A physician was telling me about a total patient communication fail.
He did not know it was a fail, until a resident jumped in and saved the day. He laughed, recounting the scene to me. He thought he was doing fine. He thought he was being clear. But when he heard the resident’s language, he knew he’d missed the patient entirely.
He said of his communication, “Maybe I should be more reflective.” (For the record, I think he’s a very reflective practitioner.)
You want your words to have an impact. I want to give you tools to help.
This article focuses on the emotional impact you want your words to have, and how you’re recruiting language to make it happen.
The weight of your words
In research, there’s agreement that affective communication is important, though direct links to patient outcomes are hard to come by.
One study finds that physicians’ “reassurance about non-abandonment can reduce patients’ physiological arousal and increase information recall in bad news consultations.” Another study found that pediatricians’ empathetic communication was “able to attenuate parents’ stress response during the medical interview” and represent “a source of social and emotional support.”
Significant research attention has been paid, for more than a decade, to the emotional impact of different metaphorical messages regarding cancer.
War imagery has long dominated the figurative language around cancer. But, as powerful as battle imagery is, the emotional impact of this language on patients is not always the one providers and public health professionals hope for.
One study indicated other possible metaphoric comparisons for cancer: sports, ecology, engineering, “journeying, sailing or working,” “consumption,” and a “silent killer.”
It is not hard to imagine how each of these could elicit quite different emotions, and have different effects on the listener.
Between the heart and the mind
I’m not telling you anything you don’t know here: we all respond to logic and emotion.
Whether it’s heart/mind, right brain/left brain, thinking/feeling, take your pick. You know from your own life experience that purely logical, or purely emotional, appeals tend to be less effective than both together.
In the patient encounter, you are communicating information, to be sure. You have a goal in mind. But you are not merely giving an objective report. Emotion always comes into interpersonal communication.
Sometimes, you are responding to a patient’s emotion. There are also those times you are explicitly planning to elicit an emotion in your patient, regarding their health condition. Borrowing some ancient tools, we take a closer look at emotion.
Pathos
I recently wrote about how some terms from classical rhetoric could be helpful as a quick and easy way to assess your communication. I’m going back to that well again. The term pathos will ground this thinking about emotion in words.
Classical scholar Richard Lantham defines the Greek rhetorical term pathos as referring to both 1) emotions themselves, and 2) the techniques for eliciting them.
Following his lead, I’ll give you tools for thinking about both. First we’ll talk about the emotions themselves. Then, how you’re eliciting them through your words.
Just to be clear, pathos can refer to the emotions of the speaker, as well as of the audience. Both are essential. But this article is about you as the speaker. Your words.
And I’m going to give you some questions to help get you there, so you can evaluate your own language. Reflect, like my physician friend said.
What emotion are you hoping to elicit?
Be clear with yourself about what you are trying to make happen.
What is the emotion is that you’re hoping you can lead someone to feel? What are your expectations? Identifying the emotion you’re going for can sometimes be tricky, so be patient with yourself.
(N.B. It’s understood that you are also trying to build trust and positive relationships—ethos–by speaking ethically and maintaining your professional duties.)
As I have read across multiple studies of emotion and health communication, I have noted the express or implied emotional impact that the speakers (or authors) of words were hoping to have. Here are some examples, to get you thinking about the emotional effects you might be going for:
- Inspire
- Encourage
- Create sense of urgency
- Reduce distress
- Increase sense of empowerment
- Calm fears
- Pique curiosity
- Give hope
- More…
I’ll take an example from the first study I mentioned above, on affective communication in “bad news consultations.” The implied emotional impact was the lowering of patients’ anxiety.
Don’t be vague here about your expectations.
What are you trying to make happen here?
Even answering this one question alone can help you gain control over your communication.
Now we’re going a step further.
Why are you hoping for this emotion?
You hope a patient will feel a certain emotion for a reason. What is that reason?
Arguably, you’re hoping to connect a patients’ emotion to something about their condition. And you do this through your talk.
Get nice and clear with yourself on the links you are assuming between the patients’ experience of this emotion and some positive health outcome. Because this guides your language.
The earlier study was concerned with lowering of anxiety. What was their reason? Recall of information.
Through a chain of prior research, the authors explained how they connected physiological arousal and recall of provided information. The lower the physiological arousal, the better the recall. Recall being important, the study was set up to test this hypothesis.
What are you assuming about this emotion’s connection to a positive health outcome? What could get in the way of this?
How does your language measure up?
You’re well aware that you are having an emotional impact on your patient simply by your presence. How you enter a room, your body language, your tone of voice and facial expressions, how close you sit to the patient. All of this counts. But we’re focusing on your verbal communication.
I encourage you to evaluate your own language – against your answers to the above questions.
Are you saying what you mean to be saying?
Staying with the earlier example, the study authors designed phrases they thought would have the desired effect of lowering anxiety. These phrases included:
“‘But whatever action we do take, and however that develops, we will continue to take good care of you. We will be with you all the way.’ ‘We will do and will continue to do our very best for you.’’’
What do you say in order to elicit the emotion you’re hoping for? What actual words and phrases do you use?
As I’ve said before, it will be helpful if you have a recording of yourself actually talking. Maybe you can audio record; maybe you’re taking the first chance you get to write everything you can remember saying. But if you really want to take it pro, you will get serious and find a way to record your actual speech (even in a simulated encounter).
Unpacking your language
What’s the emotion you’re seeking to stir in your audience, and how are your words contributing to that effect?
This is about being aware of what you’re assuming–and unpacking your language–when you are seeking to elicit an emotion.
Be upfront with yourself about the emotional impact you’re going for. Know what connections you’re assuming between this emotion and a positive health outcome.
And finally, recognize that people will have different responses than the one you have in mind. The same person may have a different response to the same message, over time. So don’t be worried about finding that one message, that one magic phrase, that works all the time.
If you are interested in taking your language use seriously, why not start with your metaphors? This workshop shows you how to break down the metaphors you use, understand their cognitive and affective aspects, and evaluate them in use. On demand, right on this site.
