American Association for Physician Leadership

THE COACH’S CORNER: The Voice in Your Head

Robert Hicks, PhD


Sept 1, 2022


Physician Leadership Journal


Volume 9, Issue 5, Pages 60-61


https://doi.org/10.55834/plj.5055089078


Abstract

Every coaching conversation has two parts: the one you have with the other person and the one you have with yourself. The conversation with yourself is known as self-talk. Simply put, it is the voice in your head. When you allow that voice to dominate your attention during a coaching conversation, you direct your mental energy inward, reducing your connection to the person you are helping.




Of course, I talk to myself. Sometimes I need expert advice.

– Anonymous

Every coaching conversation has two parts: the one you have with the other person and the one you have with yourself. The conversation with yourself is known as self-talk. Simply put, it is the voice in your head. When you allow that voice to dominate your attention during a coaching conversation, you direct your mental energy inward, reducing your connection to the person you are helping.

Self-talk is natural, but its value is determined by the type and the amount of self-talk. When the voice in your head becomes the voice of judgment — critical of others or yourself — it impedes your ability to help. Consider this example:

Dr. Rajiv is a 42-year-old internist. He prides himself on his analytical skills, which enhance his differential diagnostic abilities. He also likes to use his rationality to appraise a situation and points out flaws inherent in an idea, a plan, or a proposed solution. While he sees himself as analytical, his peers describe him as a nitpicker, overly critical, and always challenging their thinking.

Dr. Rajiv had been the medical director for his hospital’s telemetry unit for about a year when he requested some “leadership” coaching. When asked why he was reaching out for help at this time, he said that his boss, the chief of medical services, was critical of his ability to develop some of the younger physicians in the group and was questioning his leadership skills.

Dr. Rajiv was asked to describe some of the developmental conversations and what he thought about during those conversations. It turned out that he wasn’t listening to what was being said; rather than attempting to understand others, he was judging what they were saying.

Judging often results from a dichotomous thinking process, e.g., things are good or bad, right or wrong. We perceive the world in binary terms with no nuance or shades of gray and consider ourselves the arbiters of truth. Dr. Rajiv could not develop younger physicians because the voice in his head judged the people he was trying to help.

Judging and coaching cannot coexist. Humanist psychologist Carl Rogers believed that our ability to help others depends on our ability to withhold judgment regardless of what the person says. In his 1957 Journal of Consulting Psychology article, “The Necessary and Sufficient Conditions of Therapeutic Personality Change,” he called this “unconditional positive regard”: showing complete support of the person we are helping, whether they express “good” or “bad” views.

Withholding judgment and maintaining unconditional positive regard does not mean agreeing with everything the other person says. It does mean that you do not allow the judging voice in your head to capture your attention and prevent you from attending to the other person in a way that fosters acceptance and understanding.

Tyranny of the Shoulds

The voice in your head that judges others does not discriminate; it also judges you. These self-judgments take the form of “shoulds” and can be so disruptive that they are often referred to as “the tyranny of the shoulds.”

Suppose you just had an uncomfortable conversation with a colleague, and it’s nagging at you when you sit down for a coaching conversation. As you try to listen, your attention is distracted by the voice in your head that says, “I should have handled the situation differently, but I didn’t, and look what happened.” You begin to feel upset and guilty about what you should have done, and the distraction limits your ability to help someone else.

Here’s another example: You are a speaker at an upcoming conference but haven’t begun to prepare your presentation. The voice in your head says, “I should be working on my presentation, and I’m way behind. If I don’t start soon, I won’t have time to do a good job, and I’ll embarrass myself.”

You have just been inflicted with the tyranny of the shoulds. When a disruptive should (and its variations like must and ought) is directed inward, it can bring about feelings of guilt and self-reproach.

Contrast that with what happens when you stay disciplined and put your energy into understanding the other person’s perspective and eliminating judgment. It allows you to hear what the other person is saying and understand that situation or point of view, which are prerequisites to coaching. Preventing the voice of judgment from grabbing your attention requires mental discipline and effort, but that is a small price to pay for control over the voice in your head.

Summary

Giving 100% of your attention to the person you are coaching is critical. Many distractions compete for your attention; the biggest distraction is the voice in your head. While self-talk is natural, it can become disruptive to the coaching process when it is the voice of judgment. Judgment interferes with understanding and disconnects you from the other person.

The voice in your head can be the critical voice that judges others or the self-judgment that occurs when the tyranny of the “shoulds” dominate your self-talk. Either form of judgment is counterproductive. Fortunately, just as working out with weights builds muscle, practicing mental discipline can control the voice in your head.

Robert Hicks, PhD

Robert Hicks is a licensed psychologist, a clinical professor of organizational behavior, and founding director of the Executive Coaching Program at the University of Texas at Dallas. He also is a faculty associate at UT Southwestern Medical Center and the author of Coaching as a Leadership Style: The Art and Science of Coaching Conversations for Healthcare Professionals (2014) and The Process of Highly Effective Coaching: An Evidence-based Framework (2017). robert.hicks@utdallas.edu

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