Getting Somewhere New Together: Increasing Our Capacity for Dialogue Across Differences
2021; Mary Ann Liebert, Inc.; Volume: 30; Issue: 6 Linguagem: Inglês
10.1089/jwh.2021.0157
ISSN1931-843X
Autores Tópico(s)Coaching Methods and Impact
ResumoJournal of Women's HealthVol. 30, No. 6 CommentaryFree AccessGetting Somewhere New Together: Increasing Our Capacity for Dialogue Across DifferencesJanet BickelJanet BickelAddress correspondence to: Janet Bickel, MA, Leadership and Career Development Coach, 7407 Venice Street, Falls Church, VA 22043, USA E-mail Address: janetbickel@cox.netLeadership and Career Development Coach, Falls Church, Virginia, USA.Search for more papers by this authorPublished Online:10 Jun 2021https://doi.org/10.1089/jwh.2021.0157AboutSectionsPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail —"Being right is the most terrific personal state that no one else is interested in."—Franz Kline—"The deepest principle in human nature is the craving to be appreciated."—William JamesThe skills underlying the bridging of multiple differences have never been more critical in medicine and in our world. Although most team and leadership development programs increase participants' understanding of differences in temperaments and work styles, few focus on more sensitive areas such as gender, socioeconomic, and racial differences. This editorial reviews the skills foundational to such dialogues: self-monitoring, creating an invitational presence, asking open questions, listening with a desire to learn, and presenting perspectives with adequate background.Self-MonitoringWhen it comes to the intelligent use of emotions in relationships, self-monitoring means remaining open and centered even when we feel devalued or challenged. Unfortunately the more common reaction is to ready our defenses, releasing adrenaline that constricts blood flow to the cerebral cortex, effectively impairing logical thought. Fortunately, we can learn to respond more intelligently: at the first sign that a negative emotion has been triggered (e.g., faster heartbeat, rising heat), we pause, take a deep breath, exhale slowly, and silently ask ourselves: "what hooked me" and "why am I reacting so strongly?" Examining any nonproductive instinctive reaction gives us a chance to examine what triggered it. As we become smarter about our triggers, we are better prepared for difficult interactions.Invitational PresenceSince we are more accustomed to thinking alone than together, stepping into the unknown of another person when something important is at stake involves some preparation. We might reflect on: How do I want to come across? What are my goals in this interaction? What emotions might surface? Do I have balanced access to my thoughts, wants, and feelings? Am I stuck in any either/or thinking, when both/and is more likely, for example, both your truth and my truth are relevant? As this review indicates, the most important conversations may be those we have with ourselves first.Asking Open QuestionsPowerful questions encourage engagement and reflection and help others to tap into their own wisdom and solve their own problems. Good examples include "What is your interpretation of.….?" and "What are you concluding at this point? Please give an example of what you mean." Especially if any aspect of someone's identity is involved (e.g., their competence or trustworthiness), care is required to avoid provoking a defensive response (e.g., "since this is probably a sensitive issue, please help me understand how you're feeling about this right now"). Questions that begin with "why do you…" tend to elicit a defensive reaction.If someone's actions are confusing, we might ask about gaps we are observing between behaviors and espoused values, for example, "On the one hand you.…., yet you say that.…Can you help me understand how these connect?"Now that we must rely more on pixels and eyebrows in communicating, the quality of our questions is more important than ever.Listening with a Desire to LearnThe Chinese character for listening includes not only the ear, but also eyes (bodies broadcast a lot of information) and an open heart and open mind. The root of not listening is assuming we already know. We tend to listen automatically, sorting quickly into binary categories that ignore what is in between, for example, right/wrong, agree/disagree. Many professionals train to hone in on a diagnosis as soon as possible, and much of the time this automatic sorting is effective. But it is critical to sense when to slow down and ask ourselves "what does she see that I don't?" and when to invite the other to "say more." Everyone has a partial truth, and we must lean in to hear it.In tense situations, it may be helpful to visualize a "listening field." Rather than absorbing another's difficulties or barbs directly into our solar plexus, we create a space where words land in our presence while we consider their intent.Reflective listening saves time and increases our chances of hearing what people are not saying. Accurately attuning to others, we may even sense unspoken needs and fears, useful in finding common ground in a conflict or negotiation. Finally, giving someone our full attention, which is the greatest gift we can ever give another, increases trust and usually the value of the information shared. And having felt understood, the other will likely be more open to our views.In addition to already "knowing" another's mind, barriers to reflective listening are legion—multitasking, hunger, feeling rushed, a habit of drawing attention to oneself, prematurely suggesting solutions, and fatigue. Often we will not be good at it. What is important is knowing when to slow down into this mode.Presenting Perspectives with Adequate Background and Inviting DiscussionWe tend to proceed as if our reasoning is self-evident, when all we are doing is expressing opinions. Here are suggestions for combining assertions with open questions to facilitate dialogue: * Explain your reasoning [e.g.: "This is how I arrived at this conclusion"] and intent ["My goal in raising this is…."].* Use and ask for examples [e.g.: "Tell me about a time when that happened"].* Test assumptions and inferences [e.g.: "Perhaps we're starting from different assumptions about the goal. Here are mine…How do you see this?"]* Agree on what important terms mean [e.g.: "To me a successful outcome would look like… How about you?"]* Practice "perspective-taking"—that is, after the other has explained something of importance, summarize their frame-of-reference and conclusions [e.g.: "As I understand it, you believe that… Is that correct?"]* Avoid the conjunction "but"; it invites a defense. "At the same time" is usually more accurate.* Listen for ways to reframe, that is, retaining what is essential while eliminating what is unproductive [e.g.: "I understand that her action upset you—now let's focus on next steps"].* When necessary, shift the focus onto the here-now interaction (e.g.: "How do you think this conversation is going right now? Is the way that we're interacting ok with you?").ConclusionAlthough most health care professionals communicate skillfully with patients, many have room to improve in settings where they are not in charge and must bridge a potentially emotionally charged difference. Such dialogues depend above all on a willingness to examine our own thinking process to understand how we have reached the assumptions we hold.Lately sometimes it feels as if our differences exceed our capacities for communicating about them. In such cases, all we can do is demonstrate respect. People generally forget what we say but not how we make them feel.We cannot solve problems we do not talk about. The practices outlined here shift the culture in a relational direction one conversation at a time.AcknowledgmentsThe author thanks Joseph Keyes, JD, Diane Magrane, MD, Kriti Prasad, and Niki Steckler, PhD, for their assistance with an earlier version of this article.FiguresReferencesRelatedDetails Volume 30Issue 6Jun 2021 InformationCopyright 2021, Mary Ann Liebert, Inc., publishersTo cite this article:Janet Bickel.Journal of Women's Health.Jun 2021.767-768.http://doi.org/10.1089/jwh.2021.0157Published in Volume: 30 Issue 6: June 10, 2021Online Ahead of Print:April 28, 2021PDF download
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