What Does It Mean to Get Better?

There’s getting better, and then, there’s getting better.

Getting better in the sense of feeling better is not the same as getting better at tennis.

When a friend gets sick, we hope he will be getting better. When a star athlete wants to get better at his game, he is not just looking to feel better.

Therapy has been derived from the medical model, so therapists tend to think in terms of whether or not their “sick” patients are getting better. They aim at improved health and functioning.

This assumes that people who consult with therapists are really sick and that once they “get better” they will return to normal functioning. If these patients never functioned normally, therapists tend to believe that insights into the root causes of their condition will help them assume normal functioning.

Atul Gawande does not quite put it this way in his great New Yorker article about coaching, but he shows clearly that coaching differs radically from therapy.

As a surgeon Gawande felt after eight years that his technique had plateaued. So he hired a coach, a retired surgeon who would sit in on his operations, would observe what he was doing right or wrong, and would help him to improve his performance.

Perhaps it’s a sign of something afoot in the culture, but Gawande does not think that his surgical technique has not been improving because he has a mental block, an unresolved infantile neurosis, or emotional issues.

He does not think therapy; he thinks coaching.

He remarks that all great performers have coaches. From Rafael Nadal to Itzhak Perlman to Renee Fleming to all manner of executives… people who want to improve their performance hire coaches.

Based on his own experience of being coached in surgery, Gawande offers some cogent remarks about what a coach does and why it is difficult for people to accept coaching.

In his words: “The concept of a coach is slippery. Coaches are not teachers, but they teach. They’re not your boss—in professional tennis, golf, and skating, the athlete hires and fires the coach—but they can be bossy. They don’t even have to be good at the sport. The famous Olympic gymnastics coach Bela Karolyi couldn’t do a split if his life depended on it. Mainly, they observe, they judge, and they guide.”

Coaching comes to us from sports, from a highly competitive field of human endeavor. It does not come to us from the clinic.

Gawande compares coaching to teaching, not to therapy, because it works to help you improve your skills, not to gain into insight into why you don’t have any.

If you have a teacher, you are a student. Gawande points out that the role of student is time-limited. At some point you graduate and no longer have a teacher.

Coaching, however, is a longer term commitment. The better you get the more you need the services of a coach to help you to get better.

Once we get good at something we tend to bask in our glory. Why work to improve performance when we are enjoying the fruits of success?

A coach is an objective, outside observer. Therein lies the rub.

It takes a good sense of humility to accept that the way you think of yourself is not the way others see you. And it is very difficult to accept that someone else sees something other than what you think you are showing the world.

You may think that you are an effective and accomplished surgeon. Your confidence is based on your sense of your own competence.

When your coach reviews the flaws in your performance, you need to be humble to accept what you are hearing.

This is even more difficult for those who have learned from their therapists that they should not care what other people think of them.

When therapists tell you that you should only care about how you feel and how you express your feelings, they are consigning you to mediocrity.

Being susceptible to coaching requires that you accept how you look to other people and are willing to take whatever steps are required to improve your performance.

Dr. Gawande was not aware of the bad habits he acquired while honing his surgical skills. Athletes often do not know what they are doing wrong. Renee Fleming explains that you never know how you sound when you are singing.

Therapy looks at these problems from a different angle, inside/out, not outside/in.

For most of its history therapy has addressed how you feel about how you feel. It is an introspective exercise that is supposed to allow you to discover what is lurking and hidden in the recesses of your mind.

If it derives from Freud, as most talk therapy does, it will provide a means to correct those errors by a type of penance, usually in the form of self-criticism.

I have in the past related this technique to a culture based on guilt.

Coaching has a different cultural root. It has nothing to do with how you feel about how you feel, but about how you look to an outsider while performing or behaving.

A coach is primarily an observer, someone who sees the faults in the way you are playing the game and prescribes ways to overcome them.

Since a coach sees things that you had successfully managed to hide even from yourself, the experience of hearing a coach’s observation has more in common with shame than with guilt. It is, as I said, a humbling experience.

If your narcissism has been fed a steady diet of therapy, you will very likely have a great deal of difficulty accepting anything offered by an outside observer.

The more your mind has been worked over by therapy, the less you will be able to accept advice.

Thus, therapy consigns you to mediocre performance.

Note well, coaching does not involve criticism. It involves advice.

It does not aim at mental health but at excellence. Gawande explains it well: “Expertise, as the formula goes, requires going from unconscious incompetence to conscious incompetence to conscious competence and finally to unconscious competence.”

When famed basketball coach John Wooden taught his players the correct way to put on their socks, he was not criticizing them or their mothers. He was pointing out that peak athletic performance involves getting the small things right, especially, as Gawande notes, because putting your socks on wrong can spell injuries for basketball players.

The larger question, the one that is not in Gawande’s purview, is how much of what goes wrong in life is a matter of poor performance and how much is a matter of a lack of insight.

If you want to be a better husband, is it more important to mull over the forces that are making you a bad husband or to work with a coach to improve your performance as a husband?

If you are falling down on the job, do you need to gain more insight into your self-destructive tendencies or do you need how to develop better work habits?

If you are not succeeding at your career, do you need to understand why your father did not want you to succeed, or should you ask whether you are really suited for the career you have chosen?

And what if you want to be a better parent? Should you try to discover what there was in your upbringing that prevented you from being a good parent or should you think of parenting as a performance and allow someone else to observe what you are doing right or wrong?

If you don’t have very many friends, should you seek out the root cause in your past or should you ask an objective third party to observe the way you behave in social interactions?

The same applies to relationships, dating, and a myriad of other human activities.

Are people suffering from what are called emotional disturbances because they do not know how to behave or do they have psychological impediments that are preventing them from getting better?