Deflective listening - American Medical Association



Deflective listeningUnderstand and overcome barriers to empathyHere are some common forms of communication that hinder empathy by taking the focus away from the person who is speaking. To be clear, these are not incorrect ways of speaking, but they are not demonstrations of empathy. Possible alternatives are suggested; notice how these responses keep the attention on the speaker. A group exercise to practice overcoming barriers to empathy can be found after the table.?Communication formActionExamplePossible empathetic alternativeGiving advice/fixing?Telling the other person what you think they should do.??“I see people in my clinic every month with shingles, and sometimes it’s severe. I think you should get the vaccine.”???“I can see that you’re concerned about the safety of the shingles vaccine.”?Analyzing/diagnosing?Interpreting or evaluating a person’s behavior.?“You spend so much time taking care of your husband that you don’t prioritize your own health.”?“It sounds like you’d like someone to understand how time-consuming it is care for your husband after his stroke.”?Storytelling?Grabbing the focus away from another person and placing it back on your own experience.??“I had another patient who's older than you are, and they were back on their feet in no time.”?“It sounds like you’re worried, and you don't trust that your body will be able to recover from the surgery.”?Pity/sympathy?Feeling sorry for someone, or sharing your own feelings about what they said.?“Oh, you poor thing... I feel so sad for you.”??“I heard you didn’t get that job you were so excited about. How are you feeling today?”?Reassuring/consoling?Trying to make someone feel better.?“You might be upset now, but I’m sure you’ll feel better soon.”?“You look really upset. Would you like to talk about it?”?Shutting down?Discounting a person’s feelings and trying to shift them in another direction.?“Consider yourself lucky. It could have been much worse than this. We got the stent in before you had a heart attack.”?“It’s common for people to feel worried after a heart procedure. How is this affecting you?”?Changing the subject?Avoiding an uncomfortable moment that you don’t know how to deal with, and changing the course of the conversation.??To a co-worker who says, “______ is so lazy!?She never does her job!”: “I’m sorry but I need to get going to see this next patient right now.”?“Are you frustrated with how the work load is shared in the clinic?”?Communication formActionExamplePossible empathetic alternativeInterrogating?Using directed questions to expose a person’s behavior or to provoke guilt.?“So why aren’t you following the diet that our diabetes educator provided?”“You seem overwhelmed with managing your diabetes.”?Commiserating?Agreeing with the speaker’s judgments of others.?“Oh, I took care of that patient on service last month and he is a manipulative drug-seeker.”??“I bet it’s frustrating to be that patient’s physician when you are not sure if you can trust him.”One-upping?Convincing the speaker that whatever they went through, you had it worse.?“You think you’re tired??They hadn’t passed work-hour restrictions yet back when I was a resident.”??“I imagine you’re exhausted and just want some sleep!”?Group exercise: Overcoming barriers to empathy?This can be done with a group of three to 12 people.?Group sits together; each participant receives a copy of the Deflective Listening table.One participant volunteers a brief situation from work or home life for this exercise and provides one to two sentences of background.?Other participants take turns responding to the speaker using forms of deflective listening (e.g., giving advice/fixing, analyzing/diagnosing, storytelling, etc.)Next, participants take turns practicing listening with empathy. Each participant tries to infer a value and/or feeling, and address this in their response to the speaker.?Debriefing: the initial speaker has an opportunity to express how it felt to receive the deflective listening responses, and how it felt to be listened to with empathy when the focus was on values and feelings. Give other participants have an opportunity to share their reactions.Adapted with the permission of the creator:Jeff Brown, Certified Trainer with the Center for Nonviolent Communication ()(Originally created and conceived by Marshall Rosenberg)The Center for Nonviolent CommunicationSource: AMA. Practice transformation series: listening with empathy. 2016. ................
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