2 Thinking empathy and empathic communication

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Contents

• Objectives
• Communication
• The importance of listening
• Communicating with body language
• Asking questions
• Case study

Objectives

When you have completed this chapter you should be able to:

1. Explain how people communicate.
2. Describe correct body language.
3. Explain the importance of listening.
4. Use body language and non-verbal communication.
5. Define and use open and closed questions.

Communication

2-1 How do people communicate?

We often think people talk and communicate with language (the use of words). But words make up less than 10% of the message. People mostly communicate with their body, facial expressions and sound (tone of voice). This is called non-verbal language. Body language sends more than 50% of the message. Most people don’t even know this is happening. Understanding non-verbal and body language is an important part of thinking empathy. Care providers use thinking empathy so they can understand and be kind to everyone who needs care.

2-2 How can we help people to trust us?

Trust is a very important part of taking care of others. When people feel vulnerable, they look for connection and help from those they trust. Feeling vulnerable means feeling small, afraid and uncertain. Care providers must create trust very quickly.

When people are vulnerable they are more frightened and stressed than normal. Fear usually makes us behave in one of two ways. These responses are called the fight and flight response. The fight response is to stand and fight. The flight response is to run away. When people feel stressed and afraid, and they are in fight or flight mode, it is very hard for them to relax or think clearly.

People in fight or flight mode are more sensitive to the body language of others. Care providers can use this sensitivity to help clients feel safe. To do this we must make sure our bodies are sending the right message.

2-3 How can we use our body language to relax people?

Making people feel safe, comfortable and relaxed is the very first step in being able to help others. This is the same for babies, children, adolescents and adults. It is particularly important for those who are vulnerable and full of fear. Our body needs to send a message that we are calm, kind, welcoming, caring and want to help others. This will allow others to trust us, connect and start to feel safe.

The correct body language is important to get people to relax and trust us.

2-4 How do we make our body show people can trust us?

Important ways are:

• Smile and make eye contact in culturally sensitive ways.
• Notice people and greet them in a warm and welcoming way.
• Face them and have an open body attitude (don’t cross arms or turn away).
• Never look rushed or impatient.
• Show you are interested and care (kindness).
• Speak slowly and clearly.
• Show others they are important by listening without interrupting them.
• Be aware of how our body is responding to their body language.

Care providers must be self-aware, so that we can respond with compassion. If someone is in fight mode, their body may look very fierce and angry. If we are unaware we may become angry ourselves (fight), or we may feel the need to escape (flight) and create distance. Both of these responses are natural but make it difficult to be compassionate. These responses are not helpful if we want to take care of others. When we are working with vulnerable people, we have to remember that kindness starts with us.

Self-care allows us to learn to understand ourselves so we will be able to be calm, kind and helpful to others.

The importance of listening

2-5 Why is it important to listen?

We must try to listen without interrupting. This is part of thinking empathy. We try to listen with our whole body. We allow people to talk about what is important to them, and we don’t interrupt them. We listen to their words and also to their body language. When we listen in this way, we show people that they have value and that their ideas and problems are important. Sometimes all we need to do to help others is to listen.

Listening with our whole body encourages people to talk about what is important to them.

2-6 What if I don’t interrupt and they may never stop talking?

Many people worry the person will never stop talking. This doesn’t usually happen. Listening can save us time. When people feel valued and heard, this creates trust and they begin to relax. This allows them to use the thinking part rather than the feeling part of their brains, and to think more clearly. When we listen to people, they can tell us what is troubling them. Later, they will listen to us. This means we understand better and they are more likely to follow our advice. This is especially true when working with adolescents. Like kindness, listening must start with us.

2-7 Why is it sometimes difficult to listen properly?

Many people find it very difficult to listen. We often interrupt and ‘highjack’ conversations so we can hear what interests us or get a chance to talk about ourselves. Or, we may be thinking of ways to answer or fix the other person rather than listening. This sends a clear message that we are not interested in the other person.

Sometimes we hear something which makes us feel frightened or makes us worry that we won’t be able to help the other person. If we are not aware, then we may use some of the unhelpful responses described in the first chapter. For example, we may jump in and try to fix or solve the problem from our point of view. This is a way of making us feel more in control and powerful. Or, we may try to think why the problem would never happen to us, which makes the other person feel judged and without value.

Listening properly is difficult as we often want to control the conversation.

2-8 How do we listen with the whole body?

When we listen with the whole body, we use our body to show the person we are listening. We focus our attention and listen to their words and their voice tone, and we notice their body language. We also try to notice how we react to what they are saying. Listening in this way can be very difficult and takes a lot of practice. We should always try our best.

Communicating with body language

2-9 How do we reflect body language?

We reflect the emotions we notice in the body while the person is talking. It can take a lot of practice to recognise emotion in other people. We should not worry about getting this wrong at first, but we must always check with the person. It helps if we learn to recognise and name our own emotions (self-care). Feeling empathy lets us read emotions in others automatically, but we need to practise giving words to these feelings. This can be challenging for many people. Once we start noticing and naming our own feelings, it becomes easier to notice and name the feelings in others.

2-10 How do we use our body to show we are listening?

When we listen, we should focus our attention on the person. We can’t do this when we are already doing something else. It is not possible to be on the phone, write notes and listen at the same time! To show we are listening:

• We put away distractions like the cellphone.
• We come out from behind the desk.
• We face the person and try to copy their body language.
• We lean forward to show we are interested.
• We are curious and try to understand the whole message.

Be careful not to touch the other person unless you know them well.

We need to learn how to use body language to improve communication.

2-11 What does voice tone mean and why is it important?

Tone means the sound of the voice. The voice tone can give important clues about how the person is feeling inside:

• Do they speak in a loud and angry voice, or in a soft and frightened voice?
• Do they sound rushed and frightened, or slow and confident?
• Is the voice tone gentle or does it sound angry?

Voice tone often tells us more about the real meaning than the words people choose. High, fast voices sound frightened, while low, slow voices sound more calm and confident.

2-12 Do we need to make notes so we don’t forget what they say?

When we listen with empathy, we must not worry about forgetting information. We can trust that we will remember what is important. If we forget, we can check with the person using open questions. We can summarise what we remember to be sure we’ve not forgotten anything. We can also use open questions to find out more and encourage the person to keep talking.

Asking questions

2-13 What are open questions?

We mostly use two types of questions:

• Closed questions are when we need a ‘yes’ or ‘no’ answer, or when we need information where there is only one answer (e.g. an address or date of birth).
• Open questions encourage the person to give a much bigger answer. We usually get a lot more information and understand the person better when we ask open questions. It is useful to ask open questions at the beginning of a conversation, and also to encourage the person to talk. Open questions usually start with the words ‘what’, ‘how’ and ‘why’.

Other examples of open questions are:

• How can I help you today?
• Tell me more about that bruise on your arm?
• How did that make you feel?
• Can you help me understand how that happened?

We must be careful with our voice tone when we use ‘why’ at the start of an open question. This is because, if we are not careful, ‘why’ sentences can easily sound like a judgement.

Using open questions encourages people to tell their story.

2-14 When do we need to use open questions?

Open questions are an important part of thinking empathy. We use open questions to hear the other person’s view and to understand what is happening. Depending on where we work, we may also need to use open questions to explore recent life events, as well as social and health problems.

2-15 Will I cause harm if I reflect emotions incorrectly?

When we reflect emotions, we try to name how the other person is feeling. We do this by observing their body language and voice tone, and by listening to their words. We gently tell the other person what we have noticed in an open, curious way to check if we are correct.

When we start to reflect emotions in other people, we will be wrong most of the time. This should not put us off. We cannot cause harm when we reflect emotions, if we always ask if we are correct. When we do this, we help the other person understand themselves better, and make them feel that we have seen and heard them. For example:

• It looks like you may be angry. Is that how you are feeling?
• I’m confused about how you are feeling right now. Can you tell me more?
• Your body looks stressed. Is that what you are experiencing?
• I imagine that makes you feel upset.
• You say you feel happy, but your body looks sad.

With practice, this will become easier and easier to do, both in ourselves and in other people.

2-16 Why should we always check that we have understood properly?

A very important part of thinking empathy is to check that we have understood correctly. This allows the person to think about how they are feeling and correct us if we are wrong. It also allows us to separate ourselves from their experience. When we respond we will be able to respond with compassion. We must ask and not tell the other person what they feel. We can try to use questions like:

• Did you say …?
• Am I correct in thinking that …?
• What do you mean when you say …?

When we are curious and ask questions, instead of assuming we understand, we make the other person feel seen and heard, and it shows we are interested.

It is important to make sure you fully understand what someone has said.

Case study

Ntombi is 16 years old and 6 months pregnant. She ran away from her mother’s house when she found out she was pregnant. She has not been eating properly, can’t sleep and cries when she thinks about her mother. She tells you she feels useless and wants to end her life.

1. How can we help Ntombi?

We must try to get Ntombi to feel safe with us. We must speak in a calm, kind way, and use our body to send Ntombi the message that we are not going to judge her. We do this by making our body look open and welcoming. We can show we care and want to help by listening to her story.

2. How might her story make us feel?

Ntombi talks about a lot of things. Some of these things make us think of our own children and we feel angry and want to shout at her.

3. How should we respond to her story?

We need to do our best to keep listening to what Ntombi is saying. The meaning we give to her feelings might not be the same as the meaning she is experiencing. The only way we can understand is to listen with our whole body. We must stay calm so she feels safe and can start to feel relaxed. When she is relaxed, we will be able to work out the best way to manage her problem so she doesn’t feel so hopeless.