Listening Patience

On several occasions, I have observed patients who seemed to be listening when I was talking to them but left me doubtful about just how much they actually heard. When my doubt is high, I might solicit a response in order to test my impression, since this is obviously important to address. It is my reasonable assumption that if my impression is correct and the information presented is somehow not ‘getting in,’ that this is probably going on elsewhere in their lives.

When people who have this difficulty are listening to another speak to them, they are often busy planning how to respond. They might be planning a defense of their position if a disagreement is involved; or, they might be ‘shutting down’ if they are listening to something they don’t want to hear. Others may be busy trying to make a favorable impression and therefore are busy monitoring the dialogue, rather than hearing it, in order to ensure that they are viewed positively.

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Rachel, the wife in a married couple I have been seeing in my practice, is a good example of someone whose apparent listening style concerned me enough to address it directly with her. It was important to do this in a way that was not seen, as much as possible, as blameful or critical so as not to create hurt and therefore, defeat my effort to help. While observing Rachel listening to her husband recently, I saw that she seemed to be preparing for what she sometimes referred to as “my turn.” Ira had said a lot and it was important information that had potential to advance one of their treatment goals. When it was “her turn,” Rachel said nothing about any of what Ira had just told her. I asked her if she could tell me, in her own words, what she had just heard. She drew a complete blank and was unable to offer anything. The three of us sat there stunned! The efforts to help Rachel become a more patient listener and to truly focus on what is being said to her have helped her significantly, both in her marriage and in her relationships, in general.

Lila, another patient, was similar, however, she tended to be a somewhat competitive and combative person who had an argumentative manner of relating to others. ‘Winning’ was quite important to her and this guided her interactions with people leading to countless difficulties with family, friends, and co-workers. Early in our work together, I noticed that Lila had trouble waiting to speak, often talking over me or demonstrating impatience when I spoke, however much or little. Fortunately, with help and with time, Lila came to appreciate how her manner of relating and what I termed her ‘listening impatience’ was defeating her. In addition to understanding the origins of her particular style of relating, we embarked on an effort to ease the “right-wrong” nature of her interactions and to improve her ability to listen, with success.

My work with Rachel was in the context of couples’ therapy with her and her husband, Ira. With Lila, an individual patient, the work took place by using our relationship to help her work things out.

I introduced the concept of mirroring to my patients. Simply, mirroring in this effort means using “I” language to convey his or her thoughts, feelings, or experiences to the other person in the dialogue. Shaming, blaming, or criticizing the listener is avoided and the person talks about him or herself. The listener echoes the sender’s message word for word or by paraphrasing or using a lead sentence like, “Let me see if I’ve got you. You said ...” Mirroring is designed to help a person tune in and carefully listen to what the other person is really saying, rather than listening to the reactions and responses going on in his or her head while the other person is talking. When Rachel and Ira learned to mirror in this way, their communication became much more focused and productive and, rather than continue to recycle their age-old arguments and issues, they began to better resolve conflicts, settle differences, and generally enjoy their communication because it was no longer as frustrating and contentious.

Validation is another important communications tool that helps people talk to each other more productively and helps to avoid conflict. Validation refers to each person in a dialogue acknowledging what the other person said without necessarily agreeing or disagreeing with what was said to them. Too often, communication breaks down when a person instantly disagrees with the content, rather than simply acknowledging what was said, i.e. validating the other person. This keeps the connection going between the two people in the dialogue, rather than getting stuck, often angrily, in the all-too-familiar “who’s right, who's wrong” deadlock. This proved especially helpful to Lila who too often turned attempts at conversation into contentious exchanges or “debates” as we referred to them, since for her, right and wrong were paramount and she argued her “positions,” with people, all the while complaining that there were fewer and fewer people in her life … perhaps as a result of her communication style. Once Lila benefited from being mirrored and feeling validated, the angry vigor of her argumentative approach to conversing with others was gradually replaced with a more even-tempered and profound level of dialogue with others.

People who did not receive validation in early life are, not surprisingly, the adults who often have the most difficulty with this. Brenda, a patient of mine, is a good example. In the beginning of our therapeutic relationship, Brenda rarely acknowledged anything I said. She would politely listen to my comments and then offer hers, however, her remarks were mostly new thoughts or ideas and rarely a direct or relevant response to anything I had just said. Instead of a dialogue, it felt more like a parallel monologue without much, if any, connection between us. When I mirrored her and, in doing so, validated what she had said (i.e. “I hear you, Brenda,” or “I gotcha” or “That makes sense to me,” etc.) our communication improved and enhanced our working alliance immeasurably.

The patient illustrations here represent the effort made on both sides to modify troubled communication patterns that developed over a lifetime and were, therefore, not easily altered. Once some change was realized, however, each patient was not only able to enjoy the improvement but was able to positively influence their communication with others. Mirroring and validation had enabled each of them to attain a higher degree of listening patience and a calmer, more thoughtful approach to conversation with others.