Motivation and emotion/Book/2022/Difficult conversations and emotion

Difficult conversations and emotions:
What communication and emotional skills are needed to successfully negotiate difficult conversations?

Multimedia presentation (3 min)

Overview

Relationships are necessary for survival; as humans, we experience emotions associated with our relationships that serve various adaptive functions to enhance and maintain our well-being. Sometimes these relationships require maintenance and encounter hurdles that need difficult conversations to overcome. How we navigate these unavoidable and necessary conversations will influence all types of relationships in our professional and personal lives.

Focus questions:

What are difficult conversations and why do we need them?
How can communication skills be improved?
What do psychological theories of emotion have to say[about what?]?
What can I do if it [what?] starts to go wrong?

Difficult conversations

Building relationships in various contexts guarantees that clashes will occur between individuals that[grammar?] need to be addressed if the relationship is to continue in a positive direction. Positive outcomes of conversations bind people by promoting empathy and intimacy and bolstering feelings of self-worth regardless if the conversation may be difficult or not (Miller et al., 2004). Although it is impossible to completely eliminate negative aspects of difficult conversations, verbal and non-verbal communication strategies can help smooth the path and increase the likelihood of experiencing positive outcomes.

What characterises a difficult conversation?

A difficult conversation can be described as a high-tension event where the subject matter is sensitive, emotions run high, opinions vary, and the consequences are impactful (Overton & Lowry, 2013; Patterson et al., 2012). Hample and colleagues (2017) add that difficult conversations can and will occur in all relational contexts and are usually unscripted and subjective in their consequentiality, depending on different perspectives. Compared to positive outcomes, Patterson and colleagues (2012) found that potential adverse outcomes have more power to change the quality of life, where daily routines can be significantly altered. Positive outcomes include the quality of decision-making, improved understanding between individuals and groups, emotional validation and connectedness (Patterson et al., 2012).

Research conducted by Dibble and Levine (2010) on the Minimising Unpleasant Message effect (MUM effect) found that people are more hesitant and reluctant to share or discuss bad news, especially if there is not enough good news to counterbalance it. Although the risk of creating a tense situation makes hesitancy understandable when facing difficult conversations, a culture of avoidance also creates negative consequences that harm relationships and organisations over time (Pavlish et al., 2015). This means that avoidance occurs because a conversation might be difficult and complex, which is only compounded if avoidance continues. Take an example of a difficult conversation in which a manager is required to discuss performance issues but fears causing negative feelings for the employee. If, however, performance continues to decline, the organisation will suffer, and resentment can fester. The manager may attempt to “soften the blow” by acknowledging instances of good performance and encouraging professional development to counter any criticisms.

Examples of difficult conversations: "breaking bad news"

A manager discussing issues of performance with an employee.
A doctor telling a patient of a terminal diagnosis.
Romantic partners confront feeling unhappy in their relationship.
Members of a group project confront one another about workload imbalances.

Communication strategies

[Provide more detail]

Verbal cues

Given their unavoidable nature, research on communication strategies is valuable for insights into navigating difficult conversations. The caring feedback model developed by Leebov (2010) focuses on six script-based steps outlined below to find a balance between providing clear feedback and maintaining boundaries while being supportive and empathetic.

State your purpose in positive terms, such as, “I know you care; I want to be helpful..."
State the situation and specific behaviour in clear, simple terms.
State the consequences for you, your team, your patients and your organisation.
Use a touch of empathy, such as “I know you work hard and had a lot of patients that day ...”
Make it a dialogue. Let the employee respond, ask them questions and listen.
State your request or expectation in clear terms.

(Leebov, 2010, as cited in Polito, 2013, p. 147).

This model paves the way to high-quality or active listening (see Figure 1) and open-minded conversations where autonomy is supported, and speakers are encouraged to engage in self-awareness non-defensively (Weinstein et al., 2021). The above model was developed for the context of workplace performance and attitude; however, the importance of conveying positive intention and genuine care for self-development are emphasised, which can be applied in many situations.

Non-verbal cues

Non-verbal communication is also crucial for difficult conversations. Humans are designed to read physical cues such as facial expressions, gestures, eye contact, posture and proximity to gauge emotions and intentions to inform a response (Weinstein et al., 2021). Seminal research by Paul Ekman studying facial kinesics (see Figure 2) has dramatically assisted in measuring these non-verbal cues, which can be applied strategically in conversations. Despite knowing that genuine facial expressions are mostly involuntary (Bonaccio et al., 2016), gestures such as nodding, smiling and even gentle touch can be controlled to emotionally tune in and convey positive intention. Conversely, gestures such as eye rolling, lip pursing and turning away can signal contempt, frustration and defensiveness (Bonaccio et al., 2016). Core emotions expressed on the face were found by Ekman (1972) to be universally recognisable; however, it must be stressed that gestures vary across cultures and from workplace to intimate relationship contexts where the appropriateness of touch and eye contact, in particular, must be gauged (Sorokowska et al., 2021; Uono & Hietanen, 2015).

Case Study: Verbal and non-verbal cues in conversation

Aiden has been feeling frustrated recently because his partner Amy is not contributing equally to chores around the house. He confronts Amy with this and uses empathy to convey that he understands she has recently been under pressure with university work. During this conversation, Amy begins to feel defensive but later does apologise. Aiden notes that Amy rolled her eyes while apologising, which signals to him that the apology was not genuine.

Section quiz: test your knowledge!

Select the correct answer.

The role of emotions

Difficult conversations are identified as such primarily because they are emotional. Nevertheless, intervention research appears to be primarily oriented toward boosting communication skills with scriptural suggestions rather than relieving negative emotions (Hample et al., 2017). While frameworks, steps and scripts can help to ease anxiety towards broaching certain subjects (Hample et al., 2017), it is not uncommon that scripts cannot keep up with the unpredictable nature of emotions (Cheng et al., 2017). So what can biological and cognitive theory and research about our emotions tell us about what happens when we have difficult conversations and how can we get things back on track?

Biological perspectives

In the timeline of prominent emotional research (See Figure 3), two primary schools of thought emerged: the biological and cognitive perspectives. Darwin proposed in 1872 that emotions exist and adapt primarily for survival and that humans evolved to be able to read and communicate other humans' emotions to avoid danger and reproduce (Hess & Thibault, 2009). Not long after, the James-Lange theory (1884) emerged, which supports that the physical experience of emotions generates a cognitive interpretation of bodily sensations. According to these theories, emotions cannot occur without there being a physical stimulus first. The Cannon-Bard theory takes a less causal approach. It posits that the physical and psychological experiences of emotion happen at the same time as the thalamus sends sensory signals to and receives input from cortical regions (Dror, 2013).

Applying the physiological theories of emotion to difficult conversations, feelings of fear, anger and sadness serve to prevent relationship breakdown, social isolation and rejection (Oliver et al., 2017). The cognitive processing and identification of emotions then occur after or simultaneously with physiological signals such as trembling, crying, muscle tension and increased heart rate. A difficult conversation might not carry the same type of threat as coming across a grizzly bear in the woods, however social fears have been known to cause the same physical sensations in varying degrees of intensity (Brody, 2017).

Cognitive perspectives

The cognitive perspectives of emotion seek to understand nuances of emotional experience that biological perspectives cannot explain. For example, trembling and increased heart rate can occur in anger, fear and excitement. This means that cognition has to be involved in differentiating our experiences across time and based on situational evaluations. To address this, the Schachter-Singer two-factor theory (1962) deduces that physiological arousal informs the intensity of various emotions and cognitions attempt to find a label for them. For example, emotions such as gratitude, pride and shame can be considered social emotions, which are identified through subjective cognitive processes or cognitive appraisals involving analysis of situational cues (Sznycer et al., 2021). Lazarus further broke down cognitive appraisals into primary and secondary appraisals where a situation is analysed for risk factors first and then abilities to cope with the situation and emotions are analysed second (Folkman et al., 1986). In the context of a difficult conversation, confrontations are usually stressful events plagued with risks to self-esteem and devaluations by others (Sznycer et al., 2021). Appraisal theories recognise that all appraisals are subject to individual differences; therefore, attacks on an individual's values, goals, needs and beliefs are likely antecedents to difficult conversations (Moors et al., 2013).

Emotional regulation strategies

Although learning verbal and non-verbal communication strategies that follow a step-based framework can undoubtedly provide valuable insights, the above theories of emotion support the use of emotional regulation strategies, which can aid in adapting to emotions' unpredictable and complex nature. For example, Luff and colleagues (2016) report using self-care techniques and support from trusted people to manage emotions before, during and after difficult conversations. Self-monitoring or mindfulness techniques may also be a valuable skill for helping people to navigate high-stakes conversations, according to Cheng and colleagues (2017). Self-monitoring involves curiosity about our thoughts, feelings and behavioural patterns with a willingness to use these insights to improve communication and problem-solving skills in future, which can include consciously identifying fears about possible consequences of a difficult conversation (Cheng et al., 2017; Overton and Lowry, 2013). Overton and Lowry (2013) also suggest that looking at as many different perspectives as possible is an effective reappraisal technique to reduce any tension that attempts to reframe a situation in a more positive light.

Theories in action: Utilising emotional regulation strategies

Charlie is a health practitioner in training about to discuss a terminal diagnosis with a patient. Charlie begins to feel a tightness in his chest and his palms are beginning to sweat which are tell-tale signs that he is nervous. He is now imagining many devastating outcomes of the conversation which inevitably makes him more nervous and he wishes he could just send an email and take the day off. Instead, he approaches his supervisor for support and she offers an empathetic response along with some breathing exercises. She also offers to debrief after the conversation with the patient and suggests a reflective practice to address improvements in communication strategies.

Section quiz: test your knowledge!

Select the correct answer.

Conclusion

In summary, difficult conversations occur when there are sensitive subjects to discuss with the potential for emotions to run high and differences in opinions to emerge. Both positive and negative consequences are impactful though negative consequences tend to have more power to change quality of daily life. Despite being unpleasant, research shows it is best not to prolong difficult conversations even if there are not enough positive messages to counter the negative. What matters is that there is hope to improve how difficult conversations are navigated by understanding verbal and non-verbal communication strategies which can provide useful scripts and help to ease anxiety in anticipation of a conversation. For optimal progress in communication strategies, biological and cognitive theories of emotion provide an understanding of how emotions serve an important and adaptive function which can be controlled with emotional regulation strategies. Key strategies to practice involve mindfulness, support seeking and self-awareness in confronting fears of a negative outcome. Ultimately there are many more techniques to emotionally regulate and of course they are all easier said than done however practice and exposure to having difficult conversations over time will provide more opportunities for improvement.

References

Bonaccio, S., O’Reilly, J., O’Sullivan, S. L., & Chiocchio, F. (2016). Nonverbal behavior and communication in the Workplace. Journal of Management, 42(5), 1044–1074. https://doi.org/10.1177/0149206315621146

Brody, J., Scherer, D., Turner, C., Annett, R., & Dalen, J. (2017). A conceptual model and clinical framework for integrating mindfulness into family therapy with adolescents. Family Process, 57(2), 510–524. https://doi.org/10.1111/famp.12298

Cheng, A., LaDonna, K., Cristancho, S., & Ng, S. (2017). Navigating difficult conversations: The role of self-monitoring and reflection-in-action. Medical Education, 51(12), 1220–1231. https://doi.org/10.1111/medu.13448

Dibble, J., & Levine, T. (2010). Breaking good and bad news: Direction of the MUM effect and senders’ cognitive representations of news valence. Communication Research, 37(5), 703–722. https://doi.org/10.1177/0093650209356440

Dror, O. E. (2013). The cannon–bard thalamic theory of emotions: A brief genealogy and reappraisal. Emotion Review, 6(1), 13–20. https://doi.org/10.1177/1754073913494898

Ekman, P. (1972). Universal and cultural differences in facial expression of emotion. In J. R. Cole (Ed.), Nebraska Symposium on Motivation, 1971 (Vol. 19, pp. 207-283). Lincoln, NE: Nebraska University Press.

Folkman, S., Lazarus, R. S., Dunkel-Schetter, C., DeLongis, A., & Gruen, R. J. (1986). Dynamics of a stressful encounter: Cognitive appraisal, coping, and encounter outcomes. Journal of Personality and Social Psychology, 50(5), 992–1003. https://doi.org/10.1037/0022-3514.50.5.992

Hample, D., Dai, Y., Zhan, M., & Hample, J. (2017). Consequential unscripted interactions: a conceptual and empirical description. Western Journal of Communication, 82(2), 135–159. https://doi.org/10.1080/10570314.2017.1372621

Hess, U., & Thibault, P. (2009). Darwin and emotion expression. American Psychologist, 64(2), 120–128. https://doi.org/10.1037/a0013386

James W. (1884). What is an emotion? Mind, 9(34):188–205. doi:10.1093/mind/os-IX.34.188

Luff, D., Martin, E., Mills, K., Mazzola, N., Bell, S., & Meyer, E. (2016). Clinicians’ strategies for managing their emotions during difficult healthcare conversations. Patient Education and Counselling, 99(9), 1461–1466. https://doi.org/10.1016/j.pec.2016.06.017

Miller, J., Donner, S., & Fraser, E. (2004). Talking when talking is tough: Taking on conversations about race, sexual orientation, gender, class and other aspects of social identity. Smith College Studies in Social Work, 74(2), 377–392. https://doi.org/10.1080/00377310409517722

Moors, A., Ellsworth, P. C., Scherer, K. R., & Frijda, N. H. (2013). Appraisal theories of emotion: State of the art and future development. Emotion Review, 5(2), 119–124. https://doi.org/10.1177/1754073912468165

Oliver, C., Jones, E., Rayner, A., Penner, J., & Jamieson, A. (2017). Teaching social work students to speak up. Social Work Education, 36(6), 702–714. https://doi.org/10.1080/02615479.2017.1305348

Overton, A., & Lowry, A. (2013). Conflict Management: Difficult conversations with difficult People. Clinics in Colon and Rectal Surgery, 26(04), 259–264. https://doi.org/10.1055/s-0033-1356728

Patterson, K., Grenny, J., McMillan, R., & Switzler, A. (2012). Crucial Conversations: Tools for talking when stakes are high (2nd ed., pp. 23–39). McGraw Hill Companies.

Pavlish, C., Brown-Saltzman, K., Fine, A., & Jakel, P. (2015). A culture of avoidance: Voices from inside ethically difficult clinical situations. Clinical Journal of Oncology Nursing, 19(2), 159–165. https://doi.org/10.1188/15.cjon.19-02ap

Polito, J. M. (2013). Effective Communication during Difficult Conversations. The Neurodiagnostic Journal, 53(2), 142–152. https://doi.org/10.1080/21646821.2013.11079899

Schachter, S., & Singer, J. (1962). Cognitive, social, and physiological determinants of emotional state. Psychological review, 69(5), 379.

Sorokowska, A., Saluja, S., Sorokowski, P., Frąckowiak, T., Karwowski, M., Aavik, T., Akello, G., Alm, C., Amjad, N., Anjum, A., Asao, K., Atama, C. S., Atamtürk Duyar, D., Ayebare, R., Batres, C., Bendixen, M., Bensafia, A., Bizumic, B., Boussena, M., … Croy, I. (2021). Affective interpersonal touch in close relationships: A Cross-Cultural Perspective. Personality and Social Psychology Bulletin, 47(12), 1705–1721. https://doi.org/10.1177/0146167220988373

Sznycer, D., Sell, A., & Lieberman, D. (2021). Forms and functions of the social emotions. Current Directions in Psychological Science, 30(4), 292–299. https://doi.org/10.1177/09637214211007451

Uono, S., & Hietanen, J. K. (2015). Eye contact perception in the west and east: A cross-cultural study. PLOS ONE, 10(2). https://doi.org/10.1371/journal.pone.0118094

Weinstein, N., Itzchakov, G., & Legate, N. (2021). The motivational value of listening during intimate and difficult conversations. Social and Personality Psychology Compass, 16(2). https://doi.org/10.1111/spc3.12651

External links

How to train employees to have difficult conversations (TEDtalk - YouTube)
How to have difficult conversations in relationships (Psychologist Mary Hoang - YouTube)
We need difficult conversations (Simon Sinek - YouTube)
Former FBI agent explains how to read body language (Wired - YouTube)