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

I first came across the phrase “non-judgmental” long before I even began training as a psychologist, nearly 30 years ago. I didn't like the phrase then, and I like it less now. Why? Well, mainly because it is an instruction to not do something. In my experience, being instructed what not to do is never a good way to learn. Recall your very first days of driving a car - if the instructions to you had been “don't accelerate too quickly”, “don't brake too hard”, “don't go over the lane markings”, imagine how difficult it would have been to learn what you could actually do to drive a car safely (and how anxious you would’ve felt!). The origins of “non-judgmental” are in the humanistic psychotherapy of Carl Rogers. Generations of coaches, counsellors, psychologists and psychiatrists have been taught this mantra. Curiously, the idea does not help us avoid all forms of judgment. If I ask you to define “non-judgmental”, you may tell me that it requires not saying or thinking particular things about clients. But judgment and evaluation can also seem “positive” – when a client comes to a session having completed a particular goal they were working towards and the coach responds with “Wow! That’s awesome – I’m so proud of you!”, it sounds encouraging. But it is, in fact, highly judgmental and evaluative. In this case, we are determining what constitutes good work on the part of the client. You may be of the view that cheerleading like this is not that bad; however – there is an opportunity cost - and in this case the lost opportunity is affirmation. Affirmation can be thought of as a combination of empathy and summary reflection. It seeks to hold a mirror to the client so that they can see for themselves the ways in which their own values, strengths and resources have been used by them. At its best, affirmation can fuel the process of “verbal persuasion” - one of the four means by which Bandura’s social cognitive theory argues that we develop self-efficacy. The shadow side of cheerleading is that it becomes a subtle external cue or reward; and over time, this may lead to a deepening cycle of the client being motivated by the desire for external praise rather than the internal fulfillment of self-efficacy. Cheerleading is a judgment. Affirmation is a reflected observation. The idea that we should avoid judgment does not imply that we should not use our knowledge, experience and wisdom (wisdom = deeply integrated understanding as a result of applied knowledge). Sometimes ethical considerations demand that we bring our knowledge to the fore - for example if the client were at risk of engaging in an activity which may be harmful to their health. At other times, the gentle request by us to share knowledge or wisdom can support the client to clarify confusion or uncertainty and make a useful choice for themselves, with just a little guidance from us. So, to return to the original question - if we are to avoid judgment, then what should we do? The opposite action to judgment is, in fact, curiosity. Curiosity represents a deep desire to understand as fully as we possibly can, the experience of another. To do this, we seek to make sense of their experience not through our own filters and experience. We figuratively cross the room, stand next to the client, turn and orientate ourselves in the same way as the client. Then we call to mind and engage with their values, beliefs, strengths, fears, hopes and dreams and seek to understand their experience through that lens. Curiosity should not be conflated with the action of seeking information from our clients because it satisfies some internalised interest of our own. If my client has travelled on foot across South America and I’ve always wanted to do this, extended exploration of this experience is not likely curiosity; rather, it represents the satisfaction of a non-client-centered urge to know something. At its heart, curiosity is profoundly empathetic. It asks that we adopt a “naive” or “alien” mindset - setting aside our own assumptions in order to understand what is in front of us. In this context, curiosity is not an action – we are not called on to “have” curiosity about a particular aspect of our client’s experience. Instead, we are called on to adopt curiosity as a way of being, a way of engaging with the world around us. When I was training as a family therapist 30 years ago, we were taught to imagine that we had arrived from another planet and therefore had no understanding at all of local customs, practises and ways of being. Every single action that we observed would be new and we would therefore need to adopt a curious mindset in order to be able to learn about what we were encountering. The mechanism by which curiosity averts judgment is very straightforward - judgment arises from passing an experience through our own filters - beliefs, values, past experiences and expectations. When we decide to put these filters aside and look through “fresh” lenses with a continuous desire to understand what is before us, we can no longer form judgments. Rather, we remain open to learning “what is”. The primacy of the relationship between coach and client cannot be overstated. This relationship always sits at the heart of change for the good. In order to honour this relationship, as coaches we must be warm, engaging, affirming and hopeful. And above all, we must be curious.

One element of the many skills developed as part of a coaching approach is the use of motivational interviewing (Miller and Rollnick 2012). MI first emerged as a means of supporting people to manage significant and enduring addictions; however, its efficacy generally in supporting behavioural change is well documented. It is a collaborative and conversational engagement with the client that does not give primacy to expert knowledge. Rather, this knowledge is offered “just in time” and only when absolutely necessary to support behavioural change. One of the very useful features of motivational interviewing is the conceptualization of ambivalence. Coming from two Latin words, ambivalence literally represents the idea of “both options having strength” to the person. In practice, ambivalence is often seen as a problem to be overcome in the client and this can lead very quickly to the health care provider engaging in an ultimately unhelpful tug of war - trying to “pull” the client towards a particular behavioural change, while the client “pulls” equally strongly, to argue for the value they see in not changing. But ambivalence ought not be seen in this problematic way. Rather, it can be viewed as an opportunity to celebrate purpose and drive. Why? The person experiencing ambivalence is feeling driven towards two (or more) quite different outcomes. If ambivalence can be conceptualised in this way, it ceases to be a “problem to be solved” and can be looked upon as an energy or impetus within the client to be worked with – much better to have a desire for multiple possible outcomes, than no desire for any. We all experience ambivalence, and we experience it frequently throughout life. If you’ve ever scanned a cafe menu and felt an urge for two different breakfast options, or experienced the pleasurable dilemma of being invited to two social events occurring simultaneously, or felt thrilled and terrified at the same time as your roller coaster car crests the top of the rise, you’ve had an experience of ambivalence. How can coaches work effectively with ambivalence, to support client autonomy, and to create the conditions most favourable to health behaviour change in a client? Firstly, employ the fundamental tools of engaging communication and connection – deep listening, reflection of what is being said and not said, and open inquiry to understand more. While there are many types of reflection in interpersonal communication, two approaches that particularly support working with ambivalence are the “empathy” and “double-sided” reflections (Moore, Tschannen-Moran, and Jackson 2016). An empathy reflection seeks to reflect the full experience of the person, not only their words: Client: I really wanted to get to 30 minutes of continuous walking this week, but I just couldn’t. Coach: You’re feeling disappointed that you didn’t reach the goal you set for yourself. A double-sided reflection seeks to capture all aspects of a person’s feelings about change (not only those related to the benefits of change): Client: I know that moving more could help, but I’m just so afraid of ending up in the sort of pain I was in last year. Coach: You’re keen to experience the benefits of more movement, and wary of unintended setbacks too. Learn the signs that indicate ambivalence. It frequently shows up in consultations as a combination of “change talk” and “sustain talk” (Miller and Rollnick 2012) or as the client beginning to redirect or correct your efforts to influence their choice. Change talk embodies the client expressing desires, abilities, reasons or needs to make a change. Sustain talk, on the other hand, represents views expressed by the client which seek to justify or legitimise not changing. As a practise point, it's important to avoid what Miller and Rollnick refer to as “the righting reflex” - the tendency of the practitioner to respond to sustain talk with change talk. This leads to a polarising interaction in which the practitioner more and more strongly occupies the “change talk” space and the client strongly occupies the “sustain talk” space. If this continues, the client will likely become irritated or agitated with the coach and feel unheard and misunderstood. In practice, the polarising interaction could look like this: Coach: If you were to begin to gently increase the amount of exercise that you do, what do you think might be the benefits? Client: Well… I'm not sure. Last time I tried that, the pain in my knees was unbearable. Coach: A short term increase in pain is to be expected here, but it's important that you understand that your condition won't improve if you don't start moving more. Client: But I just couldn’t stand any more pain than I have already… If you think you recognise ambivalence, then don’t just do something – sit there. Resist the urge, if present, to convince the client through force, facts or fear about the imperative of change. Instead, take time to listen and to understand the value that the client sees in continuing along their current path. This can be done by using the decisional balance tool (Miller and Rose 2015). The decisional balance tool provides a means for dispassionately exploring the client’s perceived benefits and disadvantages of modifying their behaviour, and also continuing as they are; however, it is best approached in a particular order, beginning with the perceived advantages of not changing. This “meets the client” at the strongest point of their ambivalence. It also demonstrates a desire to understand the reasons for this and avoids the perception on the part of the client, that the Coach may be pushing for change. From here, move to inquiring of the client the disadvantages they perceive in modifying or changing their behaviour. Once this has been explored and reflected, inquiry about the disadvantages of not changing may be explored and finally conclude with a discussion about the perceived advantages of modifying behaviour. When undertaken in this way, the client has walked systematically through all areas of their perceptions and concerns and if appropriate, the discussion can continue, focused on what the client might do to begin the process of change. A decisional balance process may look like this: Coach: What are the benefits you see for yourself in not making any changes to your exercise and activity habits? Client: Well for one thing I won’t get the pain – it’s a killer when that happens. I really can’t stand it. Coach: Mm-hmm– what about the disadvantages you see in increasing the amount of exercise that you do? Client: Apart from the pain, I guess I'd have to re-organise some things in my day to make time for it. And I'm really not sure if I'd be doing the right thing – it's a long time since I exercised. And I don’t know what’s going to be helpful and what may not be. Coach: OK…you’re uncertain about the steps to take and whether they’re the right ones…tell me about the risks you see in not making any changes? Client: All the things you and I have spoken about already – my mobility will continue to decline; the pain I get probably won't ever really go away completely. And in a few years’ time I may find that I’m even less able to do things I want to do. And as I say that now, I worry about that because I really want to travel after I retire. Coach: Right – you need mobility for your vision for the future – so what are the benefits to you of making a change to your patterns of exercise? Client: I do know that exercise will help – and I do really want to be able to move around more freely and without pain. My wife and I have been talking for years about walking the Camino de Santiago when we retire… Lastly, remember the central role that autonomy plays in human behaviour. Autonomy is a primary psychological need of all sentient creatures (Deci and Ryan 1985; Deci and Ryan 2010). If you want to see it in action, observe your dog next time you try and encourage him or her to move away from a scent that's exciting and interesting. The drive to preserve autonomy may also be particularly strong in those who have experienced some trauma. Nothing guarantees that any particular client will engage in behavioural change; however, the honouring of autonomy maximises the likelihood that the client will engage in a behaviour that has meaning and value to them and which they will be able to sustain in the long term. So we should not be afraid of ambivalence – instead, quietly celebrate the energy and interest your client has in exploring and experiencing so many dimensions of life. By always honouring autonomy, and systematically reviewing all dimensions of a possible change, we can help build a solid foundation on which lasting change – driven by deeply held values – can be cultivated. Resources: Deci, Edward L, and Richard M Ryan. 2010. "Self‐determination." The Corsini encyclopedia of psychology:1-2. Deci, EL, and RM Ryan. 1985. "Intrinsic motivation and self-determination in human behavior: Springer Science & Business Media." Miller, William R, and Stephen Rollnick. 2012. Motivational interviewing: Helping people change: Guilford press.

Dr. Angelika Maria Koch shares a powerful story about how her career and life path ultimately came out of a “primal experience” as a young mother when her son was sick many years ago. During this experience while living in England, she shares she wasn’t getting the guidance she needed from the doctor, so she then consulted a homeopath and the remedy didn’t work and she was facing the weekend with a sick child. After discussing taking him to the emergency room, her husband suggested she get quiet, go inside herself, and then encouraged, I know you’ll know what to do. She said this was not a typical conversation they would have and it was out of character but she went along with the idea. She said she was surprised but she was able to get in touch with her inner voice. She recalled thinking, this is an intense situation and I need it (the remedy) in a higher potency. She went back to the pharmacy, got the remedy in a higher dose, and within 24 hours her son was doing well. A week later, she enrolled in a 4-year homeopathic training. Fast-forward many years later, Koch is now living in the United States and has consistently continued her education. She is a doctor of Natural Medicine with her own practice Medica Nova, has a master’s in herbalism, and has accumulated 18 years as an adjunct professor at the University of New Mexico. She teaches courses in Integrated Health Coaching & Integrative Medicine. Koch continues to share her personal story to illustrate how important it is for people to tune into themselves. For her students at the University of New Mexico, a health coaching course is part of the Bachelor of Science and Liberal Arts Degree. She said they start out in the course, because it’s a requirement but, “down the road, they realize this is fantastic.” She says they learn life skills and how they can apply these skills with clients but with themselves first. “They realize this is really interesting,” and she says usually halfway through the semester, she gets calls asking if there is a way to learn more about coaching. For Koch, she has one answer, “Wellcoaches, that is what you have to go for.” “Wellcoaches has such a kaleidoscope of resources. Although it’s based on health and wellness it’s really a universal and unique school which provides a diversity of life skills; from positive psychology to the meditative part to truly hands-on coaching skills.” Koch became a certified coach because, as she says, “for myself as a person, I like to learn.” When working with a client or a patient, she says it’s about “asking them to take charge of their life, guiding them to that place of self-efficacy, self-empowerment…get in touch with that natural impulse to be well.” It’s about taking charge of their life and the health issue is the trigger to catalyze that decision. “It’s not just about how to quit smoking or change the glycemic index. That’s just the entrance.” “Coaching skills provide the client with a sense of wholeness, coming back to oneself. They learn how to meet the obstacles in life and have the skills to overcome them, transform them. This doesn’t mean they are perfect. But they will not forget anymore that experience of self-empowerment. No money can touch that,” she said. “That is the core essence of my practice going within and listening to the truth within. The voice within.”

By Eric Kaufmann, Executive Coach www.sagatica.com I, like you, judge myself by my intent. Period. But you, like everyone else, judge me by my impact. So even when I’m well-intended, I can be hurtful or upsetting. It’s just inevitable that I’m going to upset someone, you’ll upset someone, we all upset someone. And because we’re prone to upset and offend someone we’re in relationship with, we’ve collectively invented THE APOLOGY – “I’m sorry!” Given that you’re going to have to apologize to someone sooner or later, or help a coaching client do the same, here’s how to think about making an effective apology that can quickly restore trust and heal hurt feelings. Before we go there, let’s take a quick peek at a few overused non-apologies – statements that sound like an apology, but aren’t apologies at all. If you get to that moment of choosing to apologize, I want to make sure you don’t squander the opportunity with one of these duds. “I’m sorry if I did anything wrong.” What?? This isn’t an apology, it’s conditional, it’s hedging, and it suggests that something went awry because of powers out of your control. You’re not owning the hurtful issue, and you’re even insinuating that you’re the victim here. No good. “I am sorry you think I did something wrong.” This doesn’t even smell like an apology. This is called blame-shifting and you’re moving the blame onto the other; nothing offensive happened, you claim, other than their faulty perspective. “I’m sorry, but everyone else said that I was spot on.” My blood pressure is rising just writing this. But. The word BUT negates whatever comes before it. This is pure excuse-making and doesn’t address the hurt. “I regret that mistakes were made.” No, no, no. This is pure government issue, vacuous, impersonal sidestepping of accountability. Regret isn’t remorse and doesn’t convey any agency or responsibility. You’re saying you’re off the hook for blame. “I know I probably should have checked first.” Almost sounds like an apology, almost. But it ain’t. This is whitewashing – removing the self from remorse, ownership, or even apology. It’s impersonal. Can you be both in relationship AND impersonal? No. You can’t! “You know I would never hurt you on purpose.” Whoa, wait, so because you said this, I shouldn’t feel hurt? Where’s the apology here? Oh, it doesn’t exist. The issue isn't whether this was done on purpose, just that it happened. So now that we’ve wiped away some of the verbal pretenders of apology, let’s check out the components of a meaningful apology: Ownership. Sincerity. Specificity. Remorse. Commitment. Ownership: “I'm sorry for what I did in Monday's meeting. Can we chat about this for a minute?” No excuses or minimization. You own that you did something hurtful. You also extend yourself to connect and address the issue and the hurt. Sincerity: This is a self-awareness moment, do you really mean to apologize? Don’t just do it to ameliorate, to improve your image, or for political gain. People who do this aren’t sincere, they’re self-serving or manipulative. In fact, you may have to wait a bit to apologize until your sincerity is ripe. Specificity: “When I said, right in front of everyone, that you were out of touch and not up to speed on the project, I realize that I embarrassed you.” Use “I” to show that you’re in this, it’s not just academic. Demonstrate that you’re addressing the right issue, that you understand the offense, and that you’re accountable for your actions. You can add some personal reflections, not for making excuses, but to set up the remorse part. “I was feeling boxed in, and I know that wasn't your intent, but I was defensive and I lashed out.” Remorse: "I know how embarrassing this was for you. I feel terrible, and I sincerely apologize." Don’t tiptoe around remorse. You screwed up, take responsibility, and share your emotional regret. Commitment: Commit to doing better, and keep it realistic. Saying, “I’ll never lose my cool again, I swear!” may do you more harm than good in the long run. If you lose your cool again, and chances are you will, then you’ll seem both offensive AND dishonest. Commit by saying what you'll do differently in a similar situation in the future. What’s the bottom line? Keep your apologies real. Don’t go off on a tangent about circumstances and excuses. Don’t psychoanalyze the other person. Don’t quote childhood mistreatments as the impetus for your action. This isn’t about you, it’s about them! I’m not revealing a big secret when I remind you that when you apologize well and on time, you can renew trust, soothe hurt feelings, and heal a damaged relationship. So be ready to apologize, and do it skillfully and from the heart.

Adapted from IOC Research Dose, co-authored by Margaret Moore and Andy Cook titled: What is Goal Flourishing. Introduction Most people find setting goals that involve starting and sustaining new behaviors challenging. Kenneth Nowack’s article titled: Facilitating Successful Behavior Change: Beyond Goal Setting to Goal Flourishing is a terrific resource for coaches. Nowack review issues and best practices in goal intentions, goal striving, and goal flourishing to serve coaches in maximizing client success. Nowack summarizes plenty of interesting research, including neuroscience studies that show “broad and meaningful individual differences in our motivation to try new behaviors, willingness to take risks, and a tendency to seek novel and intense experiences.” Helping clients pursue goals then requires a customized approach. Nowack’s Six Questions on Goals Here are Nowack’s six key questions about goals: What are the key characteristics of goals? What works best to facilitate behavior change? When are clients most motivated? How long does it take for new habits to form? When should people “fold” in goal striving? Does practice make perfect? Question 1: What are the key characteristics of goals? Nowack lays out some key characteristics of goals: Difficulty (easy vs. challenging) – encouraging clients to set challenging goals is more likely to encourage initial readiness to change Proximity of the end state (short term vs. long term) – focus on specific and short-term goals and the steps/behaviors to facilitate progress Number of goals (single vs. multiple) – more than one goal can work as long as they are not in conflict Type (learning vs. performance) – if a client doesn’t have the skills, focus on learning not performance goals. The latter are more stressful when skills aren’t developed. Learning goals also increase commitment, self-efficacy and self-regulation. Motivational mindset (avoidance vs. approach) – avoidance refers to an unwanted outcome, approach is aimed at a desired outcome. Approach goals focus on start doing, doing more, or doing differently, while avoidance goals focus on stopping or doing less. Stopping behaviors or doing less is harder, and the approach mindset is typically more effective. Question 2: What works best? Nowack cites some fascinating research on the limitations of goal intentions: “Most successful coaching engagements involve encouraging our clients to start, increase, decrease, modify, or stop behaviors that contribute to their effectiveness and performance on the job. Goal intentions (e.g., “I want to be a more participative leader”) have been found in a recent meta-analysis to be a weak predictor of acquiring new habits, accounting for only 28% of successful behavior change efforts.” Nowack goes on to point out that “current research suggests that availability and type of social support as well as regulation of emotions are equal to, or even more important than, cognitions in predicting both intention and initiation of new habits.” He then shares what goes wrong in 360-degree feedback in leadership coaching: “One of the purposes of using 360-degree feedback in coaching interventions is to illuminate strengths as well as potential areas for development. Some negative reactions to such feedback might actually be motivating, but neuroscience research provides answers about why “underestimators” (whose self-ratings are more critical than the ratings of their observers) or those who interpret the feedback as judgmental or hurtful are disengaged and lack motivation to change behavior. Interpersonal judgment and social evaluation tend to elicit strong stress reactions, with cortisol levels being elevated 50% longer when the stressor is interpersonal versus impersonal. Individuals who negatively interpret feedback and experience emotional hurt, rejection, and pain tend to have both blunted motivation to initiate behavior change and diminished readiness for creating implementation intentions that are crucial for successful behavior change.” These findings suggest that coaching has an important role in helping clients process their emotional responses to behavior change, improve social support, and help clients welcome, understand and accept feedback as beneficial and growth-promoting. Some other interesting findings: It’s vital to “chunk” long term goals into small, manageable steps. It’s important to experience setbacks early; setbacks that happen when less time remains for goal achievement are more likely to lead to abandoning the goal. Writing out goals, sharing them with others, and communicating with others on progress improves goal success. NOT having a backup plan can improve goal achievement. Given that goal intentions are weak predictors of change, focus on overcoming challenges and make implementation or practice plans. Use the if/then technique – for example “if my heart starts to race, then I will breathe deeply to relax” Question 3: When is motivation highest? Motivation typically follows a U-shaped pattern: motivation is highest at the beginning and end of a goal pursuit rather than in the middle. When clients work toward goals, they monitor their progress in two ways—what they have achieved so far, and how much they have left to do. They switch from the first way, what they have achieved, to the second way, what is left to achieve, about mid-way toward a goal, which decreases motivation. Because beginning and end (vs. middle) positions are often arbitrarily determined, coaches can help clients shorten the “middle” by creating subgoals that are smaller actions with shorter follow-up periods. Question 4: How long does it take to establish new behaviors? Creating new habits requires an abundance of self-control and emotional regulation. Behaviors vary in their complexity and how long they take to reach automaticity, averaging 66 days in one study. Neuroplasticity isn’t established until new behaviors are sustained, emphasizing the importance of dedicated and continuing practice. Question 5: When should you fold in goal striving? When goals are unattainable, out of reach, quitting or folding leads to better well-being as perseverance in the face of too much challenge is stressful and inflammatory. Happier people disengage from failure, don’t ruminate, and re-engage in new goals and activities. Question 6: Does practice make perfect? Nowack summarizes the research: “deliberate practice is a necessary, but not sufficient, condition to explain individual differences in skills, and it appears that more variance is NOT explained by deliberate practice than what is explained by it.” He goes on to say provocatively: “Coaches should encourage clients to practice new skills until they become comfortable and automatic, but they should be cognizant of the limits of deliberate practice in realistically converting “competent jerks” into “loveable stars” on the job. In practical terms, the magnitude of behavior change expected and required by organizations that hire coaches to help employees change behavior may, at times, be both unrealistic and unattainable for some.” Nowack’s 3 E Model Nowack created a practical model based on four bodies of scientific work (theory of planned behavior, social cognitive theory, health-belief model, and goal setting theory) called 3E for – enlighten, encourage, and enable. All of these models conclude that good levels of both motivation and self-efficacy are a critical predictor of successful goal adoption and maintenance. Coaches can help clients fully unpack their sources of motivation, ranging from the highest life values or calling to the simple benefit of “I feel better.” Enlighten stands for: Accurate insight Identify signature strengths Ideal self vs real self Encourage stands for: Motivation Self-efficacy Skill building Goal implementation Enable stands for: Practice plans Reminders Social support Relapse prevention Evaluation Takeaways for coaches Help clients fully unpack all of their sources of motivation, ranging from their most heartfelt life values or calling to the simple benefit of “I feel better.” Help clients create not just goal intentions but address their challenges in implementation plans, to steadily increase confidence. Goals come in different sizes and, like shoes, should fit the client. Help clients optimize the goal time-frame and chunking, decide whether to focus on learning or performance and perhaps focus less on backup plans. Help clients appreciate that failure in accomplishing goals is not a weakness. Terminating pursuit of unrealistic or unattainable goals might prove to be a better strategy for physical health and psychological well-being.

The ideal self is a fluid, fuzzy, desired future drawn from many sources including dreams, fantasies, values, life philosophy, personal strengths, and one’s life and career stage. Going further, unpacking the “ideal” component of the ideal self draws forth clarity around one’s life purpose or calling. In their classic 2006 article, the Ideal Self as the Driver of Intentional Change, Boyatzis and Akrivou open by noting: “Much has been written about the importance of our dreams or aspirations in motivating change and development.” They summarize related research: “From the perspective of positive psychology, the ideal self is a core mechanism for self-regulation and intrinsic motivation.” The authors describe the ideal self as a home for desires, aspirations, dreams, purpose, calling, and hope. The force of the ideal self, when activated, brings clarity and mindfulness, and stimulates motivation, self-monitoring, and focused action toward a new state of being or self-actualization. It serves as a positive emotional attractor which supports self-regulation – making ongoing choices that sacrifice immediate rewards and support longer term aspirations. The authors then expand our thinking by proposing a theoretical model of the “ideal self” – which they define as the driver of intentional change, also a key component of Intentional Change Theory. This model provides a framework for coaching inquiry that we outline in this research dose. Ideal Self as a 3-legged stool The ideal-self theory defines three components that converge to manifest one’s ideal self, a personal vision or image of who you want to be and what you want to accomplish. The three components make a three-legged stool that guides coaching inquiry: 1. Mental image The cognitive leg is a mental image of one’s desired future, a fluid articulation of one’s dreams and aspirations. The images that reflect the ideal self can be novel, or they can amplify or make consistent existing best states. The images of ideal self can also be continually evolving. 2. Core identity The identity leg, largely unconscious and fairly stable, is one’s core identity. The images of ideal self can be unpacked to expand awareness of the variety of identity components implicit in the vision. It’s also vital for the notions of ideal self to be wholistic and inclusive across the full range of one’s life domains. 3. Hope The emotional leg is fueled by hope – how the aspirations are made realistic, aspirations of becoming one’s ideal self or making one’s ideal self a consistent norm. The positive emotions that emerge from the experience of hope are the power source for the journey toward the ideal self. These three legs offer (at least) four directions of coaching inquiry to support the emergence and cultivation of clients’ ideal selves. 1. Envision images of future ideal self The authors see imagining a mental picture as providing the “content” for the ideal self. It is a fluid, fuzzy, desired future drawn from many sources including dreams, fantasies, values, life philosophy, personal strengths, and one’s life and career stage. Envisioning the ideal component of the ideal self draws forth clarity around one’s life purpose or calling, which can also change over time. Similar to using Wellcoaches Vision Tool, this is the process of building clarity around what the client wants and what version of themselves they are working toward. It’s important that the images of ideal self aren’t based on avoiding risk or bad outcomes, which triggers fear and a stress response that inhibits learning. It is also important for people to accept their visions with an open, accepting heart as the authors note “evaluating or judging the worthiness of one’s dreams immediately invokes stress. This results in limiting openness to new ideas and possibilities.” Opportunities for coaching inquiry include: a. help clients use their imaginations to envision the ideal self, which can be new, or can be an existing state that is maintained or made more consistent b. mirror, appreciate, and expand without judgment clients’ emerging mental images of ideal self and ideal c. help clients reflect on the origins and sources of values, passions, purpose, and callings 2. Clarify ideal self as emerging from internal values rather than external social values. Coaches can help clients make an important distinction between their ideal self and their “ought” self, a false version of self that emerges more from external social expectations than internally from one’s own agency, values and purpose. The authors note that it’s important to help clients discern the ideal from the “ought” self as they can ultimately feel frustrated or disappointed if they spend time working toward a version of their best self that is driven by external social forces or internal limitations, rather than their own internally derived values, strengths, and capabilities. Coaching inquiry includes: a. consider the possibility of social values and expectations inherent in professional and personal lives that may pose limitations on visions of ideal self b. explore the extent to which visions might reflect any self-biases or limitations c. unpack any internalized oppressions including racism or sexism 3. Help clients connect their ideal self to identity The authors describe one’s core identity as a relatively stable compilation of motives, roles, identity groups, habits, socialization, and other personality and character traits that give rise to individuals in their current context. Clients can feel low levels of control over shifting these, often subconscious, components of their identities. Their identities have the “leash,” controlling degrees of freedom and opportunities. The authors note that generating awareness and articulation of a client’s identity components, that contribute both resources and opportunities for change, helps anchor a clear starting point for the journey toward a desired future. A clear starting point improves clarity and interest; it also provides direction for new experiments that may generate learning and shifts. As a result, coaches have plenty of inquiry possibilities: a. expand a client’s self-awareness of their identities through assessments, self-observation, and reflection b. unpack the role of their identity components in their visions of ideal and ideal self c. explore how components of identity can be resources or opportunities for learning and growth d. consider how the ideal self can be applied and be coherent across most or all personal and professional life domains e. continually expand awareness of their visions of ideal self 4. Cultivate hope, efficacy and optimism around realizing the ideal self When a client gets in touch with a desired future emerging from internal values and purpose, it can elicit a mix of new emotions. A coaching opportunity is to explore how the envisioned ideal self can first be supported by amplifying positive emotions, particularly the experience of hope. The authors note that “hope emerges when efficacy merges with optimism.” In other words, one’s dreams go to sleep if they feel out of reach, making it important for coaches to explore diverse and creative ways to improve a client’s efficacy and optimism. A key focus is on amplifying the positive – for example, drawing out confidence-boosting strengths, past successes, along with internal and external resources. A client’s negative emotions that might emerge around considering their ideal self may signal what is reducing confidence, optimism and hope, and nicely surface growth opportunities. Coaches can help clients cultivate a growth mindset by appreciating that gaps between current and future mindsets and skills are interesting and valuable opportunities to grow. The growth mindset becomes a bridge of hope, from today’s self to the future ideal self. Coaching inquiry to consider: a. Explore positive emotions and negative emotions that emerge from the exploration of the client’s ideal self. b. Use motivational interviewing rulers to help clients self-assess on a scale of 1-10 their levels of confidence, optimism, and hope. Explore what a 10/10 would look like and possible ways to improve ratings to a 7/10 or above. c. Unpack all of the potential sources of confidence, optimism, and hope in becoming or sustaining the ideal self. d. Ask the client to describe a growth mindset for themselves. e. Explore opportunities for learning and growth on the journey to ideal self. Takeaways for coaches 1. Coaches have the opportunity to be role models and envision and process fully our own future ideal selves. 2. Help clients “dream big” through nonjudgmental inquiry and reflection that expands possibilities. The use of Wellcoaches Vision Tool helps guide clients to looking outside their current reality into what they'd like to create in their work with a coach. 3. Help clients uncover external social expectations or other limitations which may lead them away from their true compass of values and purpose. 4. Help clients complete a full process of “ideal selfing” including envisioning, unpacking identity components of the ideal self, integrating the ideal self into all life domains, and generating efficacy, optimism, and hope as fuel for the journey. Citation Boyatzis, R. E., & Akrivou, K. (2006). The ideal self as the driver of intentional change. Journal of management development. IOC Resources from Richard Boyatzis

I’ve just finished reading a great book, and I’m making my way through another at the moment (which will take a whole year – you’ll see why shortly). The book I’ve just finished is “Every tool’s a Hammer” by Adam Savage - yep, the Mythbusters guy. The subtitle of the book is “Life is what you make it”. It’s superficially autobiographical but at a deeper level, it’s a book about how to live. One of the valuable lessons he discusses is the idea of “learning by doing poorly.” This approach allows for mistakes to be made and in some ways almost redefines the idea of “mistake” as simply a “step along the way to greater understanding”. It’s a valuable characteristic for anybody, particularly for leaders. The book that will take me a whole year to read is “The Daily Stoic – 366 meditations on wisdom, perseverance and the art of living”, by Ryan Holiday. It was a recommendation from a physician colleague and I’m very grateful to him. If you don’t know a great deal about the school of philosophy called Stoicism, I’d encourage you to explore. The principles of Stoicism include accepting what’s out of your control, managing your inner life (emotions) effectively, preparing for contingencies and allowing failure to occur in our lives. People often think of stoicism as meaning “emotionless”. But this mischaracterizes stoicism. The philosophy and its practice are really about being measured, considered and mindful in our daily lives. The world desperately needs leaders – not titular leaders, but those with the capacity to nourish themselves and cultivate in others, their own strengths, visions and values. Those who are trained in the skills of coaching - to be compassionate, empathetic, joyful, respectful, and to listen deeply, are those with the capacity to lead and inspire. The 35th US President John F Kennedy was scheduled to speak in Dallas, Texas on 22 November 1963. He never delivered the speech, but it had been prepared. He was due to say this: “Leadership and learning are indispensable to each other”. Wellcoaches will continue to be a place where skills, not only of coaching, but true leadership, can be cultivated.

To set goals or not set goals, that is the question. The answer from a study of external executive coaching for a group of corporate leaders is that for coachees, facilitative coaching showed similar outcomes to goal-setting coaching. Note: This article was published by the Institute of Coaching on March 14, 2021. Join Institute of Coaching using the Wellcoaches Sponsor discount. Introduction Coaches want to provide the best to their clients, applying the most effective tool for the moment. This month, let’s focus on a randomized controlled study that compares the two most common coaching processes – goal setting process and facilitation process, led by article author Janette Williams. Williams co-authored the 2018 article describing the study, titled: The Efficacy of Executive Coaching: An empirical investigation of two approaches using random assignment and a switching-replications design. While the study focused on executive coaching, the results are relevant to health and wellness coaching. Williams and Lowman (department Chair) co-authored the 2018 article describing the study, titled: The Efficacy of Executive Coaching: An empirical investigation of two approaches using random assignment and a switching-replications design. Coaching interventions A 2009 survey of executive-coaching practices identified seven approaches most used in coaching, and the first two were selected for the study, as the most frequently used and familiar to experienced coaches: 1. process/facilitation-oriented 2. goal setting/goal-focused behavior modification 3. cognitive–behavioral 4. neurolinguistics programming 5. psychoanalytic/dynamic 6. skills training The coaching intervention was four one-hour sessions over 4-6 weeks delivered by 16 external, professional coaches (11 females, 5 males) with formal psychological training at the master’s or PhD levels. Coaches had at least two years of coaching experience and were paid $75 per session. The coaching protocol was manualized to standardize the coaching sessions. Coaches completed six hours of training and practice of the two coaching approaches – goal-focused and process-oriented. The coaches confirmed the integrity of the coaching approach by answering four “process integrity” questions via online survey after each coaching session. A goal-focused question was “I help my coachee identify and set realistic and challenging goals.” A process-focused question was: “I tailor my own approach to fit the preferences and needs of the coachee.” Each participant selected one of eight leadership competencies (sourced from the organization’s performance management system) as the coaching objective, which was agreed with their supervisor. The eight competencies to select from were: 1. Provides strategic perspectives 2. Inspires and motivates, energizes team to achieve goals 3. Drives for results, sets high standards of excellence 4. Collaborates, promotes high level of cooperation 5. Walks the walk, demonstrates honesty and integrity 6. Develops others, sponsors employee development 7. Builds relationships, stays in touch with employee issues and concerns 8. Demonstrates courage, not shying away from conflict Outcomes measurement The overall leadership behaviors were measured using the Leadership Practices Inventory (LPI) that has been administered to more than 3 million people. The LPI addresses five dimensions, each with six items, totaling 30 questions: 1. Model the way 2. Inspire a shared vision 3. Challenge the process 4. Enable others to act 5. Encourage the heart The LPI results were not shared with coachees; they were used only to measure the benefit of coaching as rated by the coachees and supervisors. Research design The study included 64 mid to senior leaders (50/50 female and male) in a multi-billion dollar corporation who agreed to participate in the research, of which 23% had received executive coaching in the past. The 39 direct supervisors (15 females, 24 males) also agreed to participate and rate their direct reports. Most of the coachees and supervisors held bachelor’s degrees or higher and four or more years of management experience. The study methodology is complex: 1. A single-blind procedure was implemented, which means that the participants and supervisor were not aware of the two coaching approaches or the research goals. 2. There were two study phases and four groups – in the first phase, two groups got the two coaching approaches (half got one approach and half got the other approach), and two groups acted as a control with no coaching. 3. In the second phase, the participants switched roles, the two groups who got coaching now got no coaching, and the two groups who served as the control group in the first phase, received the two coaching approaches (again half got one approach and half got the second approach). 4. A pre-coaching LPI assessment was given to all participants and supervisors, and the assessment was repeated twice - at the end of the first phase and 5 weeks after the end of the second phase. Study Results The coachee ratings showed an increase in leadership competencies and behaviors for the coaching groups and not for the control groups. As rated by the supervisors, there was improvement, but it was not statistically significant. There was no significant difference between the approaches of goal-focused and process-oriented coaching on leadership competencies or behaviors as rated by the coachees. Furthermore, there were no differences between the two approaches in the post-coaching follow-up. Not surprisingly, the study limitations include the short duration of the coaching intervention and the two phases, and the low number of coaching sessions. Changes in coachee behavior may not have been fully developed or observable by supervisors at five weeks after four coaching sessions. The LPI didn’t precisely align with the single coaching goal set by coachees and agreed with their supervisors. Last, in the real world, coaches would typically adjust coaching processes to meet coachee needs, often alternating between goal-focused and process-focused approaches, a hybrid approach. Takeaways for Coaches 1. While the coaching program was brief, a reasonable conclusion is that coaches can combine goal-oriented sessions with process-oriented sessions without compromising coaching outcomes. 2. It is helpful for coaches to ask clients which process might work best for each session or the overall program, focusing on goals or process. CITATION: Williams, J. S., & Lowman, R. L. (2018). The efficacy of executive coaching: An empirical investigation of two approaches using random assignment and a switching-replications design. Consulting Psychology Journal: Practice and Research, 70(3), 227–249.

Abraham Maslow described peak experiences as ‘something like mystic experiences, moments of great awe, moments of the most intense happiness or even rapture, ecstasy or bliss or pure, positive happiness when all doubts, all fears, all inhibitions, all tensions, all weaknesses, were left behind. Peak Coaching Moments While there is an abundance of stressful or low moments for all of us in pandemic time, coaches are also experiencing peak moments in coaching. What is a peak coaching moment? Czech authors Honsová and Jarošová published a lovely qualitative paper on peak coaching experiences (2018). Here are the bottom lines. First, what is a peak experience? The authors note that the construct of peak experience was introduced by Abraham Maslow. Originally Maslow hypothesized that only self-actualized people have peak experiences. Later he concluded that most people have peak experiences, which was confirmed further in a later study. The authors note: Maslow described peak experience in the whole life context as ‘something like mystic experiences, moments of great awe, moments of the most intense happiness or even rapture, ecstasy or bliss’ or ‘pure, positive happiness when all doubts, all fears, all inhibitions, all tensions, all weaknesses, were left behind,’ or simpler – moments of highest happiness and fulfillment. Other peak-like phenomena that while all being positive subjective experience, are distinct including: 1. Peak experience – unusual experiences that create intensely positive emotions or high intensity of perception. Can be triggered by wild nature, music, and learning a new language. 2. Peak performance – a superior use of human potential, transcending expectation, in efficiency, productivity, or creativity. 3. Flow – immersion in an enjoyable activity. 4. Peak learning experience – vivid and memorable learning experiences. 5. Plateau experience – a serene and calm state. Peak experiences have a variety of triggers, can happen unexpectedly, and are often not brought at will. They happen in several areas – family, children and friends, other relationships, and work. Even though they can be brief or elusive, they tend to prevail in our memories. They can influence our futures and change how we view ourselves and the world. They can have permanent effects including improving self-esteem, relationships or optimism. Now, what is a peak coaching experience? The researchers interviewed 18 coachees, senior managers at a large Czech bank going through extensive organizational change, using the Life Story Interview method, adapted for the coaching context. The coachees were asked: Please describe a scene, episode, or moment in your coaching that stands out as an especially positive – peak experience. The researchers conducted a thematic analysis, compiling the data, disassembling into labelled themes, and then reassembled into themes – summarized next: 1. Moments of insight Some coachees reported the peak experience as the moment of insight: ‘the moment of revelation or seeing the root cause of something which I wasn’t able to find or change.’ (read page 5/6 for more quotes) 2. Moments of relief or release Some coachees reported moments or relief, tension release, and calming down: ‘I mentally convinced myself that I am here for this, and that I am not looking for anything else.’ (read page 6 for more quotes) 3. Moments of mindfulness Some coachees reported moments of mindfulness or awareness as a result of a coach’s techniques for mindfulness or meditation: ‘we went through a journey in a meditation and suddenly I felt as if I could overcome this with much more ease..I was taken aback that something like this could happen.’ 4. New perspectives from external models Some coachees found models using drawing or graphics, or tokens or bricks to help visualize an external situation: ‘the feeling of excitement and joy..some kind of realization of the situation through the visualization she used.” The authors conclude: “Our research shows that the key benefits of coaching might not lie only in what comes after coaching (e.g. leadership style change, stress reduction or enhanced self-efficacy) but also in the experience lying in the coaching process itself. Each of the participants associated their coaching experience to unique positive experiences, many of which were connected to learning and growing…” WHAT’S IN IT FOR COACHES? 1. Ask your clients to share their peak coaching experiences with you. 2. Track and journal peak coaching experiences for you and your clients. 3. Experiment with new techniques to generate insights, releases, mindfulness, and new perspectives. Reference Honsová, P., & Jarošová, E. (2019). Peak coaching experiences. Coaching: An International Journal of Theory, Research and Practice, 12(1), 3-14. https://www.tandfonline.com/doi/full/10.1080/17521882.2018.1489867