Totally Coached, Inc.

How much unnecessary pain would be eliminated if everyone learned what this nurse learned?

A nurse who was learning Intrinsic Coaching® was brought into a situation involving a man who was "stubbornly refusing" to put his mother into hospice care.  By doing so, he was prolonging his mother's suffering and depriving someone else of the bed.  Day after day, no progress had been made in changing this man's mind and now it was her turn to try to get him to do what seemed obvious to everyone but him that he should do. 

As she started talking to him, she intentionally chose to regard him as capable, creative, and complete, something that she had to do so she could see more than what others told her about him, which just happened to make sense to her, too.  Doing so, of course, changed how she talked to him and that was essential to what followed. 

When she asked him what was important to him regarding his mother's care, out came the story that no one knew.  His mother had adopted him when he was old enough to know that she was rescuing him.  She had been dedicated to him from that point on, never wavering in her love, even though he needed to be rescued over and over until he finally became the man she had always seen in him.  Now, a team of healthcare professionals were asking him to give up on the woman who had never given up on him.  He just couldn't do it. 

The nurse's internal dialogue - her systemic thinking - gave her the impulse to start trying to convince him that he wouldn't be giving up on her but she recognized it as just that - her trying to get him to replace his thoughts with hers, which is what everyone else had already been trying to do and judging him for refusing.  So, instead, she was quiet and listened some more. 

Then she told him she was going to change his mother's dressings and asked him if he wanted to come and help.  He said he did.  As she changed his mother's dressings, he saw a part of his mother's experience he hadn't seen before.  Before he had always been asked to leave and now he had been asked to be a part of it.  As they talked, he asked her questions and she answered them and she also asked him in different ways and regarding different details what he was wanting for his mother's care. 

By the time his mother's dressings were changed, she had come to see him more clearly and fully than before.  How sad, she thought, that judging him had seemed more sensible than asking him what he was wanting.  And how grateful she was for her new thinking and skills because by asking him what he was wanting he gained clarity, too, and saw his mother, himself, and their relationship in a more clear and full light than before.  

His mother had dedicated everything she had to protect him from pain and surround him with all the comfort that she, as a loving mother, could provide.  Now it was his turn to do the same for her, to protect her from pain and surround her with comfort, as only her loving son could do.  

It would be in a hospice environment, one that would best support him in giving his mother all that he wanted for her in his love and gratitude for all she had wanted for him.

This story was told to Christina Marshall, founder of the Intrinsic Coaching® methodology.  June, 2009

© 2009 Totally Coached, Inc. All rights reserved

Giving a coachee the power to think better about her choices and the ability to coach herself at anytime, anywhere.

I began coaching a woman in early August 2008.  She had just completed the “Know Your Numbers Campaign” biometric screening conducted by the corporate MinuteClinic at CVS Caremark Customer Support Center.  She received screening for total cholesterol, LDL, HDL, triglycerides, BP, diabetes and BMI.  She tested above normal for cholesterol, BP, diabetes and BMI.  Because she was in a high risk category, she was offered various interventions, including face to face coaching with an onsite Intrinsic Coach®.  She chose to take advantage of Intrinsic Coaching® and so I called her and scheduled 30 minute weekly meetings which began on August 1, 2008.  This is her story.

The first half of the first meeting with her was all Intrinsic Coaching® and I was pleased that I did not fall back into my old habits of “information gathering” and then telling her what to do.  She came prepared with a written copy of her biometric results but I never asked to see them.  After introductions and a brief explanation of Intrinsic Coaching®, my first question to her was, “Given all that you learned from your screening at MinuteClinic, what was it that stood out as most important to you?”  She immediately said that her health was very important because she wanted to “be around” for her family.  She then summarized the results of her screening without giving exact numbers and said she knew that even though her cholesterol and BP were elevated, she knew that her weight was what she felt was important because it was “dragging her down and affecting everything she does.”  She talked about past attempts at weight loss and said she knows what she should do, but just couldn’t do it.  She said every time she went off a diet, she felt like she had failed and things just got worse.   She mentioned feeling like a failure and that every time she ate the wrong food, she felt bad.  It had become a vicious cycle that she wished she could change.

With that I then asked her, “Take yourself to a moment when you are in the cafeteria and you are choosing to eat, what is it you really want in that very moment?” After several moments of thinking, she said, “I’m not sure what I really want in that moment but I know I am not hungry and it is not food!”  She said she realized she was eating for reasons other than hunger and asked “Why am I like this?”  I saw this as an unanswered question and asked her if she would like to spend time in our coaching sessions exploring her question of eating for reasons other than hunger.  She emphatically said “Yes!” 

Although we went on to explore some E and S thinking around the hunger scale, physical signs of hunger, and asking herself the question 'what am I really wanting' before she eats, her intrinsic thinking was definitely informing her extrinsic and systemic thinking.   We ended the session with her stating that she wanted to spend time before our next appointment simply asking herself if she is hungry when she eats.   My “want for” statements for her were:  “I want for you greater insight into your question “What do I want when I eat if it is not food?  I also want for you the good health you are seeking so you will have the time you want with your family.”

Since that first session, my coachee and I have met 7 more times and she is making tremendous progress.  Our sessions always start with me asking what she wants to discuss and she usually wants to give a review of her week with examples of how she is applying her new learning.  She always has a scenario from her week that she highlights – some she was proud of and some she was not.  When she describes a situation, I ask her what she learned that was important and this often leads to zooming in more on what she really wants when she eats.  She has described wanting peace of mind, time by herself, and to be a good example for her children.  Overall she is learning that she eats because she wants to feel better.  When she realizes she is not hungry, she is now able to ask herself “What do I want that would make me feel better right now?”  She knows that she is so accustomed to meeting her needs with food, that eating is the first thing she reaches for when she wants to feel better.  She knows it took a long time to develop this thinking, so she understands it will take a long time to undo it as well.  She is learning to eliminate the words “good, bad, failed, should, etc..  She no longer feels bad about her choices and she stated in our last session that she feels much happier and proud of herself.  We are also using some strategies in the coaching sessions that will help her focus on whether or not she's hungry but only after her intrinsic thinking leads her there and I always ask permission.

I think one of the most important things that this coachee has received is that she has the power to think better about her choices and this will be invaluable as she begins to coach herself.  Practically speaking, when she wants to eat, she now has the ability to ask herself “What is it I really want right now – what will satisfy me now?”   When she isn't hungry but finds herself reaching for food, she has learned to ask herself “What am I wanting now?  My old habit was to reach for food but I’m not hungry so what is it I truly want at this moment besides food?”  Although this is just a start, this ability to coach herself at any time, anywhere will last!  We have discussed that we all change from moment to moment and her choices will be different at different times.  She’s planning on continuing our bi-weekly sessions for the next 2 months as long as our schedules allow; my 30 minutes with her are the highlight of my week!

Claudine Reilly, RN, MA, COHN-S, CHES, Certified Intrinsic Coach®
Wellness Manager
CVS Caremark

MY EXPERIENCE AS A COACHEE

I will never forget one Intrinsic Coaching® session during an Advanced Hours class in 2007.

I asked to be coached about my elderly parents in particularly my mother and my Intrinsic Coach® asked what I wanted for my parents. I listed the typical things one would want for aging parents: a safe environment, reasonably good health, independence for as long as possible, etc., etc..  Then she asked me what those things would look like and I began by saying I thought they may be in need of Assisted Living and that they would be very resistive to that idea.  I thought this would be the path the coaching session would take when suddenly things changed.

My coach then asked me what I wanted for myself as far as my parents were concerned.  Well, the telephone went dead because I had no idea what I wanted for myself.  My coach allowed a long silence in which I began to think very differently.  I finally said that I really did not know what I wanted but I knew something that I did NOT want; I did not want to be my mother’s physical care giver.  After more silence, I began to see some things that I did want:  I wanted to be the best daughter I could be without being a care giver, I wanted to show my gratitude for their love and caring, and I wanted to share good memories that were meaningful to me while I was growing up.  As this new thinking became more clear, it took off like a rocket ship after the call ended.  I began coaching myself around my new goals and what I wanted.   I started helping them with issues they could not handle on their own, like fighting with their insurance company to get a Power Chair approved for my mother, a complete closet makeover so she could reach her clothes more easily, etc.  I bought them the Presto Printing mailbox so they could get emails and photos from me and feel more connected to the family - for the elderly without computers this is a fabulous device!  I made them a scrapbook of memories and I verbalized many more “thank you’s” and”I love you’s.”

This Intrinsic Coaching® session had profound effect on my life because my mother died very suddenly 6 months later.   If I had not had this clarity of thinking, I would have been stuck with issues that were not as important.  My relationship with my parents was so much improved in those last months.  Not that it was perfect; my mother was very needy and being with her could be very irritating but I had learned to cope with the shortcomings and stick to my own goals of being the best daughter I could be on my own terms.  In addition, this was a good example of how the coaching goes on long after the 10 minute session is over.  I will forever be thankful to my Intrinsic Coach® and only hope that I can serve my own coachees by helping them increase their own intrinsic capacity which can make their lives better as well! 

Claudine Reilly, RN, MA, COHN-S, CHES, Certified Intrinsic Coach®
Wellness Manager
CVS Caremark

Five reflective statements on becoming an Intrinsic Coach®...

(1) Before I was an Intrinsic Coach®, I used to pre-judge people based on what I knew of them, on what was merely apparent. Now I view everyone as creative, capable and complete and, because I see everyone as a unique and individual person like no other, I have greater respect and expect they will find their own solutions as they increase intrinsic thinking.

(2) Before I was an Intrinsic Coach®, I tried to “fix” people because, after all, I was the expert and thought as long as I could give them all that I knew; they would absorb it all and change their behavior.  Now I hold back my expertise and listen with a spirit of service for what is important to them.

(3) Before I was an Intrinsic Coach®, I got frustrated and exhausted because I kept working harder to make people better.  I used to say, “You can lead a horse to water but you can’t make them drink.”  I have learned that Intrinsic Coaching® helps people learn they are thirsty and they drink all own on their own.  My work is easier and I don’t have to work so hard.  Of course, that is after training; at first it is very difficult to hold back expertise and to manage my thinking – that is a lot of work until it becomes easier with practice, practice, practice.

(4) Before I was an Intrinsic Coach®, I used to think that I always knew what was best for people.  I would think “If they only could……, they would feel so much better.”  Now I know that people have their own answers and solutions inside of them.  It is the job of the Intrinsic Coach® to elicit their own best thinking so motivation comes from the coachee, not the coach, and results will last.

(5) Before I was an Intrinsic Coach®, I got more pleasure from my own successes when I thought I had helped someone.  “Wow I must have done a great job!” Now I radiate pleasure & happiness when I see someone else succeed in learning what it is they want & what it is that’s important to them.  I know their success comes from within them, not me, and I feel so happy for them.  This results in a genuine connection between coach and coachee that I think was missing in the past.  

Claudine Reilly, RN, MA, COHN-S, CHES, Certified Intrinsic Coach®
Wellness Manager
CVS Caremark

Through Intrinsic Coaching® I’m having different conversations and I’m finding that all of what I was writing down before isn’t important anymore.

What I have noticed over the last few weeks with Intrinsic Coaching® is that I’m not writing down anything when I’m in conversation with people.  When I first started coaching I was documenting everything from health concerns, successes and challenges, goal setting and strategies.  Through Intrinsic Coaching® I’m having different conversations and I’m finding that all of what I was writing down before isn’t important anymore.  I do write a few notes afterwards, because I know I’ll be meeting with them again, and I want to remember that person.  But during the conversations, I am truly making eye-contact and listening with people.  I’m noticing more of a connection with people too and I think it’s because I’m listening more fully now and I’m not talking as much (which is a good thing).  I’m not worried or concentrating on what I should be documenting and instead am truly listening to what that person is saying.  I think the people I’m in conversation notice it too because I definitely have felt our conversations going in a different direction, one that benefits that person even more.

Carol Weinhoff, RN, MS
Health Care Manager
Core Health Group
WI

As a result of learning Intrinsic Coaching®...

I’ve learned that inside of pauses there are opportunities for thinking and that exploring goals instead of problems opens up clarity which promotes ‘ah-ha’ moments.  I’ve also learned the value of one step at a time…it puts the intrinsic into motion.  I plan on incorporating Intrinsic Coaching® in all aspects of my life.

Tracey Ream RN, BSN, CCM
Disease Manager 

Intrinsic Coaching® is an unfolding process...

I had an ah-ha moment the other day...In talking with a woman who is having upcoming surgery I asked her what was important to her in having the surgery.  She was taken aback by the question because no one had asked her that before and with past surgeries people gave her information on end of life issues.  After thinking about what she wanted she said she wanted to live.  As I sat back and listened I could hear her thinking and working through it.  Throughout this conversation I was listening more intently, let her go where her thinking was and was non-judgemental.

With Intrinsic Coaching® you get much more than you’re anticipating when you ask someone what they want.  You never know what answers you are going to get and how they’re going to move forward with that information.  I’ve learned to let them go with it because their thoughts are valuable.  It was very important for this woman to talk about living and living a normal life.  She was really strong in her thought process on how she was going to accomplish this.  All I could think was ‘wow!’  Intrinsic Coaching® is an unfolding process…you don’t know where the conversation is going to go next. 

Karen Musser
Nurse Case Manager II

Holding back on my thinking allowed the patient's thinking to surface

I was on the phone with a member and had the opportunity to apply Intrinsic Coaching®.  This woman was struggling with adjusting to a health condition that made it necessary for her to catheterize herself now.  She started the conversation saying she was exhausted.  I just listened, paused in the silences and allowed her to describe how she was exhausted and to talk through a very embarrassing outing she had had over the weekend with her family. 

Throughout our conversation I found myself going in and out of Intrinsic Coaching® which was beneficial because there were times when I applied the extrinsic because she needed some direction around something specific on catheterizing.  But the conversation always moved back to the intrinsic.  She was expressing how anxious she was about the upcoming weekend because she had a lot of family coming in from out of town and it was creating more stress for her with trying to catheterize and only having one bathroom in the house.  As she described this I really had to self-manage because I wanted to give my thoughts, my opinions and solve the problem for her but I didn’t.  I let her think through this until she came to her own solutions.  As I applied the ‘what’ questions such as ‘what is important to you about this,’ she started to think on her own.  She thought it would be helpful to keep a schedule and a routine.  She also mentioned that she could get her son to help because he understood her situation.  As she thought through things she realized that her whole family was aware of her situation and so she decided she would be open in her communication with them as she was going to be taking this all on.  During our conversation it also came out that this family event wasn’t something that she had to do, but it was something that was important to her.  It was important that she had this family time and it was important that everyone have a good time.

The most important thing for me throughout this conversation was self-management.  By holding back on my thinking it allowed for her thinking to surface.  At the end of the conversation she was so pleased and grateful that we had had that time together.  By focusing on what she wanted instead of the problem of the catheterization her new thinking emerged and she came up with great ideas and was less anxious about the weekend and was actually now looking forward to it.  This experience showed me the value of Intrinsic Coaching® and the value it brings when expertise is needed.  It’s made me more comfortable and confident in using Intrinsic Coaching® as I move forward.

Dolly Fankhanel
Nurse Case Manager II

Getting past obstacles by finding the goal...

A patient called in to speak with me the other day and I was very surprised with where the conversation went.  In the beginning I couldn’t determine what the call was about but I decided to take an Intrinsic Coaching® approach.  She started out crying and was really upset about the pain she was in; however at the end of the conversation she was laughing.  She was in a lot of pain and was verbalizing her fear of surgery and cortisone shots and didn’t want to consider any of these options.  Her mind was totally closed to accepting these as treatment options and she was trying to convince herself that her pain was in control. 

By asking her what she wanted she decided she wanted comfort and talked about what her life would look like if she was in a state of comfort.  She painted a very nice picture for herself and realized the thought process she was currently carrying about her pain wasn’t going to get her anywhere.  I asked her what she needed to move forward towards that picture of comfort.  With that the light bulb went on for her.  She knew exactly what she wanted to do---she was going to call her doctor, discuss alternative treatment options and choose something that she feels comfortable with. 

It was pretty easy because she did all of the work.  We got beyond the obstacle of being closed off to treatment options by finding the goal of comfort.  She created that picture of comfort and then the next step emerged.  I was very much surprised.  She was crying in the beginning and in the end she was laughing and thanking me for helping her know what to do.  And I didn’t tell her what to do; she figured it out because of the questions I was asking her.  Although she hasn’t made the decision on what treatment option is best for her yet, she has clarity around what she is wanting and that will impact the decisions she makes.

--Joanne Enders, RN, Nurse Case Manager II

Taking an Intrinsic Coaching® approach with my eight year old son...

I was talking with my eight year old son who was feeling frustrated in school.  I decided to take an Intrinsic Coaching® approach and held back on talking and leaned more on eliciting and listening for his response.  I thought he was going to go into the fact that his teacher was giving him too much homework, but as I listened and asked questions that brought forth his thinking I found out he was frustrated by something I would never have predicted.  It had been a hot day outside and when he had come in from recess he wanted the fans turned on in the classroom but his teacher never turned them on.  Instead of telling him what I thought he should have done I said, “In thinking about today and knowing that later in the week it might be hot outside what will you do differently so that your day is not so frustrating?”  And he came up with his own solution of asking her to turn the fans on.  It was neat watching him come to his own conclusion because I think it will stick with him more than if I would have told him what to do so that later in the week if that situation occurs again he will be much more likely to ask her and not be so frustrated.   It was a really rewarding experience which allowed him to think through the situation better.

Jennifer Cadman RNC, BSN
Condition Management Coordinator
Bowers & Associates