Once upon a time I was involved in designing clinical trials to estimate the benefit or efficacy of various types of medical interventions. One of the strategies we deployed, as well as one of the trickiest issues to deal with, was that of the placebo and the placebo effect.
At the back of my mind I have started to reflect on the placebo (expectancy) aspects of business coaching.
When many people hear of placebo they recall tales of sugar pills, deception and "playing tricks with the mind." This stigma is really misplaced and you will see that this well-researched effect, along with the Hawthorne and other expectancy effects, has surprising relevance to many human interactions.
Based on the Latin for "I shall please," placebo in medicine takes many forms and has indeed been offered as a sugar pill, a saline injection and distilled water. We have also seen placebo surgery where patients are anesthetised, cut open and stitched up again to appear as if they have had surgical interventions - even when they haven't - and all with beneficial effect. How many times have you heard sceptics dismiss responses to complementary and alternative therapies as "merely" placebo effects? They need to think again. There are deeper forces at work.
However, whether in the past you have considered the effect a curiosity, a scientific annoyance or a miracle, its power is becoming much harder to deny. Now you have certainly heard of this idea and you may well have thought that it only works because the person receiving it doesn't know it's really a placebo - but it actually works because of belief.
Science is showing that the placebo effect is not just all in the mind. In fact both the mind and the physical body are affected. When you really think about it, patients affected by pain and debility, beyond seeking a lotion or potion, look to doctors and allied health professionals for the words, gestures and deeds that reinforce their belief in medicine's power and generate an expectation that we will benefit from an intervention. In other words they generate and transfer belief. See any subtle relevance to coaching yet?
Belief, attitude and expectation - perhaps we could label these as "hope" - can be firmly embedded and shaped by the encounter between a patient and the universe of care they receive. A change in the mind-set or attitude of a patient alters their brain chemistry, which in turn has a catalytic effect on many other body systems. Hope is the leverage that can start a cascade of physical effects making improvement much more likely. Hope produces an effect that can, for example, block pain by releasing endorphins and enkephalins that in turn influence fundamental processes such as respiration, circulation, elimination and motor function.
Research in treating depression suggests that the placebo effect might account for up to one third of the clinical benefit of modern antidepressants. Some authors claim an even stronger improvement. If you are a coach are you starting to wonder if one third of your effectiveness comes via a similar channel? Do you see the effect you have on your client's state?
In clinical science we are posing a question these days:-
"If now we accept that placebo is real - how can we harness this power and really direct it in clinical situations to support our other strategies?"
As a business coach I pose you this question to reflect on:-
"If now we accept that placebo is real - how can we harness this power and really direct it in coaching situations to support our other strategies?"
Another way of asking this question is how do we generate powerful belief in a coaching relationship? The issues to deal with before getting down to work are face credibility and contractual expectations. Get these right in order to stack expectations in your favour and then all(?) you have to do is deliver.
Face credibility
There is no doubt that the coachee will consciously interpret the background and experience of the coach. Who the coach has worked with before will count for something because it builds or destroys belief. Testimonials build belief and are the basic currency of coach credibility. You might say that what really counts is when you are face to face. However, the contractual issues and clarity of expectations need to be right or life is going to be difficult from the moment you sit down together.
Contractual expectations
One of main distinctions often made in business coaching is between remedial coaching and performance coaching. In either case, it is vital to make sure that a coaching assignment will really be at the coachee's behest. Have you ever tried to change the behaviour of an adult, successful or not, that didn't want to change? How successful were you? Probably not very!
Some might argue that the techniques a coach might use are probably the same, so why bother to make the distinction between remedial and performance coaching?
Whoever is paying the bill, it is absolutely vital that the coachee desires to work with a coach. It's a question of belief and expectation and you already know that these things have real power. If the frame of reference provided for coaching is "I need to be fixed" or "I am being punished and I can only see this as a kick before the eventual push out the door" the outcomes from the process are not likely to be measured using the descriptors of exceptional performance. If the mindset of the coachee is firmly fixed on "I have a problem" probably the expectations for the coaching process are going to be limited. It's the reason that placebo works well with conditions like pain or fatigue that are often non-specific. It's easier for an individual to build belief in these circumstances than with a broken limb or cancer.
To me, a lot of the power of successful coaching is not at all in the surface detail. The magic is not about whether a coach asks the "right" question, listens intently or follows some particular process; although of course these things do have value.
With a coaching master, there is an awful lot of power in things that don't smack of technique and probably wouldn't even be grasped by a casual observer. The coach always works with his or her own state, gets his or her ego out of the way and will aim to simply "be fully present", to fan the flames of brilliance in the coachee.
In learning this attitude from Michael Breen I saw a parallel with the martial arts where mastery is in a space beyond conscious technique.
I do like to work with people who are already high performers and my intention and state will be "how I can have the biggest impact right now?" Whether we sit together for five minutes or fifty I must trust myself to really make a difference. If I am the placebo the attitude and belief start with me. Without that attitude the spark of real transformation is missing. I suspect that more than a third of the benefit of coaching can come from the attitude and mindset of the coach.