Special note: On March 13, 1997, I was diagnosed with leukemia. During that time, I wrote a book titled Dancing with the Diagnosis, Steps for Taking the Lead When Facing Cancer. It was published a few years after the completion of my treatment. In honor of the 25th anniversary of the diagnosis, I am highlighting parts of the book and the lessons I learned in this five-part series. I hope the posts will encourage and maybe even inspire. I welcome comments and conversations!
Excerpt from Chapter 12: Learn to Listen (Tips for Caregivers and Support People)
As I traveled on my path with cancer I often talked to my support team about how the disease specifically affected them. One recurring theme in our discussions was their desire to make things better for me, coupled with the frustration of not knowing what to do. Those in support roles frequently equate themselves to mechanics who need to fix the one who's hurting. In reality, the one who is hurting doesn't need to be "fixed" by their support team as much as they need to be heard by them. Many of my family members and friends didn't have to do much more than really listen to me to lift my spirits when I was feeling blue.
Just listen. Sounds easy, right? Well, it is...sort of. Listening is easy once we pay attention and commit to the practice of the necessary skills. As you know, listening involves much more than merely hearing what is said, or staying quiet while another takes their turn to speak. Effective listening starts with mindfulness -- being present in the communication situation. The focus is on the moment. Our thoughts are on the speaker's words and feelings, not our next response.
Active listening encourages listeners to check their understanding of a speaker's verbal message (what was said) and nonverbal message (indicated through facial expressions, pace, tone, and body language). Active listeners respect the speaker's ideas and feelings while encouraging further exploration of both. It's particularly appropriate when someone is expressing negative feelings about something.
Consider the following example:
Speaker: I am so sick of feeling sick. I am not getting chemotherapy anymore!
Listener 1: You want to get better, don't you?
Listener 2: Image all the people whose treatments are lengthier and harsher than yours.
Listener 3: Chemotherapy is really a blessing. Fifty years ago it wasn't even an option and people's prognoses were much worse. You're actually lucky to be getting it.
Listener 4: Don't talk like that! Don't you have any idea how much you mean to your family and me? This is hard on all of us.
Hmmm...do you think that the speaker really feels heard by any of those listeners?
Probably not.
Each response is a well-intended attempt to change the speaker's perspective, but each comes at the cost of denying the speaker's verbal and non-verbal message.
As exemplified here, more communication is not always best. There is a time to listen. Active listeners tune into the speaker's message and ask themselves, "What's really going on here?" Next, they check their perception of the situation by paraphrasing the speaker's statement with their own interpretation of its meaning.
For example:
Speaker: I am so sick of feeling sick. I am not getting chemotherapy anymore!
Active Listener: You sound so upset. These treatments must be really rough on you.
Active listening necessitates clear comprehension of the message as the speaker intended it. When paraphrasing the perceived meaning of what the speaker said, the active listener gets a chance to check if they understood correctly. Without words, the active listener is saying, "I am trying to understand what you're saying. Tell me more."
Steps for active listening include:
1. Stay present. Put your own stuff (worries, defenses, rebuttals) aside. You can retrieve it later if you want. 😉
2. Paraphrase. Focus on the actual words and the underlying feelings expressed. What did you hear them say? How do you think they are feeling? Repeat your interpretation in your own words and ask if your guess is correct.
3. Monitor nonverbal language (both theirs and yours). Be aware of what messages you are sending through your own nonverbals, and carefully check for discrepancies in theirs.
4. Ask good questions. Strive for clarity and comprehension. For example, ask, what do you mean by that? Could you give me an example? When is it worst? Best? Ideally, how do you see this turning out?
5. When permitted, reframe. After the speaker has had ample time to vent, ask if they would like a different perspective (reframe). If they are ready, offer a new vantage point. If they are not ready, save it for a time when they can really hear you.
Sample dialogue using active listening:
Speaker: I am so sick of feeling sick. I am not getting chemotherapy anymore!
Active listener: You sound so upset. These treatments must be really rough on you (paraphrase content and feelings)
Speaker: They are! It's like the treatment is worse than the actual disease! I really didn't feel bad until I started chemo. I just want to feel well...and stay feeling that way.
Active listener: I bet you do. When will the treatments be finished? (acknowledgment plus a question to elicit more information)
Speaker: Not soon enough.
Active listener: I can tell you've had it. What other options do you have? (paraphrase expressed feelings/question to find resolution)
Speaker: I guess I could just stop getting chemotherapy...
Active listener: uh-huh… (shows that you're listening while encouraging the speaker to continue)
Speaker: (spoken softly)... but then I increase my risks for relapse.
Active listener: Hmm... that sounds like a risk you're not willing to take. Is that right? (wait for answer) Can I offer a different perspective? (paraphrase/check for accuracy/ask permission to reframe)
Speaker: I guess.
Active listener: The long-term benefits of chemotherapy ultimately outweigh the short-term hardships. Maybe we can talk to the doctors about different things you can do to ease the pain as you go through it. What do you think? (reframe)
Speaker: Yeah, at this point I am willing to do just about anything.
In the semi-hypothetical example (I had a conversation very similar to this one), the active listener allowed the speaker to explore her feelings before moving to the point of resolution. If the speaker had jumped to the reframe, the speaker might have become even more frustrated. She would be left to explain, justify or defend her feelings. Instead, the listener encouraged the speaker to continue.
Active listening is not a panacea; it is a needed skill, particularly when performing the support role. ❤️ Don't worry about fixing everything. Commit to hearing your friend.
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| Original art from Dancing with the Diagnosis |