The power of having difficult conversations in our relationships and work environments
What over a decade of researching how to have conversations about death and dying taught me about how to have the most transforming difficult conversations
As a communications researcher, I am constantly drawn towards the hardest conversations life can offer up. I am drawn to these spaces because I believe they hold the power to support humans in their greatest spaces of need and pain. Humans longing to be heard and seen are always wrapped up in difficult conversations. And yet, these are the most avoided conversations. I want to help change that.
Professionally, my expertise lies in helping facilitate hard conversations in the realm of advanced illness. My work aims to help equip medical professionals to have difficult conversations around bad news, such as a treatment not working or planning for the reality that a patient is dying. Increasingly, I am seeing how the lessons learned about how to have difficult conversations about dying translate to so many realms of our lives.
Difficult conversations about layoffs within organizations.
Difficult conversations with children about continued gun violence and the reality that no, their schools aren’t as safe as we hope.
Difficult conversations about race and racial violence and inequities in our country.
There are so many difficult conversations that need to happen right now. And yet, in most cases, our human instinct is to avoid these conversations.
In the work that I do, conversations about death and dying are largely avoided. This avoidance exists for two main reasons. First, these are uncomfortable conversations to have. Second, many medical professionals believe that avoiding conversations about dying helps keep patients’ hope alive, even if it might be a false hope. Understandably, members of the medical team are trying to allow hope to remain amidst what is otherwise a very hopeless situation. Centered in this false belief, however, is the thinking that talking about “the thing” will make it worse. But the reality is that honest, trusting, and empathic communication is almost always the best route forward.
When you ignore an elephant in the room, instead of making things better it allows the elephant to crush you. We must start calling out the elephants in our proverbial rooms so that they can stop crushing all of us.
Ignoring that we will die only prevents us from living, not from dying
In my many years of working with dying patients and training hundreds of clinicians to communicate about dying effectively, I always feel compassion for how hard it is to have these conversations. No one wants the job of telling someone they are dying, especially someone like a doctor or nurse who is trained to be a healer. Someone who fixes the problem. But avoiding this conversation never prevents death from eventually coming, sometimes much sooner than later. Rather, avoiding these conversations most often prevents patients and their loved ones from effectively planning the patients’ final days. This, in turn, makes it nearly impossible for the patient to decide how they want to live towards the end of their life. Many patients, if they find out they are dying, make entirely different treatment choices than they would otherwise. Informing them that they are dying is important to patients’ dignity, but it is often overlooked. Instead, those with this information withhold it from patients, believing that speaking honestly will crush a patient’s hope.
This avoidance of difficult conversations is not unique to the medical field nor to conversations about dying. I see this theme repeated over and over in multiple iterations. We avoid conversations about gun violence with children who are old enough to see it on the news and in their own lives and be scared or anxious. Not talking about it is not making it go away for them. Rather, it’s making them feel more alone in their fear.
Companies keep rolling out massive layoffs without managers talking to their employees throughout the process in an open and empathic way. Avoiding these conversations is not reducing the anger, stress, and sadness that employees feel; it’s only making it worse. As a result, these companies’ bottom lines suffer with decreased worker productivity, satisfaction, loyalty, and quality of work.
We avoid the very hard conversations around racial tensions and violence, thinking that bringing it up might make those who identify with oppressed groups feel worse. But the truth is that they already feel worse (angry, scared, devalued), and it is precisely our conversations calling out these hard truths that is a necessary first step towards creating empathy, understanding, and ultimately change.
Hard truths exist all around us; pain is present in many facets and areas of our lives. What every single person wants most in these places is to feel seen, heard, and loved. But avoiding the conversations offers up none of these. Many of the most sacred and beautiful things in life –understanding, empathy, progress – all start with honest conversations about the hard spaces in our lives.
It’s human nature to avoid difficult conversations
To understand how to have open and honest conversations about difficult topics, it is critical to understand why we avoid these conversations in the first place. Psychologists note that any time you engage in avoidance, it is because it almost always leads to some benefits. Most often, with avoidance, it is because you get to put off an uncomfortable conversation or remove anxiety related to thinking about a difficult topic. In short, avoidance provides temporary relief of the anxiety, stress, or other uncomfortable feelings this topic may make you feel.
But we can lure ourselves into a false belief that this is the desired path of communication because we aren’t measuring how it impacts important outcomes. For instance, companies probably aren’t measuring the economic impact of poor communication amidst layoffs. Parents and caregivers aren’t measuring the consequences of avoiding hard conversations with their children. Doctors aren’t thinking about the negative outcomes for a dying patient who hasn’t been told they are dying. None of this is intentional, but it is worth noting that avoidance is almost always beneficial in the short term but holds negative consequences in the longer term.
These conversations are so hard to have because we are hard wired to avoid difficult conversations. As social creatures, humans inherently avoid conflict to keep strong social bonds. So if difficult conversations are full of things like conflict, disagreement, and difficult emotions, it makes sense that we avoid them to maintain strong social connections.
The keys to having effective difficult conversations are trust and empathic communication
So what’s the key to success here? Organizational anthropologist Judith E. Glaser came up with an effective model for having difficult conversations that is grounded in scientific research and easy for anyone to implement. Her model, called conversational intelligence, is based on insights from the neuroscience of conversations. Her method focuses on helping individuals understand what types of conversations activate the lower, more primitive brain (e.g., the amygdala) and which types of conversations activate our higher-level intelligence (e.g., the prefrontal cortex) to build things like trust and empathy. She argues that by building things like conversational trust, your difficult conversations hold the power to be transformative for and beneficial to both parties.
Glaser notes that you can build trust by creating an environment and setting ground rules for the conversation that allows both parties to engage in transparent communication and support each other. Central to her model is the neuroscience behind conversations that demonstrates humans can directly influence each other’s emotional reactions through conversation. For instance, a team leader can enter a room and begin criticizing their team. This will create distrust and activate the amgydala, the brain structure where emotions like fear and stress are situated. Alternatively, that leader could come in to co-create paths of growth for the team, taking the same situation but creating trust and empathy. This allows everyone in the conversation to partake in a solutions-based approach to the challenges they face.
Her lifelong career on effective communication came full circle when she was diagnosed with cancer, which she would ultimately pass away from in 2018. She shares her powerful story in a CoachX talk. Her story mirrors a story so commonly shared in my professional world, which is a patient’s voice isn’t heard and this ultimately leads to them needing to advocate fiercely for themselves to get diagnosed. She shares her story to illustrate the power of having open, honest difficult conversations that “enable us to open up our mind and heart with each other so that the right answers can emerge, and the right people can be there to help.”
It was in the difficult but honest conversations that she ended up finding out she had cancer. This led her to find a leading oncologist to treat her pancreatic cancer. But what she notes as being most important to her was not his accolades but rather his compassionate communication and his “art for connecting” with her. She also notes valuing being surrounded by family who cared and continued to have difficult conversations with her. This is every patient’s story – the true power for healing lies in the patient being heard and met with compassion.
Glaser notes that she valued these difficult conversations with both her medical team and her loved ones. This truth illustrates the reality that these types of conversations are important in every single facet and relationship in which pain and struggle exist.
Glaser’s model was so powerfully effective within organizations that she became the co-founder of the Harvard Institute of Coaching. Embedded in this coaching institute is Dr. Glaser’s groundbreaking work on how leaders can build trust and get extraordinary results within their teams. I love what the Harvard Institute of Coaching stated was at the heart of her work and mission, prior to her passing away in 2018: “to change the world ‘one conversation at a time.’ She believed asking beautiful questions and having difficult conversations can allow for deeper connections.”
I believe this too, and science agrees. We absolutely can create a more trusting, loving, empathic world by having difficult conversations in an empathic and trusting way. If we truly enter the conversational equation thinking about the other person as an actual human being whom we care about, these difficult conversations hold the power to become life transforming. Talking to your child about gun violence becomes about acknowledging how hard it is and creating a space for them to feel safe. Talking to your employees about layoffs becomes acknowledging how stressful it is and valuing their continued presence. Talking to a dying patient becomes about acknowledging the devastation of such news while also imagining what is still possible for them in their final days.
Avoiding difficult conversations never keeps the pain away. But having positive and trusting difficult conversations finds the good in every painful space.
So ask yourself today – what difficult conversation am I not having? And how can I start that process, grounded in humility, empathy and trust?