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Part 6 of EI and Nursing – Empathetic Listening, What Stands in the Way?

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Part 6 of EI and Nursing – Empathetic Listening, What Stands in the Way?

Empathetic Listening

            Last time in the EI and Nursing series on Fabiah Blog, we introduced empathetic listening and defined it as the skill of listening in order to understand and connect. We saw how it powers Emotional Intelligence (EI) and helps satisfy a deep, human desire to be understood. We found empathetic listening so valuable that we ended the article wondering why there isn’t more of it. This time, we’ll cover the main barrier to empathetic listening and strategies for getting past it. 

            We don’t have to go very far or search very long to find the main barrier to empathetic listening. The main barrier is us. Specifically, it’s the way you and I are preoccupied with ourselves. We’re focused on what we have to do, what we have to say, and how the words and actions of others reflect on us. This self-focus wouldn’t be a barrier if empathetic listening were about us, but it’s not; it’s about understanding and connecting with someone else.

            So, our strategy is to be less preoccupied with ourselves and more available for empathetic listening. But it’s not clear how to do that. And before we go there, it may not even be clear that we should do that. After all, isn’t it natural for us to be concerned with ourselves? Maybe it seems counter-intuitive or even wrong to try and restrain something so common and constant for us. It’s true we should acknowledge that this kind of restraint can go too far, but let’s also remember what we’ve learned about EI. If there’s one thing we’ve learned from the EI and Nursing series, it’s that we are better off when we can regulate our emotions. With our self-focus, it’s the same. The goal is not to eliminate it, but manage it.

            As for the question of how we make it less about us, that’s where strategies come in. We have to pick among many, so here are three that can be used in listening situations. Listed in order of increasing difficulty, they are:

  • Be Silent
  • Use Reflective Listening
  • Dig and Connect

            The silence we are talking about with empathetic listening could be a topic for a whole paper or a whole book. It is the easiest strategy and, in another way, the most difficult. If we tend to interrupt people with questions, opinions, and distractions, then silence is the easiest strategy to implement: just stop doing all those things, be quiet. Being quiet and giving our full attention is a good start, but we could still only be waiting for a point to criticize or our turn to speak. The silence of empathetic listening goes further. This is not really an exterior silence (though it often requires that), but an interior silence. And, as we shall see, this interior silence does not mean we don’t speak. In fact this silence requires us to speak, but in the right ways and at the right times.

            Once we are able to be at least externally silent, we can use a strategy called reflective listening. Reflective listening involves reflecting back to the speaker the words and ideas they’ve been using. There are different levels of reflective listening. At the easiest level, after we have listened silently, we say back to the speaker exactly what they said to us. This strategy communicates that we heard them and creates space for us to absorb what’s been said. At the next level of difficulty we reflect what the speaker has said but using different words, we paraphrase. This shows not just that we heard the words, but were listening to understand what the speaker was trying to say. This second level of reflective listening also gives the speaker a chance to correct us. If we’re really trying to understand (and not just pretending) then we’ll accept their corrections.

            As we move to the last strategy, we should notice that, though reflective listening requires us to speak, it is still not about us. Developing an interior silence doesn’t mean we don’t speak, it means that we use our words to discover what the other person is trying to say. Notice how our listening is beginning to look like more than something we do, but something we do with the speaker. It’s becoming collaborative. As we come closer to empathetic listening, our listening looks more like a conversation.

            The final and most difficult strategy for empathetic listening is to dig and connect. We dig under the words being spoken and help the speaker express assumptions, desires, and feelings. At this point we connect our own desires and feelings with theirs. This brings empathetic listening all the way back to empathy – entering into someone else’s perspective – and to our definition of empathetic listening, listening in order to understand and connect.Here are very brief examples of these strategies. (Of course, the silence of the nurse is implied for the first strategy.)

  • Be Silent – Assured that she has her nurse’s full attention, a patient says to us, “It’s not knowing what’s going to happen. That’s what scares me. I know it might be bad, but if the doctor would just tell me how much function I can expect to come back, I’d feel better, because then at least I could plan.”
  • Use Reflective Listening – “It scares you not to know,” says the nurse, “of course it does.”
  • Dig and Connect – “Of course it scares you; it must feel like your whole life is on hold. I bet you could tell me a lot of things you’d like to plan for the summer . . . ”  

            For the dig and connect strategy, notice how our nurse digs under what the patient has said down to what it must feel like to be in her shoes. Also notice an assumption the nurse didn’t bring up. The patient seems to think her doctor has a prognosis but isn’t sharing it. The nurse could have pointed out this assumption and told the patient it was incorrect. That course, however, doesn’t lead to connection, so the nurse did well to leave it alone.

            This has been just a glimpse of empathetic listening, but with all the rest we’ve covered of EI, we can see how it fits in a larger, Emotionally Intelligent picture of excellent care. Empathetic listening gives us understanding of other people’s feelings; that understanding gives patients and colleagues a sense of being heard, improves communication, and facilitates teamwork. As a final, small point, empathetic listening is a skill that (after all this work not thinking about ourselves) we can apply to our own thoughts and feelings, helping our emotional clarity, covered in Part 4 of this series.

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