In clinical practice, patients come and tell their stories.Some just say a few words and for others there can be many things going on.
And the clinician listens,not just listens,actively listens.
OPD consultations requires professional judgment and expertise, it can be quite tiring when done well. To completely empty oneself of ones own prejudices, patterns of responding and frame of reference, and to try to understand all of this about another person is an act of great generosity and respect. It is a commitment of not only time, but mental energy and a preparedness to explore another person’s world and see the way life appears to them.
Active listening is an advanced communication skill, which takes practise and constant awareness to avoid slipping into the patterns summarised as roadblocks.These type of ‘roadblocks’ include: • ordering • threatening • moralising • excessive/inappropriate questioning • advising.
When we suggest solutions after all this listening, interactions and examinations, we take responsibilities.
However some people still leave the consultations unhappy.
Following are excerpts from a well written article I was reading as to why this can happen:
"However, there can be risks in suggesting solutions. It takes responsibility away from the other person. It implicitly disempowers the other person by saying: ‘You can’t solve the problem, but I am better/smarter/more worldly than you, so I have to do it for you’. This can make the person feel belittled or patronised. A person will usually have been pondering their problem for some time before they present with it. If a solution seems obvious to the listener after only a short time, the chances are it is obvious enough to have occurred to the person with the problem as well. To suggest otherwise is an insult to their intelligence. Therefore the issues then become: have they already tried the solution? Presumably it has already failed, what factors led to its failure? If they have not tried the obvious solution, why not? What are the other factors about the situation that means they have decided not to proceed with the obvious solution? More active listening is needed! A sign that suggesting solutions at this particular point is not appropriate is when the speaker starts to block the suggestions. This can be frustrating to both parties, and distract them from teasing out all the thoughts and emotions about the problem. Alternatively, some people simply ‘shut down’, outwardly appearing passive and compliant, but inwardly disengaged and resigned to not getting the help they really need. Avoiding the other’s concerns A third type of ‘roadblock’ is avoiding the other’s concerns by: • diverting • logical argument • reassuring. These roadblocks deny the person the opportunity to talk about their problems, or worse still, try to convince them that they really aren’t serious problems, and they are foolish to be worried about them."
Active listening More than just paying attention
Kathryn Robertson, MBBS, FRACGP, MEd, is Senior Lecturer, Department of General Practice, University of Melbourne, and a general practitioner, Victoria. k.robertson@unimelb.edu.au
http://www.racgp.org.au/afpbackissues/2005/200512/200512robinson.pdf
‘You can learn to be a better listener, but learning it is not like learning a skill that is added to what we know. It is a peeling away of things that interfere with listening, our preoccupations, our fear, of how we might respond to what we hear’. Ian McWhinney
And the clinician listens,not just listens,actively listens.
OPD consultations requires professional judgment and expertise, it can be quite tiring when done well. To completely empty oneself of ones own prejudices, patterns of responding and frame of reference, and to try to understand all of this about another person is an act of great generosity and respect. It is a commitment of not only time, but mental energy and a preparedness to explore another person’s world and see the way life appears to them.
Active listening is an advanced communication skill, which takes practise and constant awareness to avoid slipping into the patterns summarised as roadblocks.These type of ‘roadblocks’ include: • ordering • threatening • moralising • excessive/inappropriate questioning • advising.
When we suggest solutions after all this listening, interactions and examinations, we take responsibilities.
However some people still leave the consultations unhappy.
Following are excerpts from a well written article I was reading as to why this can happen:
"However, there can be risks in suggesting solutions. It takes responsibility away from the other person. It implicitly disempowers the other person by saying: ‘You can’t solve the problem, but I am better/smarter/more worldly than you, so I have to do it for you’. This can make the person feel belittled or patronised. A person will usually have been pondering their problem for some time before they present with it. If a solution seems obvious to the listener after only a short time, the chances are it is obvious enough to have occurred to the person with the problem as well. To suggest otherwise is an insult to their intelligence. Therefore the issues then become: have they already tried the solution? Presumably it has already failed, what factors led to its failure? If they have not tried the obvious solution, why not? What are the other factors about the situation that means they have decided not to proceed with the obvious solution? More active listening is needed! A sign that suggesting solutions at this particular point is not appropriate is when the speaker starts to block the suggestions. This can be frustrating to both parties, and distract them from teasing out all the thoughts and emotions about the problem. Alternatively, some people simply ‘shut down’, outwardly appearing passive and compliant, but inwardly disengaged and resigned to not getting the help they really need. Avoiding the other’s concerns A third type of ‘roadblock’ is avoiding the other’s concerns by: • diverting • logical argument • reassuring. These roadblocks deny the person the opportunity to talk about their problems, or worse still, try to convince them that they really aren’t serious problems, and they are foolish to be worried about them."
Active listening More than just paying attention
Kathryn Robertson, MBBS, FRACGP, MEd, is Senior Lecturer, Department of General Practice, University of Melbourne, and a general practitioner, Victoria. k.robertson@unimelb.edu.au
http://www.racgp.org.au/afpbackissues/2005/200512/200512robinson.pdf
‘You can learn to be a better listener, but learning it is not like learning a skill that is added to what we know. It is a peeling away of things that interfere with listening, our preoccupations, our fear, of how we might respond to what we hear’. Ian McWhinney
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