Real Balance GLOBAL – Taking Wellness Coaching To China

Taking Wellness Worldwide
Taking Wellness Worldwide

What The World Health Organization dubbed “Lifestyle Disease” is a global phenomenon. The increase of non-communicable disease is going up the fastest in what is sometimes called the developing countries of the world. “Twenty-five years ago, the number of people with diabetes in China was less than one percent. Today, China has more than 114 million people suffering from the disease, the highest number of any country in the world. It is estimated that 11.6 percent of Chinese adults have diabetes, a proportion higher than the U.S. with 11.3 percent. Experts blame the increase in sedentary lifestyles, high consumption of sugary and high-calorie Western diets, excessive smoking and lack of exercise.” (http://www.counterpunch.org/2015/07/24/the-increasing-burden-of-diabetes-in-china/)

From the very start of my work in developing the field of wellness coaching my vision was to bring wellness worldwide. Real Balance Global Wellness Services, Inc. (http://www.realbalance.com) has now trained over 6,000 health and wellness coaches around the globe. We have trainers in Ireland, Brazil and Australia. We have trained people from places like Dubai, Ethiopia, Hong Kong, Denmark, Korea, and many more countries through our fully-interactive webinar trainings.

shanghai0515-cityscapeNow we are continuing with our global mission by TAKING WELLNESS COACHING TO CHINA ! We are proud to announce that Real Balance is teaming up with Chestnut Global China EAP (http://chestnutglobalpartners.org) to bring wellness and health coach certification training to China! I will deliver a certification training in Shanghai March 14-19, and then travel on to Beijing to promote wellness coaching and do a book signing.

2nd Ed Cover - MedThe book I will be signing in Beijing is Wellness Coaching For Lasting Lifestyle Change, 2nd Ed., newly translated into Mandarin and published in China! The challenges of “lifestyle disease” are rapidly increasing in China as more people move to urban areas, diets change, smoking continues to increase, culture shifts and stress increases as well. Helping people gain access to allies that can help them succeed at lifestyle improvement is just as important here as anywhere else.

We are exploring other ways to connect with people around the world to contribute to the health of the planet and its people. Please be a part of creating Allies For A Healthy World.

broadmoorcolospringsBack In The U.S.A.

Please join us in beautiful Colorado Springs, at The Art & Science of Health Promotion Conference (https://www.healthpromotionconference.com).  March 27-31.
Real Balance will be exhibiting there and I will be delivering two workshops: “Five Key Coaching Skills For Motivating Sustainable Lifestyle Improvement”, and “Mastering The Science and Craft of Health & Wellness Coaching: Higher-Level Methods And Skills.” See you there!

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Client-Centered Directiveness: An Oxymoron That Works – Part Two: Adapting To Your Client

Just how much directives does our client need?
Just how much directiveness does our client need?

Effective wellness and health coaching adapts in many ways to the client we are working with. As we assist a person in finding ways to live a healthier life there are many adjustments that need to be made to deliver a customized experience that will work best for that individual.

In this post we will examine how to take into account several key client determinants that will guide our choices about just how directive to be with our wellness coaching clients. Truly one size of coaching does not fit all.

In our last post – Client-Centered Directiveness Is Not An Oxymoron – Part One (http://wp.me/pUi2y-jO), we explored how coaches vary in the degree to which they are directive or non-directive. We looked at how there is a Directiveness Continuum that allows for an effective range of coaching in the middle and ineffective coaching at the extremes. We explored the Coaching Spectrum of techniques and methods that ranged from listening and understanding to ways that we might not consider coaching such as directly telling people what to do. We also looked at all of the ways that coaches are, in fact, engaging in directive work with their clients, and how to do so effectively.

Wellness coaching clients vary tremendously on both mental/emotional and environmental variables. One client may be highly motivated to improve their lifestyle and very open to and welcoming of coaching. They may have abundant resources at their disposal and great support from other people in their lives. Or they may be the mirror image of all of these qualities. Some of our clients may be familiar with coaching from experiences with business/life coaching, or from having had some form of telephonic wellness coaching as a benefit from their employer or insurance company. Many, of course, will be very unfamiliar with wellness coaching and how it works.

One way to adjust to what our client needs it to see where they fit into the following matrix:

slide18

If we just look at the variables of Experience, Control, Motivation and Ability we can see how we might work with these combinations in either more directive, less or non-directive and blended approaches. Experience may refer to more or less experience with coaching or with the process of changing lifestyle behavior. Control may refer to the client’s own needs for control, or how “in charge” they like to be. Motivation may refer to motivation to engage in the coaching process, and/or motivation to improve one’s lifestyle. Ability may refer to intellectual ability, or to environmental circumstances that limit the client’s ability to engage in lifestyle improvement efforts. The matrix is not perfect. We could, for example have a client who is of Low Ability and Low Motivation, but who has High Needs for Control. In such situations we would have to decide which variable trumps the others. In this case, I personally would recommend honoring the High Needs for Control as paramount. Perhaps this illustrates that someone will always have their own unique position in the matrix and require us to adjust the degree to which we are directive or non-directive. We might imagine their location being plotted like somewhere on a graph, as in our example, near the top of the Directive Quadrant, closer to the border with the Blended Quadrant. In other words we are not advocating a simplistic four-quadrant approach to coaching, but again, honoring the unique position of each of our clients on the matrix.

Examples – Ronaldo and Hazel

Let’s say our client, whom we’ll call Ronaldo, is an industrial design team leader who has had some experience with leadership coaching. He’s struggling with stress, sleeping well and his biometric markers have hit an alarming borderline zone with his blood sugar, blood pressure and blood lipid levels. He’s very concerned about this and highly motivated to engage in coaching and make some positive, and immediate lifestyle improvements. He clearly fits somewhere in our Non-Directive Quadrant on our matrix. Coaching with Ronaldo will most likely proceed, as it would with all of our clients, building a strong coaching alliance, using an effective coaching methodology and structure. Ronaldo will want to feel like he is definitely the one with his hands on the steering wheel. All of our steps together will be CO-CREATED. Ronaldo will need little in the way of suggestions or even education, but he may benefit tremendously from a great ally to strategize with, a strong system of support, and what we might call “gentle” accountability.

Another client of ours, whom we’ll call Hazel, is a hardworking housekeeper with a large hotel chain. She has never had any experience with coaching and is unfamiliar with what it can offer. She’s finding that despite her high level of physical activity she still continues to gain weight. She is also very discouraged from many failed attempts at crash dieting. Accurate information about how to eat better has been lacking for her. She finds learning new systems difficult and doesn’t really like change. Her family situation also contributes to making lifestyle improvement challenging. Hazel would fall somewhere more into our Directive Quadrant. Again, we would be treating Hazel with the same high level of honor and respect that we would with all of our clients in building a powerful coaching alliance. We would avoid stereotyping Hazel or making assumptions about her abilities. We would however, be realistic in meeting her where she is at. Hazel would most likely appreciate a more directive approach. She may benefit from recommendations for nutrition education resources. If the coach is a qualified dietician or nutritionist, they may want to create an agreement to combine these roles into the coaching that is done and “wear two hats.” The coach may take on a role where they are guiding the client through the coaching methodology more carefully, yet keeping it client-centered with Hazel still being in charge of choosing each step that she wants to do. Accountability agreements may need to be adjusted more closely to make sure that Hazel is clear about the agreements, and sees the value in them for her.

mappointingdirection“Just tell me what to do!”

There are times when clients more like our “Hazel” really ask the coach to simply tell them directly what to do. How should I exercise? What should I eat? Usually such clients are discouraged by past failure experiences and their own self-efficacy is so low that they have no faith in their own ability to create an effective way to change. They seek consultation more than coaching. They want a real “expert” to direct them on the “right” path. A great coaching response to such requests goes something like this:

“So, when you’ve asked the experts about what you should do, and followed their advice, how did that work for you?”

Almost always the person will think for a moment, sigh, and then have to admit that while such expert advice may have worked for a short amount of time, eventually it didn’t work at all. That’s when you can lightheartedly suggest that you and your client defy the so-called definition of insanity – doing the same thing again, and expecting different results! We need to meet our client’s request for complete direction (to the point of consultation, not coaching) with empathy and understanding. Keeping them in charge, remaining client-centered can still be done, even though we may coach them in a more directive style.

Staying True To The Coaching Mindset

No matter how directive or non-directive we are with our client, we still will be coaching from a stance where we hold them to be Naturally Creative, Resourceful and Whole. (http://www.coactive.com/learning-hub/fundamentals/res/FUN-Topics/FUN-The-Co-Active-Model.pdf) Our task is still to Evoke our client’s Inner Wisdom. Some of our client’s may have gotten to the point of doubting they even have such wisdom and strength. This is where it is good to remember the famous quote from Goethe.

“If you treat an individual as he is, he will remain how he is. But if you treat him as if he were what he ought to be and could be, he will become what he ought to be and could be.” Johann Wolfgang von Goethe

 

The Health And Wellness Coach’s Value Proposition

Vp - overall image

Every potential coaching client is looking to have the question ‘What’s in it for me?’ answered. Every coach needs to be able to succinctly answer that question by conveying what they will provide for their client.

Potential coaching clients are rarely familiar with what a coach, especially a health & wellness coach, can do for them. They are used to dealing with educators and consultants, medical and otherwise, not coaches. Usually clients expect to be directed, educated, and led in the best direction for them. All too often they hear a wellness coach tell them something like:

persuade“I’m not going to tell you what to do. I’m not going to tell you what to eat or how to exercise. You’re the one in charge. You’re the one behind the steering wheel. You’ll be making your own wellness plan, and I’ll help you follow it.”

Why should this person become your client when it appears that they,
themselves, are going to be doing all the work?
Our client-centered approach to coaching does not mean we are not providing value, however we have to communicate the value of what we offer, and do it very clearly. What will the client gain from coaching?

This is true for the self-employed coach as well as the coach working for a wellness program, a disease management company, an insurance carrier, or any other organization that provides wellness and health coaching. It is about engagement. When coaches are confronted with the “incentivized” client, who is reluctantly complying with coaching in order to get their prize (or much-needed insurance discount), conveying the Health And Wellness Coach’s Value Proposition is more vital than ever.

Here is my way of presenting The Health And Wellness Coach’s Value Proposition. Please adapt to your own words and use it!

value-proposition

The Health And Wellness Coach’s Value Proposition*

Thank you for your interest in improving your lifestyle and your life. You may be new to coaching, and especially wellness coaching, so let me share with you the value that it brings.

Wellness/health coaching is all about you living the best life possible for you. To do that most people find there needs to be some improvements in their way of living, their lifestyle. Making those improvements, those changes is challenging when you have to do it all by yourself. Perhaps you’ve already had some experience with that.

When I work with someone in coaching I’m here to serve you. You are the one in charge of your life and our work together. It’s your hands on the steering wheel. I’m not going to tell you what to do and give you a pre-maid wellness plan. But, together we can co-create a plan to help you succeed at making the lifestyle improvements that you want to make.

As your coach I will be working with you to get very clear about where you are at with your health and well being right now. We’ll help you take stock of that by exploring together, using some coaching tools that will help give you a more complete picture, and by going over the lifestyle improvement recommendations you’ve gotten from treatment professionals. Then we’ll work together to help you form a clear picture of the kind of life you want to live, your healthiest life possible for you. We’ll compare where you’re at and where you want to be and together form a solid plan to help you get there.

Once we have that plan we’ll work together as allies to help you be accountable to yourself and follow through on the steps you need to be taking on a regular basis to help you achieve the goals you have in your plan. I’ll be with you throughout the journey. I’ll be there to help you strategize over, under, around and through the barriers that come up. I’ll help you with challenges that make it tough for you to live the healthy life you want and together we’ll help you keep on track. Together we’ll help you find and develop the sources of support that will make your changes last. We’ll evaluate our progress and adjust the course along the way as we need to. My goal is to assist you in becoming self-sufficient in your wellness, to be able to live a healthy life in a completely sustainable way.

I bring the value of a professional that knows about succeeding at lifestyle improvement. I bring the value of an ally.”

*(Created by Michael Arloski, Ph.D., PCC, CWP) Please adapt to your own words and use it!  If used intact you must include authorship credit and contact information (web address for Real Balance Global Wellness Services, Inc. https://www.realbalance.com)

Medium5

In two previous blog posts I shared some ideas about Market Development for the self-employed wellness coach. Please check them out for additional resources. The Self-employed Wellness Coach and Market Development – Part One: Closed Doors, Open Doors http://wp.me/pUi2y-9L The Self-employed Wellness Coach and Market Development – Part Two: Being So Much More. http://wp.me/pUi2y-bc

“Coaching for a Lifetime of Wellness: Five Keys to Sustainable Behavioral Change”

2nd Ed Cover - MedThe theme of the 41st Annual National Wellness Conference was “Spotlight On Sustainability”. While we often think about sustainability and our environmental practices, as a wellness coach and psychologist I immediately thought of sustainable behavioral change. As I prepared for my presentation on this topic my research revealed that we actually know very little about how effective our efforts at helping people improve their lifestyles actually are.

Maintaining success at lifestyle change is often daunting. Most wellness coaching clients have a history of initiating efforts at losing weight, stopping smoking, managing stress, etc. For many, however, there is a trail of failures at maintaining those new ways of living in the long run. The result is a lowering of self-efficacy and lingering feelings of discouragement. As I explored in a previous blog post “Lessons From Albert Bandura For Wellness Coaches” (http://wp.me/pUi2y-dB) there is much for coaches to learn about self-efficacy.

 When we go to trusted sources looking for help with making healthier behavior last, what do we find? Unfortunately, not much. From Harvard Medical School’s online publication Healthbeat I found “The Trick To Real And Lasting Lifestyle Changes”. (http://www.health.harvard.edu/healthbeat/the-trick-to-real-and-lasting-lifestyle-changes) Though this title sounds like the exact resource to look for, all it advised was a simplistic review of SMART Goals.

Turning to the APA Psychology Help Center we find “The key to making lasting lifestyle and behavioral changes: Is it will or skill?” (http://www.apa.org/helpcenter/lifestyle-behavior.aspx) This disappointing short article could only offer this: “Lasting lifestyle and behavior changes don’t happen overnight. Willpower is a learned skill, not an inherent trait. We all have the capacity to develop skills to make changes last,” said Katherine C. Nordal, PhD, executive director for professional practice at APA. “It is important to break down seemingly unattainable goals into manageable portions.” The article mostly talked about how ineffective we are at making any changes in our behavior and did not even address making changes last!

As I deepened my research quest I found that other behavioral scientists had been concerned enough about this issue to establish an impressive research consortium to tackle it. The result was a publication in The American Journal of Health Behavior (2010 Nov-Dec; 34(6): 647–659) entitled The Science of Sustaining Health Behavior Change: The Health Maintenance Consortium. The authors (Marcia G. Ory, PhD, MPH,1 Matthew Lee Smith, PhD, MPH, CHES, CPP,2 Nelda Mier, PhD,3 and Meghan M. Wernicke, MPH4) did a thorough research synthesis of articles spanning 2004-2009, amassed resources and funded twenty-one projects to look at this issue of lasting change in health behavior. Here is what they concluded.

elderly_hikingWhat we are up against when it comes to lasting change.

• How long can positive gains be sustained without additional long-term support?
• In most cases this is unknown because studies only track maintenance for a year or two after the post-intervention phase.
• In the majority of cases, intervention effects on lifestyle behaviors are often strongest in the one or two years closest to active intervention.
• Without additional support, positive effects tend to diminish over time, or treatment differences vanish.

What they found was frankly, not a lot.

• It’s not realistic to expect long-term maintenance based on initial interventions. (Single-variable research)
• Moderate-intensity behavioral interventions may need to be coupled with more environmental changes to sustain long-term effects.
• In other words people need the support of healthier communities and workplaces, peer groups, etc.
• Incorporation of physical activity into the self concept emerged as the strongest predictor, with self-efficacy having a major indirect influence confirming it as an important predictor for both behavioral initiation and maintenance

LongWindingRdIn summary:  The authors conclude that no single mediator makes a large impact; rather, there is a “long and winding road” with maintenance achieved through a multitude of modest interrelated meditational pathways from behavioral initiation to maintenance.

There are many reasons for our scarcity of knowledge. One is that much research of this nature is done by universities where graduate students need short-term projects that allow them to finish up and…graduate! We may learn more from larger sociological and epidemiological studies such as The Framingham Study (https://www.framinghamheartstudy.org) , the work of The Blue Zones, (https://www.bluezones.com) etc. However, here we are not isolating variables. We can’t really say if it was the plant-based diet, the supportive extended family, or the red wine that made the healthy difference. It seems we have to be satisfied with the shotgun approach and put our best bets on culture and environment.

What can we conclude about making positive changes in health and wellness behavior last?

• Changes must be sustainable over a lifetime
• Intrinsic motivation trumps extrinsic every time
• Most research looks at single interventions and doesn’t track more than one or two years
• Long-term studies show that a combination of environmental support and “internal” shifts sustain lifestyle improvement better. Culture, environment, attitude and beliefs!
• We must ask how can coaching support shifts towards “well” attitudes and beliefs?

Healthy Choices For A Lifetime
Healthy Choices For A Lifetime

The Five Keys of Coaching For A Lifetime of Wellness

• 1. Build Self-Efficacy
• 2. Nurture Visionary & Intrinsic Motivation
• 3. Focus On The Maintenance Stage (TTM)
• 4. Co-create Relapse Prevention Strategies
• 5. Coach For Connectedness

1. Build Self-Efficacy

Bandura’s Social Cognitive Theory (formerly AKA Social Learning Theory) shows tremendous congruity between it and the foundational principles of coaching. Bandura deeply explored the concept of Self-Efficacy which is foundational to wellness coaching. (Again see the previous blog post “Lessons From Albert Bandura For Wellness Coaches” (http://wp.me/pUi2y-dB)

2. Nurture Visionary & Intrinsic Motivationgreen nature_wood path

Much of our coaching work is around helping people to envision the outcome they want. When we have a clear picture of both where we are (our current state of wellness) and where we want to be (our Well Life Vision) we can “coach to the gap” between the two and coach around what needs to change to attain that Well Life Vision. Such a positive psychology approach is foundational to coaching and motivates better than just fear and illness avoidance.

We know that when clients experience intrinsic joy in activities they will be more motivated to engage in them. Look at the work of Jay Kimiecik, The Intrinsic Exerciser: Discovering the Joy of Exercise: ( https://www.amazon.com/Intrinsic-Exerciser-Discovering-Joy-Exercise/dp/061812490X) and Daniel Pink’s book Drive: The Surprising Truth About What Motivates Us (https://www.amazon.com/Drive-Surprising-Truth-About-Motivates-ebook/dp/B004P1JDJO/ref=sr_1_1?s=books&ie=UTF8&qid=1467763122&sr=1-1&keywords=Daniel+Pink+drive#nav-subnav).

To COACH for intrinsic motivation:
* Notice! – Help your clients to focus on the enjoyment, the pleasure that they perceive as they are performing the behavior.
* Inquire! – Ask about the details of their experience. When a client reports about taking a walk, hike or bike ride outdoors ask about what they saw, what they experienced, what they felt.
* Inquire about Bonus Benefits. Clients sometimes fixate on their goal of weight loss for example, but what else is happening during their efforts? Are they experiencing more energy? Better sleep? More mental concentration?
* Avoid incentivizing. Incentives tend to decrease intrinsic motivation.
* Take a Kai Zen Approach. (https://www.amazon.com/Small-Step-Change-Your-Life-ebook/dp/B00GU2RHCG/ref=sr_1_1?s=books&ie=UTF8&qid=1467763620&sr=1-1&keywords=robert+maurer#nav-subnav) Coach with your client to set up action steps that are so small that they are very doable and allow continuously successful progress towards their goals.

3. Focus On The Maintenance Stage (TTM)

Of all of the Stages of Change that Prochaska talks about in his Transtheoretical Model of Change (https://www.amazon.com/Changing-Good-Revolutionary-Overcoming-Positively-ebook/dp/B003GYEH2Y/ref=sr_1_1?s=books&ie=UTF8&qid=1467763816&sr=1-1&keywords=prochaska+changing+for+good#nav-subnav), coaching around the Maintenance Stage may be the most vital. Here the coach again takes a positive psychology approach and acknowledges and reinforces what is working. As the old saying from coaching goes “Nothing succeeds like success!” A key in this stage is for the client to see the value in Tracking Behavior and to do it regularly. Avoiding self-deception is key. Use whatever works for keeping track of new healthier behaviors: calendars, charts, apps, activity monitoring devices, etc. Then the Accountability that coaching provides makes the process conscious, deliberate and increases consistency. Lastly, coaches really prove their worth here as they coach their clients through the barriers and the “push-back” that sometimes is received by those who clients were hoping would provide support.

4. Co-create Relapse Prevention Strategies1369010631_url

Relapse happens! Count on it! James Prochaska is fond of back-up plans. We all know that life throws us curve-balls all the time. Our best-laid plans run up against life realities. This is where coaching can get creative! Coach clients to come up with their own back-up plans for then things don’t go as they would like, or when temptation increases. Going to a potluck dinner where the dietary direction of friends tends to be sabotaging of your wellness efforts? Be sure to bring an entrée to share that will satisfy your own needs. Not enough time to do your hour-long exercise routine? Having a quick and simple set of exercises you can do anywhere fills in “better than nothing” and maintains engagement in your program.

Pivotal to this key is self-compassion. There is a real difference between excuse-making and true compassionate understanding. Coach your client to be less self-critical and more forgiving. Help them keep a healthy perspective on their wellness plan.

5. Coach For Connectedness

Real Balance Faculty At The National Wellness Conference
Real Balance Faculty At The National Wellness Conference

In our Real Balance Wellness & Health Coach training (https://www.realbalance.com) we emphasize coaching for connectedness from day one. The amount of time any client spends in coaching is a brief moment compared to the lifetime they have to live in a new way. In addition to the support of the coach, other sources of support must be encouraged, discovered or consciously developed. For each step of action we ask “Who or what else can support you in this?” If our client has little support then making the development of such support a deliberate area of focus to work on in coaching is vital. This is where the role of culture, community, workplace, peer groups, family, friends, and relationships becomes a part of coaching that cements lasting lifestyle change.

Living a wellness lifestyle is a lifetime job! Providing the kind of coaching that goes beyond simplistic goal-setting and allows our clients to transform who they are can build the foundation for a lifetime of wellness.

A PDF of the PowerPoint from my presentation on this topic at The National Wellness Conference and a complete bibliography are available for download at: http://www.nationalwellness.org/page/2016NWCHando

If It Only Was That Simple: The Illusion Of Explanatory Depth

answersWhen faced with overwhelming, frightening and ultimately complex problems we tend to search for simplistic answers. Perhaps this is an adaptive attempt originating in the deep part of our brain known as the amygdala, where fear triggers our survival instincts (and our flight/fight/freeze response). In our ancestral days near our cave, taking action to freeze, run or fight like hell often served us well. Today, however we are faced with other stimuli that, despite our rationalizations and euphemisms to the contrary, actually do scare us just as much, but in a different way. No longer fleeing Saber-toothed Tigers, today, instead we face frightening foes like global climate change, racism, war and peace, extremist politics and chronic disease.

To combat these foes, we again seek the fastest, and therefore simplest responses that attempt to be solutions. Overly simplistic thinking causes us to latch on to attractive answers that seem to bring us some semblance of relief from the anxiety of overwhelm and the fear of the unknown. We generalize, minimize and seek solace in some quoted study that showed that ten people did one thing, one time, and now are healthy and safe for life. Eat low fat. Eat high fat. Don’t exercise…just drink wine! Chocolate could be one of your basic food groups!

“Psychological scientists have a name for this easy, automatic, simplistic thinking: the illusion of explanatory depth. We strongly believe that we understand complex matters, when in fact we are clueless, and these false and extreme beliefs shape our preferences, judgments and actions—including our votes.” (http://www.psychologicalscience.org/index.php/news/full-frontal-psychology/extremist-politics-debating-the-nuts-bolts.html)

Just diet & exercise...not so simple.
Just diet & exercise…not so simple.

In healthcare and wellness we take something as supremely complex as weight management and leave our critical thinking hats off as we search for some magical Thor’s Hammer that will strike down obesity, diabetes and heart disease with one swift (and don’t forget easy) blow. If it only was that simple!

As a University Counseling Center Psychologist I worked with a great number of victims of rape and abuse. I observed how victims would astonishingly blame themselves and go through a time of attempting to feel safer by saying “If only I hadn’t been in that place at that time”, or “If only I had been doing this instead of that”. The health and wellness equivalent may be when we seek out lifestyle practices that we hope will insulate us from disease and misfortune. I’m not talking about basic health-risk reduction here, but rather the way people grab on to simple all-or-none thinking about diet, exercise, stress management practices, etc. We think that kale, mindfulness, Yoga, coconut oil, or a new Fitbit will be our single-track savior. We want the comfort of the “illusion of explanatory depth”.

Everyday, when we look harder at the research, and that means going back to what we learned in Psychology or Sociology 101 about basic research, we can sift through all of the contradictory data and at least conclude that there is nothing simple about wellness, health and especially challenges like healthy weight management. In this internet-based age we are continually bombarded with headlines sprung from single studies with incredibly small “n’s”. Changing what we eat based on the success of seventeen people who dined while standing on one leg how we are urged to take action by headline-grabbing authors.

We all know how hard it is to get rid of cockroaches once they infest a place. Research publicity sometimes creates myths that persist just as tenaciously. In a brilliant recent blog (https://www.linkedin.com/pulse/beware-cockroach-effect-faulty-data-die-jon-robison?trk=hp-feed-artic) Jon Robison gives us more evidence about not trusting sketchy “evidence”.s-l300

The Cockroach Effect is certainly not limited to weight-related research. Dr. John Ioannidis has spent his career exposing the personal biases, economic pressures and downright bad science that plague medical research. In a seminal paper in PLoS Medicine in 2005 with the intriguing title, “Why Most Published Research Findings Are False,” he presented a model which predicted correctly that 80% of non-randomized studies, 25% of randomized trials and 10% of large randomized trials were refuted by later research. While we expect contradictions as part of science, Ioannidis also found that even when faulty research was debunked, its conclusions typically persisted for years or even decades. The details of his fascinating findings are explored in an article entitled “Lies, Damned Lies and Medical Science” which appeared in the Atlantic Magazine in November 2010.”

As tempting as it is to look for quick relief in simplistic answers, we must take a deep breath and know that health and wellness is a marathon, not a sprint. The progress may be found in a combination of studying both how we change, and how we maintain change.

This June at The National Wellness Conference (http://www.nationalwellness.org/?page=NWC2016) one of the breakout sessions I will be presenting is Coaching for a Lifetime of Wellness: Integrating the Keys to Sustainable Behavioral Change. We’ll look at how to shift our thinking from short-term outcomes to the only kind of study that really counts – the longitudinal study of one’s lifetime. There is a lot to explore about how to help people make lifestyle improvements that will have to last for the entire rest of their lives. The problems we face are multi-causal. The answers we seek need to be holistic and thorough. As many of you have heard me say “I did not write a book entitled “Wellness Coaching For Temporary Lifestyle Change.” See you in St. Paul, Minnesota this June!

Be well! Coach MichaelM-ConamaraDiamond1

 

 

The first rule of sustainability is to align with natural forces, or at least not try to defy them. Paul Hawken

A Thousand Pots of Brown Rice: A Mindful Way To Be Well

A Thousand Pots of Brown Rice
A Thousand Pots of Brown Rice

We all want to be as healthy as we can be, and are usually anxious to get there quickly, like it was a destination we could actually arrive at. Mastering a wellness lifestyle is rather like mastering any art, craft or skill. It’s more of a journey than a destination. Lifestyle means a way of living, and doing it well requires enjoying the journey.

The world around us sells the quick-fix. Becoming fit is presented as a dynamic and exciting adventure. Health foods are presented as not just nutritious, but delicious, exotic, fun and intriguing. The images of “well people” in the media portray beautiful individuals at their peak of physical fitness, exuberance and youth. The weight-loss marketing world attempts to entice us with programs that promise to be both exhilarating and expeditious.

For people who make real progress at improving their health, the reality is that change is slow, methodical, repetitious, and often plagued by lengthy plateaus. The folks who lose weight, get in shape, maintain good health and make it last are those who discover the secret of finding intrinsic reward in the mundane.


A Thousand Pots Of Brown Rice

masteryBkCoverIn his classic book Mastery: The Keys to Success and Long-Term Fulfillment (available online for free at https://www.thecorporaterookie.com/wp-content/uploads/2014/03/Mastery.pdf ) George Leonard describes the path to mastery as one of short bursts of increased performance followed by slowly ascending plateaus.

 

mastery curve better

Practice, practice, practice. The key is to learn to enjoy the plateaus and know that eventually there will be progress. We live most of our life in these plateaus. Losing weight, smoking cessation, and other efforts are fraught with plateaus. Brown rice! Again? Great musicians, golfers, Yogis, all learn to love the practice. Living a wellness lifestyle is really practicing a way of living…over and over again. To keep it alive we have to notice. Noticing – being aware and mindful of the here and now – allows us to discover intrinsic joy through our senses and our emotions. There is great sensory satisfaction in the taste and smell of well-prepared wholesome food. There is real joy in the act of movement waiting to be discovered. There is true emotional satisfaction when we effectively execute a lift, a dance move, or leap over a small stream on a hike. The key is to notice.

Fortunately brown rice does taste good, kind of plain, but good. We can always spice up the brown rice in our life. Throw in a little cumin, some sort of variation to liven things up. Think of how this applies to a workout routine, a new route for that noon-time dog walk, or nurturing a new friendship to bloom instead of just sticking to our usual crowd. This helps, but what gets us through 365 days in a year, is enjoying our practice, simple as it is, of living a well-life.

Five Keys To Mastery

In Mastery, Leonard describes five keys to mastering anything, be it music, tennis, computer programming, or, in our case, living an outstandingly well life. He points to: 1) Instruction; 2) Practice; 3)Surrender; 4) Intentionality; and 5) Pushing The Edge. Here’s how this applies to our quest for mastering a wellness lifestyle.

1. Instruction

older-woman dumbells
In a world of infinite choices about what to eat, how to exercise, meditate, etc., the challenge is to separate the whole-wheat from the chaff. This is where we need to do our due diligence on the sources of our wellness information. Part of what Leonard is referring to as Instruction, means finding valid and reliable sources for health information that don’t have a commercial interest in persuading us to see and buy things their way. It may mean seeking out real expertise appropriate for our needs. A certified diabetic educator will do a better job helping you set an effective self-management course than just looking things up online. A fitness trainer with solid professional credentials can help you find ways to strength train that will keep you at it for life because you’ll learn how to do it right from the start. A professional nutritionist or registered dietician can help you far more than your friend, or nearby clinic that wants to sell you all kinds of dietary supplements.

2. Practice

Wynton Marsalis
Wynton Marsalis

One can approach practice with either a mindset of The Imperative, or The Volitional. As a junior high school student I approached my trumpet lessons under the imperative mindset. I avoided practicing all week and then a night or two before my lesson I would get in a couple of 20-30 min. practices starting with those boring scales and exercises. I did want to be in the high school band, my parents had bought this shiny trumpet for me and were paying for the lessons, so… As I got older, I found that I enjoyed the sense of accomplishment as I mastered my lessons and could play tunes I relished. Playing in the actual band and especially the jazz band, was straight-up fun and spurred me on. Today whenever I think of a professional musician, like trumpet-master and bandleader, Wynton Marsalis, I think of the thousands of hours of practice that got him to where he is today. Think of a famous martial artist, the Bruce Lee type. How many times did they do their repetitious katas to get to where they could draw upon any move in a nano-second and execute it perfectly? To get there, at some point they practiced because they wanted to – the volitional.

The wellness lifestyle that is lived with a volitional mindset is one of choice and preference. We eat well because we have gotten to the point of preferring to eat that way by finding the intrinsic reward in doing so. Yes, we may be enjoying the added benefit of reducing some key dietary health risks, but what motivates our choices is pleasure and preference. We have discovered that healthy food can taste good! We walk, bike, lift weights, practice Tai Chi or Yoga, or both, because we truly enjoy such practices. We will do our best to prioritize the time to do activities we enjoy on a regular basis.

When we operate out of the imperative wellness mindset we choose the grilled chicken salad at the restaurant because we “know” it’s good for us. We may still crave the juicy hamburger and fries, but we twist our own mental arm and “do the right thing.” The imperative mindset around exercise is very self-defeating. We can easily maintain our “I hate exercise” mindset while doing what we are “supposed” to do. It will take less of a barrier to provide an excuse to skip today. The health-risk reduction approach to motivating us to be well actually counts on us employing the imperative wellness mindset. After all, it’s imperative that we do these things in order to be avoid illness!

We often start our wellness efforts with the imperative mindset. That’s fine. Until we achieve a bit of conditioning even walking can be tiring, or strength training can make us sore. My quads were screaming after my first Tai Chi lesson! Eating brown rice is not very thrilling to begin with. Also, fear may push us towards the imperative. Borderline cholesterol or blood sugar levels can scare us into action and get us started! For the changes to be sustainable, we want to work our way towards the volitional wellness mindset where practice becomes our new way of life, and we love it.

3. Surrenderfool

The path to being well doesn’t have to be boring. When we surrender to trying new things, to allowing ourselves to perhaps even appear foolish, we often discover rich rewards. Overcoming our initial fear and getting out on the dance floor, trying a food we can’t pronounce at first try, allowing ourselves to ask for support can open amazing doors.

Surrendering is not giving up. Here we are talking about surrendering our ego, our persona. What unnecessary limitations do we put on ourselves that hold us back from new opportunities? Do we really need to avoid vegetarian dishes in order to maintain some kind of image we have of ourselves? Can we try something that seems foreign to our own culture? This is where the word “try” has a positive spin. Instead of referring to a half-hearted effort, here we mean trying something like trying on a new pair of shoes to see if they fit. Think of all the pleasing surprises that have awakened new interests, new skills, new tastes, and new opportunities in your life.

4. Intentionality Das Ziel anvisieren

The way forward in living our lives better works best when we do it with full intentionality. Envisioning our best life possible and lying out a concrete plan to get there works much better than just mustering will power. Seeing us living our well-life vision can provide a motivational tipping point that pulls us towards practicing all of the day-after-day, mundane steps that make up a wellness lifestyle. We choose the healthier food option, or to get up and move not because we want to lose forty pounds, but because we want to live the kind of life we will have when we’ve lost those forty pounds!

Mind games? Yes, but better to engage in positive and purposeful mind games, than to slip into the negative mind games of self-deception and stuckness. Setting our intentions positively is a proven process that leads to success. Creating a well-life vision that motivates and then creating an actual Wellness Plan to get there gives us a road map for achieving the life we truly desire. These are the basic tools at the heart of all effective wellness coaching.

5. Pushing The Edge

comfortzonestretch

Finally, pushing the edge means extending our efforts just a bit further than we thought we could at first. It means walking in the rain anyway, sacrificing an old pattern to adopt a healthier one, taking a step that is safe, but for us very bold.

The key here may be distinction. Life in our “comfort zone” may be living up to its name, but as one quote goes, “nothing grows there.” Think about most of what you’ve achieved in your lifetime and your reflections will show that at some point success required vacating your comfort zone. We want to move into what is for us a stretch. It may be doing 15 chest presses instead of our usual 12. It may be allowing us to dance until the band goes home! The challenge is distinguishing between a “stretch” and a “risk” or even a “danger”. Sometimes a well-considered risk pays off. The new person we met agrees to get together socially. Perhaps we get out on the dance floor and no one really stares at us after all.

The 1000 Pots Of Brown Rice Approach cautions patience. At middle-age, if you go from never running to pushing yourself to run mile after mile, day after day, in less than a week you will probably have the painful condition called shin splints, or some other injury. Jumping on a radical, unproven diet craze may upset your metabolism, digestion, or worse. You’ve gone beyond risk into the danger zone.

When we are firmly on our wellness journey and have both a well-life vision and intrinsic motivation working for us, we push through more barriers. Suddenly going out on a walk in foul weather becomes a mere exercise in selecting the appropriate clothing. We tolerate a growling stomach a while longer in order to cook a healthy meal instead of capitulating to the expediency of an unhealthy pre-packaged meal. We take the “risk” of rejection by trying out a new social group of some kind. We get more “comfortable” with “stretching”!

Dr. Michael Arloski
Dr. Michael Arloski

The Coach’s Takeaway

In my next blog I’ll share what it takes to develop Mastery of Wellness Coaching, but for now let’s look at how the content above can help us coach our wellness clients more effectively.

1. Go for sustainability. To coach our clients towards lasting lifestyle improvement the changes have to be sustainable. Sustainability requires both motivation and access or ease of maintenance. Our client will be performing these healthy lifestyle behaviors for the rest of their entire life.
2. Motivation sustains. Embrace imperative, fear-based motivation for the value it brings, but coach towards the embrace of intrinsic motivation. Help your clients develop the skills of mindfulness around their wellness activities. For example, ask for them to describe in detail their experience of a recent walk. Where did they go? What did they see and notice? How did they feel through their senses – warmth of the sun, gentle wind on the face, etc.? Help them reconnect with the positive feelings of performing the wellness behavior. Coach for the co-creation of a Well-Life Vision that provides a motivational link between what they want the behaviors (day-to-day) to get there.
3. Move from the Imperative to the Volitional. Coaching’s client-centered approach helps people to realize that they are in charge of their own wellness. All the aspects of their Wellness Plan are of their own choosing. We are empowering individuals to achieve what they want for their lives. As we coach clients who are still stuck in the blame game, we need to ask them “How’s that working for you?” Helping them leave victimhood behind is a great step. As client’s begin their wellness journey because they feel they “should” (the imperative) we can support them in practicing their wellness activities and action steps that help them get to the point of better physical and emotional/psychological conditioning. Then they are more ready to experience the more positive, intrinsic rewards in the same activities that took so much effort before. Maximizing on that motivation makes the shift to the Volitional Wellness Mindset.
4. Reassure. Clients need support and reassurance that life on the mundane plateaus will finally lead to success. Coach them with your own support and coach for connectedness. Growing other sources of support in their relationships, families, workplaces, etc. are key to lasting lifestyle change.

Leonard likes to say that most of a Master’s life is living in the plateaus. Make them enjoyable ones

The Bigger Mindset Shift: Waking Up To Lasting Lifestyle Improvement

Wake up to a whole new way forward!
Wake up to a whole new way forward!

Just back from a whirlwind of professional travel, I’m struck by a pervasive awakening that our health is largely behavioral, and if we truly want to improve health worldwide, we must seek methods that support success at lasting lifestyle improvement. At the Lifestyle Medicine 2015 Conference http://lifestylemedicine2015.org, where I presented, we saw that the medical profession is embracing wellness & health coaching as never before. In Europe we witnessed increasing interest in how to integrate wellness coaching into health systems and medical training. In the large disease management company where I just delivered a week of training, there is truly a mindset shift from a consultant style of helping relationship using simple goal-setting to an integrative model based on the Real Balance Wellness Mapping 360°™ Methodology https://www.realbalance.com.

Real Balance Wellness & Health Coach Certification Training is continually fostering “making the mindset shift” – going from “prescribe & treat” or “educate and implore” to the coaching mindset of “advocate and inspire”. We repeatedly emphasize the importance of shifting from the Consultant role to that of a true Coach. The recognition that assisting people in succeeding in behavioral change is a very different process than sharing medical, educative or other expertise, is starting to take hold stronger than ever.

Making The Mindset Shift is our way of saying Wake Up and realize that co-creating wellness is the way forward.nature-landscape-path-walkway-mist-mountain-grass-sunrise-river-clouds-water-1920x1200

A co-creative way of working with people honors their inner wisdom, acknowledges the contextual factors that facilitate or inhibit lifestyle improvement while honoring and celebrating differences. Co-creation allows a person to be the expert in their own life, and yet does not send them out to climb the mountain alone. It is our commitment to accompany them on the journey providing support, guidance, tools, and our expertise in changing lifestyle behavior.

It is easy to feel overwhelmed by the increasing “lifestyle disease” health statistics documented by the World Health Organization. As we see budgets (whether of families, states, provinces, companies or countries) plundered by chronic illness expenses we are also, finally pulling ourselves out of the floodwaters, reaching for higher ground, gaining perspective, and seeing that more of the same will just continue to drown us. There is a coalition of Wellness & Health Coaching, Wellness & Health Promotion, Lifestyle Medicine and other like-minded people with enough vision to see that lifestyle improvement, individually and collectively, will be what allows us to keep our heads above water, start to swim and return to the healthy place that seems like dry land. Please join us!

“Let’s get together and feel all right.”
One Love
By Bob Marley

Michael & Deborah Arloski in London
Michael & Deborah Arloski in London