Absolutely not. While I’m impressed with the power of coaching, I’m still a firm believer in therapy. I’ve practiced and had traditional talk therapy, and though I’ve found it to be helpful (for both myself and others), I’m convinced Tapping (a unique form of therapy) can do more and do it faster. By choosing to engage in Tapping, you acknowledge that you seek to confront the difficult and likely painful experiences that lie at the core of the problems that brought you to treatment, and the unfair or unproductive thoughts and beliefs that have contributed to the difficulties you are currently experiencing. Like many other therapies, Tapping may stir up difficult emotions such as grief/sadness, anxiety/fear, anger, shame and guilt. At times, Tapping may bring about a realization that a previously unresolved issue or long forgotten experience may contribute to your current situation. The process can include change, which may take unexpected forms and feel threatening not only to you but also to those people close to you. The prospect of giving up old habits, no matter how destructive or painful, can often make you feel very vulnerable.

A client is the person engaging with me in coaching or therapy. A sponsor is the person or entity covering the cost of the engagement, if the client is not paying themself. A sponsor is most often an employer. In any case, as my relationship is with the client, my priorities are for and responsibilities are to the client. Sponsors understandably often want particular outcomes, which are far from guaranteed. Before starting the coaching engagement, the client, sponsor, and I all must agree on expectations and understand the requirements and limits of confidentiality (e.g., I would share information with the sponsor only with the freely given consent of the client).

Because this is not a psychiatric practice, I do not treat severe mental illness despite being fully trained to manage those conditions myself. People with certain conditions (bipolar disorder, major depressive disorder, schizophrenia) or people whose conditions from time to time necessitate inpatient psychiatric treatment are required to be under the care of a psychiatrist whose practice includes prescription of psychotropics or (as may be required) who is part of an interdisciplinary team, the whole of which can provide the necessary support. Clients who experience destabilization of a psychiatric condition during coaching will have coaching suspended until their psychiatric provider(s) and I find them stable enough to proceed with enhanced coaching. Similarly, if while working together I determine that the client has a previously undiagnosed mental illness, I may suspend coaching until the client receives the appropriate treatment and all parties (the client, new provider (psychiatric prescriber and/or therapist), and I) agree that coaching can proceed. Not engaging in recommended psychotherapeutic or psychopharmacologic treatment may result in suspension or termination of the coaching engagement.

Coaching + therapy clients should consider me a therapist. Interventions such as tapping and Hacking Reality are considered psychotherapy by the Massachusetts Board of Registration in Medicine, and the International Coaching Federation does not endorse (though does not prohibit) coaches also treating people in psychotherapy. The client determines whether to engage in conventional leadership coaching alone or to combine it with therapy. In our work together, I will carry all the responsibilities a therapist. I am required to take specific action (including sending someone to an emergency department against their will) if I think someone is a danger to themselves or others or is unable to provide for their own protection in the community. I am also mandated to report suspected child or elder abuse. As a therapist licensed only in the Commonwealth of Massachusetts, currently I can only work as a therapist with people physically present in Massachusetts.

Therapy can have the reputation of the therapist telling someone what’s wrong with them and what to do. The therapy I do is called tapping. Unlike traditional therapy, tapping is intended to be time-limited. I never tell people what they should do, so people should not look to me to fix them. As a coach, I start by helping clients understand themselves better and unearth things they on some level know but may not want fully to know or completely to accept. I ask permission to make observations that the client then tries on for size. I also share information and knowledge, not to direct, but to provide additional material for decision making. When we are at the point of figuring out what to do, I ask the client to generate options. If there is something I think may be an option that the client has not already considered, I ask permission to share. I may help them work through the advantages and disadvantages of an option, but in the end, the decision is theirs. Whether working with people as a coach or therapist coach, my goal is that I eventually make myself unnecessary by helping them develop the insight and skills that will carry them forward.

One way to distinguish coaching from therapy/counseling is to view coaching as future-focused while therapy/counseling directs you to examine your past. I would add that coaching asks you as the client to consider what you can do in the here and now to manage whatever past events may be hampering your progress, whereas therapy seeks to heal old wounds. In consulting, the client expects to receive an analysis of the problem, a breakdown of the options, and a recommended set of actions to take. The consultant is the expert. In contrast, with coaching, you are the expert in yourself and your life; the coach helps sharpen and broaden that expertise. That’s why coaches don’t have to be experts in or even know a good deal about their clients’ fields. Mentors have “been there and done that.” Based on their experience and connections, they guide their mentees by advising and facilitating relationships. Coaches don’t need knowledge of the client’s field or area of business; they help the client develop the strategies and seek the resources that will help them move forward. People are people, and as a psychiatrist, I know about people and relationships.

Tapping is a practice derived from traditional Chinese medicine, which holds that energy travels through the body in certain lines or meridians. Blockages of this internal energy at certain points cause distress, which can be alleviated by tapping on these points (acupuncturists use needles). On its most superficial level, tapping can dissipate the negative energy associated with an experience or set of thoughts. Under my direction, what you do is tap on certain spots as you talk about what is bothering you. Tapping this way on its own can provide effective stress reduction for some. At a deeper level, tapping can help you release the stress and negative energy you may be holding and reframe the situation or reinforce a healthier perspective. The work that is needed to engage in tapping on this level is an exploration of what you are thinking and feeling and a readiness to experience difficult emotions so that tapping can help you release them. At its deepest level, tapping with Hacking Reality involves tapping on a younger self who is in distress. I use the present tense deliberately as Hacking Reality requires you to accept the propositions that all things are happening at once, that what we experience as our past is still a present experience for our younger selves, that those younger selves have an effect on us, and that we can have an effect on them (and therefore our current selves) for the better. By engaging with our younger selves, we can unlearn what we absorbed from those hurtful experiences and rewrite a better perspective for our younger and present selves.

Going to the equivalent of Merriam-Webster, I’ll start with the International Coach Federation’s definition of coaching: “Coaching is an ongoing relationship between the professional coach and the client, which focuses on the client taking action toward the realization of their vision, goals or desires. Coaching uses a process of inquiry and personal discovery to build the client’s level of awareness and responsibility and provides the client with structure, support and feedback.” ​As a coaching client, you are capable and responsible. You discover and generate your own solutions, the ones that will work best for who you are and the situation in which you find yourself. My questions are designed to be thought-provoking and perspective-shifting. If requested, I will offer information, feedback and suggestions for you to consider. At all times, you’re in the driver’s seat, and you’ll become increasingly aware of the choices you are making (even when it comes to word choice and the powerful impact that has).

No. Insurance doesn't cover coaching.

I do not promise outcomes because outcomes aren’t fully in my control. Only the client can control the client. My promise is to be fully present with my clients, to listen attentively and to think deeply. As I learned early in residency, “you can lead a horse to therapy, but you can’t make him think.” Whether clients choose to open their minds to new perspectives, to use a skill they learned, or to leave their comfort zones for a growth experience is completely up to them. I’ve known people who have been through coaching (or what seems more like finishing school for C-suiters) only to relapse back into old patterns of behavior.

In my career in inpatient psychiatry, I have seen medications (and other interventions such as electroconvulsive therapy) work wonders because some biochemical imbalances can be fixed only by meds (bipolar disorder or schizophrenia, for example). My interest now is to work with those conditions that do not require medications. Indeed, I have seen medications often prescribed for conditions where the core issues are psychological and where confronting hurts from the past is an essential (and unfortunately unacknowledged) element of treatment. As psychologist John Welwood put it, “apart from a few biochemical imbalances and neurological disorders, the diagnostic manual for psychological afflictions, known as the DSM, might as well begin, ‘Herein are described all the wretched ways people feel and behave when they do not feel they are loved.’” My work now is to help people fix themselves.