Communication Tools, Tips and Tactics for Tackling Important Conversation Tyson Thornton, PharmD, FACHE Associate Vice President – Support Services Sebasticook Valley Health

Objectives Identify why effective communication is important Assess the two common downfalls of most communication Recognize the signs that your conversation is falling apart Identify tools that can be utilized salvage your important conversations Apply concepts to improve resolution and decision making

Acknowledgements

Why Communication Matters Communication skills allow us to: Create a feedback rich environment Increase employee engagement Clarify expectations to decrease misunderstanding and errors Navigate difficult conversations Customize coaching to performance Increase accountability and influence

When it Matters, We Often Fail We all know when they are happening, but we are wired wrong They are often spontaneous and emotional You’re making it up as you go, un-rehearsed and un-planned. But it doesn’t have to be this way. Our behavior and others derail meaningful results Often times adrenaline kicks in and shunts blood away from where we need it most, your brain is multitasking without the energy and focus it needs, that’s why stupid things often come out in the heat of the moment Its great when we know we are entering a crucial conversation, but what about when we don’t and they catch us off guard. What are your cues? Begin to try and find ways to recognize these, then step back, and start with heart…what did YOU want to come out of this conversation Behavioral Raising voice, pointing finger, becoming quiet Emotions Scared, hurt, or angry with reactions to suppress Physical signs – Often appear first Tight stomach, dry eyes

We fail often because we avoid. “At the heart of almost all chronic problems in our organizations, our teams, and our relationships lie crucial conversations – ones that we’re either not holding or not holding well.”

Where does it all go wrong?

The Difficult Choice We believe we have to choose between telling the truth and keeping a positive relationship How can we be 100% honest and 100% respectful You think like a “Yes, but…” team and not a “Yes, and…” team. This is the either/or choice

We Are All Faced with Difficult Choices at Work https://www.youtube.com/watch?v=Pl6yOIxYpL k#action=sharehttps://www.youtube.com/watc h?v=Pl6yOIxYpLk#action=share You don’t have to make the choice between keeping friends and telling the truth. It is possible to do both but it takes work, time and commitment to have the appropriate conversation.

Failure to Have Shared Meaning We enter conversations with our own opinions, feelings, theories, experiences and goals These create pools of shared meaning Sometimes our pools don’t match Pool of shared meaning = groups IQ What happens when the pool gets too shallow? Shared pools allow for “ownership” and conviction to act These items make up the pool of shared meaning about the topic at hand. Those that are great at dialogue make is safe for everyone to contribute to the shared pool of meaning, you don’t have to agree, but find ways to keep it open As the pool grows so does relevant and accurate information, even though adding more opinions takes times, it increases quality In shallow pools even smart people make bad decisions You also can’t force meaning onto the pool, this comes in the form of subtle manipulation to verbal attacks Move to silence (Salute and Stay Mute) Cold shoulder Hints, sarcasm, caustic humor, innuendo, looks of disgust Play the martyr (pretending to help) Must win personality Partly sunny vs. mostly cloudy Aggressive language/demeanor

Tools to Avoid These Failures Look to yourself Avoid the difficult choice

Look to Yourself You control You You must begin high-risk discussions with the right motives and stay focused Don’t justify your own unhealthy behavior What do you want for yourself? Others? The relationship? The biggest and easiest person to change is the one in the mirror Very often are we innocent bystanders in bad conversations or poor outcomes “If we could fix all those other losers, we’d be just fine” After you ask yourself the key questions you have to ask yourself “how would I behave if I really wanted these results?” Asking what we want shunts blood away from the fight or flight response and forces it to answer a tough question, its no longer about a response but instead about an outcome. This is a hard questions to ask, our body loves the idea of simply choosing to attack or hide

Refuse the Difficult Choice Move away from either/or, and find the elusive “and” Start by clarifying what YOU want Second, clarify what you DON’T want (what are you afraid of) Now turn that into an AND statement Turn head to head into side by side communication Are you afraid of losing, reprocussions? How can I have a truthful and honest conversation with my wife and not offend her? What if this and statement could actually add to the pool and build the relationship? Definitely not easy…this takes time and practice. Who thinks this is impossible? Do we know people who make this happen?

Give Your Team 3 Whys Head Heart Me Remember, no one takes to the streets because of a pie chart!

Next Step…Look to Others Am I moving to silence or violence? Are others?

Looking for Safety Problems Safety is important, it allows people to say anything Reactions to lost safety are often fight or flight The problem is often not content of the message but the condition of the conversation When it’s unsafe you start to go blind, quickly followed by silence and violence Safety contributes to dialogue and shared meaning, when people no longer feel safe you remove the opportunity for shared meaning The condition of the conversation is all about safety Give the example of receiving really hard feedback that you didn’t get defensive about, ask why did that not happen (it is because you believe the other person has your best interest in mind) Recode silence and violence as a sign that people are feeling unsafe, don’t add to the safety issue, even if you are one of the people beginning to feel unsafe Dual process – watch the CONTENT and CONDITIONS Three Conditions The moment a conversation turns crucial Signs people don’t feel safe (silence/violence) Your own style under stress

Silence Silence consists of any act that purposefully withholds information from the pool of meaning Manifests itself in three forms Masking (sarcasm, sugarcoating) Avoiding (talking while avoiding real issues) Withdrawing (pulling out all together) Masking Example: I think your idea is brilliant, I just worry that others won’t catch subtle nuances. Some ideas come before their time, so expect, some, uh, resistance. What they really mean is “your idea is crazy and people will fight it until their last breath” Why can some not share that, obviously in a better way.

Consequences of Silence… https://www.youtube.com/watch?v=QCSZDM8A 4Ag#action=share

Violence Violence is any verbal strategy that attempts to convince, control, or compel others to your point of view Three common forms Controlling (coercing others) Labeling (labels for people and ideas that allow dismissal) Attacking (your purpose is winning, belittling, threatening) Labeling example: “Your not going to listen to them are you? For crying out loud! First, they are from headquarters. Second, they’re engineers! Need I say more? Meaning: If I pretend that everyone from headquarters and all engineers are somehow bad and wrong I won’t have to explain anything

Make It Safe

Mutual Respect – The Continuance Condition Once people feel that others don’t respect them the conversation immediately becomes unsafe Respect is like air (as long as its present no one thinks about it) Dignity conversations Emotions tell you about respect Pouting, name calling, yelling, threats Once respect goes away you are stuck in a conversation about defending dignity Much like mutual purpose you have to ask…Do others feel I respect them?

How do we Show Respect? Caring? Listening! On average, a nurse interrupts a patient after one minute and 14 seconds Leadership for Great Customer Service, Thom A. Mayer and Robert J. Cates The average physician will interrupt a patient after approximately 17 seconds during the opening description of a patient concern Quoted by Dr. Stephen Beeson, Practicing Excellence

Why Listening is Hard! We TALK at 150 words per minute We READ at 250 words per minute We THINK at about 600 words per minute

Recovering Lost Respect or Conversational Safety First recognize that safety is compromised The key is to step out of the content of the conversation and re-create safety Step back and handle YOU first…What did YOU want out of this conversation? When you step back establish Mutual Purpose and Mutual Respect You have notice that a conversation is no longer safe, there is silence or violence taking place

What To Do Once You Step Out Mutual purpose and respect can be regained by three important skills Apologizing Contrasting Creating a Mutual Purpose Aplogizing is self explanatory, but it has to remain heartfelt and honest. If you are the receiver of this apology and you feel it is sincere you must acknowledge that back. An important point here is that if you want to actually regain purpose and respect the apology must be real. Creating mutual purpose is also self explanatory.

Contrasting Contrasting is a don’t/do statement Address others concerns that you don’t respect them or that you have malicious purpose Confirm your respect and clarify your purpose “The last thing I wanted to do was communicate that I don’t value the work you put in or that I didn’t want to share it with the VP. I do think your work has been nothing short of spectacular” It is important to emphasize that contrasting is not apologizing, it is not away of taking back something hurtful. Rather it is a way of ensuring that what we said didn’t hurt more than it should have. Contrasting provides context and proportion – prevents people from feeling words bigger or worse than you intend Contrasting is prevention or a first aid alternative

Create a Shared Goal Agree to agree – find common ground Surrender empty conversation Suspend your belief that your way is the best way A battle of wills is really about safety Add safety back to the equation Recognize the purpose behind others strategies Commit to starting with heart, false dialogue is promises with no meaning. “It seems like we are both trying to force our views on eachother. I commit to stay in this discussion until we have a resolution that satisfies both of us” Or as “why do you want to do that?” By evaluating others purpose you find more common ground, gives you a light to what it is they want in an outcome

Master Your Stories and the Emotions They Create It’s not how you play the game, it’s how the game plays you

The Rules of Emotion Others don’t make you mad. You make you scared, annoyed, or insulted. You and only you create your emotions. Once you have created your upset emotions you have only two options: You can act on them or be acted on by them. This section is all about our emotions, and what sets us off.

How to Control the Story Notice Emotions – move from initial reaction to how you really feel. Between feeling and acting is a crucial step, story telling. Analyze your Story – Once you have defined emotion is it the right emotion? Get Back to the Facts – Can you actually see or hear this fact? Is it a behavior? “Nothing is good or bad in this world, but thinking makes it so” - Shakespeare Emotion is key, not so simple, you can’t just be angry…are you instead embarrassed, surprised, etc? It’s more than angry. Just because you are feeling an emotion doesn’t mean it is always the right emotion. Don’t confuse stories with facts, you must separate the two. “He is a male chauvanist pig is most often not a fact”

How to Control the Story Watch for incomplete stories Victim stories – “It’s not my fault” Villain stories – “It’s all your fault” Helpless stories – “There is nothing I can do” Why incomplete stories? Sometimes they match reality They get us off the hook Keep us from acknowledging our own sellouts Victim stories make us innocent sufferers. Villian stories turn normal human beings into something else while exaggerating our own innocence Sellouts are something we have done that we know we shouldn’t but then we are left with two choices, own up to it or justify it.

The Rest of The Story To return to dialogue we have to tell the rest of the story. Turn victims into actors “Am I pretending not to notice my role in this problem?” Turn villains into humans “Why would a reasonable, rational, and decent person do what this person is doing?” We should assume good intentions

Change Your Focus and “STATE” your path! Once you have focused on yourself and your story you have to start pulling others in, STATE your path provides skills for that

STATE My Path Share your facts Tell your story Ask for others paths (Facts and Stories) Talk tentatively Encourage testing Keep facts simple and non-controversial Tentative talk means not trying to disguise your story as fact – your story is truly that, your story. “perhaps you were unaware” or “in my opinion” work well. The are much better than “everyone knows that” or “the fact is” Testing is making it safe for others to share their views Remember to catch yourself if you become emotional here, it is ok to hold to your belief but not your emotions around that belief.

Explore Other’s Paths Ask to get things rolling (show interest-be sincere) Mirror to confirm feelings Paraphrase to acknowledge the story Prime when you’re getting nowhere “When people become furious, be curious” Exploring other paths will invite a free flow of meaning Simply express and interest to hearing others opinions Priming is taking your best guess at what they are thinking (Terri does this well)

Talk Tentatively Don’t describe your story as fact “Perhaps you were unaware” vs. “everyone knows that” “in my opinion” vs. “these are the facts”

Encourage Testing Invite Opposing Views – “what am I missing here” Mean It – “what problems could this cause” Devil’s Advocate Continue to encourage testing until your motive is obvious Remember your ABCs Agree, Build Compare Agree – when you do Build – where things are left out Compare – don’t suggest others are wrong Differences can’t become debates, these lead to bad results and unhealthy relationships

Does This Scare Anyone? What if the person is wrong or really crazy…

Seriously…what if they are REALLY crazy…

Exploring the Path Remember, you are simply trying to understand their point of view Listening does not equate agreement This is their path, but you still get to share yours, as well as everyone else

Uncontrolled Conversation What do you do when a conversation becomes disrespectful or in-subordinate Address the issue immediately Step away from the conversation at hand and address the ongoing behavior in the conversation

Example “The way you are leaning in towards me and raising your voice seems disrespectful. I want to help address your concerns, but I am going to have a tough time doing so if this continues.”

Offer Other Solutions Inform the person that the best option for both parties is to step away from the conversation for a period Offer to discuss at another time with another member of management of team member present Utilize Human Resources for further conversations with this individual

Making the Decision

Making the Decision Dialogue is NOT decision making Define how decisions will be made Define when decisions will be made Being part of dialogue does not guarantee a part in the decision. Who will be involved and why? Set a follow-up time Pools of shared meaning are important, but it can result in more difficult decision making

Decision Making Process Command – dangerous and MUST be explained Consult – gather input, but don’t put on a charade Vote – Know when to vote, should not replace difficult analysis and conversation Consensus – Not always appropriate, decisions should be based on merit Command – Does not involve others Consult – Don’t do this if you already know your answer, if it is a command decision than make it one Vote – Agree on consensus early on Consensus – Don’t pretend everyone gets their way, this rarely works.

Which Decision is Best Remember the decision is NOT action Four key questions to determine best decision making mode. Who cares? And wants to be involved. Who knows? Who are the experts. Who must agree? Future buy-in. How many people are worth involving? Do we have enough people to make a good choice? Remember the decision is NOT action

How Will You Make Decisions? https://www.youtube.com/watch?v=MiY1DkIVZ ro