Interpersonal Communication

Day Three – Barriers to Effective Communication Interpersonal Communication

Barriers to Communication • Cultural differences • Stereotyping and prejudice • Language • Stress • Conflict • Misunderstanding

Culture A collection of beliefs, rules, and practices that are shared by a group of people.

Culture • Cultural behaviours often become so basic to our lives, that we don’t notice them until we see someone of a different culture behaving differently. • In a sense, our culture becomes invisible to us • A subculture is a group that shares many cultural aspects with general society, but have their own distinct cultural practices as well

Culture • Discuss the following: • What are some “norms” in our culture that may seem odd to someone from a different culture? • What are the possible responses when you observe different cultural behaviours? • Identify several subcultures that exist in Canada.

Cultural Diversity The maintenance of distinct cultures within a broader society Celebrating differences without dwelling on them, in an atmosphere of understanding, respect, and tolerance

Cultural Diversity • Health professionals interact with members of many different cultures • In a care relationship, it’s important that the person seeking care doesn’t feel that they are being disrespected based on their culture • Some individuals enter into communication expecting that they will be treated differently because of their culture

Culturally-Appropriate Communication • Factors that can affect cross-culture communication • Language • Differences in understanding of words, gestures, body language, etc • Context • The healthcare environment is often confusing and unfamiliar, and may even be frightening • Ethnocentricity • The belief that one’s cultural norms are the “right” ways of behaving

Culturally-Appropriate Communication • Prejudice • Prejudging or coming to conclusions about a person or group on the basis of untested assumptions, without regard for facts • Stereotyping • Assuming that all members of a group will share the same characteristics or behaviours

Culturally-Appropriate Communication • Discuss the following: • True or False: Any stereotype is harmful. • Give an example of a stereotype that is common in our society • True or False: Prejudice and discrimination are the same thing

Need for Intercultural Understanding in Healthcare • Discuss the following: • What are the potential implications of having stereotypes and prejudices when dealing with individuals in a healthcare environment?

Strategies for Culturally-Appropriate Communication • Self-awareness • Recognize personal biases • Personal commitment to understanding differences • Exposure and learning • Become familiar with cultures you may be exposed to • Investment of time to ensure understanding • Be aware of signs of confusion or offense and take the time to clarify meaning • Anticipation of difficulties

Language • A shared language is essential for effective communication • If the client does not share a common language with their care provider, it can affect the effectiveness of treatment

Strategies for Dealing with Language Barriers • Speak more slowly • Avoid complex words or jargon • Stop often to ensure comprehension • Use an interpreter • Can be an individual brought in by the client or a professional interpreter

Using an Interpreter • Allow extra time for the communication • Keep points short to make translation easier • Speak to the individual, not to the interpreter • Be aware of the client’s nonverbal cues indicating confusion or understanding

Stress • Any factor that causes physical and emotional tension • A person under stress often uses defence mechanisms to cope with the stress • Some defence mechanisms are healthy, others have a negative impact • Often defence mechanisms will make communication with the individual more difficult

Defence Mechanisms • Procrastination • Avoiding an upsetting situation for as long as possible • Verbal Aggression • Attacking someone else without addressing the stressor to redirect attention

Defence Mechanisms • Sarcasm • Adding a negative edge to words with the intent to cause pain or anger • Rationalization • Offering excuses for behaviour and trying to convince themselves or others the behaviour was justified

Defence Mechanisms • Compensation • Making up for feeling of frustration or inadequacy in one area by focusing on achievement in another • Not always a negative response, but can be used as an excuse

Defence Mechanisms • Regression • Reversion to an earlier mental or behavioural level • Repression • Excluding unwanted thoughts from consciousness • Blocking something from one’s mind or changing the subject when mentioned are examples

Defence Mechanisms • Apathy • Lack of feeling, emotion or interest • Often a pretence of not caring • Displacement • Redirection of an emotion or impulse from it’s original object to another • Often the individual feels that they can better control the situation onto which they are displacing their stress

Defence Mechanisms • Denial • Complete avoidance by denying that the stressor actually exists • Physical Avoidance • Avoiding any location, situation or object that brings the stressor to mind • Can be healthy in the short term, but usually must be dealt with in the long term • Projection • Attribution of one’s own feelings, ideas or attitudes onto others

Conflict • Disagreement or clash between people • Examples: • Health professional and person seeking assistance • Health professional and colleagues

Examples of conflict 1. Disagreement about information 2. Difference in ideas 3. Differences in the way things should be organized 4. Different understanding of the same words 6. Different opinions about the order of priority of tasks 7. Not understanding expectations

Dealing with Conflict Identify severity of emotions • Helps to decide how to handle the conflict • Uneasiness or awkwardness • Minor conflict • Often cleared up by a quick discussion of where the uneasiness has come from • Irritation • Outcome appears unsatisfactory • Slightly more severe • Misunderstanding • Failure to understand or interpret • Honest acknowledgement and apology

Methods of Dealing with Conflict • Choose to ignore • Sometimes the best course of action • Person needs to vent emotion • Avoid responding emotionally • Do not absorb blame • Resolve negative attitudes and emotions towards another • Recognize source of attitude • Invest time in understanding • Focus on positive attributes

Patterns of Conflict Response • Aggressive • Intimidates or attacks the other • Desire to be right / to win • Causes fight or flight reaction • Passive • Does not express emotion or opinions • Believes they do not have the right • Limited confidence and self-esteem

Patterns of Conflict Response • Assertive • Expresses perceptions, ideas or opinions in a respectful manner • Affirms rights of self and other • Positive communication outcomes • Strengthens relationships

How to Communicate Assertively • Establish and focus on the problem, not the emotion • Remain calm and avoid responding in an emotional manner • Avoid placating with “calm down, you’re OK” • State the facts about the situation, do not evaluate or judge • Listen carefully, allowing the person to finish each sentence • Use ‘I’ statements • Take responsibility for your feelings and actions • Use normal speed/tone of voice.

Avoid talking slowly (appears patronizing) • Observe non-verbal behaviors carefully • State how the problem affects you, not how you feel about the situation • If appropriate, gently and calmly repeat a question or statement until the persons hears and responds • Emphasize collaboration, asking for their thoughts • Seek solutions achievable within a particular timeframe

Misunderstanding • Failure to understand or interpret words • Can occur even when the intent is to communicate successfully • Misunderstanding results in: • Anxiety • Regret • Guilt • Unfair judgment. • Misunderstandings decrease the levels of trust and can severely affect the therapeutic relationship.

Causes of Misunderstanding • Attitudes • Person seeking care may feel a negative attitude more than the health professional that holds it • Attitude of respect, empathy and inclusion, as well as an attitude that focuses on the vulnerable individual is important • A positive attitude can influence the attitudes of others.

Causes of Misunderstanding • Emotions • easy to misinterpret frustration, intolerance, impatience, anger • Failure to give adequate attention can cause misunderstandings. • Relevance of Context • Speaker and their role • Manner of communicating • Relationship to the ‘other’

Causes of Misunderstanding • Expectations of the event or procedure • Important that the health professional clearly explains their service and expected results of and reasons for particular procedures and events.

Strategies to Avoid Misunderstandings 1. Plan and prepare for the interaction 2. Understand the communication expectations 3. Become familiar with the needs of a specific culture 4. Know and understand info for discussion and organize it clearly/carefully

5. Minimize misunderstandings of words and sentences • choose words carefully • avoid using jargon • avoid everyday sayings (go with the flow, take it easy) 6. Observe the effect of information throughout the interaction 7. Ask for summary of information to determine the level of understanding 8. Reflect upon the interaction

Resolving Misunderstandings • Steps to resolving misunderstandings • Be aware that a misunderstanding occurred • Control and resolve negative emotions right away • Take responsibility for the misunderstanding as the professional, regardless of the cause or problem • Understand what caused the misunderstanding so that it won’t happen again • When communicating with the client, focus on resolving the misunderstanding, not on the cause

Interpersonal Communication