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WHY A THERAPIST BECOMES A COACH

I have had a fabulous career.  I have been able to do research, run programs and agencies and instruct at the university and graduate level.  And I have had the honor of working with literally thousands of wonderful people over the years.  I have a successful private practice doing exactly as I want and concerning myself with the issues that interest me: the professional, family, and personal concerns of men.  Finally feeling at the top of my game, I got the notion to become a coach.  Becoming a coach and encouraging people to dare to reach for a life even more fulfilling than they now enjoy was not the easy transition I had anticipated.  I had some difficulty shaking off the entrenched psychotherapeutic instincts to allow the genius of my client to shine through.  Having made the successful transition, and looking at my career from the rear view mirror of my mind, I can only now see why I was so powerfully drawn to coaching

There are, of course, the obvious advantages of working from a home office. I can conduct business in jeans and a t-shirt if I wish. I can avoid a long commute.  And there is something deliciously agreeable about being less at the mercy of 3rd party payers, like Cigna or Blue Cross.  And in becoming a coach there is the opportunity to separate myself from the “medical model” with its narrow and rigid parameters requiring the formal “professional distance” that somehow enhances your client’s confidence in your abilities.  The medical model is largely intolerant of those not traditionally anchored to the tried and true conventions of the past.  This holds me and many of my colleagues in an awkward position.  But the real issues I have with the medical model go much deeper, indeed.  The medical model compels a most disagreeable approach to the helping profession.  It is called the “illness model”.

To be certain, the real reason that I, after a long career studying, practicing and working as a Family Counselor, make a transition to coaching is that I am finally free from the “illness model”.  The “illness model” has it that a “patient” experiencing the discomfort an expert might see as anxiety, depression or anger is seen as outside of the norm and, subsequently, that man or woman requires a psychiatric diagnosis.  We diagnose patients in order to further the communication with the other medical professionals.  Proponents of the disease or illness model argue that diagnoses are vital in order to determine eligibility for disability payments, special treatment programs or the correct administration of medications.  Though it is quite difficult to rebut these arguments, the illness model still requires that when someone comes into my office for services, I am to consider him a patient and provide a diagnosis if I am to be paid for the visit.  Participating in this system compels me and the others in the field to brand someone with a label that could stigmatize him or her for the rest of their lives.

Now it is true that there are people with terrible psychiatric problems that make any functioning in the world difficult.  They need medication, psychotherapy and, often, hospitalization.  The “illness model”, for these people is fitting because it provides for a good standard of care in this world of specialization where we have a different physician for each complaint.  When I was a young Psychiatric Social Worker, newly employed in a county mental health program, I was fortunate enough to be a member of a treatment team which allowed me the opportunity to study the diseases of the mind and the “illness model” seemed appropriate.  But as I grew in professional experience and moved deeper into the field, I began to see fewer and fewer people who had a diagnosable mental disorder.  Most all clinicians have differing opinions about diagnostics and the severity of any disorder, but I found myself in the dubious position of having to provide a diagnosis and a name for the diseases that my clients brought to me when often, they were merely seeking a conversation with someone who had some specialized knowledge--hardly a mental disorder.

We are all entitled to have feelings of sadness, worry or frustrated because as human beings we take risks and make choices that are intended to make life better--for us and others.  Taking risks is a good thing.  Having said that I must also say that the more informed and better prepared we are for the consequences of our risk taking, the greater the chances that we will have success.  It is only intelligent to put thought into and ponder the possible outcomes of choices we consider because we know that, to a greater extent than we sometimes care to see, the real world can be terribly unforgiving of carelessness, incapacity or neglect.  Still, from time to time, we all find ourselves in the uncomfortable situation of having to bear the responsibility for having taken risks that did not pay off.  It happens to us all.  But I maintain that this innately human feature of taking calculated risks is the thing that is singularly responsible for the civilizations we have built, the cures and discoveries we have made and the art, music and literature we have created.  Yes, we take risks and sometimes they do not pay off.  Naturally this gives us sadness, worry and frustration, but to think of someone as having a psychiatric disorder because of those feelings is preposterous.  To participate in this system somehow means to support and perpetuate it.

So people get stuck in life’s problems and we become frustrated and sad or have some uncomfortable concerns about the choices we must make. It is interesting that the problems we have seem to inevitably involve our relationships with others.  As I was just beginning my career, an older Psychologist took me aside and told me that he believed that people’s problems must be regarded as relationship problems because almost always the uneasiness that will bring people to a therapist has to do with a relationship or relationships that are not going well.  He went on to say that people have relationship problems because we tend to break the agreements we have made with others.  Now often these agreements are unstated and only implied, but the feelings that result when someone close to us violates an agreement we believed was sacred, we can experience a certain insult to the spirit that hurts us deeply.  And, the hurt frequently brings the temptation to retaliate, which, although understandable, goes a long way to further the discord.  This can become quite a dilemma for those in relationships from which we cannot just walk away.  After successive attempts, we finally come to see that we are not successfully resolving our relationship problems because we are only attempting different variations of the same unworkable solution.  It is then, often out of desperation, that we look to others for help.

All cultures of the world have an answer to the professionals (clergymen, doctors or therapists) with whom we consult when we are not able to resolve our problems. All of us seem to know that talking about the feelings we have is a good thing because language greatly facilitates our thinking.  And, moving to finding someone with whom we might speak about our very personal and private matters is not an small decision; it must be a good fit and we must feel comfortable, secure and as sure as we can be that our confidant is worthy of our reliance.  So when we choose that person to whom we are going to entrust our most delicate and vulnerable thoughts we should rely on both our cognitive skills and our intuition.  Insist on having a short but meaningful conversation with your potential coach or therapist and ask the important questions about his experience, his education and points of view while listening with both your ears and your heart.

Remember, some emotional discomfort is decidedly human and peculiar to us all, but this distress is not necessarily a mental disorder.  Speaking to a trusted professional gives us the opportunity to take full advantage of the internal resources we all have to rethink the issues.  Somehow we all manage to get through the problems in our lives.  But we might significantly limit the emotional distress and, at the same time, learn some things very important about ourselves and the world by talking to someone trustworthy.  The things we learn from confiding in someone will likely be very useful in our future quest for solutions to the problems that will always be there.  And especially remember that there are always good solutions to be found. 

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