Navigating Challenging Health Coaching Clients: Part I

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This is my first ever practitioner to practitioner blog post.  I have been wanting to implement this for quite some now but always managed to engage in a self-limiting mind story of "I don't have worth while enough or enough content to share with other practitioners."  With the start of a new year, I am feeling rather renewed and so I figured now is a great time for me to step out of my comfort zone and test the waters.

Since stepping into the functional health coaching arena, I have made countless mistakes of which have awarded me awesome opportunities for both self and professional growth.  One area in which my mistakes have taught me a ton of valuable lessons is dealing with challenging clients.   

Although I think my particular niche of complex chronic illness such as Chronic Fatigue Syndrome, Chronic Lyme, and Mold Related illness naturally brings rather exceptionally challenging clients my way, I feel challenging clients is one area that all functional health coaches deal with to varying degrees and could use support and tips for better navigation.  For this reason, I chose to make this my first blog topic of which I will release in a series. 

Going Above and Beyond Yet Being Met With Resistance

In this blog post, I am going to focus specifically on the challenges that come when clients lose their motivation, do not follow through with agreed upon recommendations, and then have a tendency to cast the blame on something external to themselves when they don't see the results that they had originally set out to achieve.   One of those external factors can often end up being YOU, despite working your ass off behind the scenes and spending hours creating custom recommendations, protocols, and lifestyle interventions in hopes of serving and inspiring them to take charge of their health and healing the best you can. 

And, if you are anything like me, you probably spend time on your client cases well beyond what you actually charge for.   

After long hours of preparation, you excitedly present all your hard work to the client in a scheduled coaching session.  You hope that they are appreciative, receptive, and eager to get started.  Yet, instead, you are met with resistance, apathy, and sometimes even combative behavior.   

After little to no follow through on the client's part, not completing labs tests, not implementing necessary stress reduction suggestions, having numerous excuses, and the list goes on,  they may even launch an email at you to the tune of  "I thought I would be further along in my health by now.  I spent a chunk of money on your services and feel I am getting precious little for it in exchange, which is a bummer."   This was an actual email that I received from a client by the way; one for whom I did bust my butt behind the scenes, in ongoing email support, and during consults.  I later learned that her anger and blame was being fueled by lack of support and empathy from both her husband and her family; especially around financing holistic health care.  I just so happened to serve as a punching bag for her to take out her frustrations that day.  

Triggering Events!

Regardless of the reasons behind a client's behavior, these types of situations do not feel good.  They can be very triggering and lead us to doubt our skills and knowledge as a practitioner.  The level of being triggered, of course, will directly correlate with one's level of experience and knowledge of tools and techniques for dealing with these types of client situations.  In the last year I have ramped up my resilience quite a bit and am less triggered but nonetheless, these kinds of situations are still challenging, uncomfortable, and have a tendency to create a certain degree of reactivity in the moment.  After all, I am only human and a highly sensitive one at that.  This is where stepping back and taking some time to ponder a well-thought-out response, draw upon all that you have learned thus far, and seek the guidance of more experienced practitioners is best practice.  

Before moving on with my favorite and most effective action steps on how best to manage challenging client scenarios such as this, I want to be clear that sometimes the best and healthiest outcome for all involved is to terminate the client-practitioner relationship and send the client on their way, with compassion, to find a better match.   

But, if you feel the client-practitioner relationship is worth working for then you will need to switch gears a bit in order to re-establish rapport and trust for both parties.  To do this, I suggest the following:

1.  Remind Yourself That a Person's Responses To Us Have Way More To Do With Them Than Us.

I presume you are well aware of this fact already but this is something that is easily forgotten in the heat of the moment and so a friendly reminder does wonders.   I tend to forget this one all the time, even within other relationships in my life, and so I made a sign that hangs in my office.  Just by reminding ourselves of this and internalizing it can make the difference between handling a challenging client with grace and the best version of ourself versus being triggered and possibly saying or doing things that we later regret.  

2. Recognize Resistance and Help Your Client Understand The Basic Brain Science Behind It.

It is natural for all of us to resist what we need the most.  This holds true more often than not simply because our habitual ways of being become a comfort zone to us.  The stress center of our brains, otherwise known as the limbic brain or fight or flight center, is much less active when there is consistency.  It prefers the "same ol, some ol"; even if this takes the form of destructive, sabotaging behaviors.  Anything that deviates from or challenges this "safety zone" is going to run the potential of triggering all sorts of interesting responses in us.  These responses can include things such as apathy, excuse making, arguing, blaming, defending, and the list goes on.  This is why habit change is such a challenging and daunting task for most.   Spending some time to help your client understand this concept on the most basic level can be an awesome learning experience for them and possibly help to bring about some monumental shifts in their mindset.  Also, rather than point out what you see them doing or not doing, I always like to use myself as example of when I did something similar in the past.  This way, you are still calling their attention to their behavior and lack of follow through but doing so in a way that will run much less risk of putting them on the defensive.  

3.  Cultivate Awareness Of How the Human Brain is Wired.

Because of our inborn, robust fight or flight system; which is intended to help keep us alive in TRUE emergency situations, we have 5x the neural networks for stress and fear-based thinking.  The more we perceive daily life challenges as TRUE emergencies and default to this way of thinking, the stronger the stress-based neural networks become.  Just as a body-builder must work his/her muscles consistently, we must engage in daily practices that help us create new neural pathways that will allow us to CHOOSE a different response and develop greater resilience.  In applying this knowledge to a client-practitioner relationship, can you sort of see how us making suggestions for numerous dietary and lifestyle changes on top of the need to complete various lab test kits can be viewed as overwhelming to a client and thus trigger them into "emergency" type thinking?  This applies to us as well.  When a client comes at us with stress-based behavior, we may also slip into "emergency" thinking mode; which will ultimately tigger the stress response in us as well and cause us to behave in undesirable ways. 

Additionally, the fight or flight center and prefrontal cortex (home of our higher level thinking skills and the part of our brain that allows us the be best versions of ourselves) have in inverse relationship.  In other words, when one is active, it recruits blood, oxygen, and glucose from the other.  What does this translate into? Well, from a space of being triggered, we are operating from our limbic brain which puts us in a "punch now and ask for forgiveness later" state of mind. From this space, we do not have access to high level skills such as empathy, creativity, compassion. big picture thinking, or strategizing.  Just as helping clients understand the neuroscience behind resistance, teaching them about this and also understanding it ourselves can result in approaching difficult client situations with a whole new perspective.  Your clients (most of them, anyway!) will also love your for teaching them about this brain science because it will help them better navigate other relationships and situations in their lives.  This in itself is extremely empowering. 

4.  Realize That Motivation Comes From Creating a Clear Vision and Connecting with Our Passions and Big "Whys". 

It is natural to lack follow-through, procrastinate, and exhibited behavior towards others that does not reflect the best version of one's self when there is a lack of vision and disconnection from our passion and big "Whys".   In other words, a goal without a vision and clear reasons for accomplishing the goal is like  a car without gasoline and wheels.  You can sit in that car and dream all you want about driving to a beautiful destination but without gasoline and wheels, you will remain parked.  Passion is the gasoline and our big "whys" are the wheels. 

As described earlier in this post, this is a common happening with clients.  They come to us wanting to achieve wellness goals such as weight loss, more energy, less pain, greater zest for life, and the list goes on.  They are super eager out the gate but many times their enthusiasm and commitment can fade within a short amount of time.  I have found, even with myself, this is because not enough time was spent on creating a vision, getting clear on true passions, and connecting with the big "Whys".   Without doing this, when the going gets tough, then giving up and becoming apathetic becomes an easy choice.  And, we all know how challenging things can become amidst making dietary and lifestyle changes, implementing pathogen protocols, detoxing, trying to learn stress reduction techniques, and more. 

Having said this, I HIGHLY recommend spending a few coaching sessions helping a client become TRULY clear on their vision, their passions, and their big "WHYS" before beginning any thing else.  Consider doing research into Appreciate Inquiry, Motivational Interviewing, and Non-Judgmental Communication to learn some tips and strategies.  Consider your role to be that of creating a safe space and facilitating in such a way that helps clients to go on their own discovery of what matters most to them; why they TRULY want to restore their health and reclaim their life.   You may find that their real reasons for wanting to get healthy differ greatly from what they originally wrote on their initial intake or even articulated during a Discovery Session.  To help the client find their answers, consider asking exploratory questions (and use them during LIVE coaching sessions as opposed to just having a client fill out a form) such as:

1.  Describe some times in your life when you feel or felt great joy.

2.  What inspires you and why?

3.  How will your life be different if you lose weight, regain your energy, get out of pain, etc.?  How will you feel? What will you be doing? How will you be doing it?  Who will be around you? What will you be thinking? etc.  Basically, you want to lead the client into creating a vision of their future (in present tense) with as much detail as possible.  Take notes as the client talks.  Continue asking questions to lead the client into deeper answers.  Recap their answers to them at the end and confirm if they agree or not.  This could potentially take  1-2 sessions, if not more.  Consider suggesting to the client to write their vision as story  (in present tense) or create a vision board as a homework assignment.  Help the client understand all the concepts that I have explained in #4.   Don't be surprised if a client's original answer of "I want to lose weight and get healthy so I can feel good about myself" turns into something much more monumental and life shifting such as "I want to get healthy so I can I finally have the strength and courage to leave my marriage.   I have been unhappy for a long time and I will no longer sacrifice my own happiness for the sake of my children."  This was a real response by one of my clients BTW after several coaching sessions! 

4.  What road blocks do your foresee on your healing journey?  What are some ways in which you can address these if and when they come up?

5.  What will your life look like in a year and five years from now if things don't change for you?

and the list goes on! 

In closing, I recommend beginning a client-practitioner relationship with all the tips I mentioned so far versus waiting until problems arise.   But, no worries if you have not.  You can begin at any point and weave them in as they are needed.  And, if you are amidst a difficult client-practitioner situation right now, perhaps these strategies will be helpful to you in shifting the trajectory of the relationship and helping your client and yourself learn some valuable lessons. 

Stay tunes for Part II where I will be discussing a common 5 letter word and why it is SO important to your success as a functional health coach!  Hint: it is something you wear when it is cold. :)