Communication Break-Down

Three weeks ago today, my dad had a stroke.

Receiving the news, my first thought was: my dad doesn’t have strokes. This is the same man who, after watching me complete a marathon, said, “that doesn’t look so hard” and started training at the age of 65, having never run before. He went on to complete not one, but three marathons. He is always working on something -installing new flooring in his living room, re-tiling the fireplace, fixing the roof- this wasn’t a man who had health problems, much less strokes.

Except that he did. And so I cancelled a keynote, immediately got on a plane and flew to his bedside.

My dad, -my superman, really- was now lying in a hospital bed, his face contorted and paralyzed, his speech and motor skills impaired. As I watched him struggle to put on his eyeglasses, or speak, or do any of the things that a few days before had come so naturally, I felt incredibly helpless. My sister and I took turns crying in the bathroom so he wouldn’t see our grief.

Because there isn’t a lot to do while sitting in a hospital room, I watched the nurses interact with my dad. Most were terrific, a few were ok, and luckily we didn’t have any who were horrible. The best nurses, though, were those who were able to blend their position and their person.

We all want nurses who know what they’re doing, since they administer the majority of care to our loved ones. And yet we also want them to be warm and encouraging. When you’re in a hospital you are incredibly vulnerable- nurses who maintain the dignity of the patient and treat them like people instead of invalids make all the difference in the world. Our trust in the nurses comes from their ability to demonstrate their competence, or position, while at the same time demonstrating their concern, or person.

This balance of position and person is just as important to all of us as it is to those in the nursing profession. There are times when it is appropriate to come from our position -when our credibility must be demonstrated- and other times it is more appropriate to come from our person -when we need to show we care. Charismatic people are a blend of both, and bring out what’s appropriate depending on the needs of the situation.

My dad made a speedy recovery -so speedy in fact, that he is already home, walking up and down the stairs, lifting weights, joking around. He can do everything he did before, albeit a little slower, and we like to tease him that when he talks he sounds a little drunk. When I asked if he ever asks “why me?” he said, “Sure. But then I think, why not me? It happens.”

Thank goodness that when it does, there are nurses like those who attended my dad.

*A big thank you to the nurses and therapists at Presbyterian Intercommunity Hospital in Whittier, CA.

Of all the bad advice I encounter in my work -never turn your back to the audience, move around a lot when speaking, always be friendly- the advice to always maintain eye contact has to be the worst.

We have very deeply held beliefs -especially here in the States- about the role of eye contact. We’ve been taught that eye contact equals respect, and that avoiding eye contact is tantamount to disrespecting the person you are engaging with.

This is bad advice and can really get us into trouble.

Eye contact does equal respect when you are in relationship. But there are times -delivering negative information for example- when we want to separate the relationship from the message.

There are three things to remember about the use of eye contact.

1. Go visual with information, especially if it is negative.

You must have the negative information on some sort of visual if you hope to have the person receive it and not attach the negative message to you. If you are working one-on-one, the visual will be small -a piece of paper, report, fax, or memo- if you are delivering negative information to a group the visual will be larger -a PowerPoint presentation, flip chart, or white board. Those in the medical field will also want to adhere to this rule. Although medical personnel almost always have an x-ray, lab report, or diagram handy they rarely use them effectively. A doctor often looks at a patient when saying, “You have cancer.” By looking at the person while delivering this information what he or she is really saying is, “You are cancer.” When the doctor uses direct eye contact the patient has a more difficult time absorbing the information. The patient may -understandably- become upset, volatile, or breakdown. This can be avoided using the next step.

2. Avoid eye contact if the information is negative. Use eye contact if the information is positive.

If a doctor -instead of looking at the patient- looks at the x-ray and says, “The x-ray shows that cancer is present,” the patient is more apt to breathe, take the information in and assimilate it without becoming as upset. The doctor can then turn to the patient and with eye contact say, “Now here is what we’re going to do.” By using eye contact in a systematic way the doctor nonverbally separates the problem (x-ray) from the solution (doctor and patient working together.) This works in the business world as well. When you have to lay people off or tell a group that there is a salary freeze, look at the information (which should be displayed visually) not the person/group.

3. People follow your eyes, not your hands.

These skills are only effective if you understand that people follow your eyes, not your hands. Oftentimes we point to a visual but maintain eye contact with the listener. This is ineffective. Think about it: when you’re sitting having coffee across from someone and they look over your shoulder and towards the door, what do you do? You also turn and look. We’re programmed to follow someone’s eyes, and rarely look where someone is pointing unless they are also looking there. When using a visual to give sensitive or difficult information be sure to look at the visual as well as point to it. This will cause the listener to look where you want them to look.

Nonverbal intelligence is all about having more than one approach. Sometimes we’ll want to maintain eye contact (when the information is positive) and other times we’ll want to look at something else (when the information is negative.) Train yourself to be systematic with your eye contact and you’ll have an easier time separating yourself from the message.