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.