[MUSIC]. Welcome back.

In the last modules, we've talked about how coaching with compassion can invoke the positive emotional attractor, the PEA. What I'm going to do in this module is talk about some of the studies in which we've shown, why, invoking the PEA more than the NEA really helps. Besides the work as I said, of Barbara Fredrickson and Marcial Losada and Emily Heaphy and John Gottman and their colleagues. In the research that people have been doing here at the Case Western Reserve. We've got a number of very exciting discoveries. Masud Khawaja, in his PhD thesis, who is also an MD, studied the degree of treatment adherence for type 2 diabetics. Now, around the world, treatment adherence, having people take their medicine and watch their diet for type 2 diabetics is a miserable 50%. It's horrible, because it leads to a lot more complications, what are called comorbidities, and then in fact, people also increase the cost of health care. And people lose mobility and we lose our loved ones. Medical literature has done a lot to try to figure out what is it that increases the likelihood of treatment adherents? What we know is it's not telling people horror stories. Because when you tell them horror stories, they still don't kind of do what they need to do. This, again, is the difference between what happens if you appeal to the NEA and people close down, become defensive, versus appeal to the PEA. Well, what Massoud found was that a number of the things in the doctor-patient relationship, as the medical literature predicts, do affect treatment adherence.

But they are fully mediated through the patient's experience of the degree of the positive emotional attractor to negative emotional attractor in his or her relationship to the physician. And in fact, using a measure that we've used in a number of these studies, they're actually picking up, or Basud picked up the degree to which the patient experienced a perception of shared vision, of shared compassion, of shared positive mood, in the relationship to the doctor. What that means statistically is if you were going to work on one thing to improve treatment adherence. You'd work on the experience the patient has in their relationship to the physician. Again, we see this in a lot of other situations, in leadership situations for example, the power of shared vision. Byron Clayton found that his doctorate dissertation was one of the strongest predictors of successful mergers in acquisitions. And very often people misguidedly think it has to do with financial manipulations. And we know how costly the 80% of mergers and acquisitions that don't work are toward organizations and communities. John Neff showed that one of the predictors of multi-year financial success in family businesses was one of the 5 key predictors, was the degree of shared vision about the family business. [UNKNOWN] in his dissertation, showed that in technical teams that the degree of shared vision accentuated the emotional intelligence in the teams towards getting more organizational engagement. So with this Panoply of research results and this increasing excitement that we can start to see these effects we decided to look inside the neurology. two more studies.

Linda Pittinger showed in her dissertation recently that for IT managers and IT professionals the degree of shared vision and shared positive mood, accentuated, mediated, and caused their increased effectiveness and engagement in their work. Joann Quinn showed with physician leaders, their leadership effectiveness was predicted by their social intelligence. But again it was mediated by the quality of the relationships, in particular, the degree to which they experienced in their relationships with the people at work a shared vision, a shared compassion, and a shared positive mood. So to test this, we decided to go inside the brain. And we designed one FMRI study that we did several years ago, in which we brought in sophomores at Case Western Reserve University for one of two coaching sessions, advising sessions. One was PEA focused, and one was NEA focused. We decided on the PEA focus, where you'd bring the sophomore in, and the advanced doctoral student, usually some 15 to 20 years older than the undergraduates who have not taught them in any other course would ask really 1 question. Which is if your life were great 10 years after you graduated from Case Western Reserve University, what would it be like? And they would talk for 30 minutes. The NEA condition wasn't all that negative. It actually was very typical of what most parents and faculty members ask. Basically, there were four questions. How are you doing in your courses? Are you doing all the readings? Are you doing all the assignments? Are you getting enough time from your

instructor? You notice these aren't really negative, but they all have this thing of inducing some degree of guilt. Well, [COUGH] and by the way people were randomly assigned to either Massoud Koaja or Angela Passarelli doing these coaching sessions. Randomly. And they randomly sequenced whether that they had the PEA session or the NEA session first. And then, a few days later, they came into the FMRI lab. And by the way, this is now documented in series of articles. One we gave it the academy management in 2010, and one that's under review right now in a neuroscience journal. And this is under the leadership of professor Tony Jack in the biomedical lab, and the person actually running FMI for this study was Regena Likey. In the process what we discovered, three to five days later as they went through, in the FMRI scan. And they're pushing buttons reacting to video statements by the two people who interviewed them and was, were coaching and advising them. They reacted to how they felt about them. And one of the things that we did was we had PEA type statements, like, my life will be fantastic because of my time here at Case. Or we had NEA statements, Things are really boring here at Case. Or we had neutral ones, I'm learning at Case. We figured if it a university learning, a statement about learning is fairly neutral. And after we analyze all the data, we found a number of dramatic, statistically significant findings. As you'll see in the visual, one of the things that was significantly distinguishing the NEA activation. Was activation of the interior singular

cortex, and this is a part of the executive function, in particular the task positive network, which is activated when you feel torn and feel torn, and feel a degree of guilt. We've also activated the medial prefrontal cortex, which is a place where very often it's associated with feeling more self-concious. In contrast, the positive emotional attractor was predictive of activation of the orbital frontal cortex. A key part of the limbic system and the nucleus accumbens, kind of a pleasure-reward center in the brain. And the posterior singular cortex, a key part of the default mode and social network. We were so moved by the significance of these results, and in presentations at different neuroscience and management conferences, got so much encouragement. Last year, we did another study which we are, although still analyzing and we're at the point we're writing up the papers to submit to academic journals. What we did this time, was we decided to test, the degree to which when we created a control condition. And then we created a condition where people would write their vision statement, but not necessarily talk to someone about it. 'Cuz we were wondering, we, Tony, Professor Tony Jack and I began to suspect that it was in the talking to someone that the real neural activation of openness, of the PEA was happening. And then we had a do, what we call a dose dependent part of the experiment. We had people going through 130 minute PEA session, people going through 230 minute PEA sessions, and people going three. And again, on this study, Professor Tony Jack was leading the lab. Angela Passarelli was one of the two coaches interviewers, and Hector Martinez

was the other one. And Abby Dawson was actually running the the FMRIs and the scans and helping us with all the informed consent. In this case we tried to get students who were a little bit older, juniors, sometimes senior, at Case Western Reserve. So they're still undergraduates, 20, 21 year olds. And again they came in, and we did the same type of NEA session, I described earlier. for some people we had them write the vision for an hour, and then the PEA session. One of the sessions, was similar, talking about a person's personal vision, as I mentioned earlier. The second one asked people to get into compassion or gratitude. In terms of who helped them the most, and the third asked them to get into mindfulness around core values and virtues. And what we're finding again is very exciting. First, if we put people into the PEA conditions, we're saying, seeing the same statistically significant random effects activations that we saw before. An they're even clearer, because now, we had two an a half times what is normal in these FMRI studies, we had 54 subjects. Secondly, we're seeing that dose dependency really works. That the more, a person has, the more the PEA sessions they have. The stronger an clearer the activation is, in the ventral medial prefrontal cortex , a key part of activating, the parasympathetic nervous system. What came out in both of them is the activation of a part of the visual cortex, not involved in just seeing something, but the part of the visual cortex involved with imagining something.

And right now, it looks like that merely writing the vision statement helps, and activates some things. But doesn't activate the set of regions of the brain that are associated with being more open to new possibilities. So all of this is starting to help us to understand the detailed neural mechanisms of why coaching, advising, talking with someone to the positive emotional attractor can be such a lifting experience. And in the coming modules in this class, we're going to prepare you to experiment with that. To try that, to see if you can have what we call conversations that inspire. You know, by the way, one thing I should be careful about. We had people from many different cultures and countries. As subjects and as the coach's interviewers, that you might guess from their names, involved in the study. We found no differences in activation of whether the interviewer or the advisor was male or female. And we found no differences between whether or not the subject, the students, were male or female. So we weren't finding any gender differences with regard to this issue of invoking the positive emotional attractor. [SOUND]