What do recovery conversations look and sound like?

19th December 2016

As Breathing Space’s ‘Year of Listening’ campaign comes an end, SRN’s John McCormack explores some of the key listening skills that can help make coversations more recovery focused.

yollogo_featureimageSRN supports Breathing Space’s ‘Year of Listening’ (YoL) which is designed to raise awareness about the fact that listening, and being listened to, is good for your mental health. SRN have a long-standing interest in listening skills because we know that empathic listening supports recovery and reduces distress. Good communication skills and active listening now feature in the mainstream discourse. Nowadays employers demand that workers can demonstrate such competencies routinely.

Counselling skills courses such as the COSCA Certificate in Counselling Skills have an ever widening uptake. I have been fortunate to have been part of the counselling skills team at Glasgow Caledonian University for the past dozen or so years. Having travelled alongside many inspirational students and colleagues on our journey towards empathic listening, through their wisdom I’ve learned more than I’ve ever taught.

What do we know about good listening?

“Extensive research has shown that no matter how knowledgeable a clinician might be, if he or she is not able to open good communication with the patient, he or she may be of no help.” 1

It has been long known that therapists vary in their effectiveness, some get excellent results with people regardless of the theoretical model used. William Miller sought to discover why this was and what was the active ingredient in good conversations. (Prochaska and Norcross 2013) 2.

Miller’s studies showed that those who demonstrate empathy are consistently more effective in helping others. Thus it was evident that the capacity to express empathy was and is easily the best predictor of positive outcomes. Empathy is the foundation of helpful conversations. One example of the remarkable power of empathy was shown in a study whose results suggest that empathy can help measurably reduce chronic pain.3

Okay, so how do I do empathy?

We demonstrate empathy through active compassionate listening and the willingness to really attend to the speaker. Empathy (Carl Rogers 1959)4 is ‘the ability to experience another person’s world as if it were one’s own without ever losing that ‘as if’ quality’. Rogers also noted that ‘deep understanding is the most precious gift one can give to another.’

It can be argued that every conversation we have with another human being has the possibility of making them feel either better or worse. Empathy is known to help people feel better and through this we can intentionally contribute to a reduction in the sum total of distress in the world.

Doing empathy behaviorally involves being genuinely curious and fascinated by what the other people are communicating. Of course, we have to let the speaker know that we do empathise with them, and there are a number of ways to accomplish this, for example:

  • Paraphrasing the words the speaker used
  • Reflecting back our understanding of the meaning
  • Reflecting back feelings
  • Reflecting back our sense of what’s implicit and not being said in words
  • Being sensitive to body language and non verbal communication
  • Noticing physical changes like moist eyes, flushed face, and so on
  • Using silence skillfully
  • Appropriate eye contact

Key elements of good listening can be recalled by the acronym AGE meaning Acceptance, Genuineness and Empathy.

Acceptance means valuing the person for who they are without judging them. We do not necessarily need to accept their behaviour as clearly some behaviours are totally unacceptable, but we can still accept and value the person as a human being with dignity and value.

Genuineness means simply being real, without pretence or façade. Not pretending to have answers or to be something we are not. Genuineness is happening when what the listener displays on the outside matches what’s going on inside.

Here’s some great advice…don’t give advice

One of the major blockers to good listening is our overwhelming desire to give the speaker some of our brilliant advice and wisdom. ‘If only you’d do this, here’s how I fixed it, have you thought about,’ and so on. We want to help, but oddly enough advice can be disempowering whereas listening allows the person to explore possibilities and expertise and arrive at their own conclusions. This promotes self efficacy and self reliance.

Giving advice is known by some as ‘the expert trap’ wherein the helper by giving advice is cast forever after as the expert and the speaker assumes the role of novice or student. This is not necessarily comfortable or helpful for either party. Okay if someone asks you where the station is, just give them the factual answer. Don’t ask ‘how do you feel about stations’, or ‘why now are you interested in stations’?

Some types of question can help people get in touch with their own inner expertise, for example asking questions to aid recovery 5   takes a solution focused approach to eliciting self efficacy. Always remember, witnessing distress IS an intervention. You may have felt at times that you couldn’t do anything to help, and that all you did was listen. We know that often people just want to be heard and have their distress validated; they don’t actually expect us to solve their problems.

You cannot not communicate!

Silence is communication. Tears are communication. Laughter is communication. Practiced listeners are aware that people tend to laugh when disclosing their greatest pain or distress. Presumably this is an unconscious defence mechanism, so look out for that rogue giggle while the person is talking about their divorce or some other type of loss. It’s an opportunity for you to not collude with their making light of the matter but to respond compassionately.

This is where self awareness, another of the keys to good listening comes in. Pondering on reflective questions like:

  • What am I communicating as I listen?
  • Is this helping?
  • How do I feel?
  • What is my own body language saying?
  • What could I do or have done differently?

Would you like to be happy?

The golden rule of happiness; if you want to be happy, be helpful to someone else. Kindness and compassion are the roads royal to personal fulfillment and joy. Attentive listening is kindness and compassion in action. Enjoy the Year of Listening and let’s aim for the decade of listening, and beyond.

 

References

  1. http://healthcarecomm.org/about-us/impact-of-communication-in-healthcare/ (last accessed 06/12/2016)
  1. Prochaska, J.O. Norcross J.C. (2013) Systems of Psychotherapy: A Transtheoretical Analysis. Belmont, USA: Brooks / Cole,
  1. Empathy Raises Patient Pain Tolerance http://msutoday.msu.edu/news/2012/listen-up-doc-empathy-raises-patients-pain-tolerance/ (last accessed 20/12/2016)
  1. Rogers, C. R. (1959). A theory of therapy, personality, and interpersonal relationships as developed in the client-centered framework. In S. Koch, (Ed.) Psychology: A study of a science, (Vol. 3, Formulations of the person and the social context). New York: McGraw Hill.
  1. Hawkes, D. Hingley, D. Asking Questions to Aid Recovery last accessed 9/12/2016