Is integrative training the way of the future?
When Tanya Colucci, MS, trains clients, she pulls from many different resources to offer the best results possible. Owner of Tanya Colucci Myofascial Release Therapy in Bluffton, South Carolina, Colucci believes in an integrative mind-body approach, which appears to resonate with many people. Case in point: client Aileen Worthington, age 71, who has osteoporosis.
“My husband and I have had twice-weekly partner training sessions with Tanya for a year and a half,” Worthington shares. “Yes, we could go to a gym, but would we know what to do? Tanya moves us forward without injury. Sometimes she includes a bit of yoga, Pilates or meditation. Recently we have each availed ourselves of Tanya’s skill at myofascial release, a great complement to hard workouts.”
Mind-body personal training is not a new concept, and yet the demand for programming that includes mind-body practices and holistic approaches seems to be increasing. This trend reflects the growth of integrative medicine and comes from consumer demand, marketing, and emerging evidence that the benefits of complementary health approaches are real or meaningful (NCCIH 2015). Is the personal trainer’s role changing, or is this more holistic approach simply another niche training style?
Today’s Clients Need More Than Fitness Solutions
Mind-body (or integrative) personal training takes into account the needs of the client beyond the physical body. “The trend of integrating other mind-body disciplines or providing a more holistic coaching approach to personal training is big [and] here to stay,” says San Diego–based Fabio Comana, MA, MS, faculty instructor at San Diego State University, the University of California, San Diego, and the National Academy of Sports Medicine. “Historically, personal training has been very physical and ‘directive’ in its orientation. For example, trainers identify issues, [create] programs and then tell clients what to do. It’s a self-focused model that comes from medicine. Today, influences are coming from integrative medicine. We’re not only addressing physical issues; we’re also looking at cognitive and emotional aspects and how to help people change behaviors. In the future, trainers will need to be coaches, and coaching is a mind-body approach.”
“Straight exercise is not solving the health and wellness issues that we’re seeing today,” says Penny Crozier, CEO of the C.H.E.K Institute, in San Diego. “People’s problems are not just about exercise. Health and fitness professionals have to look at the whole person to find the right answers.”
An Integrative Training Model
How do you distinguish a mind-body or integrative approach from the traditional fitness model? Comana describes the difference as a fundamental shift in the trainer’s role, from telling clients what to do about physical needs, to empowering clients, connecting with them and caring about how they can improve their lives 24/7, not just during the short time they’re with their trainer in the gym.
Other experts focus more on ensuring that clients make a mind-body connection. Strong, Stretched & Centered®, a mind-body exercise instructor-training program that was based in Maui, Hawaii, from 1980 to 2006, used this definition: “Mind-body personal training is when the physical aspects of the session are executed with an inwardly directed focus. It is process-oriented, rather than goal-oriented. Movements are focused in kinesthetic awareness [and] breath and involve the perception of movement or ‘flow’ of one’s vital life force energy.”
“Mind-body training [in] its most simple form means being aware of all aspects of the body and mind, before, during and after exercise,” says Beth Shaw, founder and president of YogaFit® in New York City and Los Angeles. “It means being aware of the physical, mental and emotional energetic states, as well as being aware of all the systems—respiration, circulation, digestion and the nervous system. This leads clients to make better choices and get better results in every way.”
No uniform definition of mind-body personal training exists. Experts, however, agree that the following aspects represent some of the more significant characteristics that differentiate a mind-body or integrative approach from a physical fitness model.
Train the whole person. For example, mind-body training doesn’t focus only on reducing body fat or increasing strength; it centers on bringing different aspects of clients’ overall health—physical, mental and emotional—into better balance.
Improve the mind-body connection. Instead of just teaching exercise mechanics, trainers help clients to connect with their bodies and to feel and identify physical sensations and mental chatter.
Teach relaxation and recovery. Trainers help clients understand the relationship between well-being and the autonomic nervous system; and they give clients tools to cultivate the parasympathetic side—the “rest and digest” system—as balance.
Identify intrinsic motivation. Trainers go beyond physical goals, digging deeper into the relationship with clients to identify how they imagine their lives will be qualitatively better as a result of training. Then they use each client’s vision or dream as a motivational tool.
Some people may object that differentiating mind-body or integrative personal training from traditional fitness training implies that conventional training does not use the mind. Of course, this is untrue. Any movement can be done mindfully, with intention, breath awareness and concentration in the present moment. Fitness activities do not, however, require a mindful connection to be done correctly. The term “mind-body exercise” connotes intentional cultivation of this connection during movement and comes from the field of mind-body medicine. Similarly, from the trainer’s perspective the ability to design a physical fitness program does not require nurturing an individual’s mind-body connection or acknowledging mental or emotional aspects of his life. But these elements are needed for developing mind-body training programs.
Trainer as Facilitator of Health Improvement
Mind-body personal training is about more than fusing yoga moves or other mind-body exercises into a training session. Mind-body trainers support their clients in developing greater well-being in body and mind. In this more comprehensive training paradigm, trainers draw on concepts from traditional Eastern healing disciplines as well as modern science.
What is the training objective? Is it to improve fitness measures or to improve health? The World Health Organization defines health as “a state of complete physical, mental and social well-being, not merely the absence of disease or infirmity” (WHO 1948). So if the goal of mind-body is to improve overall health, is the trainer’s role to direct or to facilitate?
Many complementary practices, including yoga and tai chi, are rooted in ancient healing traditions like Ayurveda and Traditional Chinese Medicine that involve balancing “life energy” and stimulating self-healing mechanisms within the body and mind. These practices take an “energy-centric” approach in which the trainer guides the client with tools that help to bring mind, body and spirit into better balance, for optimal health. As Lawrence Biscontini, MA, a mindful movement specialist based in New York and Greece, says, “Traditional training approaches personal training as though we are physical beings having a spiritual experience. Mind-body trainers come from the mindset that we are spiritual beings getting together to have a physical [experience].”
Experts agree that personal trainers can pull from a spectrum of techniques that stem from traditional Eastern holistic medical arts (yoga, tai chi and qigong), martial arts, behavioral medicine and positive psychology. Options include the following:
Breath awareness. Training clients in breath awareness is an important first step, according to the experts interviewed. “The first thing I have people focus on is going slowly. We slow down and deepen the breath,” says Ryan Crandall, physical therapist assistant at Peak Motion Physical Therapy in Albuquerque, New Mexico. “Calming the autonomic nervous system and getting more into the parasympathetic side takes long and slow inhalations and even longer and slower exhalations. I usually work on a 4- to 5-second inhalation and an 8- to 10-second exhalation.”
Meditation. Many practitioners teach clients to use meditation, which encompasses a broad variety of practices. “I incorporate meditation into my sessions to help clients gain body awareness and control over their own minds,” says Stuart Posternak, owner of MindBody Personal Training, offered at Optimal Self Community Health and Wellness Center in Portland, Maine. “I usually teach vipassana [mindfulness], as it’s the most applicable and simple to teach. [We practice] during rest time between sets and before body training starts. I also recommend that clients practice at home at least 10 minutes a day and move up to twice a day for 20 minutes.”
Visualization. When clients visualize, they use their imagination to see specific behaviors or events in the mind; elite athletes use this technique. “I may begin a session with 5 minutes of deep breathing and creative visualization before the warm-up to help a client set his intentions for the session, and then use those prompts . . . during the session to keep my client focused on his intentions during the session,” says Claudia Micco, wellness director at the Ritz-Carlton Kapalua in Maui, Hawaii.
Affirmations. An affirmation is a positive statement that reflects a core personal value and “affirms” the self (Cohen & Sherman 2014). Some trainers interview their clients to identify a particularly meaningful affirmation for them, and then encourage clients to use this phrase, both during training and as homework, to create a more positive outlook. Some practices, like Ananda yoga, pair affirmations with yoga postures to “reinforce the natural effect on one’s state of consciousness, bringing the mind actively and directly into one’s practice” (McCord 2014).
Yoga. Yoga practice continues to spread at an exponential rate and is increasingly being recognized for its therapeutic qualities, as evidenced by yoga therapy’s growth as a new profession. Accordingly, more trainers are incorporating yoga postures (asanas), along with meditation and breathing (pranayama) practices, into training sessions.
Lisa Borho, MPH, MS, fitness trainer department chair at Clark College in Vancouver, Washington, says, “In 2013, we decided to incorporate the YogaFit anatomy and alignment module into our [associate of applied science degree] program in personal training, since it teaches our trainers how to use yoga as corrective exercise and it gives trainers more diverse skills to increase their marketability.”
Tai chi. An ancient mind-body practice used in Traditional Chinese Medicine, tai chi is characterized by graceful, flowing motions and attention to breath. “For clients who need to move their bodies right away, I’ll begin a session with 10 minutes of tai chi to warm up,” says Micco. “Whether I use tai chi, deep breathing, visualization or any other method, my intention is to get my client to become centered in the moment as soon as I can.”
Slow movement. Both Colucci and Crandall emphasize slow movement. For example, when working with weights, Colucci recommends using a 4/2/1–2/2/2 tempo. Crandall shares one of his favorite techniques (with client standing): “[I start with] feet shoulder-width, knees slightly bent, eyes on the horizon. The pelvis and shoulders travel together as the client slowly shifts weight from one foot to the other. The focus is on feeling the ground beneath the feet. Once clients master the frontal-plane shift, they can focus on . . . other planes and different foot positions. You can make this easy or complex, depending on the client’s needs.”
Myofascial release. The practice of addressing restrictions in the myofascial system is receiving a lot of attention in the fitness industry. Mind-body or holistic practitioners like Colucci treat the client’s whole body and mind when working with fascia. Colucci explains how this differs from a purely physical approach. “Foam rolling is typically used to warm up the body prior to exercise, to release some muscle tightness and/or fascia that a trainer has identified as tight,” she says. “I dig deeper into the emotional component, habits or belief systems that are possibly causing restrictions [and] physical pain. The fascial system actually holds memories . . . people will often have emotional releases . . . as I’m releasing an area of the body. The important aspect is for them to allow their body to feel. Feeling is healing!”
Deep relaxation. Experienced mind-body personal trainers universally agree that sessions should conclude with some form of relaxation—progressive muscle relaxation, guided meditation or silence (seated meditation or lying in corpse pose, or savasana). “Have your clients sit or lie down, close or cover their eyes, and give them time to breathe,” suggests Micco. “Guide them with a soft voice. Teach them to tune out distractions, tune in to their breath and tune up to their inner world. If trainers are worried about having a perfect, quiet place to do this, then they will be waiting forever. Our ears are always working; there is always some distraction. Teach clients how to let go of distractions in the moment.”
Motivational interviewing. Researchers define motivational interviewing as “a client-centered directive method for enhancing intrinsic motivation to change by exploring and resolving ambivalence” (Lussier & Richard 2007). Trainers use the method to identify a client-based approach for overcoming barriers to achieving desired healthier habits. For clients who are coping with more serious mental health issues—such as anxiety, depression or addiction—expert referrals are recommended (see “Train Yourself Happy” in IDEA Fitness Journal [2014; 11 (6), 28–37] for more).
This sampling of integrative techniques is not exhaustive. Other movement modalities include the Alexander Technique and the Feldenkrais Method®. Some trainers enhance training sessions with energy healing methods, like Reiki or healing touch. To learn more about techniques that work well with personal training program design, read “Putting Some Mind Into the Body,” by Lawrence Biscontini, MA (www.ideafit.com/fitness-library/putting-some-mind-into-the-body).
Who Is the Mind-Body Personal Training Client?
While people who seek integrative training include individuals of all ages and abilities, in general the clientele reflects those who are the most likely to use complementary and alternative medicine. The 2011 AARP and National Center for Complementary and Alternative Medicine Survey Report noted that women were more likely than men to use CAM; that its use increased with education; and that people aged 50–64 were twice as likely to use mind-body practices as those aged 65 and older. Among all adults, interest in CAM increased with age, peaked between ages 50 and 59, and then steadily declined. The most common reason cited for CAM use was to prevent illness or to promote general wellness, followed by the need to reduce or treat pain or to treat a specific health condition.
Factors that are fueling this interest include
- fast-paced lifestyle pressures;
- mainstream acceptance of yoga and other mindful movement activities;
- chronic health conditions (among all age groups); and
- older adults who want to live better as they live longer (AARP & NCCAM 2011).
“People’s lives are becoming more compressed; they are more stressed,” says Comana. “Yoga and other mind-body methods address these needs.”
Expert practitioners agree that many of their clients include people who are middle-aged or older, have chronic pain, are overcoming an illness or injury, are coping with how to manage one or more chronic conditions, and need to improve balance and strength to move better. “Most of my clients are overstressed and overstimulated,” says Micco. “Some have injuries, and most are very aware of their health.”
Interestingly, while many practitioners describe what they’re teaching as mind-body, they often don’t say that to clients. “In [our holistic life coaching] program, we teach what we call a ‘work-in,’ and we also discuss ‘zone’ exercises that vary depending on how the client is feeling on the specific day of training,” says Crozier. “These are related to the chakras, but we think ‘zone exercises’ are easier for people to accept.”
“Depending on how a client feels on a particular day, I may do a different exercise to get the student in the present moment, focused on feeling, breathing and listening to the body,” says Micco. “Sometimes [people] don’t even know they’re doing a ‘mind-body’ activity.”
Niche or Future Direction?
Regardless of whether we describe the new training paradigm as “mind-body,” “integrative” or “holistic,” the role of the personal trainer and the methodology of personal training is undergoing a transformation. “I see this trend expanding in the future as people seek more holistic ways of healing, since traditional medicine has left many gaps,” says Shaw. Comana predicts, “Good training will migrate because the value of the ‘old,’ one-dimensional model is diminishing as people have less time and more options, like virtual training. The whole concept of mind-body is more relevant today.”
Some point out, however, that this is more an evolution than a trend. “Movement and mind coaching, [as well as] education and empowerment—where we coordinate and orchestrate energy systems of all forms—is not a trend,” says Biscontini. “It’s been around for centuries. The traditional Western approach is slowly adapting this method, but even in the West, we’ve seen it at spas, wellness centers and evolved gyms for at least 20 years.”
Returning to Wholeness
In an increasingly fast-paced, technologically driven and fragmented world, people are seeking unity, wholeness and a connection with the inner self. They want to feel better, look better, have more energy, move without pain, and enjoy life inside their bodies. Many people are frustrated by diets that haven’t worked and exercises they haven’t enjoyed. They come to trainers to find solutions. Perhaps a more mindful and sensitive training approach, one that harnesses the mind’s power to enhance the body and considers healthy mental and emotional functioning as desirable as healthy physical functioning, may fill a need that no app can deliver.
“My clients often tell me that I have changed their view of exercise and fitness,” says Posternak. “My goal has always been to give my clients a transformative human experience, rather than just an effective exercise program.” Isn’t that the joy that all fitness professionals want to share?