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

2. 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

3. Acknowledgements

4. 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

5. 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

6. 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.”

7. Where does it all go wrong?

8. 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

9. We Are All Faced with Difficult Choices at Work
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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.

10. 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

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

12. 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

13. 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?

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

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

16. 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

17. 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.

18. Consequences of Silence…
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19. 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

20. Make It Safe

21. 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?

22. 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

23. 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

24. 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

25. 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.

26. 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

27. 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

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

29. 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.

30. 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”

31. 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.

32. 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

33. 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

34. 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.

35. 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)

36. 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”

37. 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

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

39. Seriously…what if they are REALLY crazy…

40. 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

41. 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

42. 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.”

43. 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

44. Making the Decision

45. 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

46. 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.

47. 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

48. How Will You Make Decisions?ro