Courageous Conversations
Improving Communication &
Strengthening RelationshipsAt M.D. Anderson
David Richardson, PhDOmbudsman - Mediator
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Conversations (CC)
Most people are more comfortable with old problems than new solutions
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Conversations
• …are conscious exchanges that are real, meaningful and energizing
• …are a face to face accountability session
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Conversations
…can take you to the heart of what's most important
…can lighten your heart and your life
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
How to recognize a CC
It’s the one you don't want to have the one you haven't even thought of having a conversation that can transform your
relationships, and set you free
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
OK - But Give Me Examples...
"I've hated you for leaving me" "I'm angry at how you treat your children" "I stole $2,000 from you 20 years ago" "I'm in the country illegally, and would like to apply
for legal residency" "We've never said 'I love you' in our family, and I
love you" "Will you marry me?" "I'm not enjoying our sex life" "I had an affair five years ago"
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
How about a few more...
"I really gave you a hard time at school/that old job - and I'm sorry"
"I should have told you I have an STD before we had sex" "I'm in love with you, and am scared of threatening your
marriage, but more afraid of hearing you don't love me" "I'd like to feel acknowledged for all the hard work I do" "I know I abused you sexually, and I apologize from the
bottom of my heart" "I love you so much it scares me. And...I think your ears
are really big and can't stop thinking about them"
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
How Do I Know I Need One?
• Do you find yourself avoiding the important things you want to say to family and/or coworkers?
• Are all your relationships great? Partner Family Boss and staff Patients, family members
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Why Should I?
And the best clue of all: You probably don't want to have the
conversation, you're afraid
of the outcome that you'll lose something you might feel VERY uncomfortable
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Why Should I?
Isn't the past just the past?
"I'll just move on",
"It's enough that I know about it",
"It might upset them".
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
What stops us
Fear of the reality because prior attempts were unsuccessful my actions could escalate the problem of rejection of retaliation of feeling vulnerable of losing the relationship
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
What stops us
Believing the cure could be worse than the disease
it might hurt feelings
I might discover I am part of the problem
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
But if you feel…
Any stored guilt, anger, sadness, love ‘thing that is unexpressed - then maybe …
better out than in
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Behavior Signals
• Acting out• Badmouthing others• Gossiping• Feeling depressed• Helplessness • Silence• Making serious errors
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
When others avoided a CC
The consequences were tremendous
Multiple medical errors in health care
Challenger disaster
Air crash in Potomac river
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
The Effect On Others...
• It's also amazing the effect it can have on the other person.
• Your courage can ripple out and change the world.
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Does it all add up?
The Risks No guarantees
The outcome may be even worse than you feared.
CC can lead to…
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
An easy Out
• It’s not my fault• I couldn’t help it• It’s no big deal• I had no choice• No one could work with …• She’s an idiot• He is impossible
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
What If I Don’t vs What If I Do
• The problem could escalate• I might be rejected• I could lose the relationship• There might be retaliation• I might hurt his feelings• I might not be prepared for the outcome
Where have I seen these before?
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
The dead shall live again
• To bring a dead relationship back to life start with C.P.R.
CContent
PPattern of behavior
RRelationship
Patterson et al (2005) Crucial conversations
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Personal Preparation
7 Rights of CC Right problem Right words Right delivery Right frame of mind Right… Right … Right …
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Personal Preparation
• the person vs the problem
• R-E-S-P-E-C-T
• Off your guard
• Speak but…
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
A Port In A Storm
• Provide an emotional safe haven • In the absence of safety people can’t
discuss anything meaningful Valued and respected Verbal and non-verbal Interests and plans Fear of negative consequences
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Inquiry versus Advocacy
• Share your thinking• Test your assumptions• Inquire into his views• Test her assumptions• Share your data
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Dialogue
• Name the issue
• Select an example
• Describe the feeling
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Dialogue
• Declare the stakes
• On your own
• Indicate your intent
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Dialogue
• Invite a response
• Reflect
• Follow through
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Follow through
• When all is said and done
• When I move you move
• Hold me
• “Sorry” is not a 4 letter word
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
When an apology is right
• Why am I sorry• Leaver 2000• Delta • And this time I mean it• Is it me or do you feel better• no see what happened was…
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Common mistakes
• Can you smell what the Rock’s cooking• Oreo is just a cookie• Bed, Bath and Beyond• Put the writer’s back on strike• Guerilla warfare
Scott (2002) Fierce Conversations
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Common mistakes
• Doing most of the talking• Calgon• Don’t ask, don’t change• Huh?• You know what I mean?• No big buts
Scott (2002) Fierce Conversations
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Conversations
Most people are more comfortable with old problems than new solutions
David Richardson, PhD
Improving Communication & Strengthening Relationships at M.D. Anderson
Courageous Conversations
Are you most people?
Courageous Conversations
Improving Communication &
Strengthening RelationshipsAt M.D. Anderson
David Richardson, PhDOmbudsman - Mediator
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