"Communication Techniques for Difficult Conversations" was an education session offered at the Friday portion of the Clinical Care in Oncology for the Advanced Practice Provider pre-Annual Meeting Seminar.
In this session, Dr. Walter Baile emphasized a different angle, focusing in part on the scientific aspects of emotion and the impact this can have on what we say and do in stressful settings. Using Daniel Goleman’s concept of “amygdala hijacking,” he illustrated how strong emotions can essentially deactivate a person’s ability to hear and think, which subsequently challenges a person’s capacity to make a decision outside of the hardwired fight or flight response.
This concept applies to clinicians and patients alike in the course of a difficult conversation.
Without a critical pause—coined the “Six Second Rule”—one is more likely to speak from the “emotional brain” rather than the rational, thoughtful brain. By implementing this hard stop in the clinical setting, we can better manage our own emotions and thereby increase our ability to support our patients through thoughtful language and much-needed empathy.
Of course, other elements, including preparedness, listening without interruption, purveying clear information, and outlining a plan for the future are indispensable to engaging in difficult conversations. Freeing ourselves of the idea that we can make bad news better than it is was also underscored by Dr. Baile and a concept that may be difficult for us to accept. Perhaps the maxim of “Know Thyself” applies well here, and in so doing, we can ultimately improve our ability to have difficult conversations with patients.
More information and resources on this topic can be found through accessing the MD Anderson website
or through a link on ASCO University
As always, please feel free to share your comments on this topic!