What Is He Thinking?

Decoding the male psyche.

The Difference Between Coaching and Therapy is Greatly Overstated

Coaches and therapists make too big a deal about their differences

 

I've been working with a lot of executive coaches recently, and have the utmost respect for many of them. They're smart people who help their clients immensely. But they always want to tell me that they're not doing therapy. And they usually offer up a similar story about how coaching and therapy differ. They (coaches) apparently work with the future; I (therapists) work with the past. They work to make healthy clients better; I work with pathology and illness. They work with the conscious mind; I work with the unconscious mind. Their work is time-limited, with specific desired behavioral outcomes, and is often on the phone; my work is open-ended, with understanding as its primary aim, and is in my office. The list can and does go on and on. What these coaches are describing are actually false distinctions that don't make a difference.

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It seems to me that this is a mythic narrative that aims to insulate coaching--a profession in its infancy--from claims that it's therapy without a license. It seeks to protect the egos and wallets of coaches while appeasing therapists on the same grounds. I think that the problems with this narrative, however, are caused more by therapists than by coaches. In my view, we therapists too often practice with a model of psychotherapy that is so ridiculously narrow and theory-driven that it leaves us open to the types of caricatures that coaches, for their own reasons, then legitimately apply to us. In this sense, therapists and coaches have more in common than they know-a professional myopia that gets in the way of helping people.

I was trained as a psychoanalyst, and still consider my approach to be psychodynamic, but let me go on record now and say the following about my clinical work:

1) I am concerned primarily with concrete changes in a person's real life, including actualizing their potential, promoting their growth, improving their efficiency and productivity at work, overcoming inhibitions, and resolving symptoms.
2) I only delve into a person's past if it significantly helps that person understand and master those habits, feelings, and thoughts that hold them back from achieving their most important goals.
3) I often work in a time-limited manner, on the phone, and have specific behavioral outcomes in mind at all times as an empirical measure of success.
4) I work to make relatively healthy people healthier as well as to alleviate the suffering of people who are frankly sick.
5) I work with the client's conscious experience, while helping him or her understand that sometimes their self-limiting behavior is being by thoughts and feelings and beliefs about which they are unaware.
6) I focus a great deal on the client's real interactions within the various social systems in which he or she is embedded. The more I understand the social and practical realities of a client's life, the better able I am to help him or her in therapy.
7) I am rigorously self-correcting about whether I'm on the right track with someone, a commitment made easier by my belief that a therapist can usually tell almost immediately if an intervention is useful or not.
8) I have no compunction whatsoever about getting involved in various ways with a client outside my office if I judge that to be necessary to advance our work.

Now, it escapes me how such practices as these can possibly be differentiated from good coaching. Just because a client may have the belief that there's a difference between coaching and therapy doesn't mean that there is one. By arbitrarily defining what they do as "focusing on health and not illness," coaches have simply found a way to engage in a fundamentally therapeutic process by implicitly reassuring the client against the latter's irrational fear and shame of being screwed up. That's terrific. If I thought that that would enable a particular client to open up and be more candid, I'd find a way of offering a similar reassurance. But let's not confuse what we say to a client in order to help him or her feel safe with some underlying and fundamental reality. For me, the issue-the only issue, really-is how I can help this particular person feel psychically safe enough to more candidly explore his or her inner life with a view toward moving more efficiently toward his or her goals. My impression is that because of the stigma of psychotherapy, many people can only accept it under the rubric of coaching. My only problem is mistaking something's label from that thing itself.

Unfortunately, my own profession of psychotherapy has contributed to, if not created, this confusion. Our theories are not patient-specific, they privilege understanding over symptom relief and behavioral change, they proscribe rules and norms on therapist behavior that are not flexibly related to outcome, and they advocate notions of neutrality and abstinence that are impossible to achieve and often obstacles to therapeutic success. We lend ourselves to being caricatured by clients and coaches alike.

I don't believe that there are many general principles of therapeutic technique because my view of therapy is that it has to be entirely client-specific-that is there are few things that a therapist "usually does or does not do" independent of what a particular patient needs. There is no such thing as neutrality or abstinence. There is no a priori focus on "the past" or "what's wrong" or on "deep interpretations." My work with some patients is explicitly time-limited, with others it's open ended; with some it's focused entirely on work or geared to practical help, while with others it's about intimacy and geared to enhance self-esteem. Sometimes the help I offer is based in insight, other times in helping provide experiences that are corrective. It begins with the assumption that clients who seek help from coaches or therapists want to get better, that they are held back by maladaptive expectations, beliefs, and emotions that derive from both their current and past realities, and that the job of a therapist or coach is to figure out how to get on the their clients' "side" in the latter's attempts to overcome these irrational feelings and beliefs.

Understanding the unconscious meanings and childhood origins of a client's behavior isn't necessarily my focus, but frankly it is almost always extremely helpful in guiding my work. How could it possibly not be? The more deeply you understand someone, the more effectively you can help that person. Is there really any debate about this?

The biggest difference between coaching and therapy, in my view, is that the theory that guides my work as a therapist can explain how coaching does or does not work, while theories that guide coaches can't do the same about therapy. This difference, while true, seems inconsequential to me. What matters is that people get help in their efforts to grow, master their problems, and become more effective in their lives. Both approaches aim to do this. Who cares (licensing boards notwithstanding) what you call them?

 

 

Michael Bader, D.M.H.,  is a psychologist and psychoanalyst in San Francisco. He is the author of Male Sexuality: Why Women Don't Understand It—and Men Don't Either.

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