Book Reviews - You're On!

Do you remember the first time you stood in front of a class for “show and tell”; your first piano recital; your third grade school play? How about your dissertation defense; your first classroom lecture; that presentation you just made to the local Lion’s club?

How did you prepare? How did you perform? Were you pleased with your performance? What did you learn from that experience that helped you in future?

Did you have a teacher, coach, mentor, or advisor who helped you improve your performance? If so, what was s/he like? What did s/he do that helped you? What did s/he do that didn’t help? What was that relationship like? Can you think of other occasions when a coach might have served you well?

As psychotherapists, we “engage” our patients in relationships in order to help them overcome life problems. Similarly, in one way or another, most of us have been “engaged” by our teachers and advisors. Although there are certainly psychological aspects to these relationships, they differ substantially from psychotherapy. When considering these differences, psychotherapists contemplating a journey from the office to the “external world” of coaching and/or advising clients would do well to consult, You’re On! Consulting for Peak Performance, by Division 42 colleague Kate F. Hays and co author Charles H. Brown, Jr.

The knowledge, skills, and abilities necessary to deliver effective consultation are no less rigorous than those required to practice psychotherapy. Similarly, a distinct body of scientific literature supports both disciplines. “You’re On!” is written within the context of this “scientist practitioner” model. Hays and Brown present 20 plus years of theoretical research in the emerging field of performance psychology. They organize and present this work within a practical applied framework. The initial chapters contain an excellent summary of the history and academic roots of this discipline and introduce us to some of the theoretical tenets that form the foundation for discussions in the rest of the book. However, the authors have organized the majority of the book around the perceptions and experiences of clients and consultants in their own words. As a result, reading “You’re On” is not just an academic exercise, it’s an enlightening experience; expanding our perspectives while pointing out new ways to practice psychology.

In her dedication, Kate Hays quotes naturalist James Audubon; “when the bird and the book disagree, always believe the bird”. In addition to “book” (research), Hays and Brown introduce us to a diverse and interesting group of “birds” (performers and consultants) with whom we visit throughout. Beyond the initial literature review, the substance of this book is derived from a series of interviews with a fascinating group of athletes, musicians, dancers, attorneys, surgeons, snipers, and bankers and (their) professional consultants. In this regard, the authors have (happily) taken to heart the advice of one of their respondents:

You can’t just simply throw something of great complexity to a public that is unprepared to receive it. That’s not good. The audience feels stupid, they feel like they didn’t get the message, they get angry about it, the ticket sales drop, the whole organization suffers for it. The way to do it is to prepare your audience for it, and gradually educate them and bring them along to increasing levels of appreciation and understanding of the possibilities…….-Michael (conductor)

To prepare their audience, the authors define performance in rather broad terms (a discrete activity characterized by preparation, practice, and performance episode) and differentiate performance from day to day routine activities, specifically excluding administrative activities. The performance consultant focuses on these discrete activities; issues effecting daily living remain the province of clinicians. Hays and Brown further organize the focus of their respondents within three “Domains”, performing arts, business, and high risk.

The richest, deepest and most interesting portrayals in this book involve the performing arts Domain. Within this group we meet several composers, dancers, actors, and talk show personalities as well as their consultant/coaches. We share their triumphs, failures, and fears. Through their words, we experience the tedium of practice, the rush of performance, and their struggle with perfectionism vs. artistic expression. Similarly the research linked to these vignettes is easy to follow. Many of the performing arts consultants are themselves performers (or ex-performers). Their commentaries, integrating theory with personal and professional experience, are interesting, potentially useful and wonderfully engaging. Readers will certainly experience the attraction and appeal of working within this Domain.

A half hour before the curtain was to rise, they discovered that the lighting board didn’t work. The students were going to have to do the whole show on a wing and a prayer with basically no lights. They had no other option….they had gotten themselves ready and then they had to wait ....until 8:20 for an 8p.m. show……and then they had to come bursting on and do this very lively dance. It was very difficult for some of them to hold onto the readiness that they had prepared themselves with thru 15 or 20 minutes of extra distraction. Some kind of technique to re-focus would probably been really helpful to them. –Helena (dancer; dance instructor)

The business Domain, at least as presented, is more of a mixed bag. Here we meet attorneys and bankers, advertising executives and insurance salesmen who relate their performance experiences to their job functions - litigation, negotiation, presentation, and sales. The authors effectively migrate their message, concepts (preparation, rehearsal, focused attention) and research into this Domain, as well. However, it seemed to me that many of the events these folks describe occur within the context of day to day activities. When considering these experiences it’s sometimes hard to tell where the performance episodes stop and routine management struggles start.

Find your unique ability, what it is that you do best, and delegate everything else. Find competent people to delegate to and then do what you do best. – Charles (insurance broker)

Nonetheless, these are all high performing people whose performances have been (or can be) potentially enhanced thru professional intervention. They are also representative of the kinds of issues that concern people in the business Domain. In addition, comments from the various consultants are instructive, illuminating and certain to be helpful to professionals who are considering providing service in this Domain.

High level performers have a kind of stubborn persistence and belief in self…..they are willing to take a risk to get to the goal. One guy I worked with……made quite a bit of money…he went broke a couple of times in his life…he built it back up again. He just really believed in himself….and knew it was the right idea. He had a lot of experience to the contrary for a period of several decades before he finally succeeded. –Dr “Brian Bell” (consultant, family business)

Hays and Brown call their third Domain “high risk”. These are people whose performance episodes include potentially life-threatening circumstances. The group includes a neurosurgeon, an ER physician, and a combat medic who also occasionally functions as a “sniper” on a police tactical team. Descriptions and discussions of the demands of high risk medical procedures are clearly consistent with the authors’ model. I found the examples of cognitive re-framing, focus and rehearsal techniques adopted by these performers to be quite interesting and right on the mark given the performance psychology literature.

When I am thinking about a difficult case that I am on edge about, I will tend to pull up the worst case scenario…..When all hell breaks loose you have reflex movement and memory….the field is just full of blood, you can’t see. In those cases, if you can keep a memory of where the aneurism was, you can often….take what could be a life threatening problem and just end it.

The natural reaction, until you get comfortable doing aneurysm surgery, is to panic and pull back. Then what was potentially very salvageable is gone. ….that’s a weird step to overcome…to go from panic to staying where you are and getting the clip from the nurse and putting it on. –Eric (neurosurgeon)

That said, although there were a number of consultants listed as relating to the high risk Domain, their comments often did not seem directly related to the experiences described by the high risk performers. Also, it seemed to me that the demands of a “sniper” differ considerably from the other tasks classified as “high risk” since sniping entails a lot of training but very rarely entails action. In this regard, I think the discussion of high risk performers could have been enhanced by inclusion of more familiar law enforcement/public safety specialties such as hostage negotiator, high risk entry specialist, firefighter, etc. Exploration and integration of the existing academic literature in regard to high risk public safety positions would have been helpful here, as well.

Can you recall a time when anxiety ruined your day? Do you remember your supervision sessions as an intern; your first post doc colloquium presentation? Did you “crash and burn” or were you able to save the day? Here’s how a performance consultant might have helped:

One time, five of us went to meet this group of decision makers. The first set of questions that were thrown at us were ones that other people in the room were trying to hit and they were just whiffing. I finally stood up and said…. “let’s take it from the top. Let’s try to refocus the time we have together…because this is not working….”

“What I was doing is listening and watching the body language. I was making an on the spot diagnosis of what was going on”… “Maybe we can salvage our pride…..because I am going to do something that is really…risky. I am going to tell the truth”. –Arthur (lawyer)

Two of the most useful and important chapters in this book explore the relationship of stress to performance and describe re-framing and coping techniques. In the first of these chapters, stress is described by a performer (musician), in almost poetic terms as “the microscopic nightmare of infinity”.

The microscopic nightmare of infinity is the sense that , in the space of a very tiny moment – a split part of a second, less than an eighth of a second – you can experience infinity between two notes. It is the feeling that you can fall into the black hole at that point. And that’s scary. That is deeply frightening. –Norman (musician)

Hays and Brown note that although this language is very meaningful to an artist/musician it would rarely be used by a clinician. The authors begin way back with Hans Seyle and progress thru more current literature, to explore the facilitating vs. inhibiting role of stress as it affects performance. This is familiar ground for clinicians. To facilitate the transition, the authors then introduce a simple but useful demand/resource/consequence based model and illustrate it with a number of accounts and comments from both performers and consultants.

Although one might not be able to reduce the demands of a particular type of performance, it might be possible to reduce the frequency of performance. Likewise, one may reduce the self imposed or perceived demands of a performance by changing one’s standard from the attempt at perfection to sustained excellence over time. One can reduce stress by increasing perceived resources, such as having adequate rest and energy and ensuring that physical abilities are functioning at optimal level. Stress can likewise be handled by changing one’s perspective on the importance of the outcome of a performance…..(chapter 10, page 153).

If you are a clinician considering trying your hand at performance consulting, chapters 9 and 10 are critical reads. These chapters encourage you to explore the difference between clinical work and consulting activities. Clinicians, especially cognitive behaviorists, are likely to recognize many, if not all of the techniques discussed in Chapter 10. However, the focus and use of these techniques expands the clinical context in important ways. Similarly, the descriptions and vignettes contained in these pages provide you a deeper understanding of the performing client’s needs and perspective.

A woman who had stopped dancing……was going to start working with the company the next day. She said “of course I am coming to the performance” and I just turned white. ....she said “I’m not coming to see how you dance, I ‘m coming to see you”. It just made me feel so good. I say that now to my students all the time “I don’t care what you do, I care about you; I want to see you”. –Jerry (dancer)

What makes a good consultant? Conversely, what makes a bad one? Hayes and Brown address these important issues, as well. The transition from psychotherapist to consultant is not necessarily seamless, nor is it one that can be achieved without learning, focused effort, and perhaps some attitude and behavior change on the part of the psychologist.

You need to be a cultural anthropologist…..to study that world to see how to present yourself….I don’t think most psychologists feel comfortable with some of the worlds that we are in right now. They don’t present themselves in ways that would be acceptable to a business person…..their skills would be quickly discounted or discarded because they are not presenting it in the business culture….. –Dr “Claire Crown” (consultant, business)

Were you to decide to try your hand at performance consulting, where would you fit best? In addition to knowledge, training and commitment, your personal style, talents, and abilities should appeal to the population to which you propose to consult. The consultants profiled in You’re On! provide frank and useful comments regarding personal presentation, attitude, role, and the nature of (the consulting) relationship. The authors also present an interesting discussion of the preferences, or biases, for certain personal characteristics as expressed by performer/clients in these three Domains. Similarly, they stress the need for a broad based skill set rather than a narrow or singular approach.

Each consultant may have a niche, specialty, or method that shapes his or her perception of a performers need. A consultant’s specialty, however, may also be a liability. We are mindful of the aphorism attributed to Abraham Maslow: “ when the only tool you have is a hammer, every tool begins to resemble a nail”. –(chapter 12; page 201).

Performance consulting is not psychotherapy. Nevertheless, it is psychology; particularly when practiced by psychologists. As such, training, competence, and ethical practice are paramount concerns for those of those considering entering this field. The authors present a fair and evenhanded discussion of these issues, as well. They particularly address our ethical principles (1992 and 2002) as they relate to newcomers practicing in this area.

Issues of training, competence, and ethics are highly interwoven. Ultimately, the “big picture” of ethical practice means “doing work that is good”. There are two basic ways of measuring that: (a) obtaining competent training and (b) practicing in a competent manner. – (chapter 15; page 251)

It’s been said that clinical psychologists have been known to experience discomfort around financial issues. Nonetheless, psychologists considering this practice area are probably wondering, “What does a consultant earn and how do they structure their practices”? Hays and Brown note that this activity is different from clinical work in that service is typically delivered “out of office”. There is also a (very) brief discussion about athletic consultants marketing themselves to businesses. Finally, there is a vague acknowledgement that there are differences in regard to hourly rates, but the authors don’t say much else. Since both Hays and Brown are practicing consultants, I think a few more words in this regard would have been interesting, as well.

I enjoyed this book. I found it to be an excellent blend of research, experiential, and professional content. . The authors offer us another way to apply our skills and I now have a much clearer understanding of this field as well as the scientific foundation on which it stands. Furthermore, the authors’ style is entertaining and refreshing while remaining professionally “top drawer” and uncompromised. No, it’s not psychotherapy but it is no less demanding, and professional. You’re On! is a testament to this fact as well as an important read for all psychotherapists, particularly those considering a practice transition.

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