Why Some Clients Just Can’t Change
‘Self-regulation depends on having a friendly relationship with your body. Without it you have to rely on external regulation – from medication, drugs like alcohol, constant reassurance, or compulsive compliance with the wishes of others.’
Bessel A. van der Kolk
‘I’m sorry coach, but I just couldn’t help it.’ Sound familiar? It could be the client that says they would stop snacking on the afternoon muffin to achieve their weight loss goal. It could be the client that says they want to quit smoking because they’ve been diagnosed with early stage COPD.
The solution is simple, right? Just. Don’t. Do. It. In a profoundly paradigm-changing book ‘The Body Keeps the Score’, Dr van der Kolk describes the neurological changes in patients with post-traumatic stress disorder. Of particular note, he was able to observe the changes in activation of certain regions in the brain, compared to a human without a history of PTSD. Dr van der Kolk was able to show that those who have experienced trauma were unable to rationalise their experience – because the overwhelming memory would override the parts of their brain responsible for organising events into logical sense.
The crucial element of this finding is this – for those with PTSD, they are unable to respond the same way than those without PTSD because their brains fire in ways that are different. Knowing this creates a fundamental shift in how we view these patients and therefore, how we treat them. To put simply, we cannot expect them to behave in ‘normal’ ways when they are triggered, because their response is deeply rooted in their neuroanatomy.
Most of you reading this article are probably wondering why this is relevant to your practice as a coach. After all, not many of you will be working with patients with PTSD (and if you do, I hope you will work appropriately with other medical professionals). The relevance is this – many times the roadmap to a certain health outcome is right in front of them. And it really isn’t that complex, is it? For those wanting to lose weight, the solution is to match appropriate levels of food to movement. For those wanting to improve their body composition, the solution is to match the correct training volume to their recovery.
Simple. But at the same time, not quite.
Despite the simplicity of such a step, why do our clients self-sabotage? What makes them nod their heads enthusiastically in front of us, only to shake their heads in shame when they report back to us in a few days? I believe Dr van der Kolk’s observations are important here. Whereas I do not dare draw a comparison of those with PTSD to our clients who are undergoing behaviour change, what I do emphasise is perhaps there are neuroanatomical changes in your client that play a major factor in their inability to ‘control’ themselves.
It is not so far fetched if we take the time to think deeply into it. As creatures of habit, we possess certain neurological ‘maps’ utilised in problem solving. If we’re hungry – there is a neurological circuit starting in the brain that expands all the way to our fingertips that makes us want to put something to our mouths. If we’re afraid, our hearts beat faster to prepare us for fight or flight. Could these circuits misfire due to past events? If a client has resorted to feeding or substance abuse as a self-soothing mechanism, can they be blamed for it?
Under challenging times, we are more likely to default to what we know best. Neuro-circuitry is designed to protect us (or make us feel better). But what was once protective, can easily become harmful. What can we do as coaches that help our clients without overstepping the scope of our role?
Dr van der Kolk advises that adopting a mindfulness practice is one of the key components to addressing unhelpful neurocircuitry. By mindfulness, Dr van der Kolk simply advises his patients to try to identify what it is they feel followed by why they feel that way. This simple act re-activates the ‘logical brain’, which assists with rationalising their experience.
I believe for those clients struggling with habit changes, teaching them a mindfulness practice would be highly beneficial. I do NOT advise you try this with clients that have PTSD – this should only be done by a trained mental health professional. Teaching our clients to understand the signals from their own bodies, as well as rationalising why they occur is the first step in helping them solve the puzzle of unhelpful habits.