Trying to decide whether to go to a coach or therapist for help? Reasons to consider a coach instead of a therapist:
There’s lots of conversation on the internet about seeking a coach or a therapist for healing and growth. How is one supposed to decide what’s best for them? Here are some important topics to consider when trying to resolve whether to approach a therapist or a coach for help. As well as reasons I prefer being a Life Coach to my old job of functioning as a Psychologist. I spent years coming to these conclusions, so here’s some things to ponder when making your decision:
1) Licensed therapists can diagnose mental health disorders, coaches cannot. Is this good, bad, neutral? You decide.
I spent years working as a clinical psychologist doing psychological testing, diagnosing, and providing therapy. But as the years went by, I grew tired of a field driven by the DSM, insurance, diagnosis, etc. When someone arrived in my office, I had to come up with a diagnosis the first session for insurance purposes. Now diagnosing can be helpful, and provide a quick method of speaking about generalized categories for what someone is experiencing, but it can also be limiting. Take depression or anxiety for example, diagnosing these can enable someone to go to a physician and receive medications. But it can also leave someone feeling as if something is fundamentally wrong with them. I would often tell people that I was more concerned about someone who wasn’t aware of having any anxiety or depression, than those who struggled with depression or anxiety. Emotions are like physical pain, telling us something is wrong (or right) with life. Unfortunately, people can receive a diagnosis and feel like ‘something is wrong with me,’ instead of simply being able to affirm ‘this is a natural outcome of what’s happened or is happening to me.’ I do not consider it a disadvantage to me in coaching that I no longer spend time diagnosing disorders in the DSM. Labels have helped some and hurt others. You decide.
2) Notice the highlighted word above, disorder. Disorders or failures in brain integration?
As a coach, I work from the frame of brain integration, in addition to an awareness how our brains and bodies can struggle with particular issues for real reasons. Our brains are deeply shaped by our environment. Our environment can even direct how our genetic predispositions manifest — see the field of epigenetics. Or consider how children’s brains are literally altered by the violence around them, when their brain is constantly flooded with stress hormones in the book ‘Ghosts in the Nursery.’ Disorder? Or simply the outcome of a deeply heartbreaking environment? You decide.
In my years functioning as a psychologist and teaching, I learned a lot about neuroscience. What I learned, convinced me that much of what’s occurring when we struggle to regulate our emotions is an issue of brain integration versus a brain disorder. It’s about how our brain was wired as a result of our environmental circumstances. Now the beauty of this is that we can rewire our brains. We can create a different environment for our brains and thus bring healing. Of course some will disagree and say it’s about genetics, chemicals, or _____ (you fill in the blanks), just as for years there were disagreements about whether the world was flat or round. In the field of psychiatry, you have Dr. David Burns, who writes that he doesn’t believe, from his review of all the research on psychotropic medications, that there is proof of efficacy. On the other hand, you have Dr. Daniel Amen, who uses imaging of the brain to show clients what their medications do to help their brains.
I don’t think this is simply a black and white issue, we are complex. But consider bipolar disorder as an example. It’s fundamentally a dysregulation of emotions. Psychiatry states that it’s a chemical imbalance that needs to be dealt with through medications one takes for the rest of their life. Medications can help people (and some people may need them just as somebody needs a cast with a broken bone), but medications don’t reintegrate the brain.
Neuroscience provides an alternative framework. Bipolar disorder is about failures in brain integration (see for example, Psychiatrist, Dan Siegel who’s written about an adolescent with a Bipolar Disorder diagnosis, verified by several psychiatrists, who was helped through mindfulness as opposed to medications). I agree with those who believe our failures in integration have a lot to do with our environments as we come into the world and grow, in other words how our brain fails to integrate.
Hear this term ‘integrate’ as ‘different parts of our brain communicating well.’ When our brains are dysregulated they are not well integrated, that is to say, the thinking part of our brain (cortex) struggles to control the subcortical parts of our brain (parts we share with animals like dogs and lizards), or our left (more analytical) and right (relational/emotional) hemispheres do not communicate well. (Our brain is more complex than this but these can be helpful models) Disorder? Integration? Each person needs to decide, but I prefer to work with people from a framework of brain integration as a coach. We can all achieve better brain integration whether we are a struggling adolescent or a successful CFO of a Fortune 500 company. Failures in integration don’t have to be the result of abuse or poor parenting, they often simply flow from one generation to the next because of deficiencies in a previous generation’s knowledge, functioning, and/or modeling resulting in little ability help the next generation achieve the best possibilities for their brains.
3) The above distinctions highlight an important difference between coaches and therapists. Therapists begin with a diagnosis and therefore an assumption of pathology. The DSM which forms the foundation for therapy is a book of ‘disorders’ and thus pathology. While I can’t speak for other coaches, I know that in transitioning from therapy to coaching I am allowed to function from what I believe is most true about individuals: our inherent beauty provides a foundation for our growth. Take for example the ‘beauty’ of brain plasticity. Plasticity means that our brains can change during our entire life, from age 1 day to age 100 and onward. This is beautiful and it’s inherent in our very being.
The importance of this distinction became evident to me when I became a father. A good parent highlights a child’s essential goodness. We don’t grow into more complete and whole people by emphasizing our pathology, we do it by nurturing and living out of our core beauty and goodness. A child grows by believing in what they are capable of, not by being told everything that’s wrong with them! (Not that lovingly teaching our children about their deficiencies is not also a necessary aspect of parenting).
Is it more important that you believe in how screwed up you feel now, or in what you’re capable of? You decide.
4) Mindfulness techniques, which can help us integrate our brains, do not originate in therapeutic models. Now this is not to say that therapeutic models are unhelpful. Cognitive Behavioral Therapy, attachment theories and other modalities are helpful models of healing. I did therapeutic work for so long, that some of these ways of thinking (ones I felt were important and helpful) are simply part of how I function as I move about the world, relate to my kids, etc. But the modalities of mindfulness, which help our brain become more integrated found their origin in Buddhism. Mindfulness did not come from some therapeutic framework developed in the last two hundred years, which now requires special training and endorsement to implement in order to get paid by an insurance company.
So much of our ‘healing’ in ‘mental health’ is ultimately about control, those lobbying for power in Washington as each field tries to make sure they can maintain power and jockey for position, as well as promote safety through regulation. Even the coaching field is not likely to remain unregulated forever as people will grab for power. But for now it is and that’s one of the things I appreciate. Mindfulness is free for all, and research shows that it’s a foundational key to our integration and thus healing. I can help you with mindfulness and help you become mindful of many things in your life that can lead to growth, but you don’t need me to begin to do mindfulness. I use the Calm app myself, a Muse headband, and Mendi headband for some helpful biofeedback and aid in mindfulness. Try them out!
5) The above thoughts blend with my next — therapists are regulated, coaching is not. Good? Bad? Neutral? You decide. There is no governing board over coaches. As a result it can be like a crap shoot looking for a good one. But at the same time it’s really a crap shoot looking for a good therapist as well.
Over the years, as I pursued growth myself, I went through individual, group, and couples therapies, and experienced various modalities (from CogB to EMDR), I met a couple of great therapists and several not so great ones. One positive for therapists, is that education, training, licensure, etc. are all part of their process. However, education and licensure do not guarantee that someone can be helpful to you! Some of the most intuitive and helpful people I’ve met in my life had no formal training. In the west, we live in a world that is regulated, and as a result we miss out on much that is good that doesn’t ‘qualify.’ Regulation has its strengths and its weaknesses. You decide what fits for you best, or what you’re most comfortable with.
Here’s the truth about us all: therapists, psychologists, physicians/surgeons, pastors, coaches, CEOs we all originate from the same place: a broken world where there is suffering and disease of all sorts. We are all broken. So in seeking help you are never approaching someone who’s perfect. What anyone needs is a therapist or coach who has been on a healing path themselves and has some ability to guide others toward healing. I love that coaching offers those who are naturally gifted with insight and wisdom (gained through life experience and simply who they are as a person), an avenue to help others. Find someone you really connect with who listens, and offers helpful reflection and helps you rally to live your best life. It may be a therapist. It may be a coach. It may be a pastor, monk, or shaman. But what you really need is simply to start conversations and look for someone with wisdom, insight, and an ability to guide you toward your best, most whole, integrated self.
6) Is being able to bill your insurance a good thing? Therapists, in coming up with a diagnosis, can bill insurance companies while Coaches cannot bill insurance. Now who wouldn’t want to use insurance if you could? It makes sense, and if you think you have a viable DSM diagnosis and don’t mind being given a label use your insurance. But it was also quite common over my years practicing therapy to find that by the time a person’s deductible was covered the year was almost gone and they would have to start all over again the following year. Let’s face it, not many of us have great insurance benefits, and you’re constantly starting your deductible over each year anyway. You have to pay a coach completely out of pocket, but this doesn’t have to be a bad thing.
Over the years I grew to be able to tell who would grow and change and who would not. It was simple: the ones who were motivated to grow are the ones who grew. I can be very invested in people growing, but it does no good if you yourself are not invested. Motivation is everything and a willingness to invest in and pay a coach or therapist out of pocket manifests a desire to grow. We invest in what we believe in. Science shows us that if something costs us something we tend to value and invest in it more ourselves, this heightens the possibility of change. So is being able to bill insurance good? Bad? Neutral? You decide. It doesn’t have to be the same for everyone. What matters most for change is motivation.
Conclusion: Things to keep in mind as you seek out a coach or therapist:
Find someone who is not just knowledgeable but wise, who has gained experience and thus has a broad perspective. The more narrow one’s perspective the less they can see and thus help. For example, there are so many specialties in medicine because there’s too much knowledge for any one person to understand everything (blood, cancer, surgery, etc.), and even then a physician can’t understand everything an electrical engineer or an astronomer does — but don’t you wish you could understand multiple fields of study? Seek out someone with as broad of a perspective as you can find, who also has specific knowledge to help you change in areas that matter to you. Think of this framework as finding someone who can see an entire elephant (or has a better view of it at least) than someone who can only tell you what the tail of an elephant is like or it’s ear. If you know what part of the elephant you need to study then seek them out, but if you’re wanting to really understand a broader picture of your struggles in life and how to move forward, seek out someone who has a better view of the ‘elephant’ so to say.
Seek out someone who connects with you. We each need to feel seen. It’s the relational elements of connection that are as much about healing as other things like expert knowledge. Years ago, Irvin Yalom wrote about the kind of ‘secret spice’ of cooking and how a good therapeutic relationship (and I would add coaching relationship) requires that secret spice. Find someone with whom you feel comfortable, safe, feel seen by, and who provides helpful outcomes for you over time.
Don’t assume you’ll change overnight. There may be some things which might shift for you quickly due to insight, etc. but other things, which are built into your body and thus brain will take longer. It took you years to get where you are, so don’t hold on to a fantasy for an instant cure. Our brains took time to wire and rewiring takes time even though we CAN do it. Change is like anything else, the more energy and time you invest in something the better you get at it.
Self help books versus coaching or therapy with a human. Patricia Kuhl, who specializes in infant linguistics, discovered that even as children learn a language there’s a massive difference in learning when a child learns a language from a face to face interaction versus watching the same thing on TV. Sitting with humans helps us learn, it’s how we’re made. A book can help the analytical part of your brain, but this is only part of who you are. The right hemisphere is the first thing to come online for infants. This is the part of your brain that attunes to relational realities, connection, emotional attunement, etc. We need humans to strengthen this part of our brain, not TV, not self-help books. So whatever you do, don’t believe you can learn everything you need to know from a book. Books can be helpful, but we need people to actually heal, people who attune to us and guide us.
Best of luck on your journey to find the therapist or coach who is the best fit for you!