June 22, 2016
By Joel Kreisberg, DC, CCH, ACC
An essential feature that differentiates coaching from medicine is the identification and clarification of a coaching topic. In Integral Health Coaching, I call this the healing topic. Whether a patient or client comes in for coaching or for medicine, I always take the time to find and clarify a healing topic.
How do we arrive at a healing topic? Through dialogue and discussion. Most clients see me with a medical condition that is taking their attention, a chief complaint. The implied understanding is that the goal of our work together is to “remove” the condition or symptoms that are causing pain or limiting health. In a conventional medical setting as well as many health coaching settings, success is removal those complaints- headaches, joint pain, excess weight or smoking, for example—all necessary and good outcomes. Yet notice that these goals are about getting rid of something, without much regard to the underlying experiences of self that might be wrapped up together with condition. We have all grown up in a medical system committed to reducing pathology with little emphasis on positive health goals.
In my own practice, after exploring the chief complaint thoroughly, a wonderful moment opens up in which I am able to shift the focus of our conversation to the positive, to a potential healing topic. The most common question I ask is “let’s just say we’re able to find the right treatment to really get you better from your headache (or whatever the condition). If that were to happen, what would you like to have in your life instead?” Invariably, this is question causes the client to pause, reflect, and offer an intimate longing for something currently not accessible. The discussion that follows investigates an aspect that they would love to see grow and succeed. Together we explore the possibilities and consequences that such longings create, and how that would impact their health. As an Integral Health Coach, I use the four quadrant template to explore this topic, considering behaviors, experiences, shared meaning and the social systems in my effort to deepen our understanding of the healing topic.
What emerges? Here are a few samples: a retired women in her 70’s has a chief complaint of chronic excema-her healing topic is “to be more able to be patient, open and present to the people who are close to me.” A middle aged man comes with a chief complaint of tinnitus- his healing topic is “to be more trusting in my own healing abilities (healing topics are in the 1st person).” A mother of four, whose kids have all grown and left the house has a chief complaint of menstrual irregularities and frequent acute illness- her healing topic is “ to be more able to get the care that I need from those whom I love.” A unmarried women in her forties, hasn’t been able to get rid herself of what she thought was allergies, but it seems to be a chronic low grade chest infection—her healing topic is “to be better able to choose actions that will bring me fuller, more meaningful life experiences.” A young women, a recent university graduate, struggling with severe digestive weakness, constipation, and an inability to tolerate most foods yet, still gaining weight, has a healing topic- “ to be more able to nourish myself with greater ease and resilience.”
I hope you can see from these samples the contrast between chief complaint and healing topic. With both a chief complaint and a healing topic, the conversation shifts from one of only “removing disease” to one of including health promotion. While not everyone finds this shift to be inspiring, most do. In terms of our working together, having both chief complaint and healing topic allows our process to focus on both fronts, ridding illness and promoting wellness. For most, this is a real opener and perhaps the first time they are able to consider both the negative and positive aspects of a given illness. As well, it offers clear direction for improving health in new and novel terms specific to the individual.
Finding and identifying a healing topic is an outgrowth of a positive psychology that focuses on growth, satisfaction and positive feelings. Health is more than just the removal of negative symptoms, rather, heath and healing are ongoing challenges and opportunities to improve ourselves physically, emotionally, mentally and spiritually. Approaching healing with a positive focus, facilitates internal health resources and increases the meaningfulness of the challenges we face. In doing so, we grow healthier and more resilient, facing new health challenges with more resourcefulness.
For me personally, articulating a positive healing goal or healing topic is something I do annually. I think we can all do this. Why not start right now. Consider what ails you today. Close your eyes and breathe into the sensations, feelings, and thoughts that go with your ailment. Lose yourself in your breath for a minute and see if you can hear in the silence, what you might really be needing. Ask yourself. “What would I really like to bring into my life. Listen closely, and write down what you learn. With a little help, you can turn this into a healing topic. Return regularly to your topic and you just might find yourself a little closer each time you look!
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