Welcome to the Holistic Physician Coaching Podcast. I'm your host, Dr. Jessica Singh. This podcast explores physician health, wellbeing, and fulfillment, embracing all aspects of the human experience. Just as in medicine where a single interaction can transform a life, this podcast is grounded on the belief that each coaching conversation has the power to inspire, heal, and bring about meaningful change.

In this episode, I will be debriefing my third coaching session with Dr. Mary, who is a family medicine intern in the United States. The day that I coached her, I was in a really difficult place emotionally. There's this joy that comes when you're trying to become [00:01:00] a parent and trying to have a family or trying to become a mother. It's like there's this delicate time of the month and you're just praying that your cycle doesn't come but when it does, it's like I simultaneously wanna have gratitude for it because it means that I'm healthy and that I have the potential for bearing a child. But it's sometimes really difficult when you've been trying for a while and it's like month after month you're praying that it doesn't come to indicate good news. And so when that happens sometimes it's been taking me by surprise and it's been a bit difficult to try to get excited, try not to get excited and go through that every month. And so I am praying and doing a lot of spiritual practice.

My faith in the Creator is what's holding me through this [00:02:00] because only by the Creator's will will it happen. And so I will do everything that I can and it's really been a lot of spiritual growth. But that being said, I felt grief and I felt like I was on the verge of crying and mourning an event that didn't happen.

 One thing I realized with medicine, especially during residency and just my time practicing, was just that no matter what was going on personally with family, even in global events, as soon as I walked in through that hospital door, it's like none of that mattered in the immediate moment, and all that mattered was just the patient in front of me. And so I am really grateful to medicine for that gift to [00:03:00] be able to see life through the lens of the bigger picture, and still being able to focus on helping the person in front of you.

And so when I coached Mary for the session, that's exactly what happened. I took some time to ground before the session. We grounded together and then it was all about her and I felt a lot of peace and fulfillment being able to hold space and support her as a new mother.

I was really interested for this coaching session with Mary because it was her first time going back to work as a new mom, especially to an intern schedule. And she was off of work for almost three weeks. And it's interesting because I felt like when she started off the session, she seemed put together and there was a word that just came up because when you go back to [00:04:00] work, it's like this environment of needing to survive and not letting your vulnerability show. And so even though Mary had come into the session, authentic, vulnerable, ready to share, I still felt like there was a little bit of maybe not saying the whole picture, and that I just kind of felt in my gut from being with her. And so I had used the word masking like almost as if I felt there was masquerade of what she was really feeling inside. And so I didn't wanna spin it into negative or lead her at all. I just raised that awareness using intuition to help her raise self-awareness of her own emotions that she's experiencing and what's really going on for her.

And I was, you know, it's always really powerful when you raise emotional awareness. And one of the powerful things about [00:05:00] coaching is how it supports our emotional intelligence, because Dr. Mary never had this dialogue of her inner voice of what happens towards the end of her workday out loud.

And so just to even give someone space to follow through on their thought processes out loud in front of someone who's just listening to them without judgment, she was able to then follow through on the thoughts that she was having, realizing how one was leading into another, and also reframe herself, which is utilizing her own strengths and her own gifts and her own inner wisdom. Before the session, I did look through the International Coaching Federation's PCC markers, and so Associate Certified Coach through the International Coaching Federation, they [00:06:00] have certain criteria and competencies and although I'm an Associate Certified Coach, I am working towards becoming a Professional Certified Coach, and they have different markers and competencies.

And so before my coaching sessions, I review these because I feel like it helps ground me and be a better coach.

 One of the things that's been tricky for me with coaching that I've figured out more my style now that I've been doing this for a while is when someone... so for instance, I have training in yoga, mind body medicine and a technique called integrative guided imagery.

And so sometimes during coaching sessions, especially if the coachee, the thinker is receptive, it is fun to get out of the mental framework, which is the place we're in most of our day, and harness that mind, body, spiritual connection. The thing that [00:07:00] gets tricky is how do you do this in a way without guiding, directing, or leading? Because anytime there is an activity introduced or an exercise or even a meditation, think of grounding and centering at the beginning, there's someone leading that, there's someone guiding that. And so ways that I found to make this more coach-like are one to ask permission: ask permission to offer to share an activity. And with that offering permission, make sure it's clear to the coachee or the thinker that they can say no if this activity or meditation doesn't resonate with them, and they like to go a different direction. Another thing that I like to offer is also for them to make it their own.

It's just like asking questions as questions evolve in the moment based on what the thinker is saying, and then they say, "did you mean this?" Or they try to clarify the question. I will [00:08:00] co-create the question with them. And so sometimes co-creating an activity and customizing it to the thinker also makes it more of their own and puts them in the driver's seat.

In this case, I had asked Dr. Mary if she would like to verbalize that dialogue she was having inside out loud. And for her, she found it was beneficial and helped her self-discovery process.

And I did integrate reframing into the activity to help her see how her self dialogue may change. Again, this is a little tricky to do this. It's an art to do this without feeling like you're guiding or leading the conversation, and so it's really picking up cues from the thinker and helping them shift from their state of thinking into a new state of thinking that they haven't gone to before.

[00:09:00] Similarly, talking about guiding, at the end of the session, I found myself having to self manage a little bit because when we were reviewing how she could prepare for those longer days, if there's anything she could have done to help support herself. She had talked about preparing mentally, and that was so important, and I'm not sure if it was just from having been there and learned the hard way, just like she is, I did ask her if it was okay to give some suggestions of she wanted to bring more food with her or check in more with her family. And if it's appropriate and forget about the competencies, if there's something we do know just from having been there, that may be a value to the thinker, it's really [00:10:00] up to us, each coach, to decide when it's appropriate and how often to do this if we do this at all. I don't think it should be frequently because then it kind of reinforces an expert role, but at the same point in time it really is helping to add value and a way to find that out also is to ask the thinker if it adds value.

And so in this case, I know Dr. Mary had valued the food suggestion. I always have a soft spot, especially for residents and food because it's amazing to me that they work such long days and are expected to perform at optimal levels at all times of the day, and yet maybe they'll get one solid meal if that during their shifts.

And even that one solid meal they get, are they even like talk about mindful eating? You know, it's usually while in conference [00:11:00] or while looking at charts or doing something else. It is possible to take a break for a few minutes sometimes, but usually it's really hard to advocate for yourself that way.

And so for Mary, it was really about changing her expectation and having the shift be at the thought level. And as that naturally follows, once the shift in perspective changes at that mental thought level, it does trickle down into everything. And so even though at this stage she did come up with the mental preparation, by changing this perspective as she practices it, there might be more other different types of preparation, like the physical preparations or getting food or checking in more that she will come up with herself in her own way. And so it's important to acknowledge and leave space for that.

Another thing that is difficult about coaching sometimes is the [00:12:00] self-management. At least when I first started coaching I had to self-manage more. Now it's more natural, but obviously there are topics and things that happen in medicine that I'm also very passionate on and agree with the people I'm coaching, usually that the system is, a lot of components of it don't really allow for healthy human life or even processes of life, natural processes of life that should be celebrated, like having a baby and embracing motherhood. And so it's interesting 'cause I feel like on the one hand I am observing and being there for the coachee, for the thinker, especially as Dr. Mary in this session and in previous sessions had shared so many of her concerns about not wanting to work, wanting to be there for her child, not wanting to be perceived weak at work or less interested or be penalized in any way because she wants to embrace [00:13:00] motherhood.

She had done a lot of powerful reframing herself: stating that residency is temporary and it's a short time; reframing the fulfillment she gets from work and caring for her patients when she knows at that time that's where she's needed. And so I didn't go here to this place of even suggesting that when life gets so busy another thing that I found that a lot of mothers do, a lot of family members do is really optimizing the quality of time rather than the quantity of time. But that I did self-manage myself because I just, I didn't want to try an expert role on something I'm obviously not an expert in. I'm not in her situation. She is. She is very much the expert.

And so if that phrasing or wording comes, it should come organically as a thought process from her. [00:14:00] And so I'm leaving space for that unless it naturally comes up in a coaching dialogue and you know, reframing or reflecting happens in such a way that, that sentiment comes out. But it's really hard when you agree with what the coachee is thinking and how challenging it is. And would she be wrong for just saying, "Hey, maybe medicine isn't for me. I wanna embrace motherhood and do other things." Absolutely not. And because you don't know in medicine, you don't know what medicine is going to be until you get there, which is more than a decade from when you say "Hey, I wanna be a doctor" for the first time.

it's no secret that the biological age of physicians by the time we have children usually it's much later than a general population. And so, the fertility is difficult for medicine. It's known that there's increased rates of pregnancy complications in physicians. And so [00:15:00] being an advocate for your own health in a system that's not going to advocate for you is extremely difficult. And the first eight to 12 weeks after giving birth, there's also a higher risk for postpartum depression. So it's so important to really have support and even figure out what that support is.

My final point for debriefing this episode is I realize that I'm saying this phrase, can you tell me more about ...? more frequently than I realized and I had a mentoring session and I realize that that phrase may not be the most effective because, can you tell me more about dot, dot, dot invites the thinker to tell a story versus can you tell me more about your experience that you'd like to explore in this coaching session?

A simple rephrasing of that question really helps it become more relevant. [00:16:00] And so I feel like I could have set the agenda for the coaching session better, a little bit more efficiently, even though everything I think worked out. Dr. Mary had said that her goal was to find ways to not feel very low with an extremely long day away from the house. And maybe I could have asked her right then what she would've considered being successful, to further clarify that goal. For instance, what would not feeling very low look like and how would she know she's achieved her goal? And so I am working on changing long-term habits, and I am very grateful for this opportunity to just reflect openly.

And so my takeaways for listeners are a couple from this debriefing episode. One, to really have that [00:17:00] honesty with yourself emotionally and check in with what's going on in your situation as we coach our clients, because without that, there's no way to even know what biases, if any, maybe coming into the coaching session.

It's so important, in order for us to help our clients, foster self-awareness. I really feel like we have to have that within ourselves because it helps us be present, ask better questions, do things in more of a coaching way, strive to be the best coaches we can by really empowering the person we are coaching to be the expert in their lives.

The final point for debriefing is, and this is the hardest one for me at least lately, the one that I'm working on is to be more mindful of specific phrases that I am using. And just because they're working like, can you tell me more about doesn't mean that they are the best questions and I didn't even realize that it [00:18:00] wasn't as effective as it could be. I thought I was just doing this wonderful thing of providing space until receiving mentorship. So continuing professional development is not easy to look within and realize that we maybe having these patterns that just a, they're not serving us and they're also not serving our clients.

I am an advocate for seeking professional development and coaching, whether or not it's required for re-credentialing and it should be done just as regular practice to continue to strive to improve.

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