As the COVID-19 pandemic spreads widely throughout America and the rest of the world, public health officials and government authorities are asking, then telling, then demanding that all of us keep our distance from each other. The US Centers for Disease Control define social distancing as “…remaining out of congregate settings, avoiding mass gatherings, and maintaining distance (approximately 6 feet or 2 meters) from others when possible”.1 Where I live, all non-essential businesses have been ordered to be closed and people have been told to stay at home. The reason is to avoid spreading SARS-CoV-2, the coronavirus that causes COVID-19. This is extremely important, in order to slow down the epidemic, lest our hospitals and health care workers become overwhelmed with more patients than the system can handle. It’s not hard to imagine that the phrase social distancing was adopted because – from an infectious disease epidemiologist’s point of view – it conveyed the notion of keeping infected people away from non-infected people. “Social distancing” is, unfortunately, not an apt turn of words. Social distance , however, is a sociology term meaning the separation of social intimacy between two groups, primarily of racial difference.2 Distancing , a verb, means to increase the distance between two things, such as two people. One might logically conclude that social distancing is to act on social distance, decreasing one’s intimacy, one’s connectedness, with others (and especially of others of a different race). But that is not what social distancing means. To slow down the epidemic of coronavirus, we all must increase the physical distance between ourselves. In other words, avoid getting physically close to each other, not touching each other, not touching the same objects without cleaning them between uses, and so forth. In particular, race is irrelevant. Coronavirus doesn’t care about race, it will kill with no regard for race. Failure to stay away from each other will kill a lot of people, of all races, who otherwise don’t have to die. The importance of physical distancing cannot be overemphasized. But as we take these preventive measures, one thing everyone really must do is resist the tendency for allowing the physical distance between us to cause emotional isolation, decreasing your intimacy with friends, family, co-workers, neighbors and perhaps even strangers. We must maintain our sense of community. As this epidemic causes emotional distress for everyone, it is not helpful to become more emotionally isolated, no one need suffer through this epidemic, feeling alone and isolated. As we go through this crisis, and perhaps even more so during the economic consequences that will surely follow this epidemic, we need to feel more love for each other, not less. The great news is that, today, we have many technological tools that allow us to maintain our human connections, even though we must physically stay apart. But one needn’t have a smartphone, tablet or a computer to stay connected. A regular old phone is perfectly good for reaching out to your friends and family. It’s very comforting to just hear someone’s voice. So take some great advice from the 1976 hit by the band Heat Wave, ALL YOU DO IS DIAL (and cheer yourself up by giving it a listen on YouTube!). When you’re missing someone or feeling lonely, give your friend or family member an old-fashioned phone call. Once you do, you may still both be quarantined, but those feelings of isolation will melt right away. RESOURCES – CDC website on Coronavirus Disease 2019 (COVID-19). HTTPS://WWW.CDC.GOV/CORONAVIRUS/2019-NCOV/PHP/RISK-ASSESSMENT.HTML (accessed March 24, 2020) – Park RE. The Concept of Social Distance As Applied to the Study of Racial Attitudes and Racial Relations. J Applied Sociology 8 (1924): 339-344. HTTPS://BROCKU.CA/MEADPROJECT/PARK/PARK_1924.HTML  (accessed March 24, 2020) – Heat Wave. All You Do Is Dial, from Too Hot to Handle , CBS Records, 1976. HTTPS://WWW.YOUTUBE.COM/WATCH?V=LX_CZSR1UYK  (accessed March 24, 2020)

On center stage of this pandemic are our beautiful and sometimes fragile, human lungs. For thousands in hospital with COVID-19, the struggle to breathe by ravaged lungs is a struggle to live. Hospital workers on the front-line find it hard to breathe while wearing personal protection equipment. We were asked by wellness coach, Carol Scott, to provide tips on breathing for her colleagues, particularly those who are working on the front-line in personal protective equipment. We are all more conscious of breathing, knowing that if we have been infected, our breath spreads the virus whether or not we have symptoms. Many of us spend a good deal of our waking hours holding our breath, bracing for the next wave of bad news. Pandemic times are breathtaking, remarkable and astonishing in how they are taking our breath away in so many ways. Pre-pandemic, it was easy to take for granted the ability to breathe, not seeing it as a valuable possession, and forgetting that life starts with the first breath and ends with the last. Those of us who are breathing with healthy lungs now, know that breathing is a most precious gift. We also know that so long as we can breathe freely, we can be strong and able members of the team that carries us all through pandemic recovery, when that time comes. Reflecting on the profundity of breathing in this moment, I reached out to EDDIE HARROLD, a master of modeling and teaching the art and science of breathing to executives, athletes, and coaches. Eddie helps us appreciate that the simple act of breathing properly is the path to calm, focus, resilience, and a healthy immune system. Here are some of Eddie’s wise tips on breathing with benefits. Use your nose. Breathe deep. Slow your breath. Try the four-part breath. Try the ocean sound breath. Nose breathing Give extra attention to breathing through the nose, and not the mouth, which engages the lungs’ air filtration system, the tiny hairs or cilia in nasal passages designed to protect the lungs from foreign invaders like viruses. Breathe deeply Breathing under stress is quick and shallow, inhaling and exhaling into the upper portion of the lungs where nerves signal a challenge and activate a stress response (sympathetic nervous system). Imagine your lungs as balloons that you are slowly filling up with air from the bottom of your lungs, all the way to the top of your lungs just under your collar bone. Notice the diaphragm pushing down as you inhale allowing the lungs and ribcage to expand, and rising up when you exhale. Keep your shoulders down and still. Breathing low and deep stimulates the nerves at the bottom of the lungs, activating the relaxation response (parasympathetic nervous system). Nasal, diaphragmatic breathing enhances the production of nitric oxide in the nasal passages, which boosts the immune system. Take long, slow breaths Breathing deeply in itself lengthens and slows the pace of the breath. When the rate of breathing is fewer than ten breaths a minute (6 seconds per breath), the relaxation response is activated. When we breathe at a rate of 4-6 breaths a minute (10-15 seconds per breath), the heart rate slows down and heart rate variability improves, with more relaxation and recovery. Experiment with a four-part breath, counting to 5 on a full, slow, deep inhale, and a pause for 3 at the top of the inhale. Then count to five or more on a slow, full exhale, and pause at the bottom of the exhale for 3, or longer until the natural urge to inhale arrives. Notice a pleasant stillness of the mind when you gently pause your breath at the top and the bottom of the breath. Try the ocean sound breath Who knows whether we will be together on beaches anytime soon, so in the meantime play around with the ocean sound breath. Make an ocean sound with your breath: it sounds like DARTH VADER. Slow the pace, breathing in and out slowly and deeply. The ocean sound helps slows the pace of breathing because we are constricting the epiglottis muscle on the inhale and exhale. Now, travel quickly in this video with Eddie through these breathing practices – nose, deep, slow, four-part, ocean sound. Next time the pandemic takes your breath away, bring it back. Rather than unconsciously holding your breath, inhale and exhale through your nose, deep and slow. Add a conscious pause, a shortcut to a calm and still mind. Then… Breathe in your vehicle before you go into your workplace.. Breathe in the shift change huddle IF you are a leader, practice ’team breathing’ Breathe before your put on PPE Breathe on breaks (if you get one). Alone or with a partner. Breathe after a challenging case or code Breathe when you get back into your vehicle. Breathe deeply with those with COVID-19 who are struggling to breathe. Breathe slowly to appreciate health care workers on the front line. Breathing is our future! Onward and upward. Coach Meg & EDDIE HARROLD

A new article titled Leadership Coach Effectiveness as Fostering Self-Determined, Sustained Change, features Intentional Change Theory developed for leadership coaching by Richard Boyatzis. This theory is quite similar to the Wellcoaches vision tool, developed independently for the Wellcoaches curriculum in 2002 for health and wellness coaches. The Wellcoaches blog on this article is adapted from an Institute of Coaching (IOC) research dose co-authored by Margaret Moore. RESEARCH DOSES are translations of top scientific articles into coaching practice. Become an IOC member at the WELLCOACHES SPONSOR RATE (annual $100 rather than full $180 for a member donation) to access the research doses and a treasure chest of coaching resources, including don’t miss IOC conference videos. The intentional change process walks through five discoveries for optimal and sustained change. 1. Envision, Articulate and Commit to an Ideal Self The ideal self is the one we aspire to be, doing what we desire to do or become, as opposed to what we may feel obligated to do or become. 2. Assess the Real Self in Comparison to the Ideal Self The real self, in contrast, is the current state or snapshot of one’s knowledge, capabilities, traits, etc. The real self serves as a benchmark or point of comparison in relation to the ideal self. It’s invaluable to get input from others we know or work with, by asking directly or through coaching stakeholder interviews or 360 surveys. 3. Develop a Learning Agenda to Transform the Real Self Toward the Ideal Self The learning agenda articulates how to begin the journey from the real self to the ideal self, using the strengths one has as a key resource to create the plan for change. 4. Practice and Experiment with Elements in the Learning Agenda As the practice occurs, one is testing new ways of behaving and gathering data on the tests. Through persistence, these new behaviors will lead to a transformation of the real self towards the realization of the ideal self. 5. Develop Trusting, Reassuring Relationships That Provide Support and Encouragement During the Other Four Discoveries and Throughout the Change Process. The role of a coach is critical, as the coach’s role is to facilitate intentional change by supporting the client as s/he moves through the various discoveries. The discoveries bring a bonus as they also help satisfy the THREE CORE PSYCHOLOGICAL NEEDS DEFINED IN SELF-DETERMINATION THEORY (i.e. autonomy, relatedness, and competence). The authors of the article then connect the three core needs in self-determination theory to the five discoveries of ICT with well-crafted coaching questions. Need: Autonomy Coaching Questions: -What are your core values and beliefs? (Ideal Self) -Imagine it is the year 2030, and a documentary on your ideal life is being filmed. What are you doing? By whom are you surrounded? (Ideal Self)- -What do you wish your legacy to be? (Ideal Self) -What feedback have you received that will help you move toward your ideal self? (Real Self) -What surprises you about feedback you are getting? (Real Self) -What actions do you want to take to get you closer to your ideal self? (Learning Agenda) -What are you willing to say “no” to in your life to allow you the time and energy to pursue your learning agenda? (Learning Agenda) -Out of the actions you chose to take in your learning agenda, which actions are helping the most to get you closer to your ideal self? (Experimentation and Practice) Need: Relatedness Coaching Questions: -Who helped you the most to be the person you are today? (Ideal Self) -Who is the best role model for you? (Ideal Self) -Who do you admire most and would like to emulate? (Ideal Self) -What impact would you like to have on others? (Ideal Self) -How do others see you differently than you see yourself? (Real Self) -What strengths do others see in you that you see differently? (Real Self) -Who in your life will be most supportive of your learning agenda and why? How can you engage their support? (Learning Agenda) -How might the actions in your learning agenda help you build stronger relationships with others? (Learning Agenda) -How have the actions you are experimenting/practicing helped you build stronger relationships with others? (Experimentation and Practice) Need: Competence Coaching Questions: -What are your enduring strengths and unique capabilities to carry forward? (Ideal Self) -What core aspects of your identity are central to who you would like to be in the future? (Ideal Self) -What common themes arise in feedback from others? (Real Self) -What blind spots are revealed in feedback from others? What sense do make of them? (Real Self) -How have you made the actions in your learning agenda fit into the current structure of your life? (Learning Agenda) -Who are you excited about “reality testing” the actions in your learning agenda with? (Experimentation and Practice) -How have the actions you have been taking strengthened your confidence that you can change? (Experimentation and Practice) -Here’s to the intentional inquiry that enables intentional change for ourselves as coaches and everyone we serve. Coach Meg Featured Article: Taylor, S. N., Passarelli, A. M., & Van Oosten, E. B. (2019). Leadership coach effectiveness as fostering self-determined, sustained change. The Leadership Quarterly, 30(6).

Have you noticed any uncharacteristic changes in your behavior or client behavior as  Covid 19 has impacted life in numerous other  ways? As Covid 19 became a reality to the U.S. I began to notice changes in my clients and some of the  coaches I supervise.  In some, it was a focus on things that weren’t important in the past. For others it was an edge to their behavior that I hadn’t seen previously. And then one day, it happened to me. I had an internally alarming and uncharacteristic reaction to a health concern a supervisee shared with me. I managed to reign it in  before it flew out of my mouth, but my presence was impacted, and upon reflection, I realized I missed a number of opportunities and nuances of the session. I also realized my shadow side was making an appearance. Psychologist Carl Jung was first to use the phrase “shadow side” According to Jung, we all have parts of our personalities that we reject and therefore repress. We avoid admitting to our negative tendencies, and are often not conscious that they exist, until we blurt something out or behave in ways that are unacceptable. The Jung-inspired Myers-Briggs Type Indicator identifies uncharacteristic behaviors as “being in the Grip” as we are subject to uncharacteristic behaviors as a response to stress. Psychologist Robert Hogan, took this concept step further labeling it our “dark side“ and assigning 11 personality traits to our dark side. According to Hogan, the behaviors that the dark side of our personalities exhibit are the result of primitive negative emotions and are behaviors we wouldn’t consciously choose,  including: -Seeing oneself as a victim -Quick to criticize people in less power -Harshly judging others on an impulse -Projecting our insecurities onto others -Unacknowledged bias -Overreacting to small issues -Emotional outbursts -Vacillating between dire and optimistic predictions of the outcome -Developing conspiracy theories -Inability to make decisions -Hoarding -Take a business as usual stance and not addressing the human side of change -Violating norms and policies -Micromanaging According to Jung, self-acceptance is a key to moving beyond these unconscious behaviors. Learning to manage our stress response can also keep us out of “The Grip” and keep our dark side content to remain behind the scenes. When our clients seem to be behaving uncharacteristically, our curiosity on their behalf may help clients become aware of their behavior and help us stay in the flow of coaching. When my client brought up his health issue, a thoughtful reflection, following by a simple, curious  question on my part could have helped me stay focused and help us move through his uncertainty together.

As I was doing some pandemic research for this post, two curious book titles resurfaced on multiple search pages: The Art of Saying No and The Joy of Imperfection. As I thought through the possibilities, I landed on uncertainty as a connection. How has the criteria changed for our decision-making today versus yesterday? What are the values we emphasize in our lives today  versus what we valued  most yesterday? In “normal”  times we engage in multiple routines that reinforce our sense of certainty – go to work 5 days a week, book club meeting once a month, soccer practice 3 times a week…We also engage in planning that reinforces our sense of certainty in the future – planning a wedding 6 months out, summer vacation, new car next year. And yet, certainty does not really exist. We are able to observe that truth  in all of its chaotic mess with the current extreme example of the pandemic. On a daily basis, we often focus on what we believe to be certain, avoiding the existential reality that nothing in life is certain.  When faced with an example, we don’t often look at the aberrations from a certainty perspective.  I am certain I am going to work on Monday, and I  have a car accident on the way, which ultimately prevents me from getting there. I focus on the accident, maybe what I missed at work, but not that the accident is an example of life’s uncertainty. So how do we coach effectively through such visible uncertainty, and are there hidden treasures in this pandemic that we can find and use? Having curiosity as a primary value and having positivity at the center of my life for so many years automatically leads me to two questions – What are the potential benefits of this pandemic? What can I learn from this?  The fears of the worst don’t go away, but they are muted as they are not the object of my focus. A client who owns an interior design studio and retail home furnishings store has struggled to hang-on to what she loves doing, overshadowed by large retail outlets that have attracted many of her clients.  In view of the pandemic, we brainstormed possible opportunities for her business. The result was a thought that people who normally shop in malls, might come back to local small businesses with fewer customers, and this may be a chance for her to regain some of her customer base. She sent out a flyer and over the next week saw several new and returning customers. I have watched with some amazement the focus on hoarding toilet paper that has emerged since the pandemic has hit the U.S. Friends in Canada and Australia are observing the same thing. I found it curious – why toilet paper? What can I learn from this? I first learned that 90% of toilet paper in the U.S. is manufactured in the U.S. I also learned that, for many, having enough toilet paper provides a sense of control. Then I saw the groupthink bias in full swing – if everyone is hoarding toilet paper, so should I. Perhaps the biggest learning for me has been what I have observed in myself in the midst of this.  Many of my clients are health care leaders – physicians, administration  leaders, health system leaders.  I have wondered  about the risk of seeing these clients in their settings during this time. As I observed my willingness to continue to meet in person, what came up was “This isn’t going to happen to me.”  It is part mantra, part based on expert predictions of who is at high risk, and part totally irrational but none-the-less convincing  belief that facing the fear of in-person meetings will somehow immunize me  from the potential reality. How did  I translate what I learned about myself to my coaching practice? – Look beyond the presenting concerns of my clients (i.e. toilet paper) and encourage them to look more closely at their core beliefs and values and how those can serve them during this unprecedented time. – Invite clients to brainstorm ideas about the potential upside of this time. I have a client who works for a multibillion dollar retail organization that has never allowed headquarters employees to telecommute. He is using the pandemic to hopefully persuade the CEO that telecommuting makes sense now… and in the future. – Invite clients to look more deeply into themselves , their beliefs, their values and articulate what they are learning about themselves that can serve them. – Recognize the importance of having a sense of some certainty and its place in motivation What can you learn about yourself that will help your practice during such uncertain times? Suggested Resources: THE PLACES THAT SCARE YOU, by Pema Chodron EMBRACING UNCERTAINTY, by Susan Jeffers UNCERTAINTY: TURNING FEAR AND DOUBT INTO FUEL FOR BRILLIANCE, by Jonathan Fields

Wellcoaches Professional Health and Wellness Coach Cami Smalley’s book, MINDFUL PAUSE: A SELF-CARE GUIDE TO RESILIENCE AND WELL-BEING STOP.BREATHE.THINK.CHOOSE, arrived on the literary horizon it seems at just the right time. In early March when her book was first launching and we were just starting to hear rumblings about a potential health concern, she shared her thoughts on Wellcoaches, mindfulness, and impact of worksite culture. The guidance within her book are just the sort of anchoring tools any person, especially a coach, needs right now. The four steps to a mindful pause are: stop, breathe, think, choose. And within the context of a pandemic and the experience of fear at an all time high, her steady reminders to breathe and consider “what is also true” in this time are game-changers. Cami’s niche focus of resilience both for her clients and her readers is focused on the fact that many need help with self-regulation and that emotional domain is critical for being successful in other behavior-change habits. She encouraged that we all need to take care of ourselves in this time so we don’t “freak out.” It’s important to not be hijacked by the fear of “what could happen.” And while you wait for Cami’s book to arrive on your doorstep or on your Kindle, here are two simple exercises that she suggests using to ratchet down the stress, fear and/or anxiety: 1. Remember the power of the breath— without knowing it we hold our breath. 2. Employ equally true: while we can use the facts around the current state of things to be vigilant. She says that fear, anxiety, worry can be useful in motivating putting systems into place like good hygiene or social distancing. But then shut it off. Let go of the worry and allow space for what is equally true. Such as: the sun is out, we have loving relationships, we have ways to satisfy our meaning and purpose. She encourages keeping our focus wide. She credited her Wellcoaches education for part of that outlook, “I am so grateful for my Wellcoaches training” stating that one of the powerful tools she learned was the power of positivity. When working with clients, she provides perspective and a reminder that we are wired to protectively look for negativity and that can be to our detriment. “I reinforce that with care providers and we have a built-in negativity bias to protect us. And skill development to look for what’s wrong … at the deficit of sustainability.” She encourages her clients: “When you leave work and you leave the hospital you may notice the potholes and not the sky. The other drivers are annoying you. You are finding ways to fix the city’s despair instead of noticing the blue sky.” Cami came to the process of Mindful Pause because she said she needed the skills for herself but was also clear that her approach is one of many. There are many ways to find a process of self-care and regulation that work. She says, “I couldn’t write a prescription of self-care the way some clients come up with.” Cami shared one of the ways taking a pause has been helpful for her is being able to choose between alter egos of truck driver or church lady. She said she can be hot-tempered and sharp-tongued and was even celebrated for that, it became part of her identity. She said she was often loved for that but sometimes it’s hurtful. And she didn’t want that to be how she showed up all of the time — for that to be “all of me,” she said. “I needed mindful pause to give me a gap.” A place where she got to decide. When she can think, “is it appropriate for me to truck driver or do I need to continue with breathing to shift and do my church lady?” “That’s why Margaret’s work with Internal Family Systems and the different voices is so important,” she said. What voice is most predominant is attached to a particular strength. She said, creating enough of a gap to decide how to share the mic and allow a lesser-used voice some air time is sometimes more appropriate and life-giving. Cami is a wealth of information but one of the greatest parting reminders and pieces of knowledge is that it’s the heart’s job to supply blood flow and nutrients to the body, so we can live. It only does that after supplying blood flow to itself first. Self-care is about being able to supply oneself first, then get to the work of helping others.

Mind-body medicine is one of the fastest growing evidence based areas of healthcare.  According to Moss et al. (2003) mind-body medicine is a revolutionary 21st century approach to managing one’s health that includes combining a wide-range of behavioral and lifestyle interventions including wellness coaching, along with traditional medical interventions.  Assessment, diagnosis, and treatment interventions focus on the whole patient in totality of mind, body, and spirit.  Mind-body medicine employs the use of a partnership among medical and healthcare practitioners and results in an integrated care team addressing patient health and disease. The foundational principles of mind-body medicine are: 1) A focus on healing the whole person versus treating symptoms, 2) collaboration between the healthcare provider and the patient, 3) partnership among various and diverse healthcare providers for the individual patient, 4) empowerment of the patient specifically in their healing and treatment decision-making, and 5) a focus on the whole person including the relationships among the physical, emotional, social, environmental, mental, behavioral, and spiritual. These foundational principles have a primary focus on the whole person and emphasize healing and curing versus treating symptoms.  A critical asset of mind-body medicine is the partnership among an integrated team of caregivers who work well together, respecting each other’s practices in an effort to identify the root cause of distress and disease.  Treatment addresses the mind, body, and spirit for all patient conditions.  This integrated team often includes care-givers of from many specialties, for example, physicians, nurses, various mind-body medicine specialists, massage therapists, physical and respiratory therapists, nutritionists, and even wellness coaches, counselors, chiropractors, and yoga teachers, etc. (Moss et al., 2003). Mind-body medicine’s collaborative partnership between the patient and the healthcare provider places the patient at the center of the treatment based decision-making.  Much like in wellness coaching, Moss (2003) describes the relationship between the patient and physician as a collaborative process where patient autonomy is a crucial aspect of the treatment decision-making process. As I write this, I recall an uncomfortable interaction I had with my ex-physician and her staff many years ago.  I had pain in my abdomen that had been bothering me for about eight months.  I had a full physical exam and many laboratory tests.  Everything came back normal.  Even though this pain was not causing me any difficulty eating, sleeping, or carrying out the habits of daily living, (it was simply a dull but quite annoying pain), my physician strongly encouraged me to have a CAT scan.  Not wanting to be exposed to the radiation, I decided to pass.  Even though I said, no to the CAT scan, the physician office continued to call me to schedule.  During the third nagging phone call I received from the physician office, I more firmly told them not to call me again and requested that my medical files be transferred to my new doctor.  Pressuring me to schedule the CAT scan and the physician office taking ownership of the decision-making for my health problem was not the integrative medical care I wanted.  In this example, there’s a lack of partnership and patient autonomy in my personal health care decision-making.  This example is the opposite of a patient’s experience in mind-body medicine.  Thinking my pain could be stress related, instead of the CAT scan, I decided to join a yoga studio.  Within two weeks of practicing yoga three times each week, my eight month pain was gone. Another important mind-body medicine principle is the focus on the whole person, including relationships among one’s physical, emotional, social, environmental, mental, behavioral, and spiritual health.  Gilbert (2003) highlights many studies that show how for example, environmental, social, mental, spiritual, and emotional facets directly impact our physical health.  Herbert Benson, MD, founder of the Mind Body Medical Institute at Massachusetts General Hospital says “mind-body medicine is interested in the interaction of thoughts, emotions, behaviors, faith, and an individual’s relationship to the environment and how those factors affect mental illness” (Gilbert, 2003, p. 568).  If we ignore the relationships among these parts of our whole self, this will get in the way of our health and healing.  In addition to the principles and philosophy of mind-body medicine, there are hundreds of mind-body medicine exercises and interventions that have been used with patients with various diseases and health conditions that have shown positive results in research studies. What’s ONE THING you do that helps you clear your mind and boost your resilience? Published research has shown positive findings for mind body medicine practices for various diseases and chronic health conditions including post-traumatic stress disorder, cancer, anxiety, depression, diabetes, heart disease, and the list goes on.  You can find much research on the websites and resources listed below including the Center for Mind Body Medicine and the Benson-Henry Institute for Mind Body Medicine at Mass General Hospital. As wellness coaches, we have an opportunity to learn more about our role in mind-body medicine and how we contribute as members of an integrative care team.  I had the gift of learning much about integrative medicine over the past decade especially as I worked to complete my Ph.D. in Mind-body Medicine and Integrative/Functional Nutrition.  In addition to I completed a Mind-Body Medicine Workshop at the Center for Mind Body Medicine and I’d like to share with you a small section of my specific notes of the mind-body medicine exercises that I incorporate into my coaching practice: – Shaking and dancing – James S. Gordon, MD of the Center for Mind-Body Medicine recommends dancing and shaking due to its significant benefits to the body, mind, and spirit including increases in energy, tension release, breaking habitual patterns, enhancing spirituality, self-discovery, and reprogramming physical, mental, and emotional holding patterns. – Drawing Exercise: Draw a picture of you now; draw a picture of you now with your biggest problem; lastly, draw a picture of you with your problem solved. – Raising the Qi – Raise your arms up and down as you breathe in and out; nine times. – Opening the heart – Raise the arms; open the arms wide; close the arms; lower the arms. – Waking up the Qi – Clap, rub your hands together fast for one minute; stop and steady your hands; pull your hands apart ever so slowly and move them together slowly to feel the energy. Repeat. – Self-empathy – Close your eyes and think of something stressful. Tell a partner about your thoughts and discuss what your feel showing up in your body as you think about and discuss your stressful situation.  What does this feel like?  You’re gaining awareness of the mind body stress response from the sympathetic nervous system; our fight or flight response. – Stare at another person and smile, don’t speak, just smile. Barbara Fredrickson’s research has shown this practice decreases cortisol which contributes to belly fat.  This also initiates our relaxation response and boosts our immune system. – Breathe in positive emotions – Think of a stressful situation that currently has a hold on you. Now:  Breathe in positive emotions (say positive words).  Next, smile and consider how that felt. – Writing exercise – Think of one physical or emotional issue you’re carrying right now. Does it have a name or image?  Engage in a 15 minute conversation with it, write down each piece of the conversation as you go. Debrief –Read to a friend or loved one what you wrote.  Be present to what you’re feeling in your body. – Chaotic Breathing – Press your lips together, breathe in and out filling your stomach quickly through your nose while you pump your arms imagining they are a bellow. Bounce by bending your knees while you do this for five to ten minutes to fast music. – Mindful eating of chocolate or grapes (your choice) as slowly as you can. As you’re eating consider:  What was that like?  What were your thoughts?  What did it feel like in your body? – Genogram – Draw four levels of your family tree and include all relationships. Then, share your genogram with a friend or family member by describing your picture with great detail. – Body awareness – Engage in a body awareness meditation. – Future Self – Draw a picture of how you feel now; draw a picture of how you want to be; draw a picture of how you will get there. Also, massage, acupuncture, chiropractic care, guided imagery, visualization, yoga as medicine,  and integrative and functional nutrition practices are all categorized as integrative medicine techniques along with health and wellness coaching. While mind-body medicine practices help treat core clinical imbalances and promote healing of many different types of diseases, they also promote resilience and can help you to for example unleash your best thinking, bring your best selves to the care of others, establish clarity and calm during chaos and help you live a happier and more fulfilled life.  Stress is linked to nearly every disease we know of so I invite you to consider:  What might you want to try?  How might you incorporate some mind-body medicine techniques into your self-care routine? What else might you want to learn about mind-body medicine?  Feel free to connect with me on LinkedIn or email me directly at Clombardo@Wellcoaches.com or Christina@ChristinaLombardo.com. References: Gilbert, M. D. (2003). Weaving medicine back together: Mind-body medicine in the twenty-first century. Journal of Alternative and complementary Medicine, 9(4), 563-570. Mind-Body Studies. (n.d.). Mayo Clinic. Retrieved May 30, 2020, from HTTPS://WWW.MAYO.EDU/RESEARCH/CENTERS-PROGRAMS/INTEGRATIVE-MEDICINE-HEALTH-RESEARCH/RESEARCH-STUDIES/MIND-BODY-STUDIES Mind and Body Research—Information for Researchers. (n.d.). NCCIH. Retrieved May 30, 2020, from HTTPS://WWW.NCCIH.NIH.GOV/GRANTS/MIND-AND-BODY-RESEARCH-INFORMATION-FOR-RESEARCHERS Mind-Body STREAM. (n.d.). Retrieved June 3, 2020, from HTTPS://MIND-BODYHEALTH.OSU.EDU/ Moss, D., McGrady, A., Davies T.C., and Wickramasekera, I., (Ed.). (2003). Handbook of mind-body medicine for primary care. Sage Publications. Teaching thousands to heal millions—The Center for Mind-Body Medicine. (n.d.). Retrieved May 30, 2020, from HTTPS://CMBM.ORG/

How happy are you? Did you know that happiness influences your health? Did you know that you can influence your happiness LIVE MORE – Happy is the third book from Dr Darren Morton, Director -  Lifestyle Medicine and Health Research Centre at Avondale University College in Australia.  Published in 2018, its message is as relevant as ever today. Morton is a leading researcher in lifestyle medicine and has been published widely in medical and scientific journals. To understand the context for this book, it’s useful to also understand a little of his passion for lifestyle medicine and its link to happiness. In 2016, after several years of researching and observing the ways in which discoveries in neuroscience, positive psychology and lifestyle medicine could impact happiness, Morton developed The Lift Project, a 10-week program which in an early study led to some marked changes in experiences of depression, anxiety and stress. Since then, The Lift Project has been a Profit – for – Purpose and has raised over $50,000 for various charities. Morton’s ultimate goal is to “lift” 10,000,000 lives. LIVE MORE – Happy is the outworking of that program and neatly covers current neuroscience research related to happiness for the every-day reader. Having an experience of happiness, or even joy, is central to behaviour change. Why would we make any change in our lives, regardless of what health benefit it may bring, if it didn’t also bring some measure of happiness or contentment in some way? Beginning with the links between motivation and happiness, Morton walks us through the function and power of the brain’s limbic system, the strong links between physical movement and positive emotional experience and the influence that diet has on happiness. In one British study he discusses, a strong dose-response relationship was uncovered between fruit and vegetable consumption, and happiness. He goes on to demonstrate the influence that lifestyle factors we so often take for granted directly, and indirectly, influence our level of happiness – sleep, social connection, stress management, service to others and simply getting out in nature. Every chapter explores the science in an approachable way – Morton has a capacity to take the big ideas and complex research findings and distill them in a way that allows the reader to understand and apply in their own lives – each chapter concludes with some practical steps to take, grounded in positive psychology. LIVE MORE – Happy is a book to read if you want to learn more about the aspects of your life you can control to experience greater happiness and contentment. It’s approachability and practical application make it universally appealing. It’s also a book for health and wellness coaches, forming a trove of well-researched science and ideas for personal change. In the hands of skilled coaches, the book’s ideas can be transformed into open appreciative inquiry which will cultivate in their clients a sense of control and even an urgency to experience greater happiness and health in their own lives.

Many of us have come into contact with picky eaters over the course of our careers. Whether you’re a family physician, a dietitian, nutritionist, a psychologist like I am, or any number of other allied health professionals, the likelihood is that picky eating or fussy eating has been a feature of some of the clients and patients you’ve worked with. One of the challenges of “picky eating” (which may also be referred to as fussy eating) and which can further present as an element of the diagnosis of ARFID - Avoidant/Restrictive Food Intake Disorder1 - is discerning whether it most represents the formation of a cemented and largely unexamined pattern of dietary behaviour over time or whether it better represents an underlying psychological disorder. Of note here is that ARFID frequently occurs with other conditions, such as autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD) and obsessive-compulsive disorder (OCD) and that a fear response is often involved when presented with particular foods. Furthermore, ARFID is most prevalent in children, so the presence of picky eating in adults is much less likely to be a sign of ARFID. The clients that I have seen with picky eating behaviour have often had a history of feeling “badgered” about their eating (sometimes by medical and health professionals, sometimes by family members and sometimes going as far back as childhood) and as a consequence have developed an understandable defensiveness and even a “practitioner – induced resistance” to changing their dietary habits. With health coach training, comes awareness of concepts like the “righting reflex”2, as well as the pitfalls of arguing strongly for change, which tends to evoke “sustain talk”2 rather than “change talk”2 founded in the appreciative exploration of what could be. In a recently published paper in the American Journal of Lifestyle Medicine3, I argue that health coaching is an efficacious response to non-ARFID picky eating and its frequently observed co-morbidities. Picky eating is not necessarily a benign condition. While little is understood about adult picky eating and its origins, it’s reasonable to conclude from other data that a long term and highly restricted diet, which may be focused on foods of a particular colour, or texture, or flavour profile may result in detrimental metabolic conditions. A suitably qualified and mindful health coach can begin with an appreciative and empathetic engagement. Although it may seem paradoxical to some, taking the time to understand the ways in which the apparently restricted diet and picky eating behaviour support the person will immediately begin to build and develop the practitioner-client relationship. In my experience, it is uncommon for a client to present with picky eating as the issue or concern they wish to manage. More frequently, people present with a desire for increased well-being, weight loss, reduction in prescribed medication usage or a desire for capacity to do something functional that they currently struggle to do. It’s in this context that information about picky eating behaviour tends to emerge. The creation of a personal vision for health, or that profound “Why” which fuels motivation, sits at the heart of behavioural change. Trained health coaches, of course, are adept at this “envisioning” and immediately recognise the powerful value of a conversation which begins here, rather than a conversation beginning with attempts to challenge and change picky eating. While picky eating can be assessed with tools, straightforward open inquiry is every bit as useful in gaining understanding of it. The following inquiries can help to paint a picture of what the person is eating day to day: What does a typical dinner/breakfast/ lunch look like for you? What do you eat between main meals? What new foods have you tried this year? What vegetables do you routinely eat? An inquiry such as the following can begin to develop discrepancy for the person about their eating behaviour and their health vision: What has been the impact of this eating pattern on your overall health, in your view? Beyond this, a coaching approach which focuses on the whole person and their entire health (not simply picky eating behaviour) almost always leads to an engagement in which the person feels like their needs, values, successes and struggles are understood. This itself forms the foundation of lasting behavioural change. It also addresses the deeply held and often unexpressed fear people have that the practitioner they see is “just going to be another person who tells me what I need to do.” From this point, working with a client who wishes for improved health and also has a habit of picky eating is broadly similar to working with a person who has a habit of eating “junk food” or a habit of not exercising or staying up late and missing sleep. A process of moving between the “Why?” (Vision) and the “What and How?” (SMART goals) supports the client to design goals which are personally meaningful and which enable them to make steps towards sustainable health behaviour change. Use of Motivational Interviewing2 skills, and in particular the Decisional Balance2 tool, can support the client to dispassionately explore the various dimensions of what it may mean to either make a behavioural change or continue as they are, without experiencing judgment for acknowledging that there are down sides to change and there are likely upsides for them to staying the same! As is the case with practitioners in any discipline, health coaches should remain mindful of scope of practice and if necessary, support the client to liaise with their physician, a psychologist or a social worker who may be able to provide adjunctive treatment. On the surface, picky eating may appear to present as a difficult clinical challenge. While it may have a more complex and comorbid basis, particularly in children, in adults it is most likely to represent a long-standing habitual pattern of behaviour. When the client is engaged in broadly considering their own vision for health and well-being, the opportunity to co-create multiple pathways to this outcome arises. Many of these pathways will almost certainly involve changes to picky eating behaviour. RESOURCES 1 American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013 2 Miller, William R., and Stephen Rollnick. Motivational Interviewing: Helping People Change. 3rd ed. New York, NY: Guilford Press, 2013 3 Matthews, S. Health Coaching as an Intervention for Picky Eaters. American Journal of Lifestyle Medicine. Published online 29 July 2020. Available at: https://doi.org/10.1177/1559827620943821

This blog article was inspired by a conversation I had with a friend about our strengths as related to the workplace. Though not the first time, I had recently completed the Values in Action (VIA) Character Strengths Survey, which assesses your qualities that come most naturally for you. For the first time, however, love was my number one strength. I had anticipated (honestly, hoped for) top strengths such as leadership, teamwork, etc., those which seemed  more relevant for the workplace. I would be remiss not to mention that I compared my strengths to seemingly more desirable strengths of others, which is in no one’s best interest given that character strengths are about being your natural self. I recall rhetorically saying to my friend something along the lines of, What am I supposed to do with love in the workplace? As I was finishing the question, I noticed what I was saying, and at the same time, my friend said essentially what resounded in my head and heart, "Everything." I quickly became aware that I had viewed love as a soft skill that was less accepted and valued in the workplace arena than technical skills. Sadly, I had toned down my natural strength of love because of this viewpoint. Humility, Vulnerability, & Authenticity I called upon humility to acknowledge and accept that I had missed the mark regarding use of my strengths and being true to my real self (and others). Why had I done this? It was my way of resisting the discomfort of vulnerability, which in her book, Daring Greatly, Researcher and Author, Brene Brown describes as “uncertainty, risk, and emotional exposure” that comes with stepping out of your comfort zone. The truth of toning down my love strength was a disheartening realization because love is everything to me. To live any part of my life from anyplace other than a place of love is to deny my true self, my authenticity. How might you relate to this experience? Consider the importance of authenticity in coaching relationships and the impact on cultivating a genuinely warm, safe space in which vulnerability, transparency, and genuinely being are cultivated. As with the power of silence upon empathically reflecting or profoundly inquiring, it is important to allow your strengths to naturally [do their] work by showing up as and being your authentic self. This minimizes chances of contributing to discord or disconnection and invites your clients to be their authentic selves. Gracefulness & Gratefulness In writing this article, I also want you to know that you do not have to perfect your strengths before or in order to use them. Your strengths naturally invite connection, opportunities, and relationship with others. Why is that important? There is great need in our world for authenticity and your strengths just as you need others and their strengths. Every strength is valuable. The beautiful part is that all you have to do is be your unique, magnificently imperfect, natural self. In doing so, you are gracefully and gratefully becoming and, simultaneously, modeling ongoing, transformative change that effects positive social change for greater good. You do not have to know or have it all figured out right now. You can use what you know and have to do what you can at any moment. You will learn with each experience as you apply what you learn. Each step that you take is an act of courage and faith.  Even a step backward is progress when you are genuinely trying. Keep trying. What are your strengths? How might you use your strengths to “harness the power of your positive traits to live a more fulfilling life” or to make a difference in someone else’s life? Since gaining deeper understanding of the importance and value of character strengths, I intentionally use my strength of love in expressing compassion and loving-kindness through my words, actions, and way of authentically being, including in the workplace. Heeding the freeing words of a dear friend, I am learning to “love hard and hold loosely.” Everything is Everything When it comes to coaching [and the workplace], then, love has absolutely everything to do with it because everything we, as coaches, do comes from a place of love. This is particularly true regarding empathy and compassion. The more loving and compassionate we are toward ourselves and others, the more genuinely and authentically we can relate with and guide our clients through transformative, evolutionary experiences toward achieving their goals and realizing their dreams. I encourage you to know and use your strengths to their full potential. Why should you do this? You add value to lives, including your own, by using and sharing your strengths from the gift of the real, true, authentic you. Suggested Resources Daring Greatly, Brené Brown VIA Character Strengths Survey. https://www.viacharacter.org/survey/account/register