NOW, HOW DO I SAY THIS?

 

As a surgeon we have to do this once in a while with our colleagues, with our patients or with their relatives.  A colleague who is not living up to our expectation or having inter personal issues with other team members, a patient who has been diagnosed with a life threatening disease or a life changing morbidity or concerned relatives of patients in the intensive care, all these are situations that deserve a serious and difficult conversation. Everyone dreads difficult conversations.

 

Having to deliver unpleasant news, discussing a delicate subject, or talking about a situation that was offensive or hurtful can be daunting. You may be uncomfortable with setting limits or worry about how the other person will react. While all of that is completely natural and normal, these conversations cannot be avoided altogether. In fact, putting them off for too long can potentially let the issue grow worse. Discussing difficult matters in a respectful way is an immensely important part of any healthy relationship, whether it’s a friend, an employee, a relative, or a significant other.

 

Approaching difficult conversations correctly will not only raise the chances for a positive outcome, but it will also make you feel more at ease before and during the talk. Mental health and communication experts have a few things to say about this which I intend to share with you.

 

Prepare ahead and be as clear as possible

To prepare for the conversation, you need to first identify the problem you are about to raise. To do so, ask yourself the following questions:

1.      What exactly is the behavior that is causing the problem?

2.      What impact does that behavior have on you (or the group/organization)?

3.      What do you want to accomplish by having this conversation?

It’s important that you maintain clarity for yourself so that you’re able to articulate the issue concisely to the other side. Confusion or hesitation could make the situation more awkward, and derail the conversation in a direction you didn’t plan on and that isn’t productive in solving the problem at hand.

 

It is important to use specific examples for your concerns and the things you’d like to happen differently. Avoid words like ‘always’, ‘never’, ‘everything’ or ‘nothing’. These words may express your frustration, but they over-generalize and aren’t helpful in the communication process.

 

Don’t wait too long

When a friend or a relative does something that offends you, it’s best to discuss the challenging issue as it comes up or soon thereafter. It’s never helpful to hold onto feelings of anger, frustration or resentments for days or weeks, and then unleashing them on another person all at once. Discussing an issue when it’s still fresh in your mind will usually make for a calmer, more grounded conversation.

Similarly, an unfavourable test result or a poor prognosis should be conveyed to the patient and his/her relatives well in time so that they have the option of seeking a second opinion.

 

Manage the emotions

You might be coming to the conversation with a bag of emotions like anger or frustration. It’s important that you express how you feel, but try not to fixate on these emotions and let them run the show. Speak as calmly in a matter-of-fact tone as possible. That being said, don’t block emotions completely out of the conversation. Being human is most important, more important than being robotically correct. If the other person seems annoyed, saddened, or even starts to cry, these emotions should be acknowledged and respected, not ignored.

 

Don't be afraid of silences

There will be moments in the conversation when silence occurs. Don’t let it faze you and don’t rush to fill it in with words. These silences are helpful; they allow us to really hear what was said and let the messages sink in. Some people are uncomfortable with silences and that is understandable, but it’s important to be prepared for them when approaching a sensitive conversation. A constant flow of words can come across as steamrolling or overbeating. A pause also has calming effects and allowing these moments is likely to lead to a better outcome.  It is not every day that a son hears that his mother’s condition is deteriorating and we may lose her. Let the information sink in a somber silence, it does not need many more words.

 

Give the other person your full attention and respect

When the other person is speaking, consciously listen to what they are saying, with the intent of hearing them. That is very different from waiting for the other person to finish speaking so you can respond. To achieve this, you must approach the conversation with a genuine interest in solving the problem, rather than prioritizing the need to be “right”. If you see the conversation as a competition where you need to be right, it means the other person must necessarily be ‘wrong’. This kind of either-or mentality makes reaching a mutual understating much less likely. If you are not sure what the other person said or meant, ask for clarification before you respond. For example, “I’m not sure what you mean. Can you please help me better understand?” Making the other person feel heard will prevent the conversation from turning into an argument.

 

Choose your time and place

We already established that if you need to have a challenging conversation with someone, it’s best to plan it out rather than just walking into it spontaneously. The time and place can make a big difference in the other side’s willingness to accept and hear what you are saying. Choose a relaxed location and a time that suits both of you, so no one is under any external stress. For example, if you approach the other person right before they have to meet an important deadline or you have a class to teach, the additional stress you both are under can affect the conversation negatively. Telling someone “we need to talk” helps to signal that time needs to be set aside to have the conversation.

 

Give it time

Keep in mind change doesn’t happen overnight. You might reach a big breakthrough during the conversation, or have an eye-opening moment, but chances are both parties will need time to digest and reflect. So give each other the space needed for that. Don’t be discouraged if you don’t feel like everything is perfect right away. What’s important is that both of you expressed how you feel respectfully, and are on the same page.

 

Drop your assumptions

Even if you know someone through and through, it doesn’t mean you can always predict what they are feeling and thinking. Ultimately, you can’t control how the other person will react to your effort to engage them in a challenging conversation. People grow and change, and their needs and expectations change over time too and need to be renegotiated. So it’s best to drop any assumptions before walking into the conversation in order to be truly open-minded and accept the outcome. This is even more important with those you have come to know only recently and that too under adverse circumstances and mental stress. Keep reassuring them that you are with them and your help is unconditional and uninterrupted but they need to know the truth.

 

Having these conversations promptly, however, helps us to cultivate our integrity, and helps us to develop the courage and honesty we need to address the hard moments ahead in our futures. To many of us, it can seem easier to avoid an issue, rather than to address it. Tough talks are no walk in the park, and they can leave us feeling anxious, stressed and desperate for a way out. The problem, however, is that these conversations are often the most important ones we can have. Avoiding the tough stuff will only get you so far in life, as life is made up of tough stuff. By learning how to brave hard conversations now, you’ll be better equipped for the next conflict you face, or the next situation that calls for an addressing of uncomfortable issues and emotions.