DIFFICULT CONVERSATIONS:TIPS FOR SUCCESS

Maria C. Savoia, M.D., F.A.C.PMarch 13, 2013

“Crucial Conversations”• A discussion between two people where– Stakes are high– Opinions vary– Emotions run strong

» Paterson, K., et. al., Crucial Conversations, 2011

“Difficult Conversations”

• A difficult conversation is anything you find hard to talk about

» Stone D., et. al., Difficult Conversations

Conversations are easy

• When opinions are congruent• When delivering good news• When the stakes aren’t high

Conversations are difficult• When behaviors need to improve• When disappointment is involved• When standards need to be enforced• When advocating for your own interests• When you have to say no but want to say yes– Or, when you have to say yes but want to say no

Usual Approach to Difficult Conversations

• Fight• Flight

Steps for Success• Know your heart and stay focused on your goals• Foster open dialogue • Establish a mutual purpose• Work from facts and not from “stories”

Know Your Heart• What are you trying to accomplish?• What is the real problem?• What do you really want?• Can you state your goal or the problem in one

sentence?

Foster Open Dialogue• No one likes to feel attacked• No one likes to be blindsided• Everyone wants to feel respected

Mutual Purpose• What do you want to have happen with the

relationship?• Where is there common ground?• Where are your goals and interests aligned?

Work from Facts• Don’t assume• Don’t assign motivations

Steps for Success

• Don’t assume others know• Don’t be afraid of a “no”• And don’t put it off

Set the Stage• Avoid unplanned encounters• Prepare and be prepared• Set the agenda or at least know it• Before opinions, give facts• Test the conclusions from the facts• Try for agreement• Test for understanding

Set the Tone• How you start has a strong influence on

whether you will be successful• A positive tone sets a positive climate for

discussion

When Confronting a Problem

• Why would a reasonable, rational person do what the person did?

• Try putting yourself in the other person’s shoes

When Asking for Something

• Anticipate his/her emotions• Anticipate his/her responses– Yes– Maybe– No

• But don’t presume to know the answer• Be prepared for each response

Why Things Go South

• Something “pushes your buttons”• It is the last straw• You see villains• You feel victimized• You are ambivalent or feel guilty

“The Energizer Bunny Approach”

“Show me a woman who doesn’t feel guilty, and I’ll show you a man.”

Erica Jong

“Time wounds all heels.”

Groucho Marx