International Teaching Seminars Blog

A professor of dentistry once gave me a tip about the best time to visit the dentist. “Ideally you should go soon after your dentist has just seen their dentist. That’s when they are going to be most aware of what it’s like being a patient – and what a patient needs.”

The secret of having a good bedside manner is just this - to put yourself in your clients’ shoes. In this way almost anyone can enhance their bedside manner.

First though imagine this scene. Let’s say you go to see your health professional. You arrive at their practice premises. The support staff don’t pay you much attention because they’re all very occupied with other business. When you do get their attention they are curt and you feel like you’re trying their patience. So the way you feel will already have been affected - and you haven’t even seen the practitioner yet. In the NHS it’s no coincidence that a doctor’s key frontline staff who mediate between patients and doctors are sometimes referred to by both patients and staff as ‘dragons’!

Bedside manner then begins with the practice ambience. Whether you work on your own or with others their will be a practice ambience. So what is it? The best way to find out is to ask your clients/patients what it’s like for them.

So often when clients speak in glowing terms of a practitioner they speak not of the person’s professional skills – these are presupposed – but of how they felt with this person. “He really understood me… It seemed like she had all the time in the world for me…I didn’t feel hurried…She always looks me in the eye… He advised me and then allowed me to decide.” In a nutshell, feeling acknowledged and that someone cares and has time for you lies at the heart – and I do mean the heart – of the best bedside manner.

So consider for a moment, how would you describe your own bedside manner? Would you like to be on the receiving end of it? Who do you know who does it really well? If in doubt ask colleagues and clients. Consider who is most popular patients? I often ask practitioners to find three such role models of excellence and to really get to know how they do what they do. There are so many styles to choose from.

Bedside manner isn’t time consuming. It can be achieved quickly even with a busy schedule. First impressions are critical. It only takes a moment to be put off someone and for that impression to then colour what ensues. Equally you can set the tone in those first few moments by coming across as real, caring and available. How you do this varies from one person to another. The good news about bedside manner is that patients are extraordinarily flexible and are happy for you to do it in your own way. It is not the case that one size has to fit all. If you think of colleagues you either know or have heard of who have this rapport with their clients it’s clear that they don’t all do it the same way because they are very different kinds of people.

Ultimately bedside manner is about relationship – and this holds true whether you meet a client once only for ten minutes or every week for years.

At the heart of a good bedside manner is a living, breathing human being; a person who is able to be present with another human being who is probably anxious, uncertain and vulnerable. So a really useful point to start from is to ask yourself the following questions.

1. What enables me to be present?
2. What prevents me from being present?

If you want to enhance your bedside manner ensure you do and get more of what enables you to be present and change what prevents this. Your bedside manner is in part a function of your state. If you feel rushed and harassed, say, that’s probably going to affect how you come across to clients. The key question I often ask practitioners in workshops is, what do you need so that you can be at your best? Taking care of your needs will serve your clients well.

Paying attention to your bedside manner is worth doing not just for your client’s sake but for yours too. The capacity to be present and engage with another human being reduces the stress that the practitioner experiences. And, if that wasn’t enough, interesting work in the US makes clear that when patients have good rapport with their doctors there is a much lower incidence of litigation even when mistakes have occurred.

Your bedside manner is an intervention in its own right. You cannot not have a bedside manner. The only question is whether it’s effective in promoting healing.

Ian McDermott introduces himself and International Teaching Seminars at a recent evening event.

Leadership is perceived as being in short supply. We are, so many believe, crying out for leadership.

Leadership, I have found, is like charity - it begins at home. To be a good leader of others you first need to know how to lead yourself - and when you can lead yourself you can lead others.

Leadership, when you are true to yourself, flows like a river and is without effort. It emanates and radiates. It is not something that is forced out with determination, or that creates high blood pressure and sleepless nights. Put another way, leadership is about personal congruence, and the key to personal congruence is being able to pace yourself.

You need to be clear about the journey you wish to make, the speed at which you wish to travel and the beliefs and values that will guide your path.
It is about becoming the leader that is already within you.
Once you can pace yourself you are ready to lead yourself and others.

You need to be able to honour and acknowledge the different aspects of yourself whether your conscious mind likes them or not. You will also need to address your own particular habitual patterns and experiences.
If this sounds like a tall order, the good news is that the ways to achieve this can all be taught.

In addressing these areas you will find yourself personally changing and becoming more completely aligned, a process which goes on over a lifetime.

It is like becoming a charioteer with all your horses running in the same direction, at the same speed and
with the same intentions.

The pay-off is enormous as you are truly able to walk your talk, to practice what you preach or to do what you say. It produces a particular kind of leadership style which is sometimes called ‘leading by example’. This is about leading by being: being one whose behaviour is naturally aligned with who you are and what matters to you.

So often when I’m coaching executives my function is to draw out what they have not recognised that they have within themselves. The more competent the person becomes, the less they need to dominate.

My experience is that once people know they can have this, they want it very badly because it is profoundly healing and very empowering. The fruits of such self-empowerment are readily apparent.

Unfortunately, many find themselves in businesses and organisations, in positions where they are expected to demonstrate a leadership style which is not really them, a cultural ‘norm’ that just doesn’t fit. If the culture is one of ‘have to’ as opposed to one of ‘want to’, real leadership suffers.

To enhance someone’s ability to be a leader in their life, one must first enhance the individual who will be that leader. There is no better way to do this than to create structures which draw out of an individual his or her own unique vision and mission. Why? Because these are born of that person’s identity.

The more you can draw on these the better you are able to influence. The more influential you are, the less you need to try to control.

That’s what leadership coaching means to me.

Developing Questions

Over the years I have worked with practitioners to help them make distinctions about change and to develop on-going diagnostic questions for themselves and their clients. Questions can be like tools. Having the right questions can make it much easier to do the job in hand. Just as you don’t want to be stuck with only a hammer for every job, so you don’t want your thinking limited by only ever asking the same old questions over and over.

So what would it be like to develop your own customised set of questions which you are always adding to and modifying? Maybe you’d come at things from a quite different perspective and be able to achieve more as a result.

This is particularly true if you’re feeling stuck in how to proceed with a particular client. After all it’s not just our clients who can feel stuck! Many times in working with groups of practitioners I have found that these kinds of questions can help colleagues step back and see things afresh.

We could begin with our three change questions above. These give us different ways of coming at change. They certainly are not watertight compartments.

Try this: think of a ‘tricky’ client and ask yourself:

• What might be replaced or substituted?
• What new elements might be introduced to trigger change?
• What might be altered, varied or modified – and how?

On one occasion when I asked a particular practitioner these questions his answer was brief and to the point. He answered the first and third questions with just one word – “me”. It was a profound insight for him. In a way he felt more stuck than his patient. If he could change that would open up new possibilities for all his patients.

At one time or another this has probably been true for all of us. So as practitioners we might want to start by asking these change questions of ourselves.

Defining Change

Change is one of those interesting words which has an extraordinary variety of meanings. Here are three different shades of meaning being flagged up in ordinary language:

• You need to change this dressing.
• Prozac changed him.
• The medical profession’s views on complimentary medicine have changed somewhat.

From these examples we can see that change may involve:

• Replacing or substituting (you need to change this dressing).
• Making something different by introducing a new element (Prozac changed him).
• Altering, varying or modifying (the medical profession’s views on complimentary medicine have changed somewhat).

I think a useful question for any practitioner to consider is ‘what kind of change does this particular client need and want?’ The distinctions above could be one way of starting to explore this question.

Ian McDermott, founder and director of International Teaching Seminars (ITS), offers practitcal tools for personal, business and clinical success in this three part article.

“I just want things to be like they were before I got ill.”

Working with people I have heard this sentiment expressed many times over the years. But of course if this really could be achieved; if things really were just the same as before this person got ill, guess what? Other things being equal, we might reasonably expect a repeat of what happened before. In other words they’d get ill all over again.

I think many practitioners have heard clients or patients say similar things; they want a return to what for them feels normal. Too often though normality is confused with the familiar. For most of us the familiar is deeply reassuring.

However, if that familiar way of functioning has got you to a place where things aren’t working for you, then it’s going to be necessary to do something different. And that probably means you’ll be doing something that feels unfamiliar. In NLP there’s a famous dictum which says, if what you’re doing isn’t working – do something different! This may sound pretty obvious advice but when we’re feeling stuck, by definition, we are not at our most innovative. Indeed we often fall back on our old familiar ways of being and doing.

There’s a danger that the more stuck or helpless we feel the more likely we are to just do more of the same but with more effort – this is what I know how to do so I’ll just try harder doing what doesn’t work. As one client said to me when they realised the need for change “doing virtually anything different could lead to an improvement for me if only because it would shake up my old routine.”

Motivating Clients

This is true in any area of our life but the implications of this for health practitioners and clients are particularly significant. Very often how effective we’re going to be depends on how able we are to motivate a client so that they can see the value of stepping outside their old patterns and doing what may feel unfamiliar. Much of my work in NLP has been focused on developing ways to ensure this really happens and many of my trainings are designed to teach this as a learnable skill.

I’ve found building such motivation easier to do when I can provoke a reassessment and some new thinking on the part of the client. I want to explore with clients what would need to be different so that a better life might be possible. But first I need to get their attention. I mean really get their attention. And that’s how I came to develop different ways of responding to what they said. To take the example above:

Client: “I just want things to be like they were before I got ill.”
IM: “What! You want to be ill again?!”

Of course that’s the last thing that either of us wants. What they want is for things to be different and better. But whenever we want things to be different and better it means some things are really going to have to change. So what specifically will that mean for this particular person? Together we need to get clear on what change will mean and how we’ll know if it’s happening.

Reviewed by Dr Peter Stokes, principal lecturer/division leader, Lancashire Business School, University of Central Lancashire.

This is straightforward, nut-and-bolts “how to” guide to coaching. The book takes the reader through the necessary basis of the coaching process and options. It is well-written, sticks to the business at hand, and is true to its “Essential Handbook” title.
However, don’t overlook the sections “Coaching – The Larger Issues” and “Coaching and Beyond”. These create a platform from which readers can progress to further reading.

One of the more intriguing and interesting sections of the book is “Being Impeccable”, which brings a moral and ethical dimension to the subject area. Coaching has been considered as a novelty and has, like many fashions, clearly attracted its fair share charlatans. The aspirations and code of conduct discussed here are worthy and valuable aspects of the coaching world.

Useful -
Well-written -
Practical -
Inspirational -
Value for money -
Overall -

The Coaching Bible can be purchased from the ITS site by clicking here.

Below is an extract from ‘Fantastic Federer’ by Chris Bowers. ITS founder Ian McDermott was invited by the author to lend his opinions on Roger Federer’s rise to dominance and continued excellence in his sport.

The technique of Neuro-Linguistic Programming (NLP) was developed in California in the 1970’s. It’s designed to illustrate excatly why one person can perform a skill well while someone with the basic attributes can excel at that same skill, and then work out ways for others to emulate (or model) the successful person. The technique is used by numerous athletes in many sporting disciplines.

One of NLP’s leading authorities is Ian Mcdermott, who runs the british based initiative International Teaching Seminars. He suggests looking closely at Federer’s mentors. “Children grow up modelling,” says Mcdermott, “so Federer is going to have been influenced by his social enviroment - and one of the biggest influences he cites in his childhood was Peter Carter. Everyone who speaks about Carter talks of the inherent calmness of the man, and it’s interesting that Federer’s most significant breakthrough appears to have been his response to his outburst in Hamburg in 2001.

If you look at the phrasing he uses when looking back on that event, he is clearly disasociating himself from his angry reaction to the way he played and saying he has to change the relationship he has with his own response. And in the back of his mind was this mentor who was calmness personified. Carter’s calmness may be the most important thing Federer has modelled.

“Culturally, I think we’ve tended to become very critical of people who express strong anger or emotion after losing sporting contests. What Federer did in Hamburg was a clean response, as opposed to a muted reaction to defeat with the anger and emotions let out later and away from public view. But Federer obviously felt that this angry reactin wasn’t working for him, so he learned how to change his response. Since then, he’s operated a form of iron discipline, which we see as a calmness on court. These days there are just the occasional controlled explosions of anger or emotion when he threatens to boil over, like the time he blasted the ball away in his match at the Athens Olympics, or bursting into tears after winning the Australian Open.- When incidentally Peter Carters parents were present as his guests”.

With his experience of working with successful people in all walks of life, McDermott suggests that, having reached the top, Federer biggest challenge might only now be beginning. “To get to number one, Federer will have paid a price,” he says.

“A commitment to excellence when combined with a strong competitive streak tends to produce an extreme focus that can result in a certain unbalanced development, simply because you’re so busy putting everything into the area that matters most to you. My experience of working with successful people is that very often the price they’ve paid is higher than it needed to be. Once they come to realise that a rebalancing can take place, but this doesn’t have to result in any diminishing of excellence. I can’t help wondering wheather Federer has paid a higher price than was necessary. Where has the fun loving boy gone? Where is the prankster from the Basel tennis club who loved having fun on court but then found his concentration wandered? Perhaps if Federer were, say to rediscover a little of his on-court sense of fun in matches while at the same time not losing the bite that makes him excel, he would reclaim a fuller sense of himself. That wouldn’t just increase the accomplishment of his titles but would also make him much more attractive to fans, because people would have more of him to engage with. It would also reduce the risk of what happened with Pete Sampras happening to Federer – namely that, because he was so successful the same way, over and over again, people found that they had less to care about and even started to say he was so boring.”

Only Federer himself can know how much fun he gets from being at the top of the tennis tree. The standard facial expression he has during matches is very dour- unflinching, focused, almost depressed-looking. Only when a match ends does the humanity return, almost as if the true personality was suspended for the duration of the contest. Perhaps if he does ever find himself wondering where his next challenge lies and where he might go from here, maybe one option might be to attempt to move from being one of the worlds most watchable tennis players because of his elegance of his strokes and his inherent good sportsmanship, to being one whom people care about as well as admire- and that might enhance his appeal even more.

Suppose you were offered a way to recognise and realise all your goals, to find and utilise your unique strengths, to manage yourself more effectively, to identify and work around your limitations, to focus your intention and your resources and, above all, to make changes to your life for the better. Would you be interested? This is what coaching has to offer.

In my view coaching is more than a set of skills: it is a different way of being, one that characterises excellent coaches whatever their particular training or style. If comes from a profound coherence between what the coach does, what they believe and who they are. This is what makes good coaching seamless in practice. It’s what lie’s behind its power to help people make changes and in the process discover more what they have it in them to become.

At its heart, coaching is about partnership - not just the obvious one between client and coach, but also partnerships between reason and emotion, reflection and action. Coaching is interactive: it is a dialogue between equals. It involves a pooling of expertise. The client is the expert on herself and her situation and the coach is the expert on helping her discover how to make the changes she wants to make in her work and other part of her life.

Coaching recognises that small changes, if properly targeted, can have far reaching results. That’s why the best coaches are experts on leverage. It is, however, concerned primarily with process rather than actual content. It is marked by clarity in some areas: clarity of purpose, role, boundaries and ways and means. It’s also characterised by open-endedness in other areas because of the need for inquiry, exploration, reflection and experimentation. It is a process that is highly tolerant of doubt and ambiguity, and yet at the same time sharply focused.

Coaching is all about learning - for the coach as well as the client. Each coaching partnership is unique, making its own operating rules, its own discoveries and its own journey of progress. The best coaching takes no prisoners and pulls no punches, yet it develops the clients’ acceptance of themselves and others. Over time I have noticed that coaching becomes habitual - not because its conversations continue indefinitely, but because its patterns of reflection, enquiry, experiment and evaluation transfer from the coach to the client. It becomes part of the client’s own way of dealing with their experience. It also becomes a way of thinking that can cascade through organisations and families.

Be it formal or informal, executive or life coaching, coaching can be of benefit to most members of the community. Good coaches have a natural ability to enable clients to take stock, clarify their purpose, become focused and achieve greater ease. There are also the foundation of coaching skills. Just about anybody who is working with other will be more effective if they can do this.

Hence the value of a coaching approach.

The NLP Conference in November, 2006 received tremendous feedback from delegates and presenters alike. Last years event featured over 40 presenters, including many International Trainers including Michael Grinder, Robert Dilts and International Teaching Seminars’ Director Ian McDermott taking a Master Class detailling “How Change Becomes Possible”.

Many thanks to Ian Grove-Stephensen, author of the NLP Marketing Blog who reminded us that the NLP Conference 2006 photos were available for viewing, some of which we will share with you on our blog!

Ian McDermott

Michael Grinder

These are only two of over a hundred photos taken during this conference. The NLP Conference 2006 photo set can be found at the following link:
http://www.flickr.com/photos/cantabrigensis/sets/72157594386007628/