Wellness Coaching And Chronic Lung Disease

DandelionbreathIt surprises many people to discover that the third leading cause of death in the United States, behind heart disease and cancer, is chronic lower respiratory diseases. These conditions take twice as many lives annually as does diabetes. Yet, unless COPD (Chronic Obstructive Pulmonary Disease), or another such disease is part of your life or family, the seriousness of this public health challenge seems to seldom get our attention.

It’s estimated that over 15 million people in the U.S. suffer from COPD. The two main diseases that are associated with COPD are emphysema and chronic bronchitis. Approximately 22 million people in the U.S. are affected by asthma. Pneumoconiosis, also known as Black Lung Disease, is an occupational lung disease caused by inhaling coal dust. This affects more people in coal producing areas such as Appalachia and Northern Wyoming. All of these respiratory diseases have much in common, but for this article our focus will be on COPD and the ways in which lifestyle improvement can be relevant.

The most common cause of COPD is cigarette smoking and can also be related to ongoing exposure to indoor, outdoor and occupational air pollution. The preventative implications are obvious and wellness, health and safety programs can play a significant role. Like other chronic illnesses once thought to present a health challenge that we were helpless to do much about, COPD has a behavioral component that can affect the course of the illness and improve quality of life. The lifestyle medicine approach is illuminating ways in which the COPD patient can affect their condition for better or worse. Wellness and health coaching is emerging as a delivery mechanism to support COPD patients in succeeding with the lifestyle improvements that their treatment team wants to see.

271813-exhaleThe Behavioral Side Of COPD

COPD normally develops slowly and is the cumulative effect of decades of exposure. Any damage that is done to the lung tissue is irreversible. There is no cure for COPD and so treatment goals aim to slow the progression of the disease and to reduce symptoms. Once properly diagnosed the most immediate behavioral interventions are environmental: (reduction in exposure to workplace or living environment pollutants, e.g. a person working in an industrial pottery who is daily exposed to clay dust); strategic: an effort to immediately cease smoking; and medically behavioral: compliance/adherence to medical treatment (e.g. bronchodilator treatments, regular medical appointments).

The overall wellness of the client is important on a number of fronts. As treatment continues, lifestyle changes, physical exercise, and regular practicing of breathing exercises may also help to improve a person’s ability to remain active, prevent exacerbations and improve one’s overall health. A good nutritious diet is very important in order to avoid infections and to keep their lungs as healthy as possible. Maintaining a healthy weight is an important factor for a person that has lung disease. If a person is overweight it can make it difficult to move around and make it even harder to breathe. Being underweight though is actually a worse prognosis than being overweight. As lung disease progresses a person will become more short of breath and fatigued. Even eating can become a lot of work and a person might find it very difficult to get all the nutrients and calories that they need.

Improving a person’s overall strength and exercise tolerance is also a goal. The patient photo3063should speak first with their physician to determine what exercise or activities would be safe for them to do. Even though activity can make a person feel more short of breath it is vital to strengthen their muscles so that they will be able to continue to do the things they enjoy and be able to care for themselves. An individual will greatly benefit from participating consistently in a local pulmonary rehabilitation program.

Raising self-efficacy is vital to the COPD patient. Clients/patients benefit greatly from learning as much as possible about their disease and how to manage their symptoms, work properly with their medications and make the best use of supplemental oxygen. In fact, in a study of Mindfulness training and COPD (Mindfulness: A New Approach To Reduce COPD Hospitalizations Discovery’s Edge, Mayo Clinic’s Online Research Magazine, Volume 8, Issue 1
http://www.mayo.edu/research/discoverys-edge/mindfulness-new-approach-reduce-copd-hospitalizations) researchers found that the patient’s perception of their disease was the greatest predictor of frequency of hospitalizations. (70% of the medical costs associated with a COPD patient come from hospitalizations).

Comorbidities

The majority of people that experience COPD also
have other chronic conditions too. Researchers aren’t sure
why, but for some reason COPD patients seem to have more
comorbid conditions than patients with other types of diseases.
In a recent study of over 1,500 people with COPD, researchers found
patients averaged having four other types of comorbid conditions whereas those that didn’t have COPD averaged less than two other
problems. This study confirmed that comorbidities are very
common in people with COPD. Some of these conditions
included heart disease, high cholesterol, high blood pressure,
diabetes, osteoporosis, arthritis, depression and cancer. These
comorbid conditions increase the likelihood of a COPD patient
being hospitalized and can also result in death (WebMD.
(2014a). COPD comorbid conditions: Heart disease, osteoporosis,
and more. Retrieved from
http://www.webmd.com/lung/copd/the-importance-of-
comorbidities.)

Older-Adults-Support-TeamCoaching And Coping

When we review the behavioral changes that facing the challenge of COPD requires we begin to realize what a huge potential role successful lifestyle improvement has. Wellness and health coaches have been finding effective ways to assist COPD patients in their quest for a healthier life with their illness. In a cooperative study with Duke and Ohio State Universities (Coping Techniques Help Patients With COPD Improve Mentally, Physically http://psychcentral.com/news/2014/09/28/coaching-copd-patients-on-coping-helps-boost-quality-of-life/75448.html) “147 COPD patients participated in coping skills training. Psychologists provided regularly scheduled phone sessions, offering patients and their caregivers general information about COPD, step-by-step instructions in relaxation techniques such as deep breathing, tensing and releasing muscles, and ways to manage their reactions to stressful events.
Another group of 151 patients also received regular phone consultations, but only on topics such as medication and nutrition. They did not receive specific coping techniques. Participants who received training in coping skills reported improvements in their overall mental health, and lessened depression, anxiety, fatigue and shortness of breath when compared to the other group, according to the study’s findings.
Although there were no improvements in COPD-related hospitalizations or deaths, the study suggests that the low-cost approach could enhance quality of life, reduce distress and somatic symptoms, and improve physical functioning for patients, according to the researchers.” While not coaching per se, this combination of instruction and a very coach-like relationship with the psychologists who provided the phone sessions, proved the value of lifestyle improvement in increasing quality of life for COPD patients.

At the Mayo Clinic, researcher Roberto Benzo, M.D. is using Mindfulness Training (as mentioned and referenced earlier in this article) and a coach approach to not only increase client self-efficacy (and the key factor of their perception of their illness), but has shown outstanding results in reducing the number of days his subjects have needed to stay in the hospital when they are hospitalized, and reduced the overall number of needed hospitalizations.

“Patients in Dr. Benzo’s clinical trials undergo an active eight-week rehabilitation program. A wellness coach uses motivational interviewing, a style of communication, to identify an appropriate exercise and develop an individualized plan. Participants are also trained to become aware of their body sensations and motions as they exercise. Active coaching is followed by monthly calls to keep them motivated.
“Daily practice is the core of the rehabilitation,” Dr. Benzo says. “This means carving out a special time to be present with what is going on with their body and coming to terms with their life as it is.” (http://www.mayo.edu/research/discoverys-edge/mindfulness-new-approach-reduce-copd-hospitalizations) As is found in most work with chronic illnesses, a combination of education and coaching was successful.

Dr. David Hinton Thom at the University of California, San Francisco is currently conducting a two-million dollar grant-funded study to bring the coach approach to patients in underserved communities who are challenged by COPD. “The most comprehensive disease self-management programs, i.e., “pulmonary rehabilitation,” are generally not available to patients who are seen at community clinics. While self-management educational programs are more generally available, they are not often accessed by patients and do not provide personalized, sustained support. Health coaching by trained medical assistants or health workers has emerged as an effective model to provide individualized, patient-centered information, decision and self-management support, and coordination of care to improve outcomes for patients with chronic conditions. Health coaching provides patient support and reinforcement for self-management skills and activities, strategic approaches to effect behavior change, and a platform to improve comprehensiveness and quality of care. For the management of COPD, health coaches, for example, could assist patients with getting vaccinations, prescriptions, engaging in a graded exercise program, responding to exacerbations of their COPD, learning correct inhaler technique, and coordinating care between the patient’s primary and specialty providers.” (Health Coaching to Reduce Disparities for Patients with Chronic Obstructive Pulmonary Disease http://www.pcori.org/research-results/2013/health-coaching-reduce-disparities-patients-chronic-obstructive-pulmonary.) Here we see how the role of a coach can become incredibly practical and strategic, assisting patients/clients with their medical self-care and self-advocacy.

177859857Ways Coaches Can Assist With Lifestyle Modification For COPD:

• Smoking cessation
• Securing and attending a Pulmonary Rehab Program
• Securing education about proper breathing techniques from doctor, respiratory therapist or nurse to help reduce shortness of breath, and then tracking and accountability through coaching to ensure consistent practice
• Securing education about different cough techniques and breathing positions that are more effective.
• Explore various stress management tools and relaxation techniques, learning and practicing with coaching accountability.
• Tracking the intake of water (at least 8 glasses/day), to help hydrate secretions to be able to clear them from the airway.
• Tracking, follow through and accountability re: exercising regularly to improve overall strength and cardiovascular reserve. Client should speak first with their health care provider for specific instructions.
• Assisting client with nutritional/eating goals such as:
o Eat smaller meals more frequently to diminish shortness of breath.
o Eat healthy foods and maintain a normal weight.
• Securing support for their lifestyle improvement through family, friends, workplace, and others. Coaching for connectedness.
• Securing more support through group wellness coaching and finding a greater sense of community amongst others challenged with the same illness.

The Power Of An Ally In Lifestyle Improvement

Beyond all of the concrete behavioral steps involved in lifestyle improvement nothing exceeds the importance of having a solid coaching alliance between patient, now client, and coach. Having an ally through the behavioral change process is a boost to the motivation of the client and can help them to feel that a better life is possible.

Coaches also need to be aware that clients could experience more irrational feelings and “Gremlin talk” when short of breath and oxygen level are low. Decreased oxygen levels can cause people to feel fatigued and confused, which can have a direct effect on self-efficacy. When this is suspected, once again, a referral back to the client’s treatment team is in order.

Coaches can help their clients to process the grief they feel around their loss of health. This could be directly related to diminished feelings of self-efficacy and increased helplessness. (See “Astonishing Non-compliance” in Wellness Coaching For Lasting Lifestyle Change, 2nd Ed. http://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml by the author.)

Facing the challenge of COPD while seeking one’s best life possible means integrating a well-coordinated treatment plan with a wellness plan focused on lasting lifestyle change. Taking the journey to one’s best health may best be done with an ally walking side-by-side with us all the way.

Posted in coaching, health coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , , , ,

Productive Exploration In Wellness Coaching

AgeExpMap

How can we tell if we have or have not done enough exploration with a wellness coaching client? Inadequate exploration usually results in poorly selected and set goals. In the rush to do “goal-setting” clients sometimes do so without considering all aspects of their life, health and wellbeing first. Many times I have seen a client insightfully discover that a key component of their challenge in losing weight is actually their social isolation. Until we explored their social and work relationships they thought we would simply be working on helping them to become more physically active and eat better.

Adequate exploration means coaching your client to look at their life three-hundred and sixty degrees – full circle! (https://realbalance.com/wellness-mapping-360-wellness-coaching-model) Simple tools of exploration like “The Wheel of Life” help clients realize how truly holistic wellness is. Taking the time to coach clients around the interconnections of the different areas of their life often pays off in more accurate selection of areas to work on and therefore actually saves time in the long run.

The Power Of Story

Our client’s “story” needs to be heard, honored, and understood. When clients don’t feel “heard”, they either elaborate further and further, or they clam up, withdraw, and perhaps drop out. Great coaches demonstrate excellent listening skills and show warm, empathic coaching presence as they hear the client’s story. Acknowledgement, validation and empathy pave the way to both building the relationship and establishing awareness of the client’s life as it is today.

Yet, we can perseverate on exploration! Clients often feel the need to fill us in on tremendous detail. Their thoughts, as they speak, lead them from one related detail to another and before long the coaching session is expiring and we really haven’t done much “work”. The “Chatty Cathy” sort of client talks and talks, often connecting their sentences and phrases with drawn-out “Ummmm’s” making interruption very challenging for the coach. Sound familiar? Or, the client engages with the coach in a lively conversation that seems like it should be productive, but never really delivers on that promise. Often, what is going on is that the client is simply conveying what they already know.

Effective exploration is when your client is fully and thoughtfully engaged. It’s when they are curious and want to understand themselves and their lives and behavior more. It’s when they want to Explore a new perspective, discover new insights!

bisti-wilderness-area-hd-wallpaperReal EXPLORATION is when you are exploring NEW LANDS, not just taking a walk in your neighborhood! Clients often use a lot of coaching time informing the coach about every tree, bush and rock in their neighborhood (rehashing things THEY already know). Effective exploration is when we say to the client, “How about we go someplace new? Let’s go on a journey!” Coaches help people look at the old neighborhood with “new eyes”, and yes, that is the close-to-home aspect of exploration. However, more serious growth usually takes place somewhere less familiar, perhaps even someplace riskier.

Thailand-BangkokSome international travelers never stray from the well-worn resort areas, or don’t even travel to a country that doesn’t speak their own language. Other than many trips to Canada, my first time “overseas” was to dive alone into the heart of Bangkok, Thailand. Talk about an adventure! Yet, it’s often on such adventures that we are stretched in new ways resulting in growth we never expected. You, the coach, need to become comfortable with being uncomfortable. When you exude more confidence in new territory, your traveling companion client will feel safer and allow themselves to proceed while feeling uncomfortable as well.

“Life is an adventure, it’s not a package tour.” Eckhart Tolle

The probability of our clients sailing into unchartered waters is vastly improved when they have a traveling companion, and preferably a trusted professional guide. In a way, we might all become better coaches if we fancy ourselves as “adventure guides”! To do so might mean getting some adventurous miles under our own belts. No need to book that flight to Thailand or the Amazon. Your own exploration is right where you know it is, in the land of your own personal growth. You might not need to jump into years of therapy and confront your shadow side, but simply ask yourself, “What will stretch me?” Your own Personal Wellness Foundations is rooted in your own Personal Growth.

Hudson's Ship "Half Moon"

Hudson’s Ship “Half Moon”

Then, as you work with your client you might ask yourself, “Are we really exploring here?” You might imagine you and your client like the famous explorers in history; Vasco da Gama, Henry Hudson, Daniel Boone, etc. They were all looking for new lands, and, importantly new routes to get to places that they knew existed. Henry Hudson and his crews jammed their way through artic ice again and again searching for the fabled “Northwest Passage” that would lead them to Cathay (China). They never made it to the Orient, but in the process they opened up the great land of Canada. Sometimes exploration in coaching helps our clients to discover their own passage, their own route that can lead them to the life they truly want to live.

From “Patient” to “Client”

Part of what keeps clients stuck “in the neighborhood” of their familiar lives is the patient role that they have learned well. As a patient I believe in telling my healthcare provider as much accurate information as I can about my conditions, my current health status, etc., so that they can develop an accurate diagnosis and recommend the best course of treatment. This works great when I am in this professional medical consultation situation. Coaching, as we know, works differently.

Part of building the coaching alliance is helping our clients learn how to become “clients”! We can explain how coaching works and ways in which we will be of value to our clients. As we do so we can make a distinction between how the medical consultation works and how things proceed in coaching. After this introduction we will most likely find that we will need to repeatedly coach with the client in such a way as to remind them that we, the coach, don’t really need all the details. Our job is to help the client work with the client’s own situation by facilitating the coaching process with them.

Exploring Laser Style

As I teach our Real Balance LASER COACHING CLASS I’m seeing how vital effective exploration is to time efficiency. The techniques of laser coaching really pay off by helping the client to stay focused, on track, and relevant as they share their story. Also, if it is REAL exploration, it’s NEW territory, not the time-consuming conveying what the client already knows (that’s the “walk around the same old block”). When we are working in areas the client finds productive to explore they are more engaged, more satisfied and we cover ground more quickly. Insights help us spring forward with new behavioral experiments and we see progress.

Setting Sail Or Blazing A New Path In The WildernessLeVoyageur

So, what does ineffective and effective coaching exploration sound and look like?

INEFFECTIVE EXPLORATION

• Client energy is low, even monotone in voice
• Or, client energy is fine, even anxious, speech may even be rapid
• The same ground gets “plowed” again and again
• Tangents and minutia prevail
• The client tend to stick to “favorite” topics (e.g. what to eat)
• “Drilling down” into details never “strikes oil” (we don’t gain insights, only more details)
• Client may be giving the coach what the client thinks the coach wants to hear
• The coach finds it hard to “forward the action”
• May feel like “hard work”, but is more exhausting than rewarding

EFFECTIVE EXPLORATION

• Client energy is strong and engaged
• There is a curiosity that the client shows about their own life, behavior, beliefs, etc.
• Challenges the client
• Asks about the relevance of what is being discussed
• Asks the client if they are receiving real value out of the current discussion
• Stimulates new ideas, insights, connections, potential solutions
• Helps clarify values and beliefs
• Draws upon what has worked in the past
• Experiments with new perspectives
• Can tap into body-wisdom of both the coach and client
• Includes “process coaching” where feelings may be explored and emotions processed
• Encourages looking into new topics
• Provides the substance for “possibility thinking”

THE SOUND OF EFFECTIVE EXPLORATION

Here are some questions, requests and phrases a coach might use to help make exploration more productive.

• “So, is what we’re talking about something you’re finding value in?”
• “That’s one perspective. Now tell me about the same thing, but from a completely different perspective.”
• “I understand how important the components of your diet are. Would you find it more productive to continue to explore what your are eating, or is there some other aspect of food and eating that we could benefit from looking at?”
• Summarize and then: “Hearing your long list of all the tasks and activities you are engaged in right now, what are you aware of?”
• “What question are you hoping I will ask you now?”
• “What question are you afraid I might ask you now?”
• “What would be a real stretch for you here?”

There are many more ways to speak with your clients about gaining new perspective. Encourage your clients to take Aikido Master and Conflict Expert Thomas Crum’s advice and “Get off your viewpoint, and try out a new point of view.” (http://www.aikiworks.com/products.html)

Posted in coaching, wellness, wellness coaching | Tagged , , , , , , , , ,

“Well-being” Is Whole-Person Wellness

 

Plunging Into Whole Person Wellness

Plunging Into Whole Person Wellness

The term “Well-being” may have come along at just the right time. Public speakers and marketers are re-branding wellness as wellbeing by saying that well-being is more complete, more holistic. Well-being, they say, incorporates the whole person, their environment, their financial picture, their career, etc. On the one hand it’s too bad that we have to invent a new term to refresh our memory of what “wellness” really is. On the other, with the way that corporations and organizations have allowed their wellness programs and products to deteriorate into overly simplistic efforts, based on single-measurable-variable pieces of research, “well-being” may be the kick in the pants that reminds us about “whole-person wellness”.what-is-HWB_04

Twenty to forty-year veterans of the wellness and health promotion field hear speakers appear to create false distinctions between the terms wellbeing and wellness. And yet, are they indeed false distinctions?

Has the term wellness been worn out? It has certainly been misused and abused. Here in Northern Colorado a “wellness center” is probably a medical marijuana dispensary. “Google” the word and the number one listing on that search engine is always the “Wellness” brand of dog and cat food.

What may be more disturbing though, is how we have come to look at wellness in ways that jettison its original holistic meaning. In an effort to be more scientific and “evidence-based”, we have embraced research efforts to show the effectiveness of our approaches to wellness and health promotion. While this research is important and has yielded much of great value, too much of it has been focused on what could be called the measurement of a single variable. As we’ve tried to apply the scientific method to this cause we’ve oversimplified our approach far too often.

Skinner boxWhen we want to study the health behavior of human populations the challenge is daunting. It’s easy to control extraneous variables in a “Skinner Box”. Any social scientist will tell you that people are a lot more complicated. The result has been too many health behavior studies measuring one aspect of activity, one blood lipid level, one blood sugar level. While those little building blocks all help to assemble the scientific foundation we need, too much is concluded from them. In our online digital world a simple study with twenty subjects, run one time, has its results proclaimed as headline news.

Following the medical world, where the threat of litigation for malpractice hovers over every practice like a vulture, we have sought to provide only programming that is “evidence-based”. That means, as Dee Edington stated at the 2013 American College of Lifestyle Medicine Conference, “if you only do evidence-based you’ll never innovate!” The temptation is to “dumb-down” our concept of wellness to just physical fitness and nutrition. The temptation is to be happy that we got someone to walk three times a week and call it good.

620-667-I-G36There Is Nothing New Under The Sun

Dusting off the yellowed pages of my edition of Donald Ardell’s High Level Wellness: An Alternative To Doctors, Drugs and Disease (1977) I found my long-time friend Don referred to his colleague and fellow wellness pioneer, Jack Travis, as Jack and he defined wellness: “Travis believes that wellness begins when an individual sees himself or herself as a growing, changing person. High level wellness means giving care to the physical self, using the mind constructively, channeling stress energies positively, expressing emotions effectively, becoming creatively involved with other, and staying in touch with the environment.”

Travis - 12 Dimensions Model

Travis – 12 Dimensions Model

Ardell posed five dimensions of wellness, Bill Hetler six (http://www.nationalwellness.org/?page=Six_Dimensions), and Travis, including a number of psychological dimensions, built a model with twelve dimensions (http://www.wellpeople.com/Wellness_Dimensions.aspx). Clearly “wellness” has always been meant to be a holistic concept as I stated in 1994 in my article “The Ten Tenets Of Wellness” (published in Wellness Management , the newsletter of The National Wellness Association, which also can be found in Chapter Two in Wellness Coaching For Lasting Lifestyle Change, 2nd Ed.)(http://wholeperson.com/store/wellness-coaching-for-lasting-lifestyle-change.shtml).

Indeed we’ve seen it all before. The term “Mindfulness” has been skillfully re-packaged by Jon Kabat-Zinn and others. Studying today’s version of “mindfulness” someone like me is transported back to about 1968 when I was in college and reading books like Bernard Gunther’s Sense Relaxation Below Your Mind(http://www.amazon.com/Sense-Relaxation-Below-Your-Mind/dp/B000VLH7Q8). Of course everything we’re talking about here is based on practices that go back thousands of years in the traditions of meditation, Yoga, Tai Chi, and more.

While in my doctoral program in the 1970’s, I was blessed with the opportunity to learn deeply about biofeedback and how to apply it in working with stress-related disorders. I specialized in that for many years as a psychologist and served as the President of The Ohio Society For Biofeedback and Behavioral Health. The beauty of the research done by biofeedback pioneers Elmer and Alice Greene (http://www.amazon.com/Beyond-Biofeedback-Elmer-Green/dp/0940267144 and http://www.consciousnessandbiofeedback.org) was to use recently developed technology to study the consciousness practices of Indian Yogis, monks, and others. By examining their subject’s brain waves and various physiological indicators they ended up validating the legitimacy of such practices. Thus we see that today’s “mindfulness” has its roots in research completed under other names as well.

Authentic H CoverToday’s dynamic Positive Psychology movement has invigorated the field of psychology and is providing the sound research evidence that is validating what the Humanistic Psychology folks have been saying since the 1950’s and 1960’s. The “Human Potential Movement” of the late 1960’s and the work of Abraham Maslow, Virginia Satir, Carl Rogers, Rolo May and many others, emphasized looking at human behavior from a positive growth perspective instead of the usual clinical/pathological perspective. Saying that Martin Seligman “founded” the Positive Psychology Movement may be accurate in recent history, but he did so standing on the shoulders of these earlier giants. Our field of coaching also built its self on these same shoulders and from its inception always took on a positive psychology, strengths-based approach to working with people.

WellnesssunsetkickA Return To Whole-Person Wellness

Looking at wellness programs merely as “cost-containment strategies” has caused us to develop a tunnel vision ROI-only view. Some companies today are spending more money on their incentives to get people to take a health-risk assessment, etc. than they are spending on their wellness programs! When we view employees only as statistical units that drive up healthcare costs, we down-size – or “dumb-size” our thinking. The “well-being” approach would have us view employees as whole people who can contribute to the mission and purpose of our company and do so through creative, higher performance that happens when they are “well” in this holistic sense. The term to shift to is VOI (Value On Investment).

More Than Just Corporate Health Promotion

BIGGARD_SU_C_^_SUNIQWhen we step outside of the corporate world we see wellness, and now well-being, at work in our healthcare settings, communities, schools, places of worship, and among groups and individuals who want to live their best life possible. We are realizing the powerful effect that connection and community provides for our health and well-being. We are seeing how having safe green spaces to walk, play and exercise increase the health of communities. Part of our approach to wellness/well-being is to step outside of a myopic corporate perspective and remember that not everyone works for a company with the benefits of a wellness program. Being inclusive of under-served populations in both rural and urban areas, Native American/First Nations Reservations, and others means maintaining this big-picture view of what wellness/well-being means.

If “Well-Being” helps us remember to work with the whole person and view them from a holistic perspective – great! If the term refreshes programs and generates engagement – wonderful! Bring on “Well-Being” while we remember that it really is – Whole Person Wellness.

 

Note: This June the National Wellness Conference will celebrate it’s 40th Anniversary. (http://www.nationalwellness.org/?page=NWC2015) The latest in wellness and health promotion will be on display as well as an opportunity to create community in the wellness field like nowhere else. Among the celebrations will be a special Legacy & Vision Talk with a number of the founders of the wellness field. Come and join us and experience what Whole Person Wellness is really all about!

Posted in coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , , , , , ,

The Language of Effective Coaching Accountability

accountability

While mentoring a coach along the path towards her ACC (Associate Certified Coach through the ICF – International Coaching Federation – http://coachfederation.org) I observed her repeated hesitancy in using accountability in her coaching. As we explored this I found that in her coach training she had been exposed to a style of enforcing accountability instead of co-creating accountability. The words turned her off, and she feared they would turn off her client as well.

“How will I know you’ve done this?” “How will you let me know you got this done?”

Drill Sergeant Approach Not Welcome.

Drill Sergeant Approach Not Welcome.

The subtle (or not so subtle) tone of the supervisor/teacher/drill sergeant comes through with words like this.

The MINDSET of the coach around accountability is paramount. Through Real Balance Global Wellness Services, Inc., (https://www.realbalance.com) and in my book Wellness Coaching For Lasting Lifestyle Change, 2nd Ed. (https://wholeperson.com/store/wellness-coaching-lifestyle-change.shtml) I am always teaching that in effective coaching the client is not accountable to you, the coach, they are accountable to themselves. The client wants to be accountable and follow through on their commitments. The accountability that coaching offers is, perhaps more than any other single feature, what put coaching on the map. It is a premier value that coaching offers. Clients want to have a way to finally succeed and “get er’ done”! When the coach realizes that accountability is something the client truly wants and appreciates, yet doesn’t want to be bossed, the mindset becomes one of collaboration instead of supervision.

The Word Choice Is Keywords-have-power

“How can I help you follow through and get this done?” “How can I help you accomplish this?” “What’s the best way to handle accountability around this?”

The tone here implies the work of an ally who is standing shoulder to shoulder with the client and wants to be right there during the tough part of behavioral change and action. It keeps the essential client-centered nature of coaching intact. It honors that the client is the one in the driver’s seat and the one responsible for their actions, or lack thereof. And concomitantly it takes the responsibility off of the coach’s shoulders where it can feel like more of a burden.

Teaching Our Clients To Be Clients

A crucial part of effective coaching is to build a great alliance with our client and part of that is educating them on how coaching can work for them. The accountability that our clients are used to is almost always completely from a subordinate position. They have experience being a student, an employee, a patient, and a child. Perhaps they even have been on the receiving end of an unhealthy relationship with an intimate partner who bossed them around. The “drill sergeant” approach portrayed on television by the ruthless fitness trainer makes for entertaining TV, but defies all that we know about how to help someone succeed at lasting lifestyle change.

As coaches we offer something completely different in the world of accountability. We offer an alliance to help our clients achieve what they want to achieve. The client chooses what they want to work on, and with our assistance they refine what accomplishing their tasks will look like. The action steps they define fit into a larger plan (in wellness coaching we call this The Wellness Plan). We co-create AGREEMENTS about how the client wants to be accountable to themselves, and how the coach can assist.

One of the most brilliant sayings about coaching I’ve ever heard is:

Coaching is not a helping profession. It is an assisting profession.

As we coaches explain how accountability in coaching works the mindset of this co-creative alliance must pervade our language. The coach is essentially saying: I’m just here to help you do what you want to do. You’re not accountable to me. I want to help you (assist you) find the best way possible to complete this. You’re the one in charge here. It’s not about pleasing me, it’s about pleasing yourself.

Loophole-Free Accountability

Once clients understand how coaching accountability works they truly appreciate it. If our client truly wants to accomplish a certain goal and knows that the action steps required to get there must be done and done consistently they really do want serious accountability. The irony of coaching is that the coach provides accountability without the client being accountable to them.

In Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., I talk more about what I call “loophole-free accountability”. Clients appreciate assistance in helping them avoid their own self-deception and the tiny part of themselves that resists change and may even engage in self-sabotage. Holding fast to commitments that have been made, but having zero expectations delivers a message that the coach will be solid in following the accountability agreements.

I once received what I took to be a supreme complement when my client said I was “the iron fist in the velvet glove” when it came to accountability. My language always was clothed in the velvet of kindness and that of a true ally, but the iron fist showed up in the form of language that held fast and true to our agreements.

hand2

The Sound of Great Coaching Accountability

CLIENT: I know I should practice the Tai Chi that I learned more often. I know it would be great for my knees and other joints and help me feel more relaxed. I’ve done the class now, read all I can read. I know it’s good for me. I’m ready to get serious about practicing.

COACH: Excellent! You sound like you’ve prepared all you need and now it’s time for applying what you’ve learned and benefitting from it. What would really consistent practice look like for you?

CLIENT: Well…I know I can’t do it everyday. I’m not there yet. But, you know, if I practiced say three to five times a week that would be fantastic. Realistically, let me begin with three times a week.

COACH: Great! So are you ready to make a commitment to help yourself by practicing three times a week?

CLIENT: Yes. I know I can fit it in at least three times. If I do it less than that I really won’t get the benefit I want.

COACH: Okay. So how can I help you follow through and really get that accomplished?

CLIENT: What do you mean?

COACH: Well, you really want to do this. How can I help you be accountable to yourself to practice three times a week?

CLIENT: I guess I’m not sure. I suppose we could just talk about it at our next coaching session.

COACH: Absolutely. That might be entirely sufficient. We can do that for sure. Let me ask though… since you are attempting to begin practicing three times throughout the week, would it help if you sent me an email informing me when you have practiced?

CLIENT: Actually that would help. In fact, could you send me reminder emails?

COACH: What I’ve found works best is if instead of me being responsible to remind you, that you hold yourself accountable to remember to practice and then let me know that you accomplished that. How does that sound?

CLIENT: Yeah. That probably is best. So when should I email you?

COACH: Well, let’s figure out what will work best for you. You could email me after each time your practice, or we could set up certain days that you agree to email me about it. What would be best for you?

The Client Stays Behind The Wheel

Effective coaching accountability must be a client-centered process. However, a coach can be very client-centered and still be moderately directive. Effective coaches do confront and challenge their clients. We do draw upon our training and experience to suggest implementing strategies that have a greater chance of success. It’s still the client who decides.

The coaching profession has long drawn upon the areas of communication studies and linguistics for good reason. Perhaps in no other area of coaching is language more vital than in co-creating agreements around accountability and helping clients succeed in achieving their goals.

Posted in coaching, wellness, wellness coaching | Tagged , , , , , , , ,

Crafting A Wellness Lifestyle With A World Of Choices

If we know that our lifestyle has tremendous effect upon our health,

how then shall we live?

How trapped are we in the limitations of the culture we have experienced most of our lives? Greater travel and today’s technologically shrunken world has immensely increased our awareness of alternative ways of living. We do, in fact, have a world of lifestyle choices to draw upon. Let’s look at some cultural concepts and practices we might draw upon and explore some strategies for doing so and some challenges we might face.

My best definition of wellness/well-being is living our lives consciously in ways that enhance our health. Conscious choices allow us to avoid the “automatic pilot” that often steer us toward stress, illness and poor performance. Consciousness about our entire way of living includes mindfulness. Appreciating the moment, noticing the senses, soaking it all in enriches our lives. Conscious choice means considering the path that will optimally serve us, whether it is how we will spend our Saturday, what we will order at the restaurant, or what risk we might take emotionally.

In our Wellness & Health Coach Certification Training (https://www.realbalance.com) I love to teach that it is the job of the coach to remind people that they have choices. It is so easy for us all to forget the actual choices that we really do have. Realizing that we are choosing to live our lives the way we do actually frees people to embrace the present and make life better.

A factor that can either expand or limit our perception of choices is culture. There is extensive evidence and wisdom in the health promotion literature that peer norms affect our health for better or for worse. (http://www.healthyculture.com, and http://organizationalwellness.com/who-we-are/dr_joel_bennett/) We operate on norms within our work, family, sub-culture and the larger culture that we live in. Some choices never even occur to us because we are operating so habitually within these norms.

Provence and French Alps

Provence and French Alps

L’Art De Voir

It’s no fluke that France is always the most visited country in the world, and Italy always shows up in the top five. The appeal to a large degree is for the opportunity to experience a different way of living among cultures that consciously work at “L’Art De Voir” – the art of living. Provence and Tuscany in particular seem to epitomize this cultural agreement to put quality of life first.

“Community, not work, is at the center of Provençal life. Nowhere is that more obvious than during meals, when friends and family come together to share dishes which are simple, healthy and robust in flavor. This unrushed life allows each and everyone to be in touch with themselves, and could be called true living.” (http://www.lifeinprovence.com/p_life.html)

Bk Cover Wisdom TuscAs Ferenc Máté shares in in his book The Wisdom of Tuscany “When I mention Tuscany to outsiders, the usual response is a wistful sigh. And when I add sheepishly that we live out in the hills and vineyards and olives, the common rejoinder is “You’re living my dream.” What they seem to be talking about is the quality of life: the pace, the peace, the physical beauty, the social togetherness, and, of course, the food and wine. And just as Tuscan food and wine is rooted in myriad things beyond the kitchen and cellar, so the quality of life is a vast conglomeration of daily details, each of which must be of quality for all of it to work.”

That quality in the details comes from two things: conscious awareness and a commitment to doing everything in life as best as one can. When people travel to these places they often say “there was the best tasting food there I’ve ever had”, or “the simple bread every day was amazing”. Daily things that perhaps we have allowed to become mundane, and unfortunately mediocre, suddenly astonish us when prepared and presented with pride and love. Perhaps one quick way to increase our own quality of life is by doing the same.

If one grew up in a place like Montepulciano or Roussillon the culture there would certainly have its pros and cons, but many of the healthy lifestyle components being lauded here would just be facts of life. For those of us in places like the United States, the UK, Australia, and elsewhere, we may have to very consciously work at L’Art De Voir.

Cultural cross-over is happening more and more. We see it in food especially. Ethnic restaurants and cookbooks abound. With the tremendous increase in gourmet cooking the “fusion” approach is showing up everywhere. Access to a worldwide cornucopia of food products is greater than ever. Even a small town in rural Wisconsin may have a supermarket with a fully stocked olive bar. Awareness of the Mediterranean Diet and its healthful benefits has spurred many to adopt a whole new way of cooking, often at the behest of their cardiologist. (http://www.heart.org/HEARTORG/GettingHealthy/NutritionCenter/Mediterranean-Diet_UCM_306004_Article.jsp)Med-diet

As more people travel at younger and younger ages we bring home with us awareness of how daily life can look different. What we often want to bring back with us is not what will fit in our luggage. It is often a new pace of life, a greater sense of connectedness to our community, our family and to the natural world around us.

One of the blessings of a changing population that is increasingly ethnically diverse is the cultural infusion that results. Chances are most of us live in communities today that include neighbors from India, Nicaragua, Somalia, the Ukraine, Viet Nam, Poland and many more. As we associate with this cultural mix we are reminded that we don’t have to just do everyday things the same way all of the time. We have a world of choices.

Small head cropped1Coaching The Art of Living

Rather than pine away for a villa in the Tuscan hills what can our clients (and we coaches) do to make their own lives a work of art? Without the surrounding culture already supporting such a way of living, how can our clients still create a consciously crafted lifestyle with more choices?

1. Realizing The Choices We Have.

There are many ways we can modify our lifestyles and borrow from other cultures without losing our own cultural identity. One way is to help clients identify when they are operating on assumptions and sheer habit. Help them discover the “blind spots” in the lifestyle where they have been making certain choices simply because they have “always done it that way”. Work with your clients to distinguish between the “imperative” and the “volitional”. When something feels imperative it seems like we “must” do it that way. Ask to clients to challenge themselves at such a moment and ask “Who says?” Help them reclaim greater volition in their lives.

2. Resetting Priorities.

Not everything can be a priority. That defies the very definition of what a priority is. When clients clarify and connect with their values and create a life that is more congruent with them stress is reduced and inner peace is found. Explore what the true priorities are in life with your client and coach them around the sometimes daunting challenges of living in accordance with them.

3. Possibility Thinking And Exploring.

Creating an artful life often begins with the joy of discovery. Learning more about new ways of living may take on a fun process of exploration. We know that the stage of Preparation is what ensures successful Action. (http://www.amazon.com/James-O.-Prochaska/e/B001H9VXJ0) Make it a conscious process with support and accountability built in. Allow the client to share their discoveries in the coaching session and acknowledge their efforts. Coach them around distinguishing what new ways of living will work for them and what old ways they would like to let go of.

670px-Measurably-Improve-Your-Quality-of-Life-Step-14. Focus On Quality Of Life.  As Máté shared (above) “What they seem to be talking about is the quality of life.” Don’t just think about food alone, but rather the greater question of how can one infuse greater quality into every aspect of one’s life. When we look at L’Art De Voir we might do well to consider The Wisdom of Tuscany (http://www.goodreads.com/book/show/7034969-the-wisdom-of-tuscany) and its emphasis on the pace of life, the feeling of peace and tranquility, enhancing our physical surroundings, valuing social togetherness and, of course, putting quality into our way of eating and what we eat as well. (We will explore these in more detail in an upcoming blog.)

5. Experimenting.  

Coach your clients around ways to live more consciously, more artfully, and make it a part of the Wellness Plan. Identify experiments to try out new ways of being, new foods to eat (it’s okay if you really think some olives are too sour), new ways to get together with friends, etc. Start small. Integrate new ways of living slowly into the current lifestyle. Make it part of the coaching to create these action steps, commit to conducting the experiments, and being accountable to follow through. While much of this is true fun, there can be challenges that arise that require some processing in coaching. Conflict may show up. Your client’s friends pan the new recipe or activity that they thought would be so enjoyable. The new boundaries around work and personal time get lots of pushback from co-workers. Such experiences are important to process in coaching so the client can continue with improving their lifestyle instead of giving up too soon to avoid conflict. This is why the next step is so important.

6. Gathering Supportfriends

Living L’Art De Voir is possible in Tipperary or Tulsa, not just Tuscany. The key is gathering support for one’s new way of living. An effective coach will already be working with their client around enlisting others in their Wellness Plan. Lasting lifestyle improvement comes from the supportive network that helps a person sustain their healthier ways of living. Building that network needs to be a conscious process. Before launching new experiments successful clients secure commitment from other that will be affected. Getting “buy-in” from the family on a new dietary shift can be critical to its success. Sharing with others the real intention behind a new move to set boundaries around twenty-four-seven availability helps engender support rather than criticism. Just as it helps to get a “walking buddy”, so too it may make the process more fun and successful to engage like-minded friends in these ways to culturally shift one’s lifestyle.

7. Keeping Life Artful – Maintaining

Like any new behavior, the real challenge is often in maintaining the change. Coach your client around maintenance strategies that they can develop when the lifestyle shift is still new. One approach is to anticipate boredom and have “variations on the theme” available. Keep it fresh. Don’t get stuck on that favorite recipe or it will become like a favorite song on the radio that, when overplayed, becomes annoying. Joining interest groups or classes focused on their new culture-blending pursuits may serve to reinforce interest, learn new skills and access fresh resources.

The other key to maintenance is tracking. Encourage your client to find a way to keep track of their new ways of living. Just how often are they practicing some new skill or behavior? The old habitual ways of living, reinforced constantly by the dominant culture the person is surrounded with, will re-emerge and vie for supremacy. Some clients may find that keeping a lifestyle journal works for them. Others may need to get more specific using coaching tools and/or smartphone apps.

The Art Of Living

Londoners discovered over a hundred years ago that they didn’t have to dress like people from India to enjoy a good curry and today the city is famous for this dish. We live in a world with unprecedented access to information and products about and from other cultures. The invitation is there for us to explore and to begin to consciously choose what we will integrate into our lives. Part of being well is having more choices and the world today gives that to us. The remaining challenge may be within us rather than in our culture. Will we allow ourselves to experiment, to try something new? What kind of mindset shift needs to occur for us to give ourselves permission? Can we realize that we can still hold onto our own traditions and customs and choose what else we might add? Salt and pepper over and over again is fine, but have you really looked at the rest of the spice rack?6969813-bags-of-spices-on-display-in-a-market-in-provence-spices

 

Dr. Michael Arloski is CEO and Founder of Real Balance Global Wellness Services, Inc. taking wellness and wellness coach training worldwide. (https://www.realbalance.com)

Posted in coaching, healthy food, wellness, wellness coaching, wellness travel | Tagged , , , , , , , , , , , , , , ,

Meaning And Purpose: A Key To Wellness

The meaning of life is just to be alive

 

Those in the helping professions have long observed that people who have a sense of meaning and purpose appear to do better with their lives in general and their health in particular. Research over the last ten years is showing us that our observations were spot on. A clear, if even very simple, sense of one’s values, meaning and purpose is linked with greater longevity, fewer heart attacks, better diabetes management, less depression, less sedentary behavior, less Alzheimer’s Disease, and even better sex!

In a previous blog I explored “Meaning and Purpose and the Motivation to Be Well” (http://wp.me/pUi2y-5C).  Now let’s take a deeper look at the power of this topic.

As early as 1977 (High Level Wellness) wellness author, Don Ardell included Meaning and Purpose in his model of wellness under the dimension of Self-Responsibility. “An aim in life can help you obtain the kind of rewards needed for fulfillment and balance, and is crucial to your feeling “centered” and reasonably content with your life.” Ardell notes that the famous stress researcher, Hans Seyle “believes that a goal or purpose in life is fundamental to positive health and well-being.” Ardell continued to emphasize meaning and purpose in his 1982 book 14 Days To High Level Wellness by including it as one of his five dimensions of wellness and continues to write about it to this day.

“The purpose of life is to live it, to taste experience to the utmost, to reach out eagerly and without fear for newer and richer experience.”
― Eleanor Roosevelt

LFIO-bigBusiness leaders, life and executive coaches have continuously linked Meaning and Purpose with better work and career performance. Kevin Cashman, author of one of the best books ever written on leadership (Leadership From The Inside Out) (http://cashmanleadership.com/leadership-from-the-inside-out/) included “Purpose Mastery” as one of his “Seven Pathways To Mastery of Leadership From Within”. He sees it as a way to lead by expressing our gifts to create value.

“Purpose gives meaning and direction to all life. It is the context that frames all of our life experiences into a meaningful whole. If we have it, all the challenging experiences of life serve to forge our identity and character.

Purpose may be the most practical, useful connection to an effective life. It is bigger and deeper than our goals. It is life flowing through us. Purpose releases energy. The higher the purpose, the greater the energy. Purpose also frees us. The more profound the purpose, the greater the sense of freedom. Purpose opens up possibilities.

Purpose is not a goal to be set. It is not something you create. It is something you discover. It calls you.” Kevin Cashman

For Cashman, having purpose allows average-performing individuals and organizations to become highly effective ones. He urges us all to live our lives “On Purpose”.

In recent years there has been more attention given to this topic in the media and in the work of people like researcher Victor Strecher at the University of Michigan (http://www.dungbeetle.org). He sees a direct connection between having a purpose in life and how we behave, particularly in terms of choices that affect our health. For Strecher, lacking a sense of purpose is just as great a health risk as any other (e.g. smoking, obesity, etc.). He believes that when we start thinking “bigger than ourselves” (self-transcendence) we behave in ways that result in great health.

Clarifying our values is a key step to developing our sense of meaning and purpose. Strecher cites research showing that cigarette smokers who affirm their core values are more open to anti-smoking messaging and less defensive about it. He also found that people are more likely to participate in diabetes risk assessments if they have just completed their values list.

Evidence of the connection between health and having meaning and purpose continues to mount. In research published Nov. 3, 2014 in the journal Proceedings of the National Academy of Sciences, University of Michigan researchers “found that people with greater senses of purpose in life were more likely to embrace preventive healthcare: things like mammograms, prostate exams, colonoscopies, and flu shots.” (http://www.theatlantic.com/health/archive/2014/11/live-on-purpose/382252/)

oldmancraterlake-804x1024
The longevity connection has increasingly found support as well. Dr. Patricia Boyle, a neuropsychologist at the Rush Alzheimer’s Disease Center and an assistant professor of behavioral sciences at Rush University Medical Center in Chicago studied 1,238 older adults using a sense-of-purpose evaluation. “When comparing scores, Boyle found that those with a higher sense of purpose had about half the risk of dying during the follow-up period as did those with a lower sense of purpose. And that was true, she said, even after controlling for such factors as depressive symptoms, chronic medical conditions and disability.”
“What this is saying is, if you find purpose in life, if you find your life is meaningful and if you have goal-directed behavior, you are likely to live longer,” she said.
“Though much other research has found that having a purpose in life is crucial to maintaining psychological wellness and can be important for physical health as well, Boyle said she believes the new study is one of the first large-scale investigations to examine the link between life purpose and longevity.” (http://news.health.com/2009/06/16/have-purpose-life-you-might-live-longer/)

“The purpose of life is not to be happy. It is to be useful, to be honorable, to be compassionate, to have it make some difference that you have lived and lived well.”
― Ralph Waldo Emerson

Small head cropped1The Coach’s Take Away

Despite the recognition of the importance of meaning and purpose in personal and professional growth, and numerous studies linking it to the previously mentioned health benefits, the topic is often absent in wellness and health promotion programming. Such programs often use a less-than-holistic approach that focuses on concrete, measurable and objective goals (such as weight loss, health-risk reduction, etc.). Unfortunately some wellness and health coaching work is done the same way. While the rigor of a behavioral approach is appropriate, we must not forget the whole person. This may be where it is good to remember that “wellness coaching” or “health coaching” is really a part of “life coaching”. Our best work comes forward when we help our client to improve their lifestyle by helping them improve their life.

Such whole-life coaching can include helping our clients to create a Wellness Plan that is based upon their values. In helping people get clear about what they truly want in life and develop a Well Life Vision, we help them get more in touch with what their sense of meaning and purpose is. Such a Vision guides them in co-creating with their coach, a Wellness Plan that will best serve them. When the client lacks clarity about their values and sense of meaning and purpose (again, no matter how simple it might be) it will be harder for them to see an imperative motivational link between the goals they are attempting to achieve to improve their wellness, and the action steps they are taking to get there.

Helping Your Client To Discover Their Sense Of Meaning And Purpose

Getting in touch with one’s meaning and purpose is not something that can be artificially injected into a coaching process. People arrive at more clarity about meaning and purpose at many different stages in life. Some folks find it in their youth, others not until the golden years. What a coach can do, however, is help their clients make the seeking of meaning and purpose more of a conscious process. For many it is a matter of getting in touch with the meaning and purpose that they already have.

1. Help your client to get in touch with and clarify their values.

Powerful questions in the coaching conversation can challenge a client to look a little deeper. “What would it look like…” questions are very effective here. “So, what would your life look like once that weight loss is accomplished?” “What would your life be like smoke-free?” “If there was nothing in the way and you could spend a day doing exactly what you want, what would that look like?” “Who else would benefit from you managing your diabetes at a truly effective level?” Also explore “What really energizes or excites you?”

A fun exercise to help your client get in touch with values is to have them describe what they would do on a vacation of their choosing. Present the exercise in a way like this: “Let’s say you have two weeks to take a vacation and there are no obstacles in the way. You can afford it easily. You won’t get behind at work. No problems. Just you doing what you would like to do for two weeks. Describe for me, in detail, what your vacation would be like.” Each person’s vacation story tells so much about them. While one person would backpack the Appalachian Trail, someone else would take an organized bus tour of the Civil War Battlefield sites in the Mid-Atlantic states. From this conversation draw out what values showed up.

2. Ask them to what degree they feel they are living their life in accordance with their values.

The Institute of Stress at McGill University (where Hans Selye did his pioneering stress research) says that the greatest source of stress we can have in our lives is to be living our lives out of accordance with our values. Be prepared for some sadness and possibly regret. Empathize and help your client explore the compromises they have made, the trade-offs, and what they are ready, or not ready, to do about this. Help them to identify what steps they may be ready to make to live the life they really do want to live. This process may have a tremendous and positive effect on their wellness plan.

3. Help your client to live their life “On Purpose”.

As you explore what is important to your client, help them construct “experiments” that can help them to be more in contact with what brings them joy. The pet-lover may want to volunteer with an animal shelter. The nature-lover may want to see what environmental action organizations are in their community. The closet-writer may benefit from risking joining a writers group.

4. Encourage Self-Reflection

Busy lives end up lacking in time for self-reflection. Putting one foot in front of the other, caring for a family, developing a career, etc., we often get out of touch with our true self. As your client values the process of exploring meaning and purpose, encourage them to keep a personal journal. Encourage them to read books that will help with self-exploration and personal growth. (Victor Frankl’s classic Man’s Search For Meaning heads the list.)

Solo-time is a self-reflection practice that can have tremendous value. This may be as simple as setting aside an afternoon to spend quietly alone as you set all work aside. Or it may take on the commitment of a personal quest adventure like The Sacred Passage (http://sacredpassage.com). You might also introduce your client to the idea of a “technological Sabbath” where they “go dark” for a day (no media of any kind, internet, texting, or even phone use)and spend the time more purposefully.

5. Make the development of a greater sense of meaning and purpose a conscious part of the Wellness Plan.

Instead of seeing meaning and purpose as something that just evolves on its own, help your client to engage in a purposeful quest to achieve a greater sense of meaning and purpose. Through the coaching process experiments and action steps can be set up to carry on this exploration. The goal is not to attain clarity on any particular timeline, but to begin the journey and do it consciously!

It may seem challenging to fit a personal exploration of meaning and purpose into a wellness program, or into a coaching process, but if lasting lifestyle improvement is what we are after, it may be one of the most valuable endeavors we can pursue.

“The mystery of human existence lies not in just staying alive, but in finding something to live for.”
― Fyodor Dostoyevsky, The Brothers Karamazov

walking-longevity-key

Posted in coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , , ,

Stress Coaching Part II – Recovery From Stress

Time to be still...priceless!

Time to be still…priceless!

What we refer to as “stress” is quite a mystery. Ill-defined by most everyone except psychological researchers, we ascribe devastating levels of power to it, and often feel helpless to cope with it. We know that stress is linked to worsening health, greater risk of illness and the exacerbation of most any condition we find ourselves with.

Wellness and health coaches find their clients almost always struggling to manage stress. Clients often recount how they had been successful at lifestyle change, often losing weight, stopping tobacco use, etc., until…a stressful event or change occurred in their lives. Once the stress hit the weight was regained, the smoking revived and so forth.

stress-illnessWhen we experience chronically elevated levels of stress the Stress Response of the Sympathetic branch of the Autonomic Nervous System maintains unsustainable levels of arousal in several bodily systems. This causes digestion to be inhibited, heart rate and blood pressure to remain elevated causing extra strain on the circulatory system, and higher levels stress hormones (corticosteroids) to be produced. Cortisol levels rise and research has linked this in particular to extra weight gain and more difficulty in weight loss. (http://www.simplypsychology.org/stress-immune.html)

Medical researchers aren’t exactly sure how stress increases the risk of heart disease, diabetes, cancer, and many other health challenges, but it does. For many researchers the findings don’t always put the finger on stress per se, as we can see more directly in the case of increased hypertension, but on the resultant changes in lifestyle behavior. Under more stress people tend to engage in more unhealthy behaviors – smoking, drinking, overeating, more sedentary activity, depression, and to engage in less healthy behaviors – exercise, sleeping well, taking time to eat well. It’s felt that these shifts in lifestyle contribute to the disease processes. There is also lots of evidence that higher stress has a negative effect on the immune system. (http://www.discoverymedicine.com/Frans-Pouwer/2010/02/11/does-emotional-stress-cause-type-2-diabetes-mellitus-a-review-from-the-european-depression-in-diabetes-edid-research-consortium/) (http://www.medicinenet.com/stress_and_heart_disease/article.htm)

The Health-Challenged Client And Stress

Many, if not the majority, of clients that wellness and health coaches work with are challenged by some kind of chronic illness. For these clients stress management is a vital part of the Lifestyle Medicine approach that hopes to positively affect the course of their illness.

The wellness plan supports the treatment plan.

The wellness plan supports the treatment plan.

First of all your health challenged client must be under currently active medical care. Your work with them around stress management may have an effect – albeit positive – on their physiology. This means that your coaching efforts must be coordinated with your client’s treatment team. For example, practicing relaxation training may succeed in lowering blood pressure. A client on hypertensive medication will need to have their dosage adjusted as their blood pressure changes.

To help our clients create their own way of managing stress we need to be their ally and help them to build the self-efficacy and confidence that their stress can be successfully dealt with. On a realistic level few coaches are equipped to help a client with a complex cognitive restructuring process that is more the prowess of a counselor or psychologist. We can help our clients address barriers in their lives, but we may find that a “problem solving” approach to stress may be flirting with infinity. Another brush fire springs up not long after the last one was finally extinguished.

Instead we may want to proceed with a more holistic, lifestyle-oriented, positive approach. We could divide this approach into four components:

#1 Recovery From Stress
#2 Development Of Recovery-Enhancing Skills And Strategies
#3 Lifestyle Strategies For Reducing Stress Increasers
#4 Environmental Strategies

#1 Recovery From Stress

In our previous post (http://wp.me/pUi2y-e9) we spoke about how change today has increasingly shifted from episodic change (which we are psycho-physiologically set up to deal with) to continuous change. Despite the seemingly constant barrage of information, demands and pressures today, we are still very human creatures with a nervous system that requires recovery and repair. The alternative is having stress show up in the weakest link in our chain in the form of a stress-related disorder. These often begin with milder symptoms such as headaches, insomnia, etc., but if there is insufficient frequency and intensity of recovery we often see an increase in the severity of symptoms leading to increasingly serious stress disorders such as hypertension, gastro-intestinal disorders, and even symptoms of heart disease and more.

The body has it’s own built-in counterpart to the “stress response”. It’s called the “relaxation response” (as made famous by Harvard researcher Herbert Benson (http://www.relaxationresponse.org). Eliciting this response calms the body and mind. Heart rate and blood pressure are reduced, as is the production of stress hormones. Recovery with a “capital R” would mean bringing out the stress response in some way.

Part of recovery, however is with a “small r” and that means engaging in activities that people find “relaxing” and also getting sufficient and sound rest. Taking the time to read a novel, go for a hike, play music or your favorite sport, go fishing (often a great choice for the client resistant to anything that sounds too exotic), have a cup of coffee/tea or glass of beer/wine with friends and chat, garden, or anything that the client considers fun and relaxing fills this part of the prescription. Multiple health benefits come from such activities meeting needs on physical, intellectual, creative, social and even spiritual levels.

How To Coach #1

Ask your client to list the things that they like to do to relax. Then ask them the last time they engaged in those activities. This often brings up regret and sadness. Empathize and explore. See what they may be attracted to re-engaging in and set up support and accountability to help them succeed.images

Exploring fears and assumptions about taking the time to recover may be a necessary step. Engaging in recovery time is meaningless if you’re client has too many internal barriers in the way and won’t give themselves permission for self-care. Coach them around exploring their beliefs and assumptions about taking time for themselves. Help them identify what triggers their fears and develop a different response. Are they making any assumptions about their situation at work? How safe would it be to check these assumptions out? Can new agreements be made?

It’s not unusual for clients to discover that working on improved sleep and rest becomes an important part of their wellness plan. This may become an area of focus for them and setting up goals and action steps to work on this may contribute greatly to their stress recovery.

#2 Development Of Recovery-Enhancing Skills And Strategies

There are numerous ways that your client may choose to use, once they are aware of alternatives, to enhance their ability to recover from stress and “inoculate” themselves against further effects of excessive stress. The key is not to prescribe, but to help your client find a method that is a great fit for them. Personal values, beliefs, and even prejudices that your client holds need to be respected. One person may jump at the chance to learn Yoga or Tai Chi while another person may be repelled by the same opportunity.

How To Coach #2

Biofeedback can be simple and very effective.

Biofeedback can be simple and very effective.

Help your client to explore such options as: Mindfulness-Based Stress Reduction (MBSR) (http://www.umassmed.edu/cfm/); recordings of relaxation training methods such as progressive and autogenic relaxation training; recordings of guided visualizations for relaxation; biofeedback training supplied by a qualified biofeedback therapist; meditation training; classes in Yoga, Tai Chi and Xi Gung may also be of interest to your client. Coach them through the process of finding out adequate information and following through with selection and engagement. The key is to keep coaching them and make the practice of these skills part of the coaching.

#3 Lifestyle Strategies For Reducing Stress Increasers

Too much of a good thing?

Too much of a good thing?

Some big advantages in living a healthy lifestyle are the ways in which itcontributes naturally to stress reduction. Smart wellness coaches help their clients to look at how their diet is working for or against their stress level. Excess caffeine over-stimulates and can contribute to insomnia. Too much sugar causes energy ups and downs. Excess salt causes edema, and drives hypertension. Inadequate nutrition or not following a prescribed dietary program (such a for a person with diabetes) can also contribute greatly to stress. Indeed medical noncompliance can be a terrific source of stress as medications are not able to perform adequately to maintain homeostasis or deliver proper treatment.

How To Coach #3

Help your client to examine their current lifestyle behavior and explore their potentially ambivalent feelings about making changes such as modifying their diet. Coaches can use Motivational Interviewing techniques to help resolve such ambivalence. Drawing upon all a coach knows about Readiness for Change theory (TTM) will also help the client to approach change in a stage-matched way that is more likely to succeed. Simple behavioral tracking that is combined with support and coaching accountability can often empower clients to finally make the changes they need to their diet, activity levels, and self-care behaviors.

Work with your client to examine their approach to time management and organization in their lives. It’s been astonishing how many times coaches discover that clients have not been making use of such simple tools as working with a calendar, operating off of a written (versus mentally kept) to-do list. Help your client to take charge of their life by consciously working on organization and time management.

#4 Environmental Strategies

Nothing better than a place to put your feet up!

Nothing better than a place to put your feet up!

There is such an emphasis in stress management work around cognitive approaches and relaxation methods that we often overlook the environment the client experiences every day. Home and work environments can aggravate or alleviate our stress levels.

How To Coach #4

Have your client describe a “day in the life” so to speak. That is, have them walk you through their typical day with an emphasis on where they are, not what they are doing. Does it put them in touch with stress sources? Are they facing a daunting daily commute by car in high-stress traffic? Is there neighborhood safe enough to walk and recreate in? Is there household cluttered (stressful in itself) or relaxing and peaceful?

While many of our clients are faced with economic realities that may make relocating unrealistic, other times this may be a real option. Can they move closer to work and eliminate the commute? What would it take to consciously make their home more of a relaxing haven? Could they even make one room such a refuge? Other times, through coaching, clients discover that even though moving is out of the question, there are things they can do environmentally to improve their situation and reduce sources of stress.

I love to say that “A coach’s job is to remind people that they have choices.” Sometimes under the burden of stress we forget this.

Connecting with family, friends, our greater community and the natural world also helps tremendously to relieve stress. Getting our social needs met requires…well, socializing! Exercising outdoors provides more documented benefits than exercising indoors. Spending time in nature feeds the soul.

One of the most beneficial activities a person can engage in is totally unstructured time. “Drift time” allows a person to let go of the “To Do List”, let go of expectations, roles and responsibilities. Whether it looks like hammock stretching, wandering through a shopping district on your own, fishing in a river, or whatever suits your fancy, the tension seems to fade as the day goes on.

Have A Back-Up Plan

No matter what the strategy you and your client are co-creating, have a back-up plan. Something may show up and get in the way of the best-laid plans. Coach your client to come up with an answer ahead of time to the question: “What will you do if…?” Having a fall-back strategy can allow your client to still achieve their goal. Can they modify their plans? Can they exercise for 15 min. instead of not at all? Can they go for a walk during the noon hour in their work clothes instead of a trip to the gym? Do they have food stocked in the refrigerator that will allow them to prepare a quicker meal than the one they had planned?

Maybe Stress Management Is More Simple

Pioneering Life Coach Thomas Leonard was fond of saying that “A coach’s job is help people to Eliminate Tolerations and Get Their Needs Met.” Perhaps this maxim could better guide all of us in reducing stress in our lives and being well. Coach your clients around what they are tolerating, whether it is an annoying source of aggravation like a door that sticks, or the way their colleague treats them at work. Have them list all of their tolerations and explore the list together. You’ll find that a lot of what they are tolerating often results in them not getting their needs met. Under stressful demands people often put their own needs last on the list and seldom get to them. Unmet needs lead to depression, resentment, anxiety and the experience of stress. Help your client explore this and see what they are ready to do to begin prioritizing their own health and well-being.

Posted in coaching, wellness, wellness coaching | Tagged , , , , , , , , , , , , ,