Md Anderson Cc Sslides

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




• …are conscious exchanges that are real, meaningful and energizing

• …are a face to face accountability session




…can take you to the heart of what's most important

…can lighten your heart and your life



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



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"



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"



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



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



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".



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



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



But if you feel…

Any stored guilt, anger, sadness, love ‘thing that is unexpressed - then maybe …

better out than in



Behavior Signals

• Acting out• Badmouthing others• Gossiping• Feeling depressed• Helplessness • Silence• Making serious errors



When others avoided a CC

The consequences were tremendous

Multiple medical errors in health care

Challenger disaster

Air crash in Potomac river



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.



Does it all add up?

The Risks No guarantees

The outcome may be even worse than you feared.

CC can lead to…



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



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?



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



Personal Preparation

7 Rights of CC Right problem Right words Right delivery Right frame of mind Right… Right … Right …



Personal Preparation

• the person vs the problem

• R-E-S-P-E-C-T

• Off your guard

• Speak but…



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



Inquiry versus Advocacy

• Share your thinking• Test your assumptions• Inquire into his views• Test her assumptions• Share your data



Courageous Dialogue

• Name the issue

• Select an example

• Describe the feeling



Courageous Dialogue

• Declare the stakes

• On your own

• Indicate your intent



Courageous Dialogue

• Invite a response

• Reflect

• Follow through



Follow through

• When all is said and done

• When I move you move

• Hold me

• “Sorry” is not a 4 letter word



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…



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



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




Most people are more comfortable with old problems than new solutions




Are you most people?


Improving Communication &

Strengthening RelationshipsAt M.D. Anderson

David Richardson, PhDOmbudsman - Mediator

Business

Md Anderson Cc Sslides