I took this amazing course on communication a few years back and I have never forgotten the first thing the gentleman said… you don’t really listen now, you never have and you probably never will.
Wow what a harsh way to start a communication course, but in a sense and for the most part it’s true.
But when I learned all the things that were preventing me from really listening, I actually started to hear more clearly what the people in my life were trying to say and sometimes I really noticed the things that were missing in the conversation.
It’s been said, and I believe it to be true, that most of communication is in the listening.
Now in order to really understand this statement we need to include not only the words being said but also the tone of voice, the pitch and rhythm and although it may be controversial in some circles I believe real listening requires visual cues like body language, posture and the physical response to questions especially when you are looking at communication from the therapist – patient relationship.
To really understand what our patients are trying to communicate we first need to understand how (in the context of communication) the majority of the message is relayed by the patient.
Remember that different experts break down things in different ways so the exact numbers may be slightly different but the idea is very similar.
We can break it down like this
– Only 7% of the total message is found in the words
– Up to 38% of is in the paralanguage (this is the pitch, tone and rhythm of the voice)
– The remaining 55% of the message is found in the body language (mostly facial expressions)
Now this does not mean we should ignore the words, it just means, to get the full picture we must be present and pay attention to a number of different cues while our patients are talking.
Blocks To Listening
Are you really listening to the other person when you already have an opinion about the person?
It’s kind of like looking at life through rose colored glasses.
We have so many opinions and preconceived notions about how things are and how people are that it completely invades our listening and hence how we relate to other people.
Some of the blocks to listening:
- Mind reading: assumptions do not help us hear what the other person is actually saying, they are self-confirming beliefs.
- Judging: Do I agree, do I disagree with what this person is saying are they right or wrong… these thoughts pull you away from listening they don’t help you hear what the person is saying.
- Identifying: This is when you relate the speaker’s story to something similar in your life. This is a block to listening because you are not actually listening to their story so you may miss important details that are not in your story.
- Filtering: This is only listening to the parts of the story that resonate with you and skipping over the parts that don’t.
- Placating: Bypassing the tough parts of the conversation or saying things like “at least they passed at home or they are no longer in pain”… this is what we sometime do, not for the speaker but for ourselves to avoid our discomfort.
- Advising: Thinking about advice we can give to help the person while they are talking is noble, but it can take us away from listening to what is actually being said.
These are just a few of the blocks to listening, there are many more.
But if you look honestly, you may see yourself in a few of these examples.
It is not bad and wrong to do these things, it’s just not an effective way of listening to other people.
Pseudo listening is basically pretending to listen but not really listening to what the other person is trying to say.
The intention is NOT to listen, but to have some other needs met.
I know I am guilty of this from to time in my personal life and it has even entered my professional life occasionally.
This is something to be aware of, because only when we are consciously aware of something we have the opportunity to shift.
Some of the reasons we may be pseudo listening:
- Sometimes we just want to be liked, so we try to give the appearance of listening intently.
- In social situations we may be checking for signs of rejection.
- With a spouse or an adversary we could be hunting for a specific piece of information.
- Sometimes we are buying time or rehearsing our response.
- From time it is Quid Pro Quo I am listening to you, so you will be listened to.
- During arguments we may be listening for weak points; gathering ammunition.
- Trying to be or look good or nice.
- Sometimes it’s as simple as not knowing how to leave without offending.
Think about the times you are doing this, were you really listening to the other person or were you so distracted by your own thoughts and motives that you completely missed what the other person was trying to say?
So what, you may ask, is real listening?
The Messages Workbook (a text we used to use in PD100), says that being quiet when someone talks does not constitute REAL LISTENING.
REAL LISTENING is based on the intention to do one of the four following things:
- Understand someone.
- To enjoy someone.
- To learn something.
- To give help or solace.
Intention has a big role to play in real listening, when you get out of the way, listen and watch the person in front of you listening will come easy.
In order to not only hear what the person is saying but also let them know you heard and understood what they said. You can use a three step process called active listening.
Paraphrasing is simply repeating what you heard back to your patient, but in your words.
In other words ….
So basically how you felt was…
Did you mean…?
Paraphrasing should be used any time your patients say something of importance about their pain, accident, injury etc.
We use clarifying to make sure we have understood not only what the person said but also the context.
When we take the time to clarify we show our patients that we want to fully understand the communication, we understand the impact of the situation and we are willing to put in the work to fully know and understand the person and the impact the condition is having on them.
When we understand what has been said and we have clarified that we understand the context we can now give feedback.
This can be in the form of a treatment plan, a referral to another healthcare professional when the issue is out of our scope, or it may be reminding someone that compliance to home care is vital to the treatment plan.
Listening With Openness
Have you ever heard the phrase “ looking at the world through rose colored glasses”?
I have always believed that this points to the fact that we all have some idea of the way things should be.
This is right and that is wrong, this is good and that is bad.
All of these strong beliefs, thoughts and opinions change the way we listen to others. In fact, when we come from this place we are not really listening to the other person, we are just listing to our own opinion of what the other person is saying.
To really listen to other people we need to stop “shoulding” on ourselves and others, let go of our personal opinions and really objectively listen to what the other person is saying.
Listening With Empathy
When I teach this type of listening at VCMT I usually feel like I am preaching to the choir.
I really believe that the vast majority of people who have entered the massage therapy profession have done so as an expression of the empathy and compassion they already have.
Listening with empathy comes from an understanding that people, for the most part, are just doing their best to survive and all the crazy things they do are an expression of this.
I remember a few years back when a patient came into my office in severe pain, very short and almost angry.
He kept saying get me on the table we don’t have to do all this other stuff. I realized this man was just in pain and he really did not mean to be rude or short. I calmly explained that the interview and special testing was necessary to determine the approach I would be taking with the treatment and that the better I understood exactly what was causing the pain the more effective I could be in treating him.
To make a long story short, the treatment went quite wall and the man could not shake my hand enough at the end of the treatment.
Remember, no matter what the patient is expressing, its not personal.
People in pain can sometimes say things they don’t mean. Always come from a place of understanding, a place of empathy. Try to put yourself in their shoes, how would you feel if you were on the other side of the room? How would you want to be listened to and treated? I always tell my students that true success is not just about being the best technical Massage Therapist. True success is becoming a well rounded therapist with excellent communication, listening, knowledge and technical skills. I believe that a present compassionate therapist will achieve measurably better outcomes with all their patients.
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