If you are in psychotherapy and are facing a performance situation you might talk with your therapist about a few sessions of coaching with Dr. B.

Here’s the story of Edward who had test anxiety. Edward’s therapist referred him to Dr. B for a series of coaching sessions. This appeared recently in the newsletter of the Alameda County Psychological Association.

Performance Coaching: An Adjunct To Treatment
by Ben Bernstein, Ph.D.

Recently I was referred a 45 year old man, I’ll call him Edward, who was preparing to take a civil service examination for the third time. Edward’s therapist made the referral. They had been working together for almost six years and over that time Edward had twice failed the test miserably because of “severe performance anxiety.” The therapist was looking for a resource, as an adjunct to Edward’s on-going therapy, to address the test problem.

In addition to doing individual psychotherapy, my work as a psychologist is also as a performance coach. I am often referred clients by their therapists to work on specific performance-related issues: a test; a speech; a job interview; completing a book; an athletic event; a political campaign.

When Edward came for his initial consult with me he was visibly anxious. His hands shook, his breath was erratic, his shoulders chronically tense. Often he stopped breathing until he was forced to gasp for his next inhalation.

Over the next three months I trained Edward to use the performance model that I’ve developed through twenty-five years of clinical work and teaching. I began by talking with him about the relationship between stress and performance, showing him the Yerkes-Dodson bell curve which graphically represents what happens when stress is too high or too low. In both cases, performance suffers. My work, I told him, is to train people to keep stress at a level which optimizes their performance. Athletes sometimes refer to this as “the zone.” We also talked about stress itself. I think of it as a function of disconnection. Our existence is, ultimately, all of a piece, everything is connected. I like how Einstein put it: separation is an optical delusion. On the individual level, when we get disconnected in body, mind or spirit we experience stress. The performance model trains clients to look inside for the source of stress, not point the finger to everything around them. In this way clients learn to take responsibility for their own experience.

Next, I introduced Edward to the performance model itself. I illustrate it with a three-legged stool, which came from my discovery that performers in any field who are consistently successful over time display three qualities: they keep themselves calm, they remain confident and they stay focused. Each leg of the stool represents one of the qualities. The model of the stool is useful because when all three legs are strong the stool is a sturdy platform (elephants stand on it at the circus). But when one of the legs gives out it pulls the other two with it and whole structure is destabilized. The value of the physical model of the stool is that it also represents the dynamic relationship between body (calm), mind (confidence) and spirit (focus). To perform successfully you want all three legs to be equally robust.

To give Edward a snapshot of his three-legged stool I had him complete a performance inventory that I developed with a research psychologist seven years ago. This ten item self-diagnostic tool enabled Edward to see that his strongest leg was focus, his weakest calm, and his confidence was between the two. In discussing Edward’s scores he realized that when he lost his ability to stay calm it affected his confidence and focus negatively.

The rest of the work together was a training in awareness and tools. Awareness of when Edward was disconnecting in body, mind or spirit, and tools to get himself back on track. There are nine core tools in the model, three each for staying calm, confident and focused. I have culled and distilled them from the best teachings of physiology, psychology and spirituality and my own work in education, theater and guided imagery, and I present them in a format that is easy to understand and use. For Edward, learning to stay calm by regularizing his breathing, grounding himself, and opening his senses (the three tools for staying calm) gave him the stability to study and to take the test in a wholly different way.

Over the course of the work together Edward’s therapist and I had minimal contact. This was his preference. He felt that it was good for Edward to have an independent consultant, a coach, to help him through this specific process, and in this way Edward’s working through the transference with him could retain its integrity. Edward went on to pass the test and his work with the therapist continues. He comes to see me periodically for “tune-ups,” as he calls them.

Serving as an adjunct to treatment can take various forms. For example, last year I worked with a child who had to take a math test for entry into a select middle school. The child was being treated for a diagnosed learning disability in mathematics. As we worked through the model I saw that the child (through watching her in play therapy-type exercises) was afraid of speaking up when she didn’t understand something. When she learned to take a deep breath (calm) and say “I don’t understand this” (confidence) she was able to stay with the task and get the help she needed (focus). She took the test, got the requisite score, was accepted to the school, and no longer needed intensive special tutoring in mathematics.

Keeping the door open for the referring therapists to give me input, or for me to provide information to them, works well. We all agree that some of our clients are best served by a select combination of modalities. In this way therapy takes on a broader, collaborative and collegial spirit for our clients, and for us as well.