Wellcoaches created the animated movie “How Coaching Works” to explain health and well-being coaching when it was in its infancy. Now with almost 2 million views, the video remains a helpful illustration of the beauty of the coach/client relationship. This blog series aims to share the psychological underpinnings of the cartoon. The first blog provides insight into the approaches used by the coach which are based on the principles and processes of coaching psychology. This blog series aims to share the psychological underpinnings of the cartoon. The first blog provides insight into the approaches used by the coach which are based on the principles and processes of coaching psychology. Scene One: MEET In this scene you find the coach in the office with a client. You may expect that it’s the coach’s role to tell my client what to do. Instead, the coach asks them to create a picture of their vision, symbolized by the mountains off in the distance. The client is eager to move toward that vision, and has even started doing some of the thinking necessary to get there, but feels overwhelmed by the things that stand between reality and the dream. The knotted path represents the many possible paths toward the vision. It’s up to the client, with the coach’s support, to figure out which path is the best one. The coach and client first agree on how they are going to work together. They shake hands, symbolizing the important boundary-setting conversation and agreement that starts a coaching relationship. For this relationship to be growth-promoting, the coach radiates warmth, empathy, confidence, zest, humor, and courage. Scene Two: VISION In the next scene, the coach encourages the client to get very clear about what it is that they want, and why. The coach elicits motivation by getting the client to explore why change is important now. They explore what it is exactly that the client wants to create – noting that all of life is invented – and that together they will experiment with how to get from Point A to Point B. Did you know that it’s all invented? According to the Constructionist Principle, we construct our reality - what we perceive, what we believe, what things mean, and what we value. In other words, it’s all made up! And, it’s from this frame of reference that the best coaches work with their clients. They playfully support the client in making up the rules to the client’s “game of life” and in experimenting with the ways to play it. An inspiration for coaches comes from the work of Ben and Rosamund Zander in their book The Art of Possibility. Check it out and learn to say “How fascinating!” about all of life’s knots in the road. Scene Three: THE PLAN Notice that when the client works on their plan, the coach digs into the toolbox and hands over a tool – a BIG pencil. The client is uncertain that they can handle the pencil, but the coach’s certainty is greater than the client’s doubt. From the domain of Hope Psychology, we know clients have the willpower, and now just need to develop the waypower. And, waypower isn’t best developed by having someone tell you what to do, or doing it for you; it’s best developed by experimenting with the change oneself. The client gets specific with what they want to have happen –the specific changes that will take place in their life to get to the mountains in the vision. The more specific, the better. The box that the client draws represents the importance of focus and clarity in setting one’s goals. They are exploring the question of what the client is going to take responsibility for creating, and doing, to reach the beckoning goal. Scene Four: THE JOURNEY As the coach presents the next tool, a trampoline, the client is beginning to feel more confident in their ability to take that first leap. The trampoline represents the power of setting goals that are appealing, specific, and measurable, and of thinking through all that it will take to be successful, including the ever-important supporting relationships. The coach invites the client to recall other times when they have been successful in achieving other life or work goals, as well as their strengths and talents. It’s an opportunity to learn from past successes and to apply one’s strengths, rather than focusing on what’s hard. More building blocks are constructed – the stepping stones to reaching success. The vision of the client’s best self becomes clearer and closer. But as the client continues to experiment, they fall off of the ladder – missing a challenging step. This, of course, happens in real life – we lapse and fall back into our old habits. The coach brings a safety net, a non-judgmental space in which they can explore what happened and what they learned from it. How fascinating! This leads to his insight and decision to create smaller steps, drawn onto the ladder. How important it is to move to action at the right time, with the right goal in mind. There is little benefit to clients of working on goals that are beyond their capability. When clients set goals that are well matched to their readiness to move forward, with enough stretch to be engaging but not too much to produce anxiety, they become aligned with their “best self.” The client rises above the challenge, achieves the plan, and jumps up, having grown into the image of their best self. They are excited as they experience what it feels like to be there – and that will propel more successes going forward. Scene Four: SUCCESS The Coach and Client end with a celebration – the client has found the best path, outgrown perceived roadblocks, and become the vision of their best self. Together the heartily acknowledge the accomplishment. The final scene is a cliff hanger, so to speak. Its message of “To Be Continued” speaks to the fact that change is a journey, a process to revisit continually. We know that as the client continues down the road toward the vision, there will be another knot, or a ditch, or a seemingly impenetrable object. Yet, through the coaching partnership that cultivates hope and the acknowledgement of strengths and abilities, the client will continue on the path and further develop their best self.

Today, more than 14,000 coaches in 50 countries have been trained in the Wellcoaches protocol, which was first designed and tested in 2000-2002 for the launch of the first Wellcoaches coach training program in September 2002. The protocol continued to expand, deepen, and evolve through the teamwork of ten Wellcoaches faculty, leading to its publication in the Wellcoaches Coaching Psychology Manual by Wolters Kluwer in 2009 (2nd edition in 2016). Research Since 2009, research teams in the US and Europe have designed, implemented, and published 22 outcomes-oriented studies of the Wellcoaches protocol, delivered by Wellcoaches trained and certified coaches, in peer-reviewed scientific journals. The evidence base consisting of 22 data-based studies of the Wellcoaches protocol, from 2009 to 2020, involved 623 coaches serving 34,0646 clients and delivering 129,225 coaching sessions. All 22 studies produced beneficial results with statistically significant outcomes. These 22 studies (summarized in the Table) are diverse in patient/client application, settings, demographics, and locations: Applications - patients or clients with obesity, pre-diabetes and diabetes, cancer, fibromyalgia, cardiovascular risk factors, smoking cessation, in need of lifestyle medicine or enhanced wellness behaviors. Settings - implemented in primary care practices, hospitals, community clinics, medical fitness programs, and employee wellness centers. Demographics – young, middle-age, and older adults, military, health-care workers, minority and low income, rural and urban settings Locations – throughout the US (15 states) and abroad. Weight Management There are five published studies of the Wellcoaches protocol addressing weight management. Weight loss was achieved in all four studies where it was a goal. The fifth study focused on disordered eating syndromes and showed diminished incidence of binge-eating in the 225 patients studied. Diabetes There are four research papers describing the impact of Wellcoaches protocol in patients with diabetes and/or pre-diabetes. Three of these studies tested A1C and all found a beneficial reduction in this primary diabetes outcome measure. The fourth study did not evaluate A1C; it found improved autonomy and self-efficacy, implying better diabetic self-care, after experiencing the coaching intervention. Risk Factors & Wellness There are nine research papers studying the Wellcoaches protocol for improvements in wellness, lifestyle medicine, and cardiovascular disease risk factors. These studies are unanimous in finding health benefits such as reduced blood pressure, lower BMI, improved fitness, lower anxiety, smoking cessation, and improved physical functioning. There are also reports of enhanced exercise habits and improved nutritional behaviors. Fibromyalgia and Cancer The beneficial results in studies of cancer and fibromyalgia include reduced anxiety and pain, reduced use of health care services, and improved quality of life. Physician Burnout Wellcoaches coaches adapted the Wellcoaches protocol to mitigate the effects of burnout for primary care physicans. After six coaching sessions, reduced burnout, improved job satisfaction and psychological capital were reported. Conclusions 1. The Wellcoaches protocol is the most thoroughly tested coaching protocol. 2. The evidence base for the Wellcoaches protocol includes 22 studies published in scientific journals between 2009 and 2020. 3. All 22 studies showed beneficial and statistically significant outcomes. 4. These studies involved 623 Wellcoaches-trained coaches serving 34,064 clients and delivering 139,225 coaching sessions. 5. The 22 studies addressed diverse: a. challenges including obesity, diabetes, cardiovascular risk factors, smoking cessation, lifestyle medicine/wellness behaviors, cancer, fibromyalgia, and physician burnout. b. demographics: age, low income, minority, military, healthcare workers, rural and urban populations, US and Europe. c. settings including primary care, community clinics, medical fitness facilities, hospitals, and employee wellness. Overview of published Wellcoaches Protocol studies Citations 1. Ahn S, Lee J, Bartlett-Prescott J, Carson L, Post L, Ward KD. Evaluation of a Behavioral Intervention with Multiple Components Among Low-Income and Uninsured Adults With Obesity and Diabetes. Am J Health Promotion 2018;32(2):409-422. doi:10.1177/0890117117696250 2. Berman MA, Guthrie NL, Edwards KL, Appelbaum KJ, Njike VY, Eisenberg DM, Katz DL. Change in Glycemic Control With Use of a Digital Therapeutic in Adults With Type 2 Diabetes: Cohort Study. JMIR Diabetes 2018; 3(1):e4. doi: 10.2196/diabetes.9591. PMID: 30291074; PMCID: PMC6238888 3. Djuric Z, Segar M, Orizondo C, Mann J, Faison M, Peddireddy N, Paletta M, Locke A. Delivery of Health Coaching by Medical Assistants in Primary Care. J Am Board Fam Med. 2017 May-Jun;30(3):362-370. doi: 10.3122/jabfm.2017.03.160321. PMID: 28484068; PMCID: PMC5634140 4. Edman JS, Galantino ML, Hutchinson J, Greeson JM. Health coaching for healthcare employees with chronic disease: A pilot study. Work 2019;63(1):49-56. doi: 10.3233/WOR-192907. PMID: 31127744. 5. Eisenberg DM, Righter AC, Matthews B, Zhang W, Willett WC, Massa J. Feasibility Pilot Study of a Teaching Kitchen and Self-Care Curriculum in a Workplace Setting. Am J Lifestyle Med. 2017;13(3):319-330. doi: 10.1177/1559827617709757. 6. Galantino ML, Schmid P, Milos A, Leonard S, Botis S, Dagan C, Albert W, Teixeira J, Mao J. Longitudinal Benefits of Wellness Coaching Interventions for Cancer Survivors. The International Journal of Interdisciplinary Social Sciences: Annual Review 2009: 4 (10): 41-58. doi:10.18848/1833-1882/CGP/v04i10/53020 7. Guthrie NL, Berman MA, Edwards KL, Appelbaum KJ, Dey S, Carpenter J, Eisenberg DM, Katz DL. Achieving Rapid Blood Pressure Control With Digital Therapeutics: Retrospective Cohort and Machine Learning Study. JMIR Cardio. 2019; 12;3(1):e13030. doi: 10.2196/13030. PMID: 31758792; PMCID: PMC6834235. 8. Hackshaw KV, Plans-Pujolras M, Rodriguez-Saona LE, Moore MA, Jackson EK, Sforzo GA, Buffington CA. A pilot study of health and wellness coaching for fibromyalgia. BMC Musculoskelet Disord. 2016 Nov 8;17(1):457. doi: 10.1186/s12891-016-1316-0. PMID: 27821160; PMCID: PMC5100173. 9. Hildebrandt T, Michaeledes A, Mayhew M, Greif R, Sysko R, Toro-Ramos T, DeBar L. Randomized Controlled Trial Comparing Health Coach-Delivered Smartphone-Guided Self-Help With Standard Care for Adults With Binge Eating. Am J Psychiatry 2020 Feb 1;177(2):134-142. doi:10.1176/appi.ajp.2019.19020184. 10. Long DA, Reed RW, Duncan I. Outcomes Across the Value Chain for a Comprehensive Employee Health and Wellness Intervention: A Cohort Study by Degrees of Health Engagement. J Occup Environ Med. 2016 Jul;58(7):696-706. doi: 10.1097/JOM.0000000000000765. PMID: 27294443. 11. McGloin H. Exploring the potential of telephone health and wellness coaching intervention for supporting behaviour change in adults with diabetes. Journal of Diabetes Nursing 2015:19:394-400. 12. McGonagle AK, Schwab L, Yahanda N, Duskey H, Gertz N, Prior L, Roy M, Kriegel G.. Coaching for primary care physician well-being: A randomized trial and follow-up analysis. Journal of Occupational Health Psychology 2020: 25(5), 297–314. https://doi.org/10.1037/ocp0000180 13. Mielenz TJ, Tracy M, Jia H, et al. Creation of the Person-Centered Wellness Home in Older Adults. Innov Aging. 2020;4(1): 1-13. igaa005. doi:10.1093/geroni/igaa005 14. Mettler EA, Preston HR, Jenkins SM, Lackore KA, Werneburg BL, Larson BG, Bradley KL, Warren BA, Olsen KD, Hagen PT, Vickers KS, Clark MM. Motivational improvements for health behavior change from wellness coaching. Am J Health Behav. 2014 Jan;38(1):83-91. doi: 10.5993/AJHB.38.1.9. PMID: 24034683. 15. Rivera LO, Ford JD, Hartzell MM, Hoover TA. An Evaluation of Army Wellness Center Clients' Health-Related Outcomes. Am J Health Promot. 2018 Sep;32(7):1526-1536. doi: 10.1177/0890117117753184. Epub 2018 Feb 5. PMID: 29402124. 16. Roy BA, Roberts PA, Lisowski C, Kaye MP, Sforzo GA. Integrating Health Coaching With a Medical Fitness Program to Treat Chronic Health Conditions. Am J Lifestyle Med. 2017;14(3):326-334 doi:10.1177/1559827617728025 17. Schwartz J. Wellness Coaching for Obesity: A Case Report . Global Adv Health Med. 2013;2(4)68-70. DOI: 10.7453/gahmj.2013.029 18. Sforzo GA, Kaye MP, Simunovich S, Micale FG. The effects of health coaching when added to a wellness program. Journal of Workplace Behavioral Health, 31:4, 242-257, doi: 10.1080/15555240.2016.1228463 19. Sforzo GA, Kaye M, Ayers GD, Talbert B, Hill M. Effective Tobacco Cessation via Health Coaching: An Institutional Case Report. Glob Adv Health Med. 2014 Sep;3(5):37-44. doi: 10.7453/gahmj.2014.029. PMID: 25568823; PMCID: PMC4268607. 20. Sherman RP, Petersen R, Guarino AJ, Crocker JB. Primary Care–Based Health Coaching Intervention for Weight Loss in Overweight/Obese Adults: A 2-Year Experience. Am J Lifestyle Med. 2019;13(4):405-413. doi.org/10.1177/1559827617715218 21. Sherman RP, Ganguli I. Primary Care-Based Health Coaching for the Management of Prediabetes. Am J Lifestyle Med. 2017; Apr 11;12(2):175-178. doi: 10.1177/1559827617702074. PMID: 30202390; PMCID: PMC6124994. 22. Tucker LA, Cook AJ, Nokes NR, Adams TB. Telephone-based diet and exercise coaching and a weight-loss supplement result in weight and fat loss in 120 men and women. Am J Health Promot. 2008;23(2):121-9. doi: 10.4278/ajhp.07051646.

the decline of moments of being well While looking for an image to express the concept of well-being, I came across this photo of Japanese snow monkeys relaxing in a hot spring on a winter's day. I don't know about you, but it makes me pause, exhale, feel the warmth, and appreciate the good. In case it doesn't do that for you, consider it a warm invitation to find something that does. In pandemic time, most of us need more human warmth, more long exhalations, and more appreciation of what is good. Moments of being well, of well-being, are elusive today. A 2021 survey using a respected measure of flourishing shows that around 60% of non-boomer adults (under age 58) are NOT flourishing. The level of burnout, a terrible crisis of ill-being - mental, emotional, physical, and spiritual depletion - is at an all-time high in healthcare and other industries devastated by the pandemic. Many things that had nourished our well-being, or kept ill-being at bay, keep appearing and disappearing, like unreliable magic tricks. We are not yet skilled hunters and gatherers of the moments of well-being that make up a life well-lived, particularly for young people. well-being models As you would guess, the concept of well-being, like many human endeavors, is complicated and multi-faceted. Along with the flourishing model, we have an abundance of science-based well-being models to choose from - positive psychology, PERMA, positivity, Gallup, Self-Determination Theory, Maslow's model of Self-Actualization, CDC, and lifestyle medicine - to name some respected models. Focused since 2000 on understanding and fostering wellness and well-being through coaching, our Wellcoaches contributions include: designing coaching as a science-based well-being intervention in its own right, even when coaching isn't explicitly focused on health and well-being goals organizing and integrating well-being elements into our natural multiplicity - the mind has multiple parts, each with its own well-being formula Models of work well-being have arrived (Gallup, job crafting, research handbook, for example), along with our enlightened discovery that individual well-being, leading well, and organizational well-being are profoundly interdependent. Work is a vital source of well-being. Well-being enables great work. None too soon, well-being has become a leadership priority, not just a line item in the HR budget. well-being vs wellness With all of the scientific attention, the cool factor of well-being has overtaken the fading construct of wellness, which now seems out of fashion. While the APA defines wellness as a dynamic state of well-being, others have relegated wellness to the corner of physical health, despite an abundance of well-constructed, whole-person wheels of wellness that convey the deep interconnections of mind, body, life, and work wellness or well-being. In 2019, when our NBHWC and VA team worked with the American Medical Association (AMA) to establish healthcare billing codes for coaching services, the AMA decided on "health and well-being" rather than health and wellness. Thank goodness - at last there is a healthcare profession focused on well-being, something most agree is good for physical health, even if wellness got demoted in the process. suffer well Another thing most everyone agrees on is that we need to get better at navigating our negative emotions and experiences. In particular, we need to suffer well by turning the near-universal pandemic trauma of a severely disrupted present and future into post-traumatic growth - more appreciation, meaning, strength, possibilities, creative acts, and richer relationships. Not just bouncing back with resilience, but fully experiencing the losses and fears so they carry us forward to a better place, better able to thrive during the next tough times. a life well lived - together Whether we are enjoying moments of well-being, or experiencing and turning difficult moments into good - strength, growth, and new opportunities, we are living work and life well. Reaching out to help others, helps us feel better. Asking others for help, looking to people who are thriving or flourishing, does them a favor. They feel even better (social well-being!). We are in a well-being reboot. We are in this together. Coach Meg www.coachmeg.com More resources: Everyday Health: Mental Health Stigma Wellcoaches: A New Duet

In 2006 I began a journey to discover the purpose God had created me for. While watching what I thought to be an action movie in early 2007, I was introduced to the issue of human trafficking and was wrecked to the core. Not only did I know I had to do something, I also knew I had found “my thing” and truly felt in my spirit that one day I would be working for an anti-trafficking organization. Over the years, I took several mission trips overseas to serve at safe houses and during those trips discovered my passion for working with survivors as they endeavor to recover, restore and heal from the physical and emotional trauma they endured. Yet, I never felt called to study mental health. In 2019, my employer enrolled me in the Wellcoaches Coach Training as part of my Wellness Coordinator role. During the 4-day onsite initial training we went through the process of crafting our Wellness Vision. I was slightly surprised to see working in human trafficking show up in that vision. While I was still passionate about the issue, I had encountered many roadblocks in my efforts to serve in the space domestically. But there was no denying its need to be a part of my wellness vision. In early 2020, while attending an event, I heard a speaker who from a local anti-trafficking organization, Harbour Hope International, whose main mission is to provide mentoring relationships to survivors of human trafficking on their journey towards self-sustainability. I again felt the strong conviction that this was the place I was to pour out my passion. I went through their volunteer training and began serving as a mentor for a survivor. As my mentor partner and I helped our mentee establish goals for her life, I realized I had finally found the place for all of my Wellcoaches training to be applied in a way I was extremely passionate about. As the issue of trafficking continues to grow, so does our need for mentors to come alongside those survivors who are lucky enough to leave “the life”. In July of 2021 I was offered a position with Harbour Hope as their Mentor Program Coordinator, leading our mentor teams that are serving survivors on a daily basis. The skills I acquired during my Wellcoaches training perfectly prepared me for this position, equipping me to help guide others to discover how to be the best version of themselves, unlocking the great potential that already lies within but simply needs to be uncovered. When survivors of trafficking make the brave step to leave the life for good, they come with a lot of baggage but little self-efficacy in their ability to do anything but the life they came from. Witnessing the transformation of the heart, mindset and behaviors of these individuals, facilitated by the Wellcoaches approach to coaching, is truly life-changing – for me as a coach and the survivors we serve. It moves these courageous individuals from a life of literally just surviving to an expectant future of thriving. As my mentor team grows to accommodate the need, the evidence-based and practical protocols learned in my Wellcoaches certification allow me to help my mentors discover what sets their soul on fire and how they can step confidently & fully into that vision. While I appreciate every aspect of the comprehensive Wellcoaches training, creating my wellness vision and then watching it become my reality, has been the most motivating byproduct of the experience. Knowing we get to do the same for others is a blessing I feel honored to be a part of.

In an interview on Java with Jimmy, Coach Meg and Dr. Claude Alabre at Massachusetts General Hospital meet with host Jimmy Hills to discuss New Year’s resolutions. Here’s what we talked about. Juice last year to the last drop Left to our own devices with New Year’s resolutions, they can work out but they often don’t. But not for the reasons we imagine. We tend to blame a lack of motivation, laziness or being too busy as the reasons we miss the mark. There’s more to unpack. Coach Meg explained that because the new year switches over so quickly, we don’t take the time to really process the year before. We start running hard toward new goals as soon as the new year begins. Changing yourself is not easy, in the best of times. In order to move toward new change and growth, we need to cultivate a foundation of strengths. People can’t get better if they don’t have sufficient “psychological capital,” the resources needed to support the self-improvement process. We need to take time to ground ourselves in our resources and strengths. From that place, we are better prepared to move forward and step into the ups and downs of self-change. How to do that? Harvest the good that emerged last year. “Juice” the good experiences to the last drop: what did I do well, what are the biggest wins, how did I get better, what did I learn, how did I grow? Only then, is it a good time to start to consider – what are my next opportunities to get better? Create a lane in your life for the inside game Improving ourselves starts with an inside game. Lasting change requires a lot of reflection and internal discoveries about ourselves. When our energies are focused on meeting the demands of the external world, including expectations about New Year’s resolutions, we lose connection to the inner game. It’s important to create space in our lives to pause, reflect and allow ourselves to harvest in order to grow. If we are running in the lane of getting stuff done and performing well ALL of the time, there is no space to pull back and reflect and gather - gather lessons, gather gratitude, and breathe in what’s good in our lives and work. Give ourselves grace and gratitude as Jimmy says. Working with a partner or coach can help us to reflect and gather all of our psychological capital. Once we open up the lane of reflection on our strengths and we invest in our psychological bank accounts, we can turn to reflecting on what powers us through improving ourselves – the combination of deep, heartfelt motivation AND a solid amount of confidence in being successful. Go deeper than you would typically do to find out what goal is really important, what change really matters to you, and why it’s important, why it’s a top priority to get better. Then dig some more to cultivate confidence in your ability to change by considering your challenges and getting creative in finding ways to get around them. Ignore social pressures in order to pause Forget about the social pressures in the ritual of New Year’s resolutions. As humans, pausing and reflecting first is vital. Of course, we also need to strive - productive striving is really important. However, striving isn’t just for the start of a new year. If we make time for pausing and harvesting the wins from last year, striving can begin later. Whether you give yourself an extra push to strive in January, June, or September it doesn’t really matter. You don’t always have to be striving, even if it’s the start of a new year. What also works against our efforts to pause and harvest is the incessant thinking that takes over our minds. In the book Coach Meg co-authored with Paul Hammerness, “Organize Your Mind, Organize Your Life,” (now Train Your Brain) we explore the topic of frenzy. It’s one word with a lot behind it. The culture we live in creates frenzy by telling us: if we are not achieving something, we have no value. It’s important to keep in perspective that this force surrounds us. It’s like being in an intense weather system. It can take real effort to move against it and understand that we don’t need to be achieving or producing every moment of every day, including at the start of a new year. For starters, let’s give ourselves some group compassion for how we are all living in this pressure cooker of achievement, and appreciate that the extreme pressure runs counter to pausing - stopping to reflect and gather, or simply doing nothing, catching our breath and resting. See stress as a direction for growth The second thing in the big umbrella term of frenzy - is stress. By its simplest definition, stress is the sign that the demands of the moment are greater than our perceived abilities. Stress puts us into the state of being afraid we can’t keep up. In pandemic times, we all have a lot of stress and negative emotions circulating inside and outside. And the suffering is our path to new growth and more strength. We can be with, and work with, our stress and other difficult emotions and feel compassion for them, bringing warmth and curiosity. Then we can ask ourselves “what is the meaning of this experience?” After that, we can move toward learning and growth. A bigger way to think about this is the scientific model of post-traumatic growth. Trauma is a situation where the general future and our individual futures are disrupted. COVID has been and still is a trauma. We are all traumatized because our future continues to be disrupted. We need to let go of the idea of bouncing back, returning to old norms, and instead learn to suffer well, lean in, and turn the trauma into growth. If we have survived, the pandemic is ultimately a force for good in our lives, if we use the experiences well. Nature has growth in its basic design. We lose track of our basic nature – the urge to grow, become wiser, stronger, and more competent. A mindset to consider then is to view the whole process of living through a pandemic as a way to grow and expand ourselves. The goal to strive for isn’t reducing stress, it’s to expand ourselves; becoming bigger, stronger, and better people. Get in touch with how you are growing and who you are becoming. The deeper the sense of who you are and who you want to be and why that matters, the more likely you'll be successful in your efforts. What goals really matter Java with Jimmy is focused on helping people get healthier. Despite all of the urging, most people don’t view good health in itself as a high priority goal - the bigger goal is living a good life. What matters then is connecting your health to what you really want in life. Go a few layers deeper on what you would lose if you didn’t have your health. That’s what you need to think of every time you make a choice: apple or cookie, exercise or stay in bed, e-cigarette or yoga stretches. In those moments where we choose either our dearest life goals or, feeling better for a quick moment - pause to ask: who do I want to become? How do I want to get better? And how does this choice serve that? If we are not clear on our highest yearnings, we go for what feels better in the moment, rather than investing in the future we want, the future that’s precious to us. New Year New What? "Juice" the good from the last year Invest in your psychological bank account by pausing and reflecting on the good Feel compassion for the disruption of the pandemic on yourself and everyone else Welcome your stress and suffering as a signpost to grow Focus on the goals that really matter to you Strive well – know why self-improvement is precious to you. Then recall what is most precious when you make choices, remembering your goal for getting better. Onward to getting better, better days, and a better future. Coach Meg

“In this century, human knowledge is extremely expanded and developed. But this is mainly knowledge of the external world. In the field of what we may call "inner science", dealing with the inner things, there are many things, I think, that you do not know. You spend a large amount of the best human brain-power looking outside - too much. and it seems you do not spend adequate effort to look within, to think inwardly. . . . Perhaps now that the Western sciences have reached down into the atom and out into the cosmos finally to realize the extreme vulnerability of all life and value, it is becoming credible, even obvious, that the Inner Science is of supreme importance. Certainly, physics designed the bombs, biology, the germ warfare, chemistry the nerve gas, and so on, but it will be the unhealthy emotions of individuals that will trigger these horrors. These emotions can only be controlled, reshaped, and rechanneled, by technologies developed from successful Inner Science.” ~ The Dalai Lama, speaking at Harvard in 1984 ( courtesy of www.wisdomatwork.com)

One of the enduringly fascinating questions in coaching is why it actually works. To consider this question, a valuable body of research is that of common factors theory. Believe it or not, we’ve been talking about why therapy and coaching work for over 80 years. The common factors research suggests that elements such as client resources, strengths, supports and practitioner attitudes – warmth, empathy, compassion and many others account for about 70% of the beneficial changes a client experiences. These ideas area discussed widely in what remains one of the best books on the subject – The Heart and Soul of Change. Still, the question remains – why do these elements make such a difference? In coach training, we teach the 3 core skills – “doing skills”, if you will, or “micro-skills” – deep listening, open inquiry and reflection. These are embedded in the words of Epictetus, the Greek Stoic philosopher, who lived from about 50 CE to 135 CE. He was born into slavery in what is now Turkey, living many of those enslaved years in Rome, before gaining his freedom as an adult. He moved to Greece and established a school of philosophy. Among many other profound reflections on the nature of being human, Epictetus observed this: “We have two ears and one mouth - we should therefore use them in that proportion.” Applied to coaching, such a view centralises the skill of listening, as the most important of the three core skills. Listening demonstrates a deep commitment to being present for another person. It also provides the foundation on which the other two core skills – open inquiry and reflection – are built. Without listening, any inquiries would be “unanchored”, and reflections would be impossible. Open inquiry embodies the attitude of curiosity in coaching. Curiosity is key to remaining “non-judgmental”. Curious open inquiry communicates to the client a desire to know and learn about them. It is “co-created” by client and coach, in that a client’s response to one inquiry then has a shaping response on the following inquiry. At its best, curious open inquiry conveys to a person that their story, however it emerges, has value. Reflection is the skill which “closes the loop” of communication – it tells the sender of a message that it has been received and understood as intended. This approach is already used in many industries all over the world including aviation, marine, rescue, first response and more. The importance of understanding a message as intended is embedded in those industries. Yet in interpersonal communication, we sometimes make the assumption that because something has been said, it has been understood. Reflection helps the speaker to be confident that they have conveyed the message they wish to convey. When these three skills – deep listening, open inquiry, reflection - are used together, they do the work of establishing channels of communication. But they do much more than this – they provide a “meta-communication” to the client which builds a bridge between two unalike beings and forges a bond which says: I am with you I want to learn about you I see you I hear you I understand you

Ellen Albertson is launching her newest book this month entitled: "Rock Your Midlife: 7 Steps to Transform Yourself and Make Your Next Chapter Your Best Chapter.” Albertson, a Wellcoaches professional coach training graduate, has been working with women in midlife her whole career. Today, at nearly 60, her aim is to revolutionize aging and live well to at least 100. She calls this period in life, a second adulthood, a rich time to take everything we’ve learned and ask, “what do I want to create?” One of her aspirations is that “when our daughters get to be midlife there’s no crisis left.” Anybody can pick up this book and get something from it, she said, adding it is based on reams of science and research much like Wellcoaches curriculum. A major section of the book is focused on “destination vibration.” What that means in practical application is to become the person you want to be, today. And you start by thinking about a time in your life that you were really happy. For Albertson, she visualizes herself dancing. She recreates the energy and joy she feels while dancing. Albertson’s career has morphed and transformed as much as she has over the years. Moving from a dietician and personal trainer into coaching and practicing self-compassion. “I would not be who I am without Margaret Moore. Wellcoaches changed my trajectory.” She recalls Wellcoaches Professional Coach Training having a distinct impact on her work. Through the training, she has even more tools in her toolbox. The work of Bob Kegan, Barbara Frederickson, Martin Seligman, all this work that was introduced in Wellcoaches training also shows up in her book. “It was so worth it and it was so much fun. It’s going to have a profound impact on your coaching skills. No hesitation one of the absolute best training I have ever done. If not THE best,” Albertson said. “PCT transformed my life. Getting all of this coaching and a profound opportunity for enlightening yourself." She said Margaret Moore guided her toward Fielding Graduate University where she earned her Ph.D. and learned about self-compassion. Albertson shared that while earlier in life she had a negative body image and experienced depression, she has now through the integration of Kristin Neff’s work on Self-compassion (who also was on her dissertation committee) created a better relationship with herself. She feels more empowered. The seven steps in her book are all part of her personal experience too. She has moved through them and said she is now called to make the world a better place.

Good morning! “I’m so tired and overloaded,” he exclaims. "How come?" I ask. "I don’t know why I keep saying yes to things,” he replies. "I’ve agreed to two new projects, to changing my plans, to a couple of truly messy meetings, and to a new committee role. It’s too much!” Indeed, we have an epidemic of ‘yes.’ In theory, saying ‘no’ should be straightforward. But every day I talk to leaders that say ‘yes’ when they really want to say ‘no.’ We realized that ‘no’ is bad when mom and dad fussed at us for saying “I don’t want to go to bed/brush my teeth/ share with my sister.” We’ve been cajoled, bribed, or downright forced to say ‘yes’ instead of ‘no.’ So we learned to say ‘yes’ in order to please people, avoid conflict, not be criticized, get kudos and praise, prove our worth, demonstrate our commitments, and even show our love. Oy! Turns out that saying ‘no’ is an act of maturity and personal power, and leadership skill of its own. Of course, there are times when saying ‘yes’ is the exact right answer; times to agree, accede, compromise, and even capitulate. And even if you’re asked to do something that’ll cost you (family time, energy, money, falling behind on your duties), it can still be a ‘yes' if you’re staying true to your values, and the cost is worth it. But if your ‘yes’ is an automatic reflex that has no boundaries, then you pay with your health, get burnt out, frustrated, disengaged, and even resentful. A default and automatic ‘yes’ isn’t a choice, it’s a habit. Your ability to say ‘no’ is correlated with making choices. Choices are correlated with having agency. Agency is correlated with personal power and saying ‘yes’ when you mean ‘no’ leaks away your power. As a “healing” process, I invite you to be a conscious being at choice, and experiment with intentional ‘no.’ Turns out that when you feel your power and choose to say ‘no,’ you can then say ‘yes’ with genuine commitment and sincerity. Next time someone invites you to a meeting, asks for a favor, or wants you to take on a project, in your mind, say ‘no.’ Don’t answer aloud yet. Listen to your heart and your gut, and notice what they are saying. Does saying ‘no’ make you more relaxed or more tense? Why say ‘yes?’ Is it to soothe or appease, to get approval or people please? Or is ‘yes’ your genuine choice? Mentally start with ‘no’ and then make a choice, but don’t just agree on autopilot. Then if you want to say 'no' out loud, here are a few starters that you can adapt to your personal style. “I can’t do this now, but I’d love to revisit this next week” “I want to do a great job, and given everything on my plate, I can’t take this on and do a job I’m proud of. What do you think I should deprioritize?” “I can’t do this, but Brenden over in Marketing might be interested.” "I’m going to say no for now, but if conditions change, I promise I’ll get back to you.” “I can’t do what you’re asking for, but I can do this instead.” And, "No, I'm not going to do that." As you bring on the ‘no,’ some folks will feel (and some will tell you) that you’re being selfish and “not a team player.” Not true. You’re becoming a conscious being at choice. I promise that with practice, saying ‘no’ makes you more effective, less overwhelmed, and more powerful.

Effects of the COVID-19 pandemic reinforced intuitive relationships between suffering from infirmity and mental/physical health. Of course, the emergence of the novel coronavirus has taken a negative toll on population health and well-being. However, the inverse of that relationship is not as intuitive but may also be true. We expect healthy people to get less sick, but do they have any specific protection against coronavirus? Do wellness, wellness habits, and psychological well-being have any impact on the rate and severity of infection from the virus? It may be surprising to learn these questions are being empirically studied. An enormous repository of published pandemic-related research is growing rapidly, and many COVID studies address issues surrounding wellness (i.e., status and habits). Wellness habits, particularly related to exercise and diet, are well-studied. This blog focuses on these questions while describing findings from related research. The accompanying Reading List contains the relevant citations, and most all are freely available open access via a Google search. Wellness Habits: Exercise and COVID While well studied, there is only one randomized controlled trial of the effects of exercise on COVID. Researchers asked 30 COVID patients with mild or moderate symptoms to exercise while recuperating in Turkish hospitals. They assigned half of the patients to 40 minutes of moderate-intensity aerobic exercise (treadmill or bike) and half to a control group. After just two weeks, they concluded the exercise group improved COVID-related symptomology and immune profile (leukocytes, lymphocytes, IgA) better than non-exercising patients. It is encouraging to see exercise being investigated as a treatment, and, this behavioral change has a positive impact on patients’ progression at such a critical time in their convalescence. Another study of COVID patients (n=145) examined the effects of prior habitual physical activity on COVID symptoms (fever, cough, sore throat, loss of taste, etc). Physical activity was self-reported using a questionnaire asking about the type and duration of regular weekly activities. This study found participation in prior moderate physical activity was the only independent predictor of COVID symptomology with greater habitual activity lessening the number of symptoms experienced during COVID. This suggests an active lifestyle might lessen suffering after COVID infection. Another impressive and much larger study, also done retrospectively, examined prior exercise habits in nearly 50,000 COVID patients tracked by Kaiser-Permanente electronic health records. Inactive patients (those who consistently did not exercise over the prior two years) had more than twice the likelihood of hospitalization from COVID infection than those who were previously meeting physical activity guidelines (>150 min of physical activity weekly). They were also more than twice as likely to die from complications of the infection. Patients who previously engaged in some physical activity were better off than those who did no activity, but these light exercisers had poorer outcomes than those who met published activity guidelines. The Kaiser-Permanente study is a landmark paper showing an active lifestyle can improve outcomes during a pandemic. These effects of exercise habits on COVID-19 are not completely unexpected because similar results have been seen in American studies with other types of upper respiratory tract infection. A decrease in the rate and severity of infection is commonly seen in those who regularly perform moderate-intensity exercise. There are sound immunologic reasons to expect a beneficial exercise effect on COVID-19. These immune system mechanisms are nicely addressed by Codella et al. (see Reading List) and include effects on immunoglobulins (e.g., IL-6), T-cells, and natural killer cells. Regular exercise also initiates mechanisms to reduce chronic inflammation, and this can be potentially beneficial to COVID patients who may suffer from fluid accumulation in the lungs. Wellness Habits: Nutrition and COVID Like exercise, nutrition can also play a role in immune system function and resistance to infection. Glutathione, vitamins A, D, and C are all known immune influencers. As described in a recent review (see Scudiero et al. in Reading List), each of these nutrients was studied in COVID patients. All were shown to have a potential beneficial impact on the course of recovery when kept in proper balance. The merits of Vitamin D effects on COVID progression have been argued in the popular press; the limited data we have suggests it may be helpful, especially in cases of Vitamin D deficiency. The immune system connections to good nutrition have been further elucidated by others (see Calder et al. in Reading List). On a macro-dietary level, adherence to the Mediterranean diet was shown to lessen COVID infection rate and related mortality. As opposed to the traditional Western diet, the Mediterranean diet is rich in fresh fruit and vegetables, whole grain, nuts, fish, and olive oil. While very encouraging to see a drop in COVID cases associated with this diet, the study did not go so far as to clearly describe the extent of reduction in infection rate. The authors discussed the limitations of their ecological study design but ultimately concluded that any diet-reducing inflammation might reduce the risk for severe COVID. A similar argument of benefit has been postulated for the Keto diet (see Gangitano in Reading List). However, this proposal currently has a smaller evidence base and is more speculative than the case made for the beneficial effects of the Mediterranean diet on COVID. Another study, using data from the World Health Organization, globally evaluated 23 dietary attributes across 188 countries. They found diet can greatly impact COVID recovery and death rates and emphasized the negative role of sugar consumption in this effect. The authors simply stated, “Good nutrition is important before, during, and after an infection.” They concluded unbalanced diets are a health threat across the world and urged policymakers to make societal modifications for healthier dietary choice accessibility. A Harvard study presented large-scale evidence for nutrition-based COVID protection. Examining over 500,000 participants, in a cell-phone based project, they reported a high-quality diet (plant-based: fruits and veggies) was associated with a lower risk of COVID infection and lower risk of disease severity. In other words, a diet much like the aforementioned Mediterranean diet provides a protective effect against COVID. It was valuable to learn this dietary effect was prominent in persons living in disadvantaged conditions. In summary, diet like exercise, can impact the COVID pandemic experience. Wellness Status and COVID Wellness status (e.g., BMI, stress level, fitness) appears to have a strong relationship with COVID-19 infection and infection outcomes. Obesity is possibly the most studied characteristic, and it is clear that obesity leads to a greater rate of infection and a poorer prognosis once infected. A meta-analysis using 41 studies and over 200,000 subjects (more than 100,000 infected) concluded obese subjects have more positive COVID test findings and greater incidence of hospitalization, intensive care, ventilator use, and mortality. Specifically, visceral fat is the culprit and researchers have speculated it may be responsible for the “cytokine storm” reported in severely deteriorating COVID cases. One theoretical paper postulated this potentially fatal and exaggerated immunological response is related to chronic psychological stress (see Lamontange et al. in Reading List). These authors speculated patients with a history of chronic stress ought to seek strategies of stress reduction that can be implemented during a period of social isolation. Other wellness-related indicators that predict COVID outcomes are fitness, age, and disease status. Those with greater cardiorespiratory fitness had a lower rate of dying after COVID infection than a less fit cohort. Moreover, performance on maximal exercise testing was shown to be inversely related to the likelihood of COVID hospitalization. The message is clear, increasing fitness level through habitual exercise leads to protective effects during a pandemic! Male gender, older age, diabetes, and chronic illness are risk factors each associated with poorer COVID outcomes. A study of over 3,700 COVID patients in New York determined male gender and having more than two comorbidities (e.g., heart failure, dementia) increased odds for hospitalization and death. A meta-analysis reiterated the negative impact of male gender and diabetes and added hypertension, smoking history, and fatigue to the list of risk factors for severe COVID. Those with these risk factors should be especially careful and should seek the most effective rehabilitative measures should they become infected with COVID. It seems clear that wellness status is a critical factor in COVID prognosis and poor initial health greatly worsens outcomes expected after a COVID diagnosis. We can conclude that healthy behavioral habits, such as regular exercise and a plant-based diet, appear to be protective against becoming infected or suffering greatly if infected by the coronavirus. Being physically fit, maintaining normal body composition, and avoiding unhealthy stress are also important to maintaining health during a pandemic. Health care professionals, especially health and wellness coaches, can take this information and use it to help those trying to safely make it through these difficult times. From a broader perspective, healthy behavior habits can now be encouraged to attenuate the effects of future COVID variants or unforeseen pandemics that might be down the road. Add this benefit to the ever-growing list of advantages attributed to living a healthy lifestyle. READING LIST Wellness Habits: Exercise and COVID Mohamed AA, Alawna M. The effect of aerobic exercise on immune biomarkers and symptoms severity and progression in patients with COVID-19: A randomized control trial. J Bodyw Mov Ther. 2021;28:425-432. doi:10.1016/j.jbmt.2021.07.012 Zeigler Z, Lawrence J, Jamison A, Salzano P. Physical Activity Behaviors and COVID-19 Symptoms. OBM Integrative and Complementary Medicine 2021; 6(3): 11; doi: 10.21926/obm.icm.2103027. Sallis R, Young DR, Tartof SY, et al. Physical inactivity is associated with a higher risk for severe COVID-19 outcomes: a study in 48 440 adult patients. British Journal of Sports Medicine 2021;55:1099-1105. https://bjsm.bmj.com/content/55/19/1099 Codella R, Chirico A, Lucidi F, Ferrulli A, La Torre A, Luzi L. The immune-modulatory effects of exercise should be favorably harnessed against COVID-19. J Endocrinol Invest. 2021;44(5):1119-1122. doi:10.1007/s40618-020-01403-5 Wellness Habits: Nutrition and COVID Scudiero O, Lombardo B, Brancaccio et al. . Exercise, Immune System, Nutrition, Respiratory and Cardiovascular Diseases during COVID-19: A Complex Combination. Int J Environ Res Public Health. 2021 Jan 21;18(3):904. doi: 10.3390/ijerph18030904. PMID: 33494244; PMCID: PMC7908487. DeLuccia R, Clegg D, Sukumar D. The implications of vitamin D deficiency on COVID-19 for at-risk populations. Nutr Rev. 2021 Jan 9;79(2):227-234. doi: 10.1093/nutrit/nuaa092. PMID: 32974671; PMCID: PMC7543577. (Calder Nutrim). Greene MW, Roberts AP, Frugé AD. Negative Association Between Mediterranean Diet Adherence and COVID-19 Cases and Related Deaths in Spain and 23 OECD Countries: An Ecological Study. Front Nutr. 2021 Mar 5;8:591964. doi: 10.3389/fnut.2021.591964. PMID: 33748170; PMCID: PMC7973012. Gangitano E, Tozzi R, Gandini O, et al. Ketogenic Diet as a Preventive and Supportive Care for COVID-19 Patients. Nutrients. 2021 Mar 20;13(3):1004. doi: 10.3390/nu13031004. PMID: 33804603; PMCID: PMC8003632. Kamyari N, Soltanian AR, Mahjub H, Moghimbeigi A. Diet, Nutrition, Obesity, and Their Implications for COVID-19 Mortality: Development of a Marginalized Two-Part Model for Semicontinuous Data. JMIR Public Health Surveill. 2021 Jan 26;7(1):e22717. doi: 10.2196/22717. PMID: 33439850; PMCID: PMC7842860. Merino J, Joshi AD, Nguyen LH, et al. Diet quality and risk and severity of COVID-19: a prospective cohort study. Gut. 2021 Nov;70(11):2096-2104. doi: 10.1136/gutjnl-2021-325353. Epub 2021 Sep 6. PMID: 34489306; PMCID: PMC8500931. Wellness Status and COVID Yang J, Hu J, Zhu C. Obesity aggravates COVID-19: A systematic review and meta-analysis. J Med Virol. 2021 Jan;93(1):257-261. doi: 10.1002/jmv.26237. Epub 2020 Oct 5. PMID: 32603481; PMCID: PMC7361606. Sattar N, McInnes IB, McMurray JJV. Obesity Is a Risk Factor for Severe COVID-19 Infection: Multiple Potential Mechanisms. Circulation. 2020 Jul 7;142(1):4-6. doi: 10.1161/CIRCULATIONAHA.120.047659. Epub 2020 Apr 22. PMID: 32320270. Favre G, Legueult K, Pradier C et al. Visceral fat is associated to the severity of COVID-19. Metabolism. 2021 Feb;115:154440. doi: 10.1016/j.metabol.2020.154440. Epub 2020 Nov 25. PMID: 33246009; PMCID: PMC7685947. Lamontagne, S. J., Pizzagalli, D. A., & Olmstead, M. C. (2021). Does inflammation link stress to poor COVID-19 outcome? Stress and Health, 37( 3), 401– 414. https://doi.org/10.1002/smi.3017 Rahman A, Sathi NJ. Risk factors of the severity of COVID-19: A meta-analysis. Int J Clin Pract. 2021 Jul;75(7):e13916. doi: 10.1111/ijcp.13916. Epub 2020 Dec 20. PMID: 33372407.

“Hey Eric,” Brianna launches in, “I’ve been meditating regularly for more than six months, been trying to get into this for years.” She’s pleased with her accomplishment, I can tell. And she adds, “One of the themes that keep coming up as I meditate is Doing versus Being.” “Oh, that’s super cool,” I say, “I’ve been thinking about this for a while, too.” “Yeah,” she adds, “It took this crazy pandemic to get me going with a meditation practice.” “I totally get it, Bree. I know you’re among a crowd of leaders that have taken up meditation to deal with the anxiety, stress, and burnout that this unprecedented pandemic has brought on.” Then I ask, “What are you thinking about Doing Vs. Being?” “Well,” she answers, “I guess what I really want to do is stop all this crazy Doing and learn to just Be.” “Crap,” I blurt, “I don’t know how to do that!” “No way Eric! You’ve been at this for decades,” her surprise is mixed with disappointment. “Seriously,” I add, “the word versus is a dead-end for me. Versus means ‘as opposed to or in contrast to’.” “But that’s exactly what I want.” Brianna presses, “I want to stop the stress of Doing and enjoy the peace of Being.” “From my experience, Bree, when we jam ‘versus’ between Being and Doing, we get trapped in a binary distinction, a false binary.” I think for a moment and add, “Versus implies that one is opposed to the other. To me, that’s not helpful. Personally, I’ve stopped trying to oppose Doing with Being. What I’m focused on is how to bring more Being quality to my Doing.” I’m 35 years into my meditation practice, and I don’t see credible evidence that you can just BE. To be alive is to DO. Even meditating is doing something. Thinking is doing something. Loving is doing something. Relaxing is doing something. You can't not do something. Being is NOT opposed to Doing. Being is the way you do what you do. The problem isn’t Doing, it’s Compulsive Doing – pushing ourselves with shoulds and have-tos and oughts, fixating on the future, constantly fixing our flaws, being impatient with our moods, rejecting our feelings, and measuring every aspect of our activity and progress. It’s too simplistic to conceive that the always-on crazy-busy of Compulsive Doing will be permanently replaced with relaxing, not stressing out about task lists, and not fixating on goals and objectives. I mean, that’s a vacation, right? For sure, take a vacation; there’s no prize for racking up the most unused PTO. But that’s not the same as Being. Being isn’t the same as ‘not doing.’ BEING is the way that you direct your attention, your awareness; Being is a type of PRESENCE. Compulsive Doing is a constant humdrum of attention to the present, past, and future; it’s a blend of activity + anxiety + scarcity. Activity is either physical or mental. Anxiety is fixating on the future (especially possible negative future). And scarcity is believing that you're inadequate, “not enough” - time, money, power, opportunity, value, or love. Being isn’t opposed to Doing, it’s a form of Doing. Being is attending to the present moment. In the present moment, there's activity, there are sensations, and there are thoughts and feelings. But in this present moment, you don't weave your thoughts into stories, you don't convert feelings into identity, and you don't endlessly reflect on everything that can go wrong. In the present moment, you make unfiltered, direct contact with experience and phenomena. This is how you peel away anxiety and scarcity. Immerse yourself in the direct experience of your task at hand and, voila, you are Being (even as you’re doing). So, what are a few practical steps to subdue Compulsive Doing and experience more Being? Here are four tips. Pause. Yup, this is foundational. In Compulsive Doing mode your attention flits over and over from present to past, to future. Use a timer or an app to set up a sequence of daily pauses, just moments long, to break the cycle. And what to do in that pause? Notice if you’re on Compulsive Doing Autopilot. Breathe deeply a few times. Notice your body and the myriad sensations in your body. Be fascinated by the sounds around you. In other words, be mindful; shift to intimate contact with current reality. The more you do this, the more you entrain yourself into Being. Align with values. If you haven’t already, make time to identify and articulate your values (adventure, boldness, compassion, curiosity, fun, influence, etc.). Your Being mode switches on when you live deliberately, and values are your guides for deliberate, intentional living. Living into your values reduces the triggers of have-tos and oughts, and creates more alignment and meaning. If you haven’t done this, ask me for a values clarification exercise. Work your strengths. Compulsive Doing is implicitly focused on your inadequacy. This sets off a perpetual drive to self-improvement, self-criticism, and a relentless self-beating to work harder, fix yourself, and monitor your progress. Truth is that you’re really good at a few things, and you can’t be a master of all things. Identify your strengths and honor them, then your efforts will be more harmonious and less odious. Make friends with your past. Regret is a super expensive mental activity – it drains energy by replaying the past, and it keeps you upset and ashamed. I’d be a fool to glibly tell you to “let bygones be bygones,” it’s not always easy to “just let go.” Do, however, engage in whatever inner work you have to do to resolve your regrets, shame, and guilt. Dwelling on the past holds your attention captive. It also compels you to keep planning and preparing to make sure you don’t repeat your shameful screw-up. Go to the past to learn from it and extract the wisdom. Then bring your powerful attention to the present. Since NOT DOING is off the table, I deeply encourage you to uplevel your BEING skills. This isn’t just good for you, it’s good for your loved ones, your teams, and the entire human ecosystem. In the spirit of leading and learning. Eric

Note: This article was published by the Institute of Coaching on July 26, 2021. Join Institute of Coaching using the Wellcoaches Sponsor discount. Introduction We quoted Christina Maslach here as she is respected by many as a scientific leader in burnout, and a beloved presenter at a recent IOC conference. While thriving is an optimal state for everyone, it is a state which is hard to achieve, especially for physicians who are dealing with the epidemic of burnout, well-established before they had to navigate the peaks and the long tail of the pandemic. Suzanne Koven, a physician at Massachusetts General Hospital, began a 2016 article in the New England Journal of Medicine, titled, The Doctor’s Dilemma: “Then I sit at my workstation to document and bill for our encounter, perched at the edge of my seat, on the verge of despair. This IOC research dose explores an article by Alyssa McGonagle and team entitled Coaching for Primary Care Physician Well-Being: A Randomized Trial and Follow-Up Analysis, which describes a well-designed research study of a coaching intervention for physician burnout. This research project is an IOC success story, supported by an IOC Harnisch grant, presented in an IOC webinar, and published in a highly respected journal of the American Psychological Association. Physician burnout The authors note that “burnout, which often manifests in the face of ongoing work stress, is characterized by emotional exhaustion, depersonalization or cynicism, and reduced perceptions of personal efficacy and accomplishment.” Physicians experience significantly greater burnout symptoms than the general U.S. population: they reported levels of emotional exhaustion and/or depersonalization of 45%, 54%, and 44% in 2011, 2014, and 2017, respectively. Literature on physician burnout highlights several contributing factors, including lack of control over workload, poor teamwork, a chaotic work environment, and a requirement to chart on electronic systems at home after hours. Physicians are often also finding that their values don’t align with their leaders. Physician burnout is linked to higher rates of medical errors and diminished patient satisfaction. It’s associated with substance use issues, marital discord, and can contribute to suicidal ideation. Physician specialties reporting the highest burnout rates were those on the front lines of care, including primary care (family medicine and internal medicine) and emergency medicine. Primary care physicians (PCPs) are integral to population health in the U.S. and their well-being impacts all of us; by 2018 the US had a shortfall of approximately 14,000 PCPs which is expected to rise to a shortage of almost 50,000 PCPs by 2030. (Association of American Medical Colleges, 2020) Existing interventions The issue of PCP burnout is not only pressing but also multifaceted; successful interventions are required at various levels—targeting organizational level issues such as work culture and environment, leadership, workflows, and structure, and team dynamics, as well as individual issues related to, for instance, coping, stress management, and communication. Interventions for physician burnout are typically group trainings on topics such as communication and stress management. The researchers cited a 2017 study that identified 20 interventions that were able to produce small or medium level decreases in burnout scores. Twelve of these were individual interventions and included training in mindfulness, communication, stress management, self-care, and coping; however, none studied coaching. Along with other reviews of physician burnout interventions, this review comes to the conclusion that there are methodological limitations in the literature, such as a lack of control groups and post-intervention follow-up assessments to evaluate the sustainability of results. Coaching as a potential Intervention The research team describes coaching as a: “one-on-one intervention between a coach and individual coachee that is systematic, collaborative, future-focused, and goal-focused, and is meant to help coachees attain valued professional or personal development outcomes… The one-on-one nature of coaching allows it to be contextualized to an individual’s role and workplace, the challenges they experience, and the meaning they derive from work…We propose that coaching should be helpful for PCPs in terms of accessing personal resources and handling work-related stressors, which should help promote well-being and decrease vulnerability toward and experiences of burnout.” The study intervention The researchers’ hypothesis was that "a positive psychology coaching intervention will promote positive emotional states in PCPs, which will improve their levels of personal resources and well-being. We selected personal and work-related outcomes of coaching that align with our theoretical framework and are indicators of well-being across different PCPs, despite variation in individual PCP’s goals: psychological capital, sense of compassion, job self-efficacy, job satisfaction, work engagement, job stress, burnout, and turnover intentions.”  They describe the potential of coaching to shift these indicators: Psychological capital includes the interrelated dimensions of efficacy, hope, optimism, and resilience. Coachee goal setting and striving as well as reframing negative situations improve positive emotions and psychological capital. Sense of compassion is important in patient care, and compassion fatigue is one expression of burnout. Coaching can help build self-compassion through reflection, and also improve compassion for others. Job self-efficacy represents one’s positive beliefs in one’s abilities to perform well at work. Coaching helps coachees improve confidence by reframing challenging situations and seeing new possibilities. Job satisfaction can be improved in coaching by expanding opportunities for job aspects that bring joy. Meaning, and enthusiasm. Work engagement can be enhanced in coaching by job crafting to align with personal strengths, using strengths to overcome challenges, and increasing opportunities for a state of flow. Job stress and burnout can be reduced in coaching by increasing psychological capital with new strategies and possibilities to better manage overload. Turnover intentions to leave an organization are reduced when stress and burnout decrease and job satisfaction and engagement improve. The study The research team recruited 5 coaches with master’s or doctoral degrees and prior experience in coaching health care professionals. The 59 study subjects were recruited from four medical practices in the Boston area. They were early and midcareer PCPs and more than 70% of them were women. Potential coachees were screened for serious levels of psychological distress that would need mental health support, a study exclusion criterion. The PCPs were randomized using a coin flip to start coaching immediately (29) or waitlisted as a control group with a 6-month delay of the start of coaching (30). The PCPs completed online surveys pre-coaching, immediately post-coaching, and at 3 months and 6 months after coaching. The PCPs received six coaching sessions over a 3-month period. Before starting, each participant completed the Maslach Burnout Inventory and Workplace PERMA Profiler. The first coaching session was a one-hour in-person session that reviewed PERMA results, assessed strengths, and set client-centered goals. The five following sessions were 30-minute phone sessions and concluded with agreement on homework for the next session. Validated tools were available and their use was customized to each coachee: Values in Action Inventory Character Strengths Assessment, Using Strengths in New Ways, Best Self, Mindfulness Reflections, Reframing, Social Flow, and Gratitude Reflections. Each tool included standardized instructions used by all coaches. In the post-coaching survey, coaching framework fidelity (not training or mentoring) was assessed with six questions: Who set the coaching meeting agenda for the majority of your coaching sessions? Who did most of the talking during the coaching sessions? Did your coach tell you how to behave or what to do? Did your coach check-in to see whether the session met the goals you had for the session? Did you have a “homework assignment” to do between sessions? Did your coach review your homework at the subsequent session? Results from this study The coaching intervention significantly reduced burnout, job stress, turnover intentions, improved psychological capital, job satisfaction/engagement, and job self-efficacy by the end of the coaching intervention. The reduction in burnout is similar to an earlier randomized controlled study of a coaching intervention that we summarized in an IOC research dose. The earlier study didn’t find improvements in job engagement or satisfaction as did the featured study. The current study also assessed psychological capital, previously shown to correlate with lower burnout levels in leaders, which wasn’t assessed in the earlier study. In fact, this study is one of the first coaching studies to evaluate psychological capital. The researchers conclude that coaching is an effective intervention for reducing PCP burnout, improving work engagement, and psychological capital. Takeaways for coaches Share the positive effects of coaching on primary care physician burnout in your network, including health care professionals you know. Learn about the characteristics of burnout so that you are better able to recognize burnout for yourself and your clients. Burnout may be a significant clinical issue; be aware of and plan for clinical referrals. Investigate the validated tools used in this study: Workplace PERMA Profiler, Values in Action Inventory Character Strengths Assessment, Using Strengths in New Ways, Best Self, Reframing, Social Flow, and Gratitude Reflections