previous year.

Dean Ornish (http://www.ornishspectrum.com) spoke for two riveting hours. While he started out with the obligatory review of his professional research on the reversal of heart disease, etc., his last hour was spent focusing almost entirely on how the really key ingredients in health are social support, connectedness, and a person’s spiritual connection or meaning in life.

Dr. Dee Edington

Dr. Dee Edington

We heard from some of the real innovators and leaders in the field like David Katz, Caldwll Esselton, James McDougal and others. Someone on the schedule that I was really looking forward to hearing was Dee Edington  (http://www.edingtonassociates.com/index/aboutus)  It would not be exaggerating to call him the “Godfather Of The HRA” (health risk assessment). His thirty-five years at the University of Michigan Health Management Research Center (http://www.hmrc.umich.edu) forged much of what we know today about health risk assessment and the tons of data that came from researching this field. As wellness programs developed during the 1980’s they all started with giving their populations an HRA and building their wellness programs around the results. HRA’s are still in widespread use as there is tons of evidence that when you can help a population reduce their number of health risks everyone is healthier and healthcare costs are significantly reduced.

HRA’s are hugely incentivized by employers who will offer health insurance premium discounts and/or hundreds of dollars in cash to employees for merely completing them. One upside is that HRA’s today are often what get someone through the wellness coach’s door as they do a follow up interpretation session.

Over the years however, many of us have seen little value in HRA’s from the client’s perspective. Being told that if you eliminate a number of your risky (and often much-loved) lifestyle behaviors will add about 7.2 years to your life usually falls far short of providing what you would call stimulating motivation for change! Most of the coaches that I have trained who are already out there working with clients say three things about HRA’s: 1) we love them for the aggregate data they provide; 2) client’s do not find them motivating (fear based motivation is easy to deny and just doesn’t last); and 3) so many employees do not trust their employers to keep it confidential that they “fake good” on them when they fill them out.

So, for me, Edington’s talk was much anticipated. Dr. Edington began slowly talking boldly about how upon visiting the Lifestyle Medicine website he was disappointed to see that their definition of Lifestyle Medicine was not about health…it was about disease.

“Lifestyle Medicine (LM) is the use of lifestyle interventions in the treatment and management of disease.” (http://lifestylemedicine.org/define)

He then went on to remark how despite accomplishments in many areas, the impact of all our work in medicine, health promotion, etc. the health of the nation is in many ways no better today than it was thirty-five years ago when he began this work. The obesity epidemic and all the chronic diseases (lifestyle driven) that go with it are killing us. Looking back disheartened, he said that our health-risk reduction approach was a mistake. Looking back over thirty-five years and 12 million HRA’s administered, he said “I’d like to take most of them back. I was part of the problem.”

Here was the man everyone listened to for years and who lead an approach to wellness programming that thousands of companies and organizations followed, admitting that we have been on the wrong track all this time. What a huge realization, and what a huge admission!

“We’re in the mud, the muck, talking about risk factors and disease.” he said. What about health? What about real wellness? He urged us to consider instead of running away from healthcare costs, to run toward health!

It was another speaker who quoted Einstein that day (Arthur Franks) but it could just have easily fit into Dee’s Powerpoint presentation.

einstein-quotes-solve-problemsThe big challenge we face according to Dee is this question:

“How can you beat the natural flow of decreasing population health status?” His research was not all for naught. It showed us that if we provide nothing for the healthy people in a population to help them stay healthy they will become those high risk individuals with increasing health problems.

“Disruptive innovation!” is what Dee Edington is calling upon all of us in the health and wellness fields to do. We clearly need some new thinking if we are truly going to make a dent in the health problems we face. Innovate. Be bold.

Dee even chided the Holy Grail of “Evidence Based Medicine”. If you are oh-so-carefully following EBM he reasoned, “You are a follower. Be a leader!” he urged.

The outcome measures we should be shooting for are not these fearful risks, they should instead be things like “Engagement in life! Love, compassion and resiliency.”

Lifestyle medicine by it’s very nature is a form of “disruptive innovation”, as the wellness field was in it’s early years. What I now question is have we forgotten our innovative roots? In the late 1970’s when we got this wellness field moving it was indeed revolutionary. We shook up the status quo of remedial care and found more and more effective ways to look at what really influences health. Behavior. Culture. Belief. Connection.

As the years passed and every wellness program struggled for funding, and as the business model conquered the healthcare field with chilling completeness, we embraced the statistics, the algorithms, the data and, I think in many ways lost our way.

I would stand with Edington and ask us all “What is our vision of health and wellness?” What is our way forward so that we might once again embrace the whole person; mind, body, spirit and environment? We began this wellness journey almost forty years ago on the shoulders of Abraham Maslow and others who looked for ways we could help people live their best lives possible. When people are in fact on that journey to live their best possible life they are on the path of wellness. Let’s be the allies that help people find their way.

two-people-on-stroll-panorama

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High Altitude Wellness

Rocky Mountain National Park, Glacier Gorge.  Photo by M. Arloski

Rocky Mountain National Park, Glacier Gorge. Elevation at Trailhead 9,240 ft.  Photo by M. Arloski

Whether it’s a trek in the Alps or a time to be “Rocky Mountain High”, getting up in the mountains is a great way to be well physically, mentally and spiritually. Being well at higher altitude however requires some important knowledge and sometimes, some caution. The people a wellness coach works with may face some challenges at higher elevation, especially if they are dealing with health challenges to begin with.

Gaining elevation quickly is easy in a place like my home state of Colorado. Say you start your day in Fort Collins where, like Denver we are basically a “mile high” (5,003 ft.). Off you go to Estes Park (7,522 ft.) and suddenly you have experienced an elevation gain of 2,519 feet. Drive into Rocky Mountain National Park and up to Bear Lake (9,450 ft.) for a hike and now you’ve risen 4,447 feet. All the trails from there only go up and you could easily exceed 10,000 feet in altitude as you enjoy the stunning beauty of the area. Top it off later with a ride to the peak of Trail Ridge Road (12,183 ft.) and now you’ve attained 7,180 feet (2,188 meters) in elevation gain. That gain itself is higher than any mountain east of the Mississippi.

When we experience how different it is to walk uphill at these suddenly higher elevations we often blame our lack of conditioning. The reality is based in physics and the resultant effect on our own physiology. This is not a time for a “try harder” attitude, in fact continuing to push may just invite serious trouble.

In Banff National Park, Canada

In Banff National Park, Canada

Simply Less Oxygen

Here is the best explanation of why we experience less oxygen at higher elevation. “The pressure in the atmosphere decreases as you gain elevation. The percent of oxygen is actually the same at all altitudes, 21%; however, it is 21% of a smaller number as one goes higher. The barometric pressure at sea level is 760 mmHg, and at 10,000 ft, it is 534 mmHg. Breathing the air of Telluride (Colorado) is the equivalent to breathing air with only 15% oxygen at sea level, instead of 21%. The net result is that there is 29% less oxygen in the air at Telluride compared with sea level. At 14,000 ft, the air has 43% less oxygen than at sea level. Because of the reduced air pressure at high altitude, the volume of air you breathe into you lungs contains less oxygen molecules in each breath.” http://www.altitudemedicine.org/index.php/altitude-medicine/altitude-physiology.

There are two main things to be concerned about at altitude: Acute Mountain Sickness (AMS) and your current state of health, especially looking at preexisting health conditions. AMS can affect people with symptoms at elevations as low as 6,500 feet, but usually we start to see greater occurrence when we exceed 8,000 feet. The Institute for Altitude Medicine (IAM) in Telluride, CO is an excellent resource for learning about AMS or altitude sickness. “One survey done at a Colorado ski resort at 9,800 ft. found that 60% of visitors developed a headache, the first sign of AMS, and also called high altitude headache. To meet the definition of AMS, other symptoms need to develop, such as loss of appetite, sometimes vomiting, weakness, dizziness, fatigue, and difficulty sleeping. AMS feels exactly like a bad hangover.” (http://www.altitudemedicine.org. )

Preventing AMS is all about a slow ascent and adequate hydration. Treatment strategies depend upon severity but the first step is “go no higher”, rest, hydrate and consider immediate descent if there is no improvement. See the I.A.M. website and learn detailed information.

Preexisting Conditions And High Altitude

Rocky Mtn. N.P. The Ute Trail- elevation 11,466 ft. Photo by M. Arloski

Rocky Mtn. N.P. The Ute Trail- elevation 11,466 ft. Photo by M. Arloski

According to Peter Hackett, M.D., the director of I.A.M., experience at higher elevations can sometimes “unmask” preexisting health conditions that the person was not aware of. Struggling with breath and heart rate, feeling exhausted, can sometimes reveal heart and/or lung disease and is a red flag to get in to see your physician as soon as possible.

People with preexisting conditions such as high blood pressure, heart disease, valve disease, heart failure, heart arrhythmias, diabetes, Sickle Cell disease, and other conditions should know that higher altitude could aggravate their conditions. It is also important to know the effects of the medications you might be taking. For example, metoprolol, a beta-blocker, acts as a governor on your heart, preventing excessive heart rate, and thus inhibiting your athletic performance. This means being incredibly patient with yourself and allowing for more breaks when you are hiking uphill, skiing, etc.

Dr. Hackett says that while living at higher elevations can actually help some conditions (we develop more capillaries, asthma can be easier due to cleaner air, etc.) people with COPD and various lung diseases fair worse as they have difficulty transporting oxygen to the lungs.

The “High Country” does not have to be off limits to you, but knowledge about how altitude affects your condition, your medications, and what to do to make adjustments is vital. Again, the I.A.M. website is a treasure house of information. Enjoy the mountains and all their majesty, just do it wisely and well.

Small head cropped1The Coach’s Take Away

A key part of any coaching Foundation Session is getting to know where your client lives and what their lifestyle is like. Your telephonic client may live in a very different world from the one outside your door. If you discover that they live at or near higher elevation, or they visit such places on skiing or outdoors vacations then helping them understand and deal with “altitude wellness” could be vital.

Being in great physical condition does not make one immune to AMS. In fact it has no correlation whatsoever. The especially fit client may want to maintain their sea-level workout routines or push themselves past wise limits physically as they play in the mountains. They need to play by the rules of elevation gain and energy output like everyone else. There is simply less oxygen available to those well-toned muscles at higher altitude and performance goes down.

The standard wisdom is to gain a thousand feet of elevation a day and build in plenty of rest. Hydration is vital as we produce more red blood cells to absorb the decreasing amounts of oxygen available. This thickens the blood and our bodies steal water from all our cells to maintain proper viscosity. So, we get severely dehydrated if we don’t pound the water. (Again refer to the Altitude Medicine site for guidance.)

As wellness coaches work with clients with preexisting medical conditions this is perhaps the most important area to be aware that altitude often has a significant effect. Clients with diabetes may discover an increased insulin requirement. The Altitude Medicine institute recommends that “Only diabetics experienced with exercise and in good control should attempt vigorous exercise at high altitude.” Clients with high blood pressure, any type of heart condition or disease, anyone with lung disease, etc. can be vulnerable to the effects of high elevation. Coaches should help these clients become familiar with the information on the Preexisting Conditions page of the Altitude Medicine Website. http://www.altitudemedicine.org/index.php/altitude-medicine/preexisting-conditions

Wellness coaching clients may find that their medical condition and/or the medications related to these conditions limit their ability to exercise or do what they used to do. Experiencing these limitations can bring up lots of emotion. The person can feel angry, frustrated, and can even get in touch with grief over what they have lost due to their medical condition. This is where coaches can be the empathic source of support that helps the client process these feelings. Plug in what you know about grief, remembering that a loss of health is a loss. Help your client to grieve what is lost and emotionally move on. And, of course, if this yields greater grief than can be dealt with in coaching, make a good referral to a mental health professional.

A great way to begin with such a client is to inquire about their level of knowledge about both their health and the effects of higher altitude. If, like most folks, there is a lack of this specific information, ask if they could see the value in knowing more about it, then co-create a strategy and accountability for how they can go about finding out what they need to know to be healthy and well in the High Country.

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The Bonus Benefits Of Exercise

Michael Arloski hiking in Conamara N.P., Ireland

Michael Arloski hiking in Conamara N.P., Ireland

Harvard’s School of Public Health (http://www.hsph.harvard.edu/nutritionsource/staying-active-full-story/) is quick to tell of all the prevention advantages of exercise. We know that getting more movement and exercise into our lives can help prevent the onset of heart disease, diabetes, certain cancers, high blood pressure, metabolic syndrome and osteoporosis. Exercise can be vital to positively affect the course of these illnesses once they are diagnosed as well. What is perhaps even more motivating is not just avoiding illness, but discovering how exercise can improve our mental functioning and improve the quality of our lives.

“Exercise is the single most powerful tool you have to optimize your brain sparkfunction” says Harvard psychiatrist John Ratey (Spark: The Revolutionary New Science of Exercise and the Brain). He and fellow neuroscientists are showing us that exercise can combat the toxic effects of stress and make us more resilient. “Adding exercise to your lifestyle sparks your brain function to improve learning on three levels: First, it optimizes your mind-set to improve alertness, attention, mood, and motivation; Second, it prepares and encourages nerve cells to bind to one another, which is the cellular basis for logging in new information; and Third, it spurs the development of new nerve cells from stem cells in the hippocampus.” Research is showing us that exercise can help lift depression, improve memory and mental performance, relieve insomnia, boost immunity, and even help stave off Alzheimer’s.

ExerciseAfAmBicycle
It’s always nice to get a bonus. An unexpected pay-off for some effort of ours puts a grin on our face and increases our chances of continuing that activity. Often we see people create a wellness plan and do their best to increase activity, improve their nutrition, etc., only to find that the changes they hoped to see are slow in coming. The person seeking weight loss may hit a plateau and the scales just stare back at them. Rather than sink into discouragement, we might ask “What else am I noticing?”

When people focus on the scales as the single indicator of success they set themselves up for some real motivational challenges. As we improve our wellness the scales will move in the right direction, but while we are getting there we need to fuel our motivation by noticing what bonus benefits we are gaining. When we take stock of our whole lives we start to realize that we may be sleeping much better, have more energy, feel less fatigued, be able to walk, hike or bike longer, or simply get up off the floor or out of a chair with greater ease.

YogaTaiChiBenefitsFocusing on the benefits of exercise alone, research is showing us astonishing bonuses we didn’t even anticipate. The windfall of advantages we gain can motivate us through that weight loss effort and provide incentive to the person with a slim body type who mistakenly thinks they don’t “need” to exercise.

Diversify the exercise you do. Include flexibility, strength and endurance though a variety of activities and cash your bonus checks often!

Small head cropped1The Coach’s Take Away
Convincing or persuading our clients to exercise is not an effective strategy in wellness programming, or especially in coaching. However, if your client is:

• Someone who is up for increasing their mental performance at work
• On the edge of readiness to begin exercising
• Someone with a slim body but unaware of the multitude of benefits exercise offers
• Someone with or without a “weight problem” but who needs the benefits of exercise to more positively affect the course of a chronic illness
• Someone you are coaching around stress, insomnia, etc.

Then sharing this kind of information may provide just the “tipping point” leverage they need to make some lifestyle improvement.

James Prochaska always says that people underestimate the benefits of change, especially exercise, and overestimate the costs. Help your client tip the scales in a healthy direction. And…don’t forget to be the sharpest coach around by taking advantage of these benefits of exercise yourself!

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The Road Ahead for Wellness Coaching: Trends To Look For

LongAndWindingRoad

Returning from the 2013 National Wellness Conference this month, I continue to be amazed at how wellness coaching has become such a vital part of the wellness field.  The tiny trickle of interest in wellness coaching that began in the late 1990’s is now practically a tsunami of both excitement and action washing the field forward with surprising speed.

Like any flood there is a lot of debris and profound changes that are not fully formed.  Hospitals, corporate wellness programs, disease management organizations, EAP’s, and insurance companies are scrambling to bridge the behavioral skills gap as their nurses, health educators and others seek training in wellness coaching and effective behavioral change methodologies.  Independent coaches still struggle to educate the public on the value and benefits of hiring a wellness coach.   Wellness Coach Training programs are not all equal and not all aspects of the profession define wellness coaching in the same manner making it challenging to measure the positive outcomes of wellness coaching programs.  (see blog post “Wellness Coach Certification: What It Means and the Top Six  Features to Look for in a Wellness Coach Training Program”  http://wp.me/pUi2y-6F)  This new era stretches us to standardize wellness & health coaching as a profession.

To help with the efforts to improve standards and credentials for wellness and health coaches and to continue to help the wellness field grow, I have become committed to three primary efforts: the National Consortium for Credentialing Health and Wellness Coaches – NCCHWC (http://www.ncchwc.org), The National Wellness Institute (http://www.nationalwellness.org) and The International Coach Federation- ICF (http://www.coachfederation.org).

My role as a founding member of NCCHWC has now grown into a position as a member of its Board of Directors. After a long haul getting organized and clear we are now moving forward this year with fund raising and the process of doing both a job task analysis and a curriculum analysis for wellness coaching.

2013 National Wellness Institute Board of Directors

2013 National Wellness Institute Board of Directors

It was also an honor to be elected to the Board of Directors of the National Wellness Institute this year.  This will allow me to help shape the future for this great organization and the wellness field itself. Our board now has five of its eleven positions filled with individuals who include wellness coaching in their professional identity, a true testament to what a central part of wellness programing coaching has become!

Janet Harvey (ICF), Michael Arloski (RBGWS) Magda Mook (ICF) and Linda Gogl (RBGWS)

Janet Harvey (ICF), Michael Arloski (RBGWS) Magda Mook (ICF) and Linda Gogl (RBGWS)

This year at The National Wellness Conference (http://www.nationalwellness.org/?page=NWC2013) we were happy to have two ICF Officers presenting. Janet Harvey (Immediate Past-President of ICF Global) and Magda Mook (Current CEO of the ICF) presented on wellness coaching and leadership as part of the conference’s coaching academy. This showed the increased recognition by the ICF that more and more coaches are identifying themselves as wellness coaches and the field is growing rapidly. The Wellness Coach Training Institute (http://www.realbalance.com)will continue to build its core curriculum around the Core Coaching Competencies that the ICF outlines. We are happy to have more direct contact with its officers as we move forward.

Involvement on these three fronts, combined with the training that our company does both in the U.S.A. and around the world, will continue to position me to have a broad perspective on how the wellness coaching movement continues to grow and move forward.

So! What lies ahead on this road?  Our trail through the wilderness that we blazed years ago has fast become a multi-lane expressway! Looking at our rapidly increasing enrolment, and the proliferation of training programs I would say that the wave we are riding is still cresting and has lots of energy behind it.

Trends arrowsTRENDS

Here are some trends/directions we will continue to see for wellness coaching.

• As 2014 looms for The Affordable Care Act more and more wellness programs will seek to include certified wellness coaches as part of their wellness programs. “Pay for performance” will drive an outcome-based incentive for healthcare delivery, and the programs that include a behavioral/lifestyle medicine approach (delivered through wellness coaching) will see greater success in improving their patient’s conditions and overall health. As a result, more coaches will find a direct role in medical settings.
• Infatuation with highly scalable technology-based coaching methods will reduce as more is learned about effective, though limited, ways emerge to apply these methods.
• Coaches working live with their clients will continue to find effective ways to integrate technology as part of the coaching process and will find that tracking tools such as phone apps, and web-portals for communication can be very helpful.
Positive Psychology will continue to provide validation for the “coach approach” and will help drive a movement away from the old risk-reduction model of wellness programming.
• Wellness programs will find better ways to attract people to wellness programs (and wellness coaching) than to offer a financial discount on health insurance premiums.
• More clarity about an operational definition of wellness coaching will allow for better research parameters and what we might call “true” wellness coaching programs will build a base of positive evidence.

Hopes For The Future

Projecting trends is about keen observation, sharing hopes is more about what comes from the heart. Having nurtured this field of wellness coaching along since infancy I have a lot of love for what we’ve seen it achieve. Reading our student’s case studies showing evidence of literally life-saving coaching efforts and seeing organizations report huge health cost savings has been incredibly rewarding. My hope is that we will see the field grow in its professionalism, recognition and that this will lead to eventual financial coverage by insurance. The value is there. Here are some other small hopes of mine for wellness coaching:
• That we will avoid the temptation to over-train and set the requirement bar higher than it needs to be. If coaches stick to coaching and refer the rest, it can be a profession that remains at an affordable level for organizations.
• That we avoid another temptation…that of over-psychologizing coaching. As a licensed psychologist with many years of clinical experience I can tell you that infusing coaching with complex psychological theories and psychotherapeutic approaches will set those coaches up for disaster. A well-trained psychotherapist has years of in-depth education that allows them to handle psychological emergencies and crisis…a coach does not. If you can’t go there with a client and help them come all the way back, don’t even start that journey…refer!
• That we will continue to see the amazing spirit of collaboration that I have witnessed between the participants in the NCCHWC. Organizations and companies that compete for students have pulled together for the good of all.
That we will continue to coach the whole person, helping them to discover the motivation that a Well-Life Vision and a sense of meaning and purpose can provide.
• That we can take the coaching concept of alliance and spread it world-wide. We can all be Allies For A Healthy World (see more about our efforts in this direction in upcoming posts).

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FAVE ! First Acknowledge, Validate and Empathize.

What really reaches us is empathy.

What really reaches us is empathy.

Effective coach training teaches about   the power of relationship, of person-to-person connection, not just because it’s warm and “nice”, but because all the evidence from coaching and psychotherapy says it works! We each need to feel truly heard by others that we are attempting to be in relationship with. When we share our lives, our experiences and our feelings we truly want to have acceptance, acknowledgement, and validation.

If I share that I have been in pain since an injury and it is breaking my heart that I can’t get out and enjoy the physically active things I love to do, I don’t want someone to consult with me about a solution (“Let’s explore what you can do to exercise now.”). I want someone to say “Wow! That must be so terribly difficult for you to be unable to exercise.” I want them to “get it” that I’m not only in pain, but I’m frustrated, angry, stuck, depressed, and feeling loss. I want to HEAR that they “get it”.

Once I feel like my experience is understood at that heart level, that my feelings have been affirmed, and it’s been conveyed that it’s okay for me to feel the way I feel, THEN I’ll be happy to launch into some great strategic thinking about seeking solutions.

Empathy RogersWhen coaches convey what I love to call The Facilitative Conditions of Coaching (see my previous post: http://wp.me/pUi2y-6i) clients feel the validation, acceptance, acknowledgement that we’re talking about. Coaches have to find the words to convey empathy, acknowledgement, unconditional positive regard, warmth and genuiness. But, they have to remember to do that FIRST, before they jump to solution seeking.

Having trained over 4,000 wellness coaches worldwide, I’m continually amazed by two things: 1) we train some of the warmest, kindest, most caring people on the planet, and 2) when learning the new skill of coaching these same wonderful people so often totally forget to express warmth, kindness and caring. They struggle on the hot seat of
demonstrating/practicing coaching, and in their anxiety of new learning, instead plow right into seeking to “fix” the problem presented. No statements of empathy. No expression of understanding what the client is feeling. Instead one question after another seeking to find a solution (So what types of exercise have you already tried since your injury?). And by the way, we have observed no difference here by gender, probably 85% of the coaches we have trained have been female.

Remember to be a coach, not a consultant. Consultation is all about finding solutions. Consultants name their businesses things like “Totally Amazing Solutions, Inc.”. Coaches help people discover/create their OWN solutions, they don’t just provide them for their clients…that’s consulting. The mindset shift from treatment provider, consultant (medical or otherwise), or educator to that of coach takes repetitive practice. It’s so easy to slip back into the “What wrong and how can we fix it?” thinking, instead of staying in the coach’s “What’s possible?” thinking.

Acronyms can help us remember processes. Let’s try this one: FAVE.

FAVE: First acknowledge, validate and empathize.

As our client’s story unfolds tune into it with the mind of compassion, the mind of understanding and the mind of connection. Some of what works is relaxing into the coaching process and realizing that just by being true to our naturally warm and empathic way of being we are providing that “safe container”. We “hold sacred ground” for our clients to do the exploration they need to do. When solution finding is embarked upon without adequate exploration, the path taken is often unproductive at best and counterproductive at worst.

So, FAVE! First of all ACKNOWLEDGE your client’s experience. Paraphrase, restate and reiterate what they have said. Remember to reflect their feelings. Help them feel that it has been recognized that they have been experiencing the emotions they have been living. Acknowledge the courage it takes to share. Acknowledge the self-caring it takes to seek help and assistance. Acknowledge the depth of your client’s challenges, their strengths, etc. So you haven’t been able to run or bike ride for three months now. How tough it must be to go from being so athletic to hardly exercising at all! Tell me more about what that has been like for you.

As you do this you VALIDATE their experience and their emotions.  Your unconditional positive regard (and therefore lack of judgment) makes it possible for the client to feel that it is okay for them to feel the way they feel. You are affirming that what they have told you has been their reality. You help the client feel that their story is validated, and as you coach further, with that accepting and yet at times challenging coaching presence, you help them learn that they are NOT their story. As you acknowledge, affirm and validate you help them feel well heard. You help them explore their experience and EXPRESS their feelings about it so they can let go of it, put it in the rear-view mirror, and realize they are not trapped by their story.

Our most powerful vehicles to convey this acceptance and affirmation, this sense of support is the EXPRESSION of empathic understanding. That kind look in the eyes, your thoughts of compassion are very sweet, but they are not enough. We have to put it into words (think telephonic coaching!) and COVEY our empathy. So when you have free time you just have to sit there and wish you were able to move like you used to. How challenging! You must miss being active very much. It sounds like you’ve tried to deal with as best you can, but it’s got to be a real loss for you.

It takes courage on the part of the coach to practice FAVE. You’ve got to be okay with emotion, not afraid of it. Empathy is not trying to cheer the person up, quickly reassuring them that everything will be all right, in essence rescuing them. This conveys a message like “Don’t feel they way you’re feeling. Feel the way I’m more comfortable with you feeling. Cheer up!” FAVE is getting down in the mud, or up riding high in the sky WITH our clients…meeting them where they are at, not where we want them to be. I want MY reality acknowledged, not YOUR fantasy!

Creating "Sacred Space"

Creating “Sacred Space”

The thing to remember is that when we allow our clients to feel the way they feel they usually do so and move through it more fluidly. When they are not able to, even after our repeated attempts at providing our best facilitative conditions, it’s probably time to consider referral to a mental health professional (see my previous post http://wp.me/pUi2y-bA.).

Perhaps some of our “rush to solution” is connected to our fear of dealing more directly with feelings. I’m not going to second guess a coach’s intentions and motivations here. I would just love to see coaches serving their clients in the most effective way possible, and that begins with FAVE.

What are some of your thoughts on the idea of making acknowledgement of our client’s experience a priority?  Please leave your comments.

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Access Excess: Always Wired Makes Us Tired and Less Productive

Access Excess!

Access Excess!

Paradox, double-edged sword, blessing and curse combined, mobile devices have made our lives easier and more stressful at the same time. I remember the feeling of relief the day I finally got my calendar synched on my work/home computer, my laptop and my smartphone. Now I could be in a conversation with someone at a conference and set an appointment seamlessly. It helped tremendously using a GPS navigating app to help find a tricky destination. I absolutely love using the travel app “Tripit” to track all my business travel arrangements. Connecting with others is easier than everWhile we can benefit from technology in so many ways, we are also seeing a “dark side” rising far too fast. The accessible anytime and anywhere nature of smartphones, wi-fi enabled tablets, etc. is causing a shift in workplace norms and, sadly, a shift in in the quality of our personal lives as well. A recent cover story in USA Today reveals how the so-called digital lifestyle and work-style may be seriously damaging our health and well-being. “Nearly two-thirds of full-time workers own smartphones, up from 48% just two years ago, according to the Pew Research Center. One-third own a tablet, up from 12%.  The exploding use of these devices — and connected employees never calling it a day — has created a workplace domino effect: If one person answers the boss’s e-mail after hours, others feel compelled to as well.”

cell-phone-stress-300x199When people are under stress for performance it is so easy to create a sense of digital vigilance that never lets down. Our notification alert signal is on full volume 24/7 so we don’t miss that opportunity that just might be calling. As we get more anxious it becomes more common to even get downright obsessive about our need to be accessible.

Some companies are realizing the price they pay in stress and health and are instituting policies to “leave it at the office”. The need for some ground rules is becoming apparent as the demands on the digitally connected worker increase. “Under the Fair Labor Standards Act, employees entitled to overtime pay must receive it when they work beyond a maximum number of hours, such as a 40-hour workweek. The constant technological tether to work is testing what constitutes the standard workweek, and lawsuits are challenging this new world.” Salaried employees have no such limits.

The self-employed have to set their own limits and often don’t. Fear of missing that opportunity for a sale by not responding at light speed keeps the smartphone charged and within easy grasp. The infectious sense of urgency in society is hard to be immune to.Double Cell

The whistle never blows in this world of Access Excess. There are no natural breaks. Time off has disappeared. This of course runs in total opposition to how our mind/body system works. We are wired to deal with stress, but can survive only if we also have what the authors of The Way We’re Working Isn’t Working call “sufficient volume and intensity of recovery”.

Wellness coaching clients almost always list stress as a barrier to them living a healthier life in almost all dimensions of wellness. Coaches can help their clients to consciously work on their fears, communicate and create agreements at work that are healthier. We can also help our clients to determine if their work environment can be changed for the better or if looking for work in a healthier environment is final solution. We can help our clients create experiments to help them see just how digitally healthy they really can be by being less “wired”. We can help them increase awareness of how much they are allowing fear and anxiety to rule them and work consciously on this issue.

Boundary setting is so much harder when it insidiously has become weakened by cultural norms. “Access Excess” has become a norm that no one ever agreed to. Let’s create agreements at work and at home that allow us to make times to be “unplugged” and healthier!

Question?  Is the man in the picture below able to be free to be at this relaxing lake because he can still be connected, or is he there and stressed because he is allowing himself to be connected?

Lakeside Tech

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