Three Steps to Spark Story Sharing in Lifestyle Counseling

Early in my career as a dietitian, I answered a panicky phone call from a participant in my weight loss program. Pat (not her real name) said, “Jean, I have a problem and really need to talk to you.” She had been a “perfect” participant: never missed class, her food diaries and exercise log showed stellar compliance, and her weight loss was steady. After three months, Pat was walking five miles a day and had lost 15 pounds and 5% of her body fat. When she “graduated” from the program, she was feeling confident about her new lifestyle. So I was really excited to hear from her and dropped what I was doing to chat.

With a shaky voice, Pat told me that when getting out of bed that morning, she looked down and saw “skinny legs.” I applauded her hard work and results – but that only increased her agitation. I listened as Pat continued, “I went downstairs, reached into the cupboard, and saw a skinny arm.” Perplexed, I responded, “I’m sorry, Pat, but I don’t see the problem.” She blurted out, “Jean you don’t understand. I’m starting to believe that I can be a thin person. What am I going to do? People might want to talk to me at parties – what am I going to say? I’m just Jim’s wife and no one talks to me. Maybe I need to go to college or get a job . . . I don’t know what to do.”

Pat’s story helped me realize that successful experiences sometimes can be as defeating as experiences of failure. More importantly, I learned that I was in over my head – my technical skills in nutrition and exercise were only the tip of the iceberg in lifestyle change. After consulting with experts and reading literature in the psychology of eating and behavior change, I realized that I needed some tools to explore the emotional side of lifestyle change and ways to address the “whole person.” I created a module, called the “Challenge of Change,” in which participants explored the emotions experienced during life changes, like getting a new job, moving, or becoming a parent. We would examine the challenges inherent in these life changes, and participants shared stories about how they overcame challenges. As a group, we drew wisdom and inspiration from their stories, which we applied to weight management struggles.

Dietitians, weight loss counselors, and health coaches who wish to incorporate story sharing into their practice and create deeper connections with their clients might try this three-step approach.

• Prompt Sharing of Success Stories – Stories that involve a struggle that has been resolved will be the most useful. If the struggle has not been resolved, the emotions that surface might be raw and uncomfortable. It’s also harder to extract and apply meaning. Try a prompt like, “Tell me about a time when you succeeded at something that was really difficult.” If you accidentally surface an unresolved story, show empathy then gently redirect the conversation to stories of success.
• Explore the Meaning – Stories almost always contain some universal truths that motivate and inspire. After someone shares a story, ask questions to help the client extract deeper meaning from the story, like “What did you learn from that experience?” As you listen, validate their insights and build on them. Focus on the story and its meaning, rather than providing advice or feedback.
• Apply the “Lesson Learned” to Today’s Challenge – Help your clients connect the dots between past successes and their current struggles. Try questions, like “How might that experience help you navigate the challenge you face with [spacing eating throughout the day] [controlling portion sizes] [finding time to exercise]?” If they are stuck, illuminate meaningful elements of the story for them, such as heroic deeds, how a big goal was carved into manageable steps, or perseverance against the odds.

I won’t claim that story sharing is the secret sauce for weight loss, but I do advocate that listening to your clients’ stories will provide clues to their motivations and barriers to change. Do you have an inspiring story to share about yourself or someone you know overcoming an obstacle? How have stories enabled your success in counseling and coaching about healthy lifestyles?