Let’s face it, most of us don’t like having ‘difficult’ conversations with other people. We don’t like conflict, we feel uncomfortable disappointing people, and often we’d rather take responsibility to sort things out ourselves rather than holding others to account. It all goes back to the way our brains are hardwired from an evolutionary perspective- stay in the tribe, don’t stand out – coupled with our own early life and adulthood experiences which combine to make our personalities, such as scoring high on the trait of ‘agreeableness’, pleasing other people.
However, having difficult conversations is an essential part of any medical or professional role, let alone in our personal lives. It’s a key leadership and management skill, and is also a key skill to enable us to negotiate more of what we want and need to honour ourselves. And the great news is that because it’s a skill, it’s something we can all learn how to do, and we can all continually improve on how we do it.
First, be clear on your own intentions
Unless you are in the extreme situation of having to cut someone out of your life (generally a last resort after everything else has been tried), you will probably want to stay in relationship with the other person. This may be on different terms than before and with new agreements or boundaries, but nonetheless you are seeking to stay in relationship, and remembering this in your intentions can be really important. Your main aim is to connect with the other person and to increase understanding between you both, and perhaps to make requests and new agreements for the future.
Choose the right moment
It’s important that whenever possible, the other party doesn’t feel on the spot as that will make them instantly defensive and less likely to hear what you are seeking to communicate. ‘I need to talk with you about something important, can we agree a time to do this? Is now a good time, or would another time suit you better?’. Make sure that your conversation is in a confidential environment and that you both feel safe to discuss a difficult issue.
Stick with the observable facts and remove evaluations
Imagine a video camera or microphone had recorded what had happened that you needed to discuss with the other person. Take out any diagnosis, judgement, labels, analysis, criticisms, and comparisons. State the observable facts, ‘When I remember you…’, ‘When I see you…’, ‘When I hear you say….’.
Examples could be ‘When I see you using your phone in our team meetings…’; ‘When I remember you raising your voice at your colleague…’; ‘The last three times I asked you to complete this task, you did not complete it.’
You may wish to remove any comments such as ‘you always/ never/ constantly’ if at all possible, as the effect of using these words is that the other person goes straight to defending the time(s) when that was not true.
Comment on the effect
The effect could be the effect on yourself, on the other person, or on other people. Or it could be on inanimate objects. When the effect is on your own feelings it is very powerful, because no one can deny you your own experience.
‘When I see you using your phone in our team meetings, I feel that you are not committed to working together’; ‘When I remember you raising your voice at your colleague, I feel that you are not respecting her professionally’; ‘The last three times I asked you to complete this task, you did not complete it. This makes me feel that I am unable to rely on you.’
Discuss how it is for the other person
This stage involves your advanced listening skills. ‘I would like to understand what is happening for you/ how you feel about this conversation/ your thoughts and feelings about this matter’. You then need to really listen to what the other person is feeling and what needs they are trying to meet in their unskilful behaviour. Understanding that all human beings are seeking to get their needs met most of the time is a useful perspective to hold. Knowing that most of us are not very skilful at communicating most of the time is also very useful, as we can be more compassionate about our own and others’ behaviours. This doesn’t mean letting people off the hook, but it does mean that we can approach our communication with others from a kinder and more effective perspective. So, listen deeply for what the other person is feeling and needing and if appropriate help them to draw this understanding out for themselves. ‘So, you raised your voice at your colleague, because you were feeling worried that we wouldn’t get this piece of work completed on time, and you hoped that by raising your voice she would understand your feelings of worry?’.
Make requests and new agreements for the future
Making clear and unambiguous requests is crucial. First we need to build connection (above) and then move on to what we want in terms of solutions. In making a request, it is an invitation for the other person to say yes or no to. Requests need to be clear (not ambiguous), positive (what you want to see more of rather than less of), and immediately do-able (practical and from now on).
‘In the future, would you be willing to…’
‘I would like to request that in future you… will you agree to that?’
Close on a connection
Make sure that you close the conversation on a connection. This could be a check whether the person heard what you wanted to communicate, or it could be a check how the other person is feeling after hearing what you said. ‘Would you be willing to tell me what you just heard me say/ what we just agreed?’; ‘would you be willing to tell me how you feel now after this conversation?’. You may like to close with a thank you, ‘I’m glad we talked, thank you for your time today, I look forward to continuing to work together in the future’.
As doctors, professionals, managers and leaders, we need to paint bright lines (describe our feelings and make agreements about new behaviours), build connection and relationship with people, and also we need to honour our own needs and to understand others’ needs. It is possible to communicate from a perspective of compassion and connection rather than domination – and your own skill and willingness to have difficult conversations makes everyone’s working life much better, including your own.
Dr Fiona Day (MBChB, FFPH, Dip Occ Med, ILM 7 Executive Coaching and Mentoring) is a Leadership and Career Coach and helps Doctors and Professionals to succeed as Leaders and to improve their careers and working lives, using evidence based psychological theory and behaviour change science. Download a free career planning workbook and find out more at www.fionadayconsulting.co.uk; to explore working with Fiona please book a confidential half hour Career Consultation here.