May 25, 2020
You’ve just heard the terrible news of your close friend - they have lost a family member to cancer, Covid-19 or a traumatic road traffic accident. Along with your own emotions of shock, horror and overwhelming upset, you start to worry about speaking to your friend and are wondering how you can talk to them about this. First things first, this is not going to be easy. Your emotions are going to be very labile and that’s completely natural, normal and understandable, given the circumstances.
Before we delve into this further, let’s get that straight. You have formed an emotional bond with two people (in this particular example) and one of them has just died. A fractured emotional bond is very difficult to deal with psychologically and you will be going through a natural period of grief. Actually listening to your head and your body is key. Engage with your emotions. Are you upset? Fine, go and be upset. Are you angry? That’s fine too, go and be angry. Whatever you’re feeling at this time, that’s completely normal.
Ok, that’s the hard bit over with. It’s strange isn’t it, because in today’s society, people don’t feel anymore. We ignore our emotions because we’re told we aren’t being professional, or we appear weak. Wrong. This is pathologically wrong. If someone approaches the situation like this, kindly slide this article under their nose; thank you. Proper engagement with your emotions and the way you feel is the correct way to be dealing with any situation such as the one described above. Sometimes however, you may not feel any emotions about the situation just yet. You may be sat there thinking “why aren’t I upset”. This is called a delayed grief reaction and we will discuss this in another blog.
Anyway, back to your friend. You want to speak to them about what has happened but you feel that words are weak and fruitless to appropriately convey your feelings and offer support. Ok, now the next sentence is really important. Focus not on what you say, but on being authentic. What does this mean? They way you interact and react with the person is far more important than the words you are saying.
“FOCUS NOT ON WHAT YOU SAY, BUT ON BEING AUTHENTIC”
Let me break this down into sections for you, starting with the basics. We will go into much more depth soon, especially about bereavement itself and how to be authentic.
You may be reading this during the Covid-19 pandemic, and if so, some of the techniques described will be more difficult to implement; they will however give you great underpinning knowledge about how you can approach these kinds of situations. This is what we are taught as doctors when holding difficult conversations with patients. I have tried and tested these techniques over the past 7 years so bare with me; they work. That isn’t to say, however, that you’re going to be slick at implementing these tactics straight away. Who knows, you may be a relationship genius and pick this up straight away, but it can be a difficult learning curve.
So first you must think about your environment. Place your focus around reducing distractions and making the person you want to speak to your primary focus. My little checklist before I speak to someone goes a bit like this: bleep off, phone on silent, find a quiet room, leave a notice on the door and tell anyone that may need me in the next 2 hours that I am just in a meeting - give yourself plenty of time.
With all distractions now removed, think about your set up. Ideally you want to be sat down and sat at 90 degrees to each other. Try not to sit completely opposite the person you are speaking to as this isn’t as natural and you may make them feel pressured to open up. Reflect on your GP practice. There is a reason why they are always sitting to the side of you. Get yourself comfy and relaxed.
If you’re speaking over the phone or over a live stream video to the person, you can still adopt some of the aforementioned tactics. Mainly around removing other distractions. Give that person 100% of your attention.
- Remove distractions.
- Adopt a natural set up.
- Give them your 100% focus.
Ok, before we actually start speaking to the person lets go over what I said earlier: Focus not on what you say, but on being authentic. If you’re sat there thinking about what you can say or what you should say, you obviously aren’t properly engaging with the person in front of you.
The absolute key for this conversation to go well is to be genuinely and completely yourself. Interact with the person as if this was any other conversation. Let it flow naturally. Don’t allow yourself to get stuck in your own head - assessing your behaviour. If you are assessing how you are behaving, you have removed that 100% focus on them. You have years worth of experience building your social skills so trust your instincts and flow with how you feel in the moment. Remember what we said earlier about engaging with your emotions?
Trust yourself and be yourself.
Mirroring is a technique we use in medicine all of the time. It will be a social skill that you have probably used all of the time, without even realising. Mirroring means to “match” the “energy” of the person in front of you. People squirm a little inside when you talk about someone’s “energy” but between you and me, we both know exactly what we’re talking about. How do we pick up on someone’s energy? Well, we can look at someone’s body language, their level of eye contact, the speed of their movements, the volume and rhythm of their speech. This will give you a great idea of where their mood is sitting and will allow you to “get onto their level” so that you can engage in conversation together appropriately. Think about when you’re really upset and want to talk to somebody about it. If person you were speaking to was sat opposite you with a massive grin on their face and were tapping their hands on their leg to a song they have suck in their head, you’d probably tell them where to go. Matching people’s energy is a key component in this process, and to do it properly, you must give all of your focus and be behaving authentically. If you can mirror properly, the person who you are speaking to will know that you are completely there with them, living this with them. They will know that they aren’t alone and that you are here to support. This is a large proportion of the work done, and arguably, in a strange sense, the most enjoyable. Mirroring embodies empathy. For me, I love engaging on this level with people. It is where the most important connections are made with people. Even if no words are spoken with the person at this stage, the amount of “experience” you can share with each other is truly incredible. Almost like an emotional ballet. You dance in tune with each other and share the experience.
As a small side note, try soul gazing. This will give you a glimpse of what mirroring can offer.
Ok, now you can open your mouth. Scary, ey! No, not at all. As we said before, just be yourself and engage! Engage, engage, engage! It may even be the case that no words are required. A hug or your presence may be enough. Alas, let’s stick with verbal communication; oh and by the way, saying “I’m sorry to hear that”, is almost a nicety, and I’m guessing you know the person much better than that so we’re going to go deeper than that.
Start with an open question and let them direct the conversation. If they aren’t ready to talk about certain things, that’s absolutely fine. Don’t press them to talk about something that they aren’t ready to. This is remarkably situation dependent, but I would open with something simple like: “How are you feeling?”. This gives the individual full scope to discuss whatever they want and you are directly asking them about their feelings. Let them talk and don’t interrupt. Once they have finished talking, stay relaxed and don’t jump straight back in. They may just be about to tell you something they have never told anyone, but they’re waiting for the emotion to hit them to muster up the courage to verbalise it. Stay relaxed here and embrace the silence. Don’t let the silence make you awkward. The silence is remarkably powerful and really allows them to delve into their thoughts and bring up their feelings and emotions.
Once they have been talking openly, you will have so much more to delve into. This is where some more specific questions (aka closed questions) can be asked. Use these with care as you don’t want to prod somewhere the person doesn’t want to talk about. If used correctly, closed questions are marvellous at helping the person explore their feelings and develops the understanding of the situation between you two.
In this example of using closed questions, I would like to briefly touch on suicide, if you don’t mind. When you are asking a closed question, make sure you aren’t using negative language. What I mean by this is, let’s say we are asking someone about their mood and they tell you that they have been really down; spending a lot of time walking across bridges or dangerously crossing roads. You will be thinking about if they are a risk to themselves and whether or not they are considering suicide. Absolutely make sure that you don’t use any negative language here. Don’t say something like “You haven’t thought about doing anything silly, have you?”. Here you are describing their thought processes as “silly” and this is most unhelpful, to say the least. Instead, as we have discussed, be careful in how you ask the question, but be direct. Use the appropriate words. In this situation, I would ask, “Have you thought about killing yourself”. You can even use the word suicide if you want.
When you start talking to people, you may find that you cover so many topics that it is hard to stay on track of what you have covered. I find that mini-summaries is really really useful. It consolidates your combined thought processes and begins the normalise the situation. Use mini-summaries as and when you find it appropriate; they can be very powerful indeed.
- Start with open questions
- Be direct
- Embrace the silence and stay relaxed
- Utilise closed questions with care.
- Don’t use negative language
- Mini-summaries to consolidate thoughts.
Let me now summarise what we have just discussed. Engage with your emotions and place the person you want to talk to at the epicentre of your focus. Set the environment, removing distractions and use mirroring to empathise and “stand in their shoes”. Talk to them on the same level and use the 6 pointers above to help you.
PS, using their name and appropriate physical contact is a great way to break down emotional barriers.
As a Team of Doctors at Lyfe, we can appreciate that these conversations are some of the hardest to face and navigate. We hope these tools guide you during this difficult time and help you to connect with your loved ones.