Coaching for Mental Health: Ethical Dilemma or Ethical Development?

Personal Practice

The focus of my coaching is to support and challenge for lifestyle change, to become fully alive. I do not differentiate between whether the change is self generated or caused by a breakdown.

It is refreshing when I am able to use the clear coaching strategy of the GROW model in a coaching session. The stumbling block is in deciding on a clear issue with a coachee who is locked in polarized negative thinking, but when one is identified the following process flows.

What do you want? What will achieving it look like? What have you done about it before? How did that work? What haven’t you done? With a magic wand, what could you do? What is the first step? What could stop you? When will it be achieved by? How do you feel now?

Finding the clarity to decide and act is what I feel coaching is really about. It is a pleasure to introduce the GROW process to coachees, some of whom have never experienced the training or learnt the life skills that support clear confident, decision making and thinking.

Following are some conclusions resulting from my experience of using coaching with existing clients of Social Services.

I have found that the coaching partnership is a very powerful tool for highly dependent people. Their absence of self-esteem renders them powerless and there is a pressing need for energy and inspiration from another source to move them out of their paralysis. Paradoxically too much emphasis given to the coach could be the last straw for their self worth, so emphasis on the “invisible coach” is a vital component.

Although I aspire to using brief questions, I struggle with putting this into practice. The ability to respond to powerful questions seems initially impossible, thwarted by emotional and habitual blocks of self-isolation and medication. A communication desert with the gremlin as dictator! Tests my abilities, yet despite my frustration, I am improving. A sample dialogue of first sessions would consist of approx 99% my input, (yes, I do try open questions). I am throwing in words and ideas, suggesting similarities/differences, grabbing at possibilities, having to accept that a “yes” or “no” is a triumph, mainly “yes” as “no” is far too challenging. A subtle difference in the tone of their response is sometimes my only indication of progress and the coachee is far too shut down to detect any change themselves, fortunately when pointed out to them, they can sense what I have observed, it feels like teaching a lifelong blind person to see. Sessions can be prolonged and take monumental effort. Thank goodness for metaphor and image work, initially the images are of my invention and interpretation, but this unfamiliar language slowly becomes part of assessing development and adds a new creative skill.

All goals and actions need to be very simple, both to remember and to implement, as medication and lethargy are difficult to work against. It is akin to carp fishing; hours and hours of patient coaxing, trust and rapport building, creating a strong partnership. It can take enormous commitment to keep my energy level up and my mind flexible.

I certainly agree that for the coachee it is “a relationship in your life with a person who is sometimes more committed to what you want in your life than you are”. Co-active Coaching. (p. xix). Finally through sheer slogging on both our parts, there is an epiphany or insight and the gremlin loses one of its many heads. The problem then is that the next head appears to wear a different face and it is left to me to keep reminding that we have been here before and succeeded.

Stuck is safe, change is awesome and giving up is a possibility any moment. Taking responsibility and making a commitment is hugely difficult and painful. The gremlin isn’t just an irritant or inconvenience it is an ogre of monumental proportions and I have found it necessary to slyly circumvent it, not openly defying it at first. I act out the smug excitement of progress, allowing the coachee their virtual satisfaction.

Because we are dealing with major negative self talk and entrenched self abusive habits I have been trying a programme of daily encouraging and assessing phone calls for the first 3 weeks with a weekly review – thereafter calls every other day. In time, as the coaching alliance strengthens we can openly joke about life and the gremlin, self deprecating in a light healthy way instead of the dark doom laden self abusive one.

Unfortunately there is the danger of substituting one dependency for another. I have to be vigilant and constantly remind the coachee of their increasing power. The carp fishing analogy keeps reminding me to pace myself and trust their process.

My own personal experiences have been vital as I am supporting vulnerable people at the edge of self-destruct. Some crisis sessions have just been marking time until a metaphorical sunrise. To acknowledge their hell without giving it any more power is delicate territory. I keep in mind my own values, and continue to learn. As the ‘invisible coach’ I hold their hopes and aspirations until they can own them for themselves. To be positive but authentic at all times is vital. Relapses are frequent and disconcerting, so I keep an attitude of “one step at a time”.


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