Mindful communication, part 1: Listening well

George Bernard Shaw once said, “The single biggest problem in communication is the illusion that it has taken place.”

It's so true. We email someone, text someone, say something, and then are shocked when the person feels we didn't communicate.  And at other times, people expect that we know something because they're under the false assumption we are in the loop.

We can only be responsible for our own part of communicating. So let's zero in on a couple of key ways we can improve our own skills. This week it will be on listening/receiving.  As busy physicians, we likely all have room to improve our listening skills.

First, to listen well, you have to believe the person speaking to you has something valuable to say—Check in with yourself when you prematurely assume otherwise. 

 Second, determine what level of listening you are employing. I like the way Co-Active Coaching teaches that the are 3 levels of listening. 

There is first-level listening where many of us live most of the time. We are tuned in to our own thoughts and agendas, even when listening to others talk to us. This is often where we fall into the trap of listening to respond instead of to understand. Or, we are thinking about how we need to move the conversation along or about how hungry we are.  At other times, we often excel so well; we can be so in tune with our thoughts we actually don't hear it when our kids say, "Can I have a snack?" and yet somehow subconsciously nod.  My kids were surprised when I was like, "Why are you eating a snack so close to dinner?" (They were crafty too. They learned to wait until they could tell I was in the thinking zone to ask me for things to get that permissive unconscious nod). There isn’t anything inherently wrong with level 1 listening, but we will often miss the fullness of what’s being communicated. When it’s in an email or text form, this first level receiving is skimming and thinking we got the gist. I do this frequently when I'm in a hurry or have other things going on. (Don’t worry, I have very in-tuned family members who are happy to point it out to me.)

Second-level listening is when we are out of our own heads and fully focused on the content of what the person is saying to us. This serves us well in key patient interactions and with our colleagues, friends, spouses, and kids. I would equate this to being fully present with the person at hand. Truly understanding what's being communicated is very helpful to diffuse escalating situations as well. For example, a person who is upset gets disarmed a bit, knowing they are actually being listened to.

Third-level listening is when you are still focused on the person communicating with you, but now you zoom out to more than the content. You notice the voice inflections, facial expressions, body positions, breathing patterns, and where their visual focus changes. You can see the change in energy. You can also use this with your patients. It's fun when someone is unaware of the change, and you point it out, they gain some insight.  For example, when their whole demeanor changes when they talk about swimming, you can point that out to them. You can help them figure out how to get back to doing something that obviously brings them joy.

Third, try to reserve judgment as you listen. Judgment skews what you are really hearing and understanding. 

Last, be sure to ask clarifying questions and use closed-loop communication when appropriate to ensure you're on the same page. 

So, this week, notice as you are listening, do you believe that the person communicating has something valuable to relay? Can you withhold judgment until you have heard them out? What level of listening are you employing? What level do you want to be in? Play around with it and learn how you can adjust on the fly. These things will improve your listening skills.  Next week we will tackle how we can improve our speaking skills.

Have a joy-filled week!   Tonya

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