Eating Disorder Referral and Information Center

International Eating Disorder Referral Organization

 

 

Coaching Questions and Answers by Joanna Stonestreet of Stonestreet Coaching

Joanna Stonestreet, MA, CPEC, PCC

Website: www.stonestreetcoaching.com

Email: joanna@stonestreetcoaching.com

How do you coach a client during recovery? Does the process differ depending on the client's stage of recovery?

Coaching is designed to meet an individual where s/he is and continue forward. For some, intervention-style coaching can initially provide necessary motivation and tools to seek a higher level of care. One father explains:

A Note of Gratitude

Our family was first "introduced" to Joanna in 2007 by a prominent national expert in the treatment of eating disorders who was impressed by her keen insights and message of hope. The introduction could not have come at a more sensitive or critical time for us. Weeks earlier, our 19 yr. old daughter had been discharged after a four month stay at one of the premier eating disorder treatment facilities in the country, only to find herself right back in the death grip of her ED behaviors. Despite our collective best efforts, neither we, nor the members of our daughter's "treatment team," which included several of the best medical doctors and other health care providers our local community had to offer (a psychologist, internist, psychiatrist, nutritionist) could "convince" our daughter of the criticality of her medical condition or the urgent need for her to seek immediate in-patient care and support. We were, however, able to get her to pick up the phone and call a very special young woman (Joanna), who we thought "might be able to help." Two weeks later, they met in person and within 3 weeks our daughter took the initiative to seek the in-patient care she desperately needed - a decision that likely saved her life.

I'll never forget what our daughter said to me after she hung up the phone after that initial call: "Dad, Joanna helped me to see things from a completely different perspective. It made a lot of sense." Therein lies one of the many unique "gifts" that Joanna brings to the incredibly complex world of eating disorder treatment. In doing battle with an enemy whose principal weapons are lies, deception and mistrust, it is imperative to have a "coach" like Joanna on your "team" and, more importantly, in your daughter's corner, who, in part, by virtue of her having lived through the nightmare and come out on the other side, is able to provide a knowing, reassuring, compassionate, unwavering and hopeful "voice" in a "language" that only those who have struggled with this disease can "hear" and fully understand. Joanna recognizes a fundamental reality that I believe is too often overlooked in "traditional" treatment models, namely that, for all of their similarities, women afflicted with eating disorders are, at the end of day, unique individuals, who require and greatly benefit from individualized care and attention - preferably from someone who is intent on knowing "their story" and meeting them, with an open and non-judgmental heart, wherever they may be on their life's journey. It is impossible to fully express the level of patience, dedication and unwavering commitment Joanna exhibited towards our daughter over the past 2 years or our gratitude for her support and guidance. I believe our daughter is alive today, in part, because God led us to Joanna's doorstep and established her as a glimmer of hope in what were some of our daughter's and our family's darkest hours.  -A Grateful Dad

For clients who are medically stable, coaching provides an opportunity to build confidence by practicing life in a supportive environment. Coaching assumes that regardless of diagnosis, disease or obstacle, there are unique strengths that each individual can tap into. Coaching is about finding an opportunity that is more compelling than the obstacle at hand. Together with a coach, clients set goals and take very pointed, practical steps forward. The Stonestreet Coaching PACT (Purpose, Action, Commitment, Trust/confidentiality) provides an individualized structure for each client and/or family.
Examples of coaching exercises might include:

A (orthorexia) writes a list of all of the things she has avoided because of her ED: going to lunch w/ colleagues, going to a happy hour networking event, cooking dinner w/ boyfriend, eating Italian with sisters, etc... We tackle the list together. Obviously some of the things I can do alongside A and others are assignments that she will do alone or in mixed-company and report back on. We aren't focused on why these things haven't happened. My coaching role is to give her "permission" to take these risks one by one as "experiments" with high learning value. As we make our way through the list, she not only has a longer list of things she wants to try, but also a longer list of things she in confident in doing again.

B (compulsive overeater, diabetic) has been in therapy for several years and has recently come to realize that his job is leaving him "hungry" and unfulfilled, thus unable to accomplish his weight loss goals and more likely to binge. While continuing to work with his therapist around issues at the current job and within his family system, our coaching work is focused around finding new career opportunities, role playing for interview practice, taking a close look at what did work well within his past work experiences and what changes could be made in his relationships w/ co-workers, boss, work-life balance etc... (the point was not to quit the job or run from a negative situation, but to fully understand what opportunities the change might bring if B also made important personal adjustments). As a result of a positive job change, he is now losing the weight recommended by his physician, participating more fully in therapy sessions, becoming involved in his community and building the confidence to pursue relationships and hobbies that provide additional fulfillment.

C (bulimia, compulsive exercise) completed step down IOP post treatment over the summer and has been coaching for 9 months. She identifies certain times in the semester that she is more likely to over-eat and/or feel threatened by ED. Rather than focusing on what feels "uncomfortable," we make a "progress list" of all of the changes she has committed to over the past 2 semesters. Able to see this visible sign of her progress, she can isolate the triggers that remain without becoming as overwhelmed. What seemed daunting becomes more manageable. Armed with a more specific understanding she decides to set up a meal schedule that she will look forward to and feel confident in during midterms. For this individual, who is medically stable, using her strict meal plan doesn't feel intuitive. Rather than going to a strict plan, she creates a schedule that incorporates certain supportive people, ambiance and the appropriate balance of structure and variety to meet her needs.

D (anorexia/bulimia) made a list of all of her lingering “fear foods.” She has no idea if she likes or dislikes many of them. Together we explore the different items as a sort of science experiment, allowing her the opportunity to notice from a sensory perspective what her reaction is to the food itself. This process reveals many things about the range of foods (associated past experiences, fat/caloric content, image of others eating that food, actual surprise of liking/disliking the taste or texture) that gradually release the power from the food and allows D to determine whether or not she enjoys it. During one of our tasting experiments, D suggests that her life experiences still mirror her experience of food in some ways. She is suddenly involved in so many activities at school, but she doesn’t really know which commitments are fulfilling or important to her. She has said “no” to certain foods for lack of reason and “yes” to certain opportunities, also ignoring her own level of desire and energy. She just feels like she should say “yes” because she can and she doesn’t want to disappoint others on the team, in the group etc… D decides to create a broad-based timeline with some of her longer term goals toward the end. Along the way she identifies certain actions and associations that are consistent with her goals both in the near and long term. She places all of her current activities/responsibilities along the time line. Rather than designating herself a “quitter” by relinquishing several of her commitments, she is able to connect meaning to each of the activities/groups she is involved in presently while allowing herself to let certain ones go. To designate this, she draws meandering trails off to the side of her path and continues forward realizing conceptually that the meandering trails are not failures, but that each plays a part in the learning process, necessary for forward, fulfilling movement.

Summary: The focus of coaching is to allow the recovery process be honest, realistic and sustainable. People that do not ever experience a diagnosable eating disorder do eat in response to emotion and struggle with their body image and the normal pressure and stressors imposed by media, culture, and other internal and external expectations. Recovery doesn't mean that you will never have to face the same challenges that anyone might face on a day to day basis. It simply means that you have your choices back and that you are now able and willing to take responsibility for your choices. ED doesn't decide how you will respond. You get to decide. Transferring the "power" from food, exercise, body, etc... back to self by practicing patience, assertiveness, gratefulness, etc… is a lifelong process.
Treatment is not a conversion experience. It is the acquisition of a new skill set that must be practiced and can always be grown.

How does coaching enhance therapy? Why might both be necessary?

Coaching provides a structured, safe place for individuals to practice new skills, set goals and receive accountability and affirmation. Certain real-world tasks, experiences and experiments that cannot happen in therapy, whether for logistical or ethical reasons, can be supported by a coach. Therapy is critical as it provides a safe place for client process, understanding and growth. Coaching comes alongside and provides the necessary day-in-day-out practice. Together therapy and coaching can sustain client progress. Therapy provides clarity necessary for forward motion. Coaching provides a playground for that motion to be carried out alongside a supportive partner. Hand-in-hand therapy and coaching create an opportunity for confidence to be built and to flourish.

Individual feedback

“I have the logic, but I am scared of the application. Coaching takes what seemed overwhelming to me and breaks it down into smaller, more manageable parts… showing me that changes will not result in chaos.”

“I finally found the miracle I need to get my life back. I never needed someone telling me what to eat or what to do to restore my health. I knew all of those things and probably even better than those lecturing me. I just needed a warm, compassionate and patient person to be with me, listen and provide reassurance as I faced my fears and let down my strict boundaries. In these past few days, I have accomplished more than in the past 5 years.”

“I so enjoyed eating a meal and sharing in that experience… rather than having an uncomfortable conversation about food. Rather than following a regime, I am experimenting with foods I once limited myself from and deciding which ones I enjoy. ”
“If everyone could have the experience we are sharing in recovery coaching, I might wish them the “gift” of an eating disorder. I know that sounds so weird. I just don’t think I could have the depth of insight and life experience in college today if I had not had the opportunity to accept and overcome my eating disorder in the real world. “

“Now today I have rediscovered turkey, beef jerky and real ice cream, and without much anxiety or angst…without even being tempted to add up or feel guilty about the calories. I am truly looking forward to going cheese tasting.”
“Coaching includes me in the process, guiding me according to what I say. Coaching is recovery in action.”

Parent feedback

“Coaching has helped me to let go of my own defenses as I understand what my daughter is going through. I can see her strengths shining through this disease. I am able to give her the gift of looking at her “healthy eyes” with hope instead of fear. She can recognize the difference. “ -Dad

“Coaching recognizes the complexities of being alive… For me, the parent, coaching is so present and smart and helpful. I “save” our words because they seem to save me in particular moments.” –Mom

“Coaching helped mediate the conflict and the unexpected when our daughter came home. From buying groceries to practicing conversations to planning activities, coaching helped me communicate my good intentions with less misunderstanding between my daughter, my husband and I.” -Mom

“It is imperative to have a "coach" … on your "team" and, more importantly, in your daughter's corner, who is able to provide a knowing, reassuring, compassionate, unwavering and hopeful "voice" in a "language" that only those who have struggled with this disease can "hear" and fully understand.” -Dad

What type of certification or credential can we look for when choosing a coach to support our clients in the recovery process? How is the coaching field regulated?

For those interested in the credentialing process as well as ethical guidelines for the coaching industry please visit www.coachfederation.org.

The International Coach Federation (ICF) is the leading global organization dedicated to regulating and advancing the coaching profession by setting high standards, providing independent certification, and building a worldwide network of credentialed coaches. With more than 16,000 professional personal and business coaches representing over 90 countries, the ICF is the voice of the global coaching profession.

Offering 3 levels of certification ACC, PCC and MCC www.coachfederation.org/research-education/icf-credentials/become-credentialed, ICF accepts applications only from individuals who have completed training at a fully accredited institution listed on their website. While there are a variety of programs that offer any kind of coaching certificate you can imagine, ICF provides a gold standard that mandates education, professionalism and experience in our field. The coaching field is flooded right now by people claiming to be "wellness coaches," "sober coaches," "recovery coaches," etc… Among the well-intentioned many lack professional education, adherence to ethical guidelines, and industry specific expertise.

From a personal standpoint, I completed my MA in Psychology and Leadership Studies at Columbia University before pursuing certification from the College of Executive coaching, an ICF accredited institution that only accepts individuals with a Masters or PhD level education. I received coaching hours toward my ICF-PCC level credential while working as an internal coach within an educational organization and began my practice with individuals and families in recovery and/or other types of life transition in 2006. Having personally recovered from an eating disorder, I honor the individual recovery experience and understand the value of having a thought and action partner along this walk back into life...

 The views and opinions expressed in this article are strictly those of the author and are presented without editing. The opinions expressed herein do not necessarily reflect the position or the policy of EDReferral.com, and no official endorsement by EDReferral.com of the opinions expressed herein should be inferred.

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