Radical Listening: How to Stay in Control of Conversations

One of the most critical skills and valuable tools you need as a physician leader is listening. Yet listening can also be your greatest challenge when you’re already running on empty, strapped for time, blamed by the board, misunderstood by the CMO, or listening to a long-winded staff member who can’t get to the point.

Through radical listening, you can control the tone and direction of a conversation and get quickly to the crux of the real issue. Radical listening helps you maximize time and build trust, which speeds up decision making and conflict resolution.

Here are six techniques to help you build the skill of radical listening.

1. Expand Conflict Capacity

Radical listening tests not only your skill level, but also your mindset and emotional resilience. It’s about listening when it’s difficult, when every fiber of your being wants to argue, interrupt, correct, advise, or ignore.

When our capacity for conflict is low, we often use adaptive strategies such as appeasing, avoiding, or being aggressive. Appeasing gives temporary relief, avoiding is just another way to put off the inevitable, and aggression contributes to a toxic culture.

Expanding conflict capacity allows you to stay in the conversation, stay in control, and get to the crux of the real issue without getting distracted or creating more drama.

How to Expand Conflict Capacity: The first step is to become aware of the situations in which you find it difficult to listen. If possible, identify the individuals who test you the most. Chances are they will be people who exhibit behaviors you find difficult to tolerate, such as your practice partner who can’t seem to get to the point, the nurse practitioner who doesn’t have a good sense of timing, or your CNO who blames others instead of leading.

These unproductive encounters give rise to feelings such as irritation, anger, or resentment. Don’t let your emotions ride under the radar and don’t suppress them. Instead, embrace your experience, become familiar with how the emotions manifest in your body, and learn how to make distinctions between irritation, anger, impatience, and frustration. Try to separate the individuals from the emotions you experience.

When you experience these emotions, look at your own behavior. For example, if you find yourself avoiding conflict, it may be because you don’t know how to manage your emotional energy and are afraid of becoming too aggressive. If you appease others instead of doing the difficult work of listening, it may be because you don’t like the feeling of pressure and loose ends.

Understanding your emotional responses and being willing to feel them rather than avoid them is the key to expanding conflict capacity.

2. Listen First

Radical listening is about listening first. Even if you think you know the answer, even if you disagree, even if you feel provoked, listening is the first act of self-control and the expansion of conflict capacity.

Perhaps you are thinking, “This is a waste of time” or “When do I get my turn?” I hear you! But remember this: The one who listens first controls the conversation. Here’s why: Until the other person feels heard, you will only get defensiveness, argument, and disagreement. Making someone feel heard does not mean you appease them or even agree with their point of view. It means you understand their point of view long before you try to advise, persuade, or disagree.

How to Listen First: One barrier to listening first is believing that listening encourages the other person to go on and on. (I’ll give you some techniques to get to closure faster later.) You listen first by taking a deep breath, getting centered, and creating a space between stimulus and response.

At first you may have to hold your tongue on the roof of your mouth to remind yourself not to interrupt, disagree, or defend. Maintain eye contact and make sure your body language indicates that you are curious and interested. Don’t roll your eyes, fold your arms, or sigh to signal your disagreement.

Maintain an open posture. Notice how your body responds. Your neck may be hot. You may feel overwhelmed. That’s OK. You are still expanding your conflict capacity. You might even say something like, “That’s interesting. I’ve never thought of it that way,” or even, “Tell me more.…”

3. Acknowledge Their Reality

The speaker’s reality may not be grounded in critical thinking or fact. But you still need to let people know you understand how they see things and, more importantly, how they feel. Human beings are emotional creatures and for the most part, our experience and behavior are shaped by how we interpret the world and the emotions that those interpretations create. Your goal is to acknowledge the other person’s reality, which is made up of their interpretations and emotions.

How to Acknowledge Their Reality: Articulate the emotion. For example, if your administrator complains that you override his decisions, you’ll hear frustration in his tone or in his language. Say something like, “It sounds like that’s extremely frustrating.” He might say, “No, I’m just overwhelmed with all the rule changes.” The key is not to hit the target the first time or to argue about how you perceive their emotional experience. The goal is to get on the same page even if you have to course-correct your own interpretation.

In this example, you course-correct by saying, “You are overwhelmed at all the changes we are making.” When he says, “Yes,” you’ve gained control of the conversation. At this point you can start guiding the conversation toward a positive outcome.

4. Direct the Conversation

When you’re listening, it’s easy to lose direction and focus. How do you know if you lost direction? If you are arguing or getting triggered, you’ve lost direction. If the other person is going on and on, offering irrelevant details or distractions, you’ve lost focus. If you argue, get distracted, take on the other person’s emotional pain, or allow them to go on and on with no end in sight, you’ve lost direction and focus. Once you’ve acknowledged their reality, it’s time to control the direction and duration of the conversation.

How to Direct the Conversation: Encapsulate the situation into a paragraph. For example, “Kim, let me interrupt for a moment to make sure I’m understanding the situation.” At this point Kim will pause. Then you say, “The database keeps locking up, and as a result, you think there might be some security issues as well as lost productivity?”

Notice that this time the focus is on the facts and the situation, not on the feelings. You aren’t trying to problem-solve here; you are only providing “a situation analysis.” The situation analysis answers the question, “What is happening or not happening?” The situation analysis is not answering questions about process or figuring out who is at fault. The situation analysis is simply stating the problem at hand.

If you find that the conversation is all over the place or you feel confused, ask yourself if you have clearly defined and understand the situation at hand.

5. Control Your Time

Knowing that you always have control of the time helps you be a more effective leader. Decide once and for all that you no longer will be held hostage to petty arguments, time-wasting drama, or a long-winded multidirectional conversation. This decision helps you maintain a positive outlook even when your resources are drained. In short, when it’s not an emergency, it’s always about prioritization.

How to Control Your Time: Radical listening does not mean you are available around the clock. You do others a disservice if you pretend to listen while you secretly multitask and look at your computer. It’s better to be honest if you don’t have the time or the capacity to truly listen. Radical listening can only happen if you believe you have the time and attention to do so, and that’s why you must take control.

You may need to control your time at various points in any conversation by using a calendar to reschedule or setting a boundary for how much time you can allot. For example, when someone interrupts you, and you can tell it isn’t going to be a quick question, you can say, “I only have 10 minutes. Is that enough time?” or, “I want to be available to you, but I’m on a deadline. Can you put a request on the calendar for us to discuss this on Thursday?”

Suppose you get caught off guard or you notice the emotional temperature is rising. You can say something like, “This is difficult for both of us, but we don’t have to have the answer right now. Let’s put time on the calendar to meet again tomorrow.”

If your decision requires some collaboration, investigation, or preliminary research, you can say, “I appreciate what you have told me. I want to clear my head and think about this further. Can you meet again next Tuesday at 2:00?” Make sure you aren’t using the buying of time to procrastinate, appease, or avoid, but as a real tool to gain control.

6. Circumvent the Power of Attorney Trap

One of the biggest traps of listening is to get entangled in “he said, she said” conversations and gossip. Radical listening does not mean listening without discernment. In fact, radical listening means holding space even when you notice irresponsible language or lack of critical thought. The distinction is that you listen without getting caught up in gossip. When you hear, “Everyone else says…” or “Olivia isn’t happy with the schedule changes…” it means that one person is representing another person. I call this “playing power of attorney.”

How to Circumvent the Power of Attorney Trap: When you hear someone speaking for someone else or for everyone else, redirect the conversation. You have two choices here. Say, “It sounds like you are concerned about Olivia.” If the conversation continues to be about Olivia, say, “I’ll have Olivia come talk with me about this. It wouldn’t be fair to her if I made a decision that impacts her unless I hear directly from her.” You may hear some resistance or explanation about why this isn’t a good idea, but this technique will help you to redirect the conversation.

Be careful not to use the power of attorney technique when you are trying to course-correct behavior. For example, don’t say to one of your direct reports, “Your employees have been saying.…” Instead, represent yourself by saying, “I’ve noticed” or “I’m sensing something is off…” or “It concerns me when I notice….”

Conclusion

Radical listening is about controlling your urge to be right, to prove a point, to be understood, or to win an argument. Radical listening is a learned skill that can be used effectively only through practice, self-discipline, and a desire to excel as a leader.