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In health coaching, as in society, we just don’t seem to like silence! We’ll do just about anything to avoid silence. We keep talking without giving the other person a chance to talk.  We interrupt.   We fill in the silence with fillers like “um” or “uh”.  Here’s the truth: those pauses in communication can be one of the most powerful communication tools we have.

— Rob Jolles, jolles.com

Last week at one of my trainings on motivational interviewing in health care, the “power of the pause” came out as one of the key “take aways” for a nurse who was attending.  I always provide an opportunity for participants to provide what was a “precious jewel” that they will remember for the day and describe to the group.  For Jane, it was the power of the pause.

Fills in the Void

Why is the power of the pause so effective in motivational interviewing and health coaching?   Because it gives the opportunity for the patient/client to fill in the void.  During conversations, a pause, a time when no one is saying anything, feels uncomfortable, awkward and quite frankly, a waste of valuable time.  I could be providing knowledge to this person, we often think!

Typically, if we, the coach, the health practitioner, are quiet, who will fill in the void?  The patient/client.   And most likely, it is rich thoughts the patient/client provide and often realizing something for the first time.  In addition, saying those thoughts out loud is powerful and helpful in the change process.  Dr. William Miller. Motivationalinterviewing.org

Pausing Shows Respect

Pausing after someone has spoken shows respect to the other person, indicating that you are taking into account their ideas.  (Source)

You are giving them space to think, ponder and go deeper into their why.  This translates into a deeper more meaningful conversation about change. This is designated as the first and most essential process of motivational interviewing; engagement.


  1.  Just stop talking. Think of WAIT.  Better known in my trainings as WHY AM I TALKING. When we stop talking, the patient/client will feel the need to fill the “awkward silence”.  In that way, we learn more about the other person. 
  1.  Pause. Instead of repeating “um”, “like”, “ok”, “you know”, just pause, take a breath and give the other person time to fill in the pause. They will understand as you are genuinely curious, interested in their story and their “why”.  With this, they will feel more comfortable to share their story.

In a time when we think, more is better.  In communication and changing the conversation, less many be more.  Less talking and more listening on our part as health practitioners.  Remember, those pauses in communication can be one of the most powerful communication tools we have.  The POWER of the pause.

Transform conversations.  Transform healthcare.

Dr. Becky Lang


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“Dr. Lang’s training provided me with a better understanding of the motivational interviewing process. The skills I learned from her training have helped me feel more engaged and thoughtful when listening and talking with those around me. Dr. Lang is energetic, knowledgeable, passionate and provides a great learning environment.”

Nancy AdrianseBSDH, Oral Health Manager, Iowa Primary Care Association

“The training I received in Becky’s motivational interviewing class was invaluable. It laid a wonderful foundation for me to effectively empower my patients to develop and implement positive changes for their health. Becky created such a nurturing, nonthreatening environment that allowed me to freely learn and practice. This is certainly a class I can recommend to anyone wanting to learn to assist others with behavior changes.”

Robin GeorgeRN, Motivational Interviewing training participant

“At the YMCA, we have worked with Dr. Becky Lang for over a decade now to help us shift and shape our culture. As an organization committed to strengthening our community, the coaching and training skills that Dr. Lang has provided have helped us immensely. With her education and guidance she has helped us establish a culture that focuses on building meaningful relationships with our members, focusing on their needs, and coaching them towards success in their pursuit of a healthy lifestyle. Dr. Lang has trained all levels of our staff from our front line Wellness Coaches to our Executive Directors and Leadership Teams. Her on-going support has allowed the coaching-culture to come alive in our organization.”

Kim Stewart Kim Stewart Director of Operations, YMCA of Greater Des Moines

“The training Becky provided has been one of the most rewarding nursing experience I have had in 30 years. The style of interviewing and teaching patients is rewarding and positive. Her techniques drive the sessions to be more personal and patient-centered. Through Becky’s teaching, I was comfortable to practice and get familiar with the motivational interviewing process. Becky is an exceptional trainer and I recommend her training to all health coaches and educators.”

Sandy LovelessRN, Motivational Interviewing training participant

“The motivational interviewing techniques Becky teaches allow patients to set goals and work toward changes that are important to them. Patients feel in control of their own health and allow me to be in a more supportive roll. Becky has a positive and uplifting spirit that makes her classes extremely enjoyable.”

Tyra CarltonRN, Motivational Interviewing training participant

“Rebecca Lang was a respected colleague who diligently served as a teacher and mentor to hundreds of students over her long career at Grand View University. I had the distinct pleasure to work with Becky and regularly witness her vocation to Wellness education. She motivates those around her by a strong and genuine commitment to a lifestyle which promotes health and well-being.”

Katharina TumpekPhD, Professor and former Chair, Dept. of Health Promotions, Grand View University

“It has been a pleasure to work with Becky Lang over the last 25 years. Within a variety of contexts in the wellness arena, I have witnessed Dr. Lang’s mastery as a wellness educator, a health coach, a professor, and, most recently, as a health coaching trainer. I could go on at length about Dr. Lang’s passion, enthusiasm, high energy, wisdom, and deep knowledge in health promotion and behavior change. One of the attributes that impresses me most, though, is her ability to create a relaxed, fun, interactive, and content-rich training environment. Her refreshingly supportive, inviting, and empathic style of training and coaching allows learners to take risks, experiment, try on new skills, and participate authentically in role play exercises without feeling awkward and intimidated. Through Dr. Lang’s coaching and training, people learn–often more than they imagined.”

Jill NorrisRN, MPH, PCMH-CCE, Director, Care Management, University of Iowa Health Alliance