an invitation to heal

 

Listening is a critical skill for health care providers--for doctors, nurses, and therapists in every field. All day long we listen to patients as they tell us their stories...their symptoms, and the timing, severity, and course of their illness. We organize and record the facts in order to arrive at an accurate diagnosis and formulate a treatment plan. 

Deep listening adds another layer of connection with our patients. It involves more than just getting the facts down. It requires us to remain open-hearted, receptive, attentive, and nonjudgmental in each and every patient encounter. It is the key to accurate diagnosis and to healing. It is not, however, an easy skill to acquire or to sustain.

"In deep listening, we listen

with the sole purpose of helping

the other person feel heard and accepted."

~Thich Nhat Hanh~ 

 

In his book, "The Road Home," Ethan Nichtern describes some similarities between deep listening and mindfulness meditation. Deep listening involves sustained awareness, intention, patience, and compassion. As such, the deep listener encounters some of the same obstacles that trip us up during meditation: 

• DISTRACTION: Attention is difficult to sustain because we are distracted much of the time. Linda Stone ("The Attention Project" at https://lindastone.net/) coined the phrase "continuous partial attention" to describe the difficulty we have sustaining focus. Our minds are constantly darting from task to task, from issue to issue, from patient to patient, or simply drifting from one thought to another. We divide our attention between the story the patient in front of us is telling while worrying about the next difficult case, or the results of the tests we ordered on the last patient we saw. Not to mention the emails and text messages that are waiting for a response. Just as we do during meditation, we need to acknowledge the fact that our attention has wandered and return to the present moment.

• FEAR: Another obstacle is the anxiety that can arise during the patient encounter. We worry about getting behind schedule. We worry about making a mistake or missing the diagnosis. The patient's story may trigger a memory from our own experience that reminds us of a painful ordeal we thought we'd put behind us. Suddenly, our hands are shaking and our heart is racing.

• INTERJECTING OUR OWN STORY: In an effort to identify with the patient, we may be tempted to interject our own story into the conversation. Perhaps, like the person sitting in front of us, we, too, have lost a child or struggled through chemo and radiation. We want to share our experience with her--what helped us get through it, where we turned for support, how we coped with side effects. This attempt to create connection and identification can backfire if our story is not what the patient wants to hear, if he is not ready to hear it, or our experience does not accurately reflect his story.

• OFFERING ADVICE: This, of course, is what we do all day long. We order tests, prescribe medication, recommend diets and exercise programs, and make plans for follow-up. The sooner we get to this, the sooner we can move on to the next patient. The problem is that we run the risk of intervening too soon, before we understand the patient's whole story, or worse, before the patient is ready to listen to us.

"The biggest communication problem

is we do not listen to understand.

We listen to reply."

~Stephen Covey~ 



When the patient tells us his story ("the history of the present illness"), he offers us a glimpse into his most private thoughts and feelings. He makes himself vulnerable...literally and figuratively naked before us. We elevate and dignify his presence when we receive his story with an open and non-judgmental heart, when we are attentive and responsive to his needs, and when we respect and welcome his offering.

"The most precious gift

we can offer anyone

is our attention."

~Thich Nhat Hanh~

Deep listening embodies compassion, empathy, and equanimity. It relieves suffering by providing the storyteller with a safe, nonjudgmental, receptive listener. It is an invitation to heal.

jan