Basic Listening Skills Spiritual Care Partners

1. Basic Listening Skills Spiritual Care Partners “The deepest level of communication is not communication, but communion.” — Thomas Merton

2. Foundations • Effective listening is simple, but it is very hard work. • When we listen, what is it we are trying to accomplish? • We are trying to listen in such a way that helps a person tell his/her story. • Talking about our lives, our struggles, our pains, our joys, our successes, and everything in between is therapeutic; it helps us gain understanding into ourselves and our experiences in life.

3. Theoretical Framework The non-directive approach of Carl Rogers: • The speaker takes the lead. • The listener maintains an attitude of allowing the speaker to determine the direction of the conversation. • The listener exhibits unconditional positive regard and an attitude of non-judging openness that helps the speaker feel safe to share.

4. “When the therapist is experiencing a positive, nonjudgmental, acceptant attitude toward whatever client is at that moment, therapeutic movement or change is more likely. It involves the therapist’s willingness for the client to be whatever immediate feeling is going on—confusion, resentment, fear, anger, courage, love, or pride … When the therapist prizes the client in a total rather than a conditional way, forward movement is likely.” —C. Rogers, quoted in Corsini and Wedding, 2005, 145

5. Qualities of Good Listening • Making eye contact • Validating the speaker’s feelings • Maintaining a non-judgmental attitude • Keeping the focus on the speaker • Using an attentive posture • Withholding unsolicited advice • Focusing on holding the pain with the speaker • Maintaining an attitude of compassion and “suffering with”

6. Ineffective Listening • Invalidation of feelings: • Speaker: “I am having such a bad day.” • Listener: “It’s OK, you’ll get over it. We all have bad days.” • Offering platitudes and clichés: • “Well, you’ll be OK. God never gives us more than we can handle.” • Offering unsolicited advice in a conversation when someone just needs to talk: • “You’ll have a better day if you just shift your focus to something more positive. Why don’t you go outside and take a deep breath. That will make you feel much better.” • Making ourselves the focus of the conversation: • “Oh, I had such an awful day yesterday. The pipes burst under my house and my dog got sick. It’s always something. Hey, do you want to go out for lunch? We both need a little treat.”

7. SomeImportant Don’ts Don’t… ▪Correct ▪Advise ▪Fix ▪Save — Parker Palmer, author of A Hidden Wholeness

8. Effective Listening • Speaker: “I am having such a bad day.” • Listener: “Gosh, I’m so sorry to hear that. What’s going on?” • Speaker: “I’m so mad at myself. I keep getting sick and coming to the hospital. I do what the doctor says but these chronic problems keep coming back. It makes me wonder if I’m doing something wrong.” • Listener: “You must be so frustrated. I’m sorry you are going through this. I’d like to hear more if you are willing to share.” • Notice in this last comment, the listener offers an invitation. The listener is inviting the speaker to share more of her story, more of her feelings about the situation. The speaker is offering to be present rather than trying to give advice. “HEAR” is a key word and it reflects the non-directive approach of Carl Rogers.

9. “When I say that I enjoy hearing someone, I mean, of course, hearing deeply. I mean that I hear the words, the thoughts, the feeling tones, the personal meaning, even the meaning that is below the conscious intent of the speaker…can I hear the sounds and sense the shape of this other person’s inner world?” —C. Rogers, 1995, 8

10. Body Language Be mindful of your: Posture: It should demonstrate gentleness, humility, and respect. Facial expressions:We are often unaware of them, especially in moments of stress. Energy: Match the energy in the room.

11. Reflective Listening

12. Acceptance Reflective listening requires acceptance: “…to accept is to give all your attention and energy to the process of understanding what the person means and to reflect that meaning back to the person accurately.It is being open, allowing the other person to be as he or she really is, without using masks or filters. It is listening without judging.” — Miller and Jackson, 1995, 55

13. Example of Reflective Listening • Speaker: “I come to the hospital a lot to manage my arthritis. Every time I come my friend says, ‘You are such a hypochondriac. Your pain is just in your mind and you need to get over it.’” • Listener: “So you’ve been hospitalized many times for this chronic issue and your friend doesn’t seem to grasp your need for help.” • Speaker: “Exactly. He just doesn’t understand. This is not in my mind. If it were, wouldn’t I choose not to have this pain?”

14. Mirroring Techniques ▪ Restatement ▪ Summary Paraphrase ▪ Reflecting Emotion — Everly, 2006, 68

15. Restatement The process of feeding the speaker’s words directly back to the speaker using the exact same words, focusing on the words you wish to highlight. Example: Speaker: “I am so angry, I just don’t know what to do.” Listener: “You just don’t know what to do.” — Everly, 2006, 68, 75

16. Summary Paraphrase A summary in your own words of the main points made by the speaker, in order to: • Show attentiveness • Solicit further comment or elaboration • Demonstrate acceptance or validation • Foster introspection — Everly, 2006, 69, 73

17. Stems in Summary Paraphrase • “So, in other words…” • “Sounds like…” • “What I’m hearing you say is…” —Everly, 2006, 69 Example: Speaker: “I am so angry, I just don’t know what to do.” Listener: “What I’m hearing you say is that you are so upset that you are beside yourself.”

18. Reflecting Emotion • Identifies speaker’s feelings based on verbal and/or non-verbal cues • Encourages discussion of feelings and removal of emotional blocks to communication • Builds empathy and rapport • Encourages ventilation • Helps defuse anger • Attempts to accurately label the experienced emotion of the other person • Example: “You seem really angry…” — Everly, 2006, 69, 72

19. Other Techniques • Non-Verbal Attending • Nodding head, facial expressions, etc. • Open-Ended Questions • Example: “What do you mean when you say…?” • Silence — Everly, 2006, 71-72

20. Silence How can silence be a helpful tool in a conversation?

21. “Silence is often difficult because we want to tell our own story.” “Sometimes it is important to just be with the person, listen, and not give much feedback.” “Knowing when to interact and when to keep silent is accomplished by much practice and by watching the response of the speaker.” —Savage, 1996, 98

22. “Silent” and “Listen”Same Letters

23. “No word was ever as effective as a rightly timed pause.” — Mark Twain

24. ACCESS POINTS

25. Access Points • Access points are portals for the listener to walk through, much like a door, to invite further sharing. • Another term for them is “Care Gates” (Lewis, 2002). • They provide opportunities for the listener to say, “I noticed that you just said…” or ask, “Can you tell me more about that?” • Examples: • Facial expressions • Body posture • Tones of voice • Specific words or phrases used • Tears • Complaints

26. Example You encounter a woman on the medical-surgical unit who underwent gall bladder surgery. All was supposed to be routine, but she developed an infection which is very painful and has forced her to remain in the hospital for several weeks. You introduce yourself as a Spiritual Care Partner and ask how she is doing today. She replies, “I’m OK I guess, but I really wasn’t expecting to be at the hospital this long.” Discussion: What access points do you see?

27. Possible Access Points: • The word “OK”: • Listener: “How are you doing today?” • Speaker: “I’m OK, I guess.” • Listener: “So you are OK. How could things be going better?” • Speaker: “Well, I’ve developed this infection and it’s extended my hospital stay. I am very frustrated.” • The word “long”: • Listener: “How are you doing today?” • Speaker:“I’m OK I guess, but I really wasn’t expecting to be at the hospital this long.” • Listener: “So, it sounds like you’ve been here longer than expected. How long were you expecting to be here?” • Speaker: “I was only expecting to be here for three days, butI’ve been here for two weeks.”

28. “When persons offer you free information, it is like opening a door through which you are invited to come.” — Savage, 1996, 31 “…free information is like a doorway into the unconscious.” — Savage, 1996, 31 “Be intentional with the questions you ask, and you will help the speakers share the kind of information that will help them understand their own struggles and joys.” — Savage, 1996, 38

29. Summary of Lesson In this module, we explored the following concepts: • Listening for a speaker’s story utilizing the non-directive approach of Carl Rogers • Qualitiesof effective and ineffective listening • Reflective listening using mirroring techniques • Access points as opportunities to take conversations to a deeper level

30. Sources • Corsini, Raymond J. and Danny Wedding. Current Psychotherapies, 7th ed. Belmont, CA: Brooks/Cole, 2005. • Everly, George S. Jr. Assisting Individuals in Crisis, 4th ed. The International Critical Incident Stress Foundation, Inc. (ICISF), 2006. • James Michael Lewis (2002) Pastoral Assessment in Hospital Ministry: A Conversational Approach, Chaplaincy Today, 18:2, 5-13. • Miller, William R. and Kathleen A. Jackson. Practical Psychology for Pastors (2nd ed.). Englewood Cliffs, NJ: Prentice-Hall, 1995. • Rogers, Carl. A Way of Being. New York: Houghton Mifflin, 1995. • Savage, John. Listening and Caring Skills: A Guide for Groups and Leaders. Nashville, TN: Abingdon Press, 1996.