You Hear Me??!!

My old friend, Dr John Ewing, a Scottish psychiatrist and chair of the Department of Psychiatry at UNC Chapel Hill, tells the story of coming to the psychiatric hospital one day and reviewing his dictation from the previous day.  He does a quick-take when he reads in an History & Physical:  "Patient became despondent upon returning home and finding her husband in bed with his power mower." 

Dr Ewing thinks, "Surely I would have remembered THAT!"  Then he remembers what he actually dictated:  "Patient became despondent upon returning home and finding her husband in bed with his paramour."  

While the story is both funny and true, it points to the importance of being heard correctly.  As behavioral health professionals we, of all people, should be experts in listening and making sure people are heard correctly and understood.  I was taught in graduate school that there are “5 Keys to Active Listening”:

1. QUIET.  You can’t hear what others are saying when you are talking yourself.  Just as important is an “inner quiet”, that is, keeping your inner voice quiet as well so you are focused 100% on what the other individual is saying.

2. LISTEN.  Duh, thank you, Dr Obvious J .  But, kidding aside, by “Listen” I mean employing “active” listening techniques that assure (a) you are getting the message correctly and (b) the individual knows their message was received correctly.  We do this by:

3.  EVALUATE.  What is the person saying?  How are they saying it?  What are they trying to communicate?  What does their non-verbal behavior suggest?  Evaluate the message, how it is being communicated and what you think it means.

4. ASK.  Ask questions to clarify the message and to indicate to the individual that you are listening.  “When did that happen to you?”  “How did that make you feel?”  “What did you do then?”

5. REFLECT.  “Reflect” or mirror the individual’s message back to them to make sure you are getting it correctly.  “So, you said this happened two years ago and it made you feel angry?” 

The way I remember these techniques is the anagram:  Quiet L.E.A.R.  Try them today and see if they don’t improve the way you communicate with patients, families and colleagues. 

    

The Mayonnaise Jar & Two Beers

A professor stood before his philosophy class and had some items in front of him. When the class began, he wordlessly picked up a very large and empty mayonnaise jar and proceeded to fill it with golf balls.

He then asked the students if the jar was full. They agreed that it was. The professor then picked up a box of pebbles and poured them into the jar. He shook the jar lightly. The pebbles rolled into the open areas between the golf balls. He then asked the students again if the jar was full. They agreed it was.

The professor next picked up a box of sand and poured it into the jar.  Of course, the sand filled up everything else. He asked once more if the jar was full.  The students responded with a unanimous 'yes.'

The professor then produced two beers from under the table and poured the entire contents into the jar effectively filling the empty space between the sand.  The students laughed.... 

“Now, said the professor as the laughter subsided, 'I want you to recognize that this jar represents your life. The golf balls are the important things---your family, your children, your health, your friends and your favorite passions---and if everything else was lost and only they remained, your life would still be full.”

“The pebbles are the other things that matter like your job, your house and your car.  The sand is everything else---the small stuff.”  REMEMBER:  “If you put the sand into the jar first,' he continued, 'there is no room for the pebbles or the golf balls and the same goes for life. If you spend all your time and energy on the small stuff you will never have room for the things that are important to you.”

“Pay attention to the things that are critical to your happiness:  Your children, your parents, your grandparents.  Take time to get medical checkups. Take your spouse out to dinner. Play another 18. There will always be time to clean the house and fix the disposal. Take care of the golf balls first---the things that really matter.  Set your priorities. The rest is just sand.”

One of the students raised her hand and inquired what the beer represented. The professor smiled and said, “I'm glad you asked:  The beer just shows you that no matter how full your Life may seem, there's always room for a couple of beers with a friend.”One of the students raised her hand and inquired what the Beer represented. The professor smiled and said, “I'm glad you asked:  The Beer just shows you that no matter how full your Life may seem, there's always room for a couple of Beers with a Friend.”