Techniques for Empathetic

Listening

Rev. David Eisenmenger, MAMFTDirector of Education, Research and ProgrammingSignature HealthCARE, LLCSpirituality Pillar

Our Lives are Spent

Communicating• Study conducted

across a variety of

occupations

• Up to 70% of waking

time spent

communicating

Everything else

Communicating

How Much Time Do You

Spend?• Up to 70% of waking

time spent communicating

• Nearly 45% of communication time spent listening

• Conclusion: Listening is a key component to every aspect of our lives

Communicating

All other communicating

Listening

Hearing vs. Listening

Hearing• A physiological sensory process by which

sensations are received by the ears and transmitted to the brain

Listening• A psychological procedure involving interpreting

and understanding the significance of the sensory process

Listen: An Etymology

Derived from two Old English words:

Hlystan, “hearing”

Hlosnian, “to wait in suspense”

Attending

Attending Behaviors have four

components• Eye contact

• Body language

• Vocal qualities

• Verbal tracking

Eye Contact

• Get on the same level as the people you are speaking with

• Give enough eye contact…but not too much

• Most patients:– Will be comfortable with more eye contact when you’re

talking

– Less eye contact when they’re talking—but this can vary

• Cultures vary greatly in what is considered appropriate eye contact

Body Language

• Positive body language

• Leaning slightly toward the patient

• Maintaining a relaxed but attentive posture

• Mirroring

Body Language: Mirroring

• Matching the patient’s facial expression

and body posture

Vocal Qualities

• Refers to the tone and inflections of your voice

– Not the content of what you say, but how you say it

• For example: Pacing

– Moving slightly toward matching the patient’s vocal qualities

• You can also use your vocal qualities to lead the patient

Verbal Tracking

• Using your words to demonstrate accurate following

• Includes restating or summarizing

Too much of a good thing

• Positive attending behaviors can become negative or annoying if you use them too much

• Staring

• Leaning in

• Over tracking

Negative Attending Behaviors

• Infrequent eye contact

• Turning away from the patient

• Leaning back from the waist up

• Crossing your legs away from the patient

• Folding your arms

Individual and Cultural

Differences• Every patient is unique

• Listening behaviors to accommodate individuals

Following

Following Skills

• Door openers

– Open-ended questions

– Going up at the end of your sentence

• Minimal encouragers

• Infrequent questions

• Attentive silence

Door Openers

• Open ended

questions

• “Going up” on the end

of your sentences

Minimal Encourage

• Small words

– Convey that you are listening

– Offers an implied invitation to continue talking

Infrequent questions

• Less is more

Attentive Silence

• Sitting with the patient in the midst of

silence

Reflecting

Paraphrasing

• Summarize, repackage and return what

you hear

• Reflect the content

• Reflect the feelings

The Feeling Wheel

• Primary Emotion

• Secondary Emotion

• Tertiary Emotion

Listening for Feelings

Primary Emotions

• Sad

• Mad

• Scared

• Peaceful

• Powerful

• Joyful

Secondary Emotions

• Tertiary Emotion: Relaxed

• Verbalization: “You have such a relaxing voice.”

• Secondary Emotion: Content

• Primary Emotion: Peaceful

Tertiary Emotions

• Tertiary Emotion: Embarrassed

• Verbalization: “I cant’ believe I did that. What an embarrassment.”

• Secondary Emotion: Insecure

• Core Emotion: Scared

Resources• Bolton, R. (1979). People skills. New York, NY: Simon

• Ivey, A., et al (1997). Basic attending skills. North Amherst, MA: Microtraining Associates

• Lanier, S. A. (2000). Foreign to familiar: a guide to understanding hot- and cold-climate cultures. Hagerstown, MD: McDougal Pub.

• Lipson, J. G., Minarik, P. A., & Dibble, S. L. (1996). Culture & nursing care: a pocket guide. San Francisco: UCSF Nursing Press.

• Wilcox, G. (Array). Feeling Wheel [ PDF ]. Retrieved from http://med.emory.edu/excel/documents/Feeling Wheel.pdf