Behavioral or Developmental Approach

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October 12, 2015

With  Reggie Marra, MA, IMC, ACC and Dr. Joel Kreisberg, DC, CCH. ACC

Interview Transcript

DR. JOEL KREISBERG: Hi. I’m Joel Kreisberg.

REGGIE MARRA: And I’m Reggie Marra, and we’re here to talk about the difference or the contrast between behavioral and developmental approaches to coaching.

DR. JOEL KREISBERG: So we’re going to start out with a question or two questions and ask you to think about them. When you’re coaching, are you focusing on what the client is doing and working with them to either get better at it to add a new way of doing it or stop doing something that is getting in the way of doing it or…

REGGIE MARRA: Or are you working with creating awareness at how they see what they’re doing, how they feel about it, and what motivates their behavior? In other words, looking for a more complex understanding or the potential for mastering new skills.

DR. JOEL KREISBERG: So we’re going to talk about behavioral approach or developmental approach. And this is really important to us because it seems like a behavior – or focusing on behavior in health coaching is very common, and so we want to help give a language to this so that we can distinguish. It’s not that one’s right or wrong, right? They’re different, okay? And there are times when behavior is really important, like when running a marathon, and there’s other times where we’re suggesting or I believe that a more complex or a developmental approach is key to making the type of deep changes that people want to see in their health. Can you give us an example, Reggie, a story that might help us exemplify behavior versus developmental?

REGGIE MARRA: Oh, sure. I mean, just one that I like, and I say this with great respect to surgeons, because I have two artificial hips, but if you consider a surgeon who develops a brand new procedure and gets very, very good at performing the procedure and even teaches it, that’s a very complex skill and a behavior change, but it doesn’t require a developmental move or more awareness. But if the same surgeon actually becomes ill or gets injured and must enter the hospital now as a patient and goes through the entire surgical procedure as a patient, he or she might come out or almost definitely will come out with a shift in perspective, a change in how they see their work as a surgeon, how they feel about it and what motivates them because now they’ll know how the patient feels about it. So there’s a whole different developmental move or perspective that they got based on this experience.

DR. JOEL KREISBERG: Yeah, that’s a good example. So when we say shifting perspective or advancing different ways, I tend to think of thinking or cognitive, feeling, emotional, motivational, why am I doing that, which could be internally motivated or externally motivated. We can talk a little bit about that. How I understand things intuitively, I can build that, what my behaviors are, which are still very similar, and then also somatic, what are my body capacities. So those are all different approaches that come into play when we look at a developmental perspective.

REGGIE MARRA: Yeah. And I think that’s really important because beyond just the behavior, what I heard you refer to there, we could call domains or intelligences, but for development to take place, we are complex beings, we humans are, and I think it’s really essential that we realize development takes place across the spectrum of these multiple domains or intelligences for a human being. And if we’re not paying attention to some of them, not necessarily all of them every moment but at least to some of them beyond just the behavior, we’re losing the opportunity to really develop ourselves as coaches, but even more importantly, to help our clients develop.

DR. JOEL KREISBERG: Yeah. That’s good. So of course we went and focused on developmental, which is what we favor in our conversation. So let’s just go back to behavior so we can really understand behavioral approaches or what are behavioral approaches because it actually, you know, is useful. I mean, the one that I like to think of is that a lot of approaches to diet are behavioral.

REGGIE MARRA: Okay.

DR. JOEL KREISBERG: Okay? So it’s like becoming aware of what I’m doing, what I’m eating, asking people to stop eating certain things, so become aware of different choices and stop eating things, start eating more of certain types of things, keep eating foods that you might be eating that you’re doing already, change of focus from eating one type of food to another, right? I may ask someone to do more activity. But if I’m asked to do more activity, often it’s the activities that I often already like to do in some way. And so they see the focus. I keep saying the word doing when I talk about a behavioral approach.

REGGIE MARRA: Yeah, that’s a great example. Just a real personal note. When I stopped running–I ran for over 25 years, and I was a decent middle of the pack runner–when I could no longer run because of the problems I had with my hips, I had to relearn how to eat, basically. I had to change how I ate, and that was a behavioral change. It was portion control. I never had a weight problem per se, but I was no longer burning several thousand calories a day as a runner, so I had to change my behavior in order to adjust that.

DR. JOEL KREISBERG: Yeah. And so it’s a really important piece. I noticed it with my kids. My oldest kid is a professional athlete, and I watched him in high school just eat what he ate and not be able to balance his energy. And as he became more interested in being an elite athlete, he had to learn what it takes to eat really well and to have the capacity to actually play an hour and a half of basketball every day. So he took a very behavioral approach. He had to learn the kind of foods that were going to make a difference. But in a lot of ways, what he was doing is already within his domain of, you know, he didn’t physically eat differently, essentially. So it’s getting better at what he’s already doing is one way of thinking it.

REGGIE MARRA: Yeah, yeah. I mean, he was already eating. He wasn’t going to stop eating, but he had to do it in a more constructive or a more intelligent way. Yeah.

DR. JOEL KREISBERG: Right, a more constructive way.

REGGIE MARRA: Yeah.

DR. JOEL KREISBERG: And so we think that’s what we mean by a behavioral approach. And so there’s nothing the matter with a behavioral approach. However, there’s a difference between a behavioral approach and what some language, a vertical approach or a developmental approach, which has to do with mastering a more variety of skills versus just a behavior. So when we say a variety of skills, we use the word domains or intelligences. What are the more common ones that we use? Or what are you paying attention to often, Reggie?

REGGIE MARRA: More often than not, it’s cognitive, what I’m actually aware of or what the client is aware of. Emotional, you know, emotional intelligence is increasingly popular nowadays. Somatic, a real body-based awareness is important. Motivational, you know, why am I or why is somebody doing this? Also, moral is a big deal. In some ways, it is considered passé, but what should I do in a given moment is part of my tool kit as well. Anything else that I didn’t mention that you would add?

DR. JOEL KREISBERG: One is intuitive. So what do I intrinsically, you know, what do I naturally feel like doing or the intuitive. But I want to go back to motivational because I think motivational is such a useful piece in coaching, and there is a lot of motivation – motivation, we often set up into intrinsic motivation and extrinsic motivation. So often a behavioral approach uses extrinsic motivation. Whereas in a developmental approach, we’re trying to shift to a more intrinsic type of motivation. And so how do we shift to more intrinsic motivation? How do we access more intrinsic motivation? How do you do that?

REGGIE MARRA: I keep on coming back to the idea of creating awareness. In order to be intrinsically motivated to do something, I or my client needs to understand my values and my desires and what it is I truly want. Otherwise, I’ll be open to all kinds of extrinsic motivations and punishments and rewards coming from outside. So the first step for me is awareness.

DR. JOEL KREISBERG: Yes. I really like that. So you become aware of what’s important to me.

REGGIE MARRA: Right.

DR. JOEL KREISBERG: Right? And then I try and align my behavior to reflect what’s important to me because I spent the time getting to understand what’s deeply important to me. So you see, intuitive is wrapped up in that because intuitive is partly what’s important to me, but also motivation is moving intrinsic rather than having motivation be, okay, so I want to lose weight. I want to weigh 240. But why is that important to me? Well, it’s partly because I feel differently inside. I may emotionally feel differently, right? But it’s also really – there’s some deep part of me that feels like – I guess there’s a way that I want to really be my healthiest. I want to perform at my peak level. I want to have the biggest impact on the world. That’s a really internal motivation. If I can access that, that almost becomes the fuel for making the behavioral change. So we still have behaviors in a developmental perspective, in a developmental approach.

REGGIE MARRA: Oh, sure. Yeah. And as you were speaking, and I was surprised to hear this, I didn’t think I was even going to mention the moral intelligence or line before…

DR. JOEL KREISBERG: Neither did I.

REGGIE MARRA: But basically, what you were just speaking about, what is it that motivates me, what should I do for myself, for my family or my co-workers or for the world at large, that ties in with moral intelligence and moral reasoning. So they all really – well, they can be teased apart in certain ways. There’s definitely an interconnection among these domains or intelligences.

DR. JOEL KREISBERG: Yeah. So in a developmental approach, therefore, we’re sort of gaining awareness of these broader domains which allows us to improve a variety of skills, and through that complexity of skill development, we can now improve the behavior because we’re actually coming to the behavior from a different perspective, basically.

REGGIE MARRA: Yeah. I mean, telling someone or suggesting to someone or getting them to convince themselves that behavior change is necessary or helpful can work, but in the absence of the awareness of why I’m doing this, what my motivation is, there’s a good chance that the behavior change will not stick as long as it might with increased awareness of motivation and just, you know, the reason for doing it.

DR. JOEL KREISBERG: Right. So the key words I hear, and then we’re going to wrap up, are increased awareness, mastering skills, a variety of skills leading to improved outcomes in changing a behavior.

REGGIE MARRA: Yeah, I agree with that. And I have a bias on that. I think I mentioned creating awareness four or five times. So there’s definitely a bias. I have to go there first, but just creating a new awareness in the absence of any behavioral change needed isn’t good enough either.

DR. JOEL KREISBERG: Right. So we still have the behavior. So let’s go back to our original question. So now if you’re listening, reflect on as a health coach, are you focusing on what your client is doing and working with them either getting better at how they do it, adding a new way of doing something, stopping doing something that they’re already doing or…

REGGIE MARRA: Or are you working with creating awareness of how they see what they’re doing, how they feel about it, what motivates their behavior and then looking for a more complex understanding with the potential for mastering new skills that will lead to changed behaviors. So there’s a significant contrast between those two approaches.

DR. JOEL KREISBERG: So it’s a reflection that you can take off into your day, and actually, it’s not even if you’re coaching. In a way, it’s how you interact with people and how you make change in your own life or how we make change in our life, and we do both.

REGGIE MARRA: Yeah, for sure.

DR. JOEL KREISBERG: Well, this is Joel Kreisberg signing out.

REGGIE MARRA: This is Reggie Marra saying goodbye and thank you for joining us.

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