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The Case for Autonomy-Centered Health Coaching: An Evolutionary Perspective

by: Marisa Moon
Published: June 8, 2021
Updated: June 23, 2022

Why is it that when we give someone advice, they are less likely to make the changes we suggest?

It’s human nature.

When we share unsolicited advice, we are undermining the other person’s basic need for autonomy. Autonomy is a sense of personal freedom to act in a way that’s entirely self-governed. We humans have a deeply-seated need to feel a sense of ownership over our actions—without feeling pressured to behave a certain way.

What’s even more interesting is that beneath our need for autonomy lies an even deeper, unconscious need, dating back to the times of our earliest human ancestors when our primal instincts were crucial for daily survival.

In today’s article, we’ll explore how these instincts play into a challenge we face as health coaches, and, by the end of this post, you’ll understand why a client is less likely to heed your advice when they sense signals of authority. Most importantly, we’ll guide you to integrate some of the most effective coaching strategies that make space for client-driven participation and change.

First, let’s get clear on why autonomy is so foundational in behavior change psychology and health coaching.

Autonomy is one of three basic psychological needs, meaning, it’s essential for one’s well-being. Without it, there’s an increased risk for defensiveness and distress (Ryan and Deci 2000a; Vansteenkiste and Ryan 2013).

When someone is autonomously motivated, their actions are driven by ideas that are of personal value or interest to them. And this matters so much because autonomously motivated actions are more likely to become long-term behavior changes (e.g. your client wants to eat healthy so they can dance at their daughter’s wedding twenty years from now) compared to changes that are externally pressured (e.g. your client wants to get healthy because their spouse criticizes the extra weight they’ve put on).

As discussed in our recent article about The Coach Approach, one of the primary reasons to resist the urge to tell clients what to do (“the expert approach”) is because it usually doesn’t work. When you put on the expert hat too impulsively, you communicate “I’m in control here,” which is likely to trigger defensiveness because the client feels rushed, misunderstood, or undervalued.

A fascinating study titled Understanding Motivational Interviewing: an Evolutionary Perspective, explores our tendency to react defensively and what evolutionary biology can tell us about our need for autonomy.

Essentially, when a coach helps the client feel safe, respected, and free to explore their own ideas, they’re able to bypass an evolutionary trait known as psychological reactance—a tendency to act contrary to recommendations from others—which theoretically evolved to help us form and maintain social hierarchies that were necessary for civilization. Whoa…you might want to read that one more time.

We are psychologically reactant because, evolutionarily, humans needed that instinct to advance in social living.

Think back to what we know about our ancient hunter-gatherer ancestors when they were first transitioning into civilized life. Before we were socialized creatures, life could be pretty barbaric—killing for food, land, or mates. Because there were no laws or community to force us to behave, we were wild, untamed, even, vicious! Then, we took an evolutionary leap around 12,000 years ago, advancing beyond the Paleolithic time period as we began forming social units in order to work collectively and grow food, specialize labor, and keep each other safe as communities.

If we weren’t able to recognize signs of social dominance back then, we wouldn’t have advanced into civilized beings. “Who’s in charge? What’s the pecking order?” We needed to establish a ranking order, a social hierarchy, in order for the group to function as a unit and increase everyone’s chance of survival…thus, we have the hardwired neural circuitry to ensure that happens.

This brings us back to the phenomenon of psychological reactance, which played an important role in establishing social hierarchies. When we’re oppositional to someone, it’s because of an innate tendency from the most primitive part of our brains—the limbic system or amygdala—where social cues are translated as either opportunities or threats to one’s social status within a community.

We’re born with this oppositional tendency and it happens in an instant, below our conscious awareness. So, when we’re told what to do, even today, our instinctual brain interferes and thinks, “If I take this advice, I’m sending signs of submission and I’ll get knocked down the ranks.” What did that imply for our survival? Less access to food, resources, safety, and mating opportunities.

Here’s the big eye-opener for us health coaches: Psychological reactance causes us to be less likely to do what people tell us to do, regardless of how valuable the recommendation is [Brehm 1996]. “So even in a situation where we notice that a recommendation can be beneficial to us, we are still significantly less likely to take that recommendation.”

It’s worth noting that this reactance exists on a spectrum, with some individuals being highly reactant and oppositional, while other individuals are less likely to sense a threat from authority.

Why, though, can’t we use our powerful brains to reason our way out of this unreasonable reaction?

Because the primal brain—specifically the amygdala—is hardwired for the needs of our most primitive ancestors who would’ve risked harm or death if our brains relied on rational thinking to detect a threat. It was vital that we could detect signals of dominance and initiate a favorable response without conscious cognition (it needed to be instantaneous, without wasting precious cognitive energy). Thus, it was a survival advantage to react without reason.

Our amygdala and instincts only care about our immediate survival, and they don’t know that our coach, friend, or therapist is not an actual threat, even if our rational brain understands that. The instinctual brain says, “Hey, you’re being told what to do, and this is a threat to your position of power. Oppose so they know you can’t be bossed around.”

Where does this leave us today, as health coaches who seek to support clients in making healthy, lasting changes in their lives?

As suggested in Self-Determination Theory, consider these four elements of client-centered coaching to support autonomy:

  1. Seek to understand the client’s perspective.
  2. Actively explore the client’s own thoughts, beliefs, and feelings.
  3. Collaboratively devise a menu of possible behavior change options with, not for, the client.
  4. Seek to develop meaningful actions or changes that are personally relevant to the client themselves.

Motivational Interviewing—a powerful communication method for eliciting client-driven behavior change—also helps us shift the client from instinctual survival mode into a collaborative mode where they feel safe and open to explore. By having genuine curiosity about a client’s experience and ideas, and by not telling the client what to do, we signal to their amygdala that they’re physically/socially safe. We’re able to quiet the reactive center in the brain allowing the more rational brain to engage in reasoning and decision making.

With active listening skills, health coaches signal to clients that we respect them and their perspectives. If instead, we imply that we know what’s best for a client or push them to change, we can trigger their fight or flight response which translates into one of three things: 1) attack—or show opposition, 2) yield—comply as long as the pressure is on, or 3) retreat—dodge your coach or quit altogether.

And that’s human nature, not a difficult client.

Effective health and wellness coaches assist the client in exploring the possibility of change. We ask open questions, providing reflections and genuine affirmations to enhance their sense of autonomy and social support. Together you explore which behaviors are in harmony with the client’s big-picture goals, values, and interests, helping them regain self-efficacy and feel autonomously motivated to pursue their wellness goals.

Now tell us what you think! Leave a comment below to start or join the discussion...

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