Talking about the difficulties of having a difficult conversation

Last week turned out to be a real emotional rollercoaster of a week, with many ups and downs. I think over all, the ups had it. But the downs were hard to work through. What caused these ups and down? It was handing over the keys from the Old House to the new owners. We had lived in the Old House for over 20 years and its walls contained many memories. Some were good; others not so, but overall it had been a happy home for much of that time. The New House is in the coastal town of Bispham, situated on the Fylde coast. It shares the coast line with eccentric Cleveleys; entertaining Blackpool and; expensive Lytham. I get to pick up the keys to the New House in 12 days’ time and I am so looking forward to living near the sea again.  

When it came to handing over the keys to the Old House to the estate agent, I had to wait a few minutes and the estate agent asked me how I was feeling. I was very surprised to find my eyes were leaking and it was a difficult conversation. It wasn’t the only difficult conversation I had last week. 

Conversations of any kind are a funny thing. It is surprisingly hard to find a definition of what a conversation is other than usually a conversation involves at least two people talking to each other. Mary Conklin, a writer on social etiquette, had this to say about conversations way back in 1738 - ‘they are the polite give and take of subjects thought by people talking with each other for company’. This is a definition that might still hold true today. Certainly, conversations like all social interactions, tend to follow an established set of ‘rules’. If these are not adhered to by one or other of the parties to a conversation, then it usually deteriorates or ends. 

  

I hate it when people cut across me in conversation. The result is that I simply stop talking. Likewise, I’m amazed at the number of people who, in conversation with me, know what I’m thinking, and feel so confident in their mind-reading abilities that they tell me. In such situations, the result is that I simply stop talking. Conversation will involve a great deal more nuanced and implied context than simply the words being spoken. I have always told my students, that in conversation with their patients, they need to learn to listen to what is being said, and equally what is not being said.  

Many folk working in health and social care will be familiar with difficult conversations. This might involve telling someone bad news about their prognosis, finding the words of comfort for someone dying, or challenging someone’s bad practice, particularly if they are a senior professional. Those involved in mentoring students will know how difficult some conversations can be. Perhaps bringing to the student’s attention something that needs to change, or the fact that they haven’t achieved their placement learning objectives. 

As a Dean of School, I've had my fair share of difficult conversations too - for example, telling someone they haven’t got the promotion they wanted, or they have not passed their PhD examination. And there were those difficult conversations where a colleague comes to tell me they have received a diagnosis of a life-shortening condition. One of the first things I did on my appointment was to get rid of the board room type table, replacing it with a low coffee table and armchair seats. I would tell people that I could only help them if they put the problem, or issues on the table. But it doesn’t matter how many times one has been involved in a difficult conversation, in my experience they are always difficult. However, what experience does help with, is the knowledge that the other party to a difficult conversation is also likely to be as apprehensive as you. 

So last week I had yet another difficult conversation to deal with. It was a conversation that was required to be had to try and resolve an apparent breakdown in trust and a dysfunctional working relationship between some very senior managers in an NHS Trust. I had done my preparation and had practised the questions I wanted to ask, how I might frame those and the order in which I might want to ask them. My mindset what was not a combative one. There was no intention on my part to end up a winner, with the other person being a loser. I wanted to set out my stall, both how I saw my responsibilities as the Senior Independent Non-Executive Director, and what I thought had brought us to the meeting. 

It was then over to the other person to tell me how they saw the situation and the issues involved. Thankfully it was then possible to agree what was fact and what was perception, and importantly consider the impact the situation was having on them and the team in which they worked. In an organisation that sometimes complains that leaders are not visible, I was acutely aware that the rumour mill was a powerful entity and others might already be aware of the apparent breakdown. Anyway, it was possible to develop some possible ways forward, I wouldn’t say we were able to resolve all the problems, but we were able to agree the next steps for each of us. In a week already heavily charged with emotions, I was pleased that we were able to get to the place we did. 

Finally, in thinking about this blog, I came across a study undertaken in 2007 that completely dismissed the popular notion that women use more words in their conversations than men. Actually, the study showed that both men and women use about the same. On average we use about 16,000 words per day. I’ve used mine up already, so I will stop talking now.