The Surprisingly Difficult Skill of Listening

Posted by Bill Esteb on Dec 17th 2014


Once a month I have a one-hour mastermind phone call with a terrific chiropractic coach. During his long career he has helped thousands of chiropractors. I consider it a privilege to know him and we regularly spend time exchanging thoughts, concerns, insights and testing new ideas.

Each month one of us chooses a topic and then the following month we discuss its implications. Iron sharpening iron (Proverbs 27:17).

Last week when we met we explored the subject of listening. I'm using this space to share my notes. Mostly, so I'll "own" the major takeaways through the process of writing them down. (One of the reasons our teachers asked us to write book reports.) Here are the seven key points I got out of our mastermind on the subject of listening:

1. Listening is a social skill – Listening, like all social skills is a learned behavior. You can see this exhibited in children who have not been taught this essential life skill and who inappropriately interrupt, gaze disinterestedly into the distance, abruptly change subjects or behave in other disengaged and disrespectful ways. While some of us may not know how to tie a black tie for a tuxedo or know what to do with a table setting of nine different forks, spoons and knives, the ability to listen is something we all should have learned at the family dinner table. Years ago. Thankfully, it's never too late to learn.

2. To listen is to value the other person – Listening requires that we pay attention. The operative word is "pay." Because there is a cost. In fact, Thomas Davenport, author of The Attention Economy observes that these days attention is scarce. And like any scarce resource, is valuable. When so much of our communication is reduced to a text message, an email subject line, a magazine headline or 10-second sound bite, nuance is increasingly missing from our social intercourse. To consciously ignore the bombardment of things vying for our attention in favor of another person is an act of respect.

3. Be 100% present – If you're going to listen as a patient explains why they've chosen this moment to show up in your practice, it's crucial that you're fully present when you conduct your precare interview. No multi-tasking. No eavesdropping in on a conversation at the front desk. No eying on the clock. Be 100% there. Anything else and patients not only can tell, but you're likely to miss an important detail or nuance.

4. Actively participate – This is a fancy way of regularly repeating back to the person you're listening to with an interpretation of what you're getting, in your own words. "What I'm hearing you say is…" or "It sounds like what you're saying is…" or "If I'm hearing you correctly, your major concern is…" This is the ONLY way the patient knows that their message is being accurately received. It is a most essential ingredient to the perception "I've been heard," a most extraordinary (and rare) feeling for patients. Create a dialogue, not a monologue.

5. Show up empty – If you already know your care plan for a patient you haven't even yet met (three times a week for the first four weeks, etc.) then you're not empty. It's difficult to be an effective listener if you already have your answer before the patient opens his or her mouth. Granted, a one-size-fits-all answer saves time and may work most of the time, but you're merely going through the motions. Oh, and as you listen, be vigilant for unusual word choices or expressions. Especially if use them more than once. There is usually a critical part of their story embedded in that word or expression. "You've mentioned twice that this is 'driving you nuts.' Tell me about that."

6. Replace judgment with curiosity – It's so tempting to make judgments about a patient's willingness to participate or their interest in true health. These assumptions are often incorrect. They tend to shut down a relationship before it can even begin. Instead, show up interested and curious, prepared to serve in a way that best aligns with the patient's desires and your skills and values. Judgments may hold the illusion of saving time, but they tend to reduce the possibilities of the relationship. Instead, try to understand, as in "stand under," which is about being supportive.

7. No taboo topics – Will you freak out if the patient reveals a crime they've committed? Is it safe to reveal a legal or illegal addiction? How will you respond should they disclose a fear of your cervical adjustments? Are there certain subjects that patients dare not mention? Such as how they feel? Good listeners convey the attitude that every secret is safe, that they've pretty much heard it all before and you can handle anything.

All too often, listening is merely the process of "reloading," busily constructing our rebuttal to what the other person is saying and then impatiently waiting for them to finish so we can say our piece. A silent film of such an interchange might suggest a conversation is occurring, but it's not.

Being a successful healer and facilitator requires fastidious boundaries and total confidentiality. It starts with profound listening at your initial precare interview and extends to every patient on every patient visit. Feeling listened to is a crucial element in patient satisfaction.

Next month the topic we're exploring is relationships. Should be interesting.

By the way, why don't you form a mastermind group? You could benefit by exploring topics, solving problems and enjoying the support of one or more other like-minded individuals. This article on masterminding and this blog post on creating a successful mastermind group may help you get started. Might be a great project for the New Year.