“Communicating Effectively with Others” – chapter 3 of “Caregiver Helpbook”

A course called “Powerful Tools for Caregivers” was developed by an organization in Portland.  You can read general info about the self-care education program for family caregivers at powerfultoolsforcaregivers.org.

As part of the course, class participants receive a copy of a book titled “The Caregiver Helpbook.”  The book is available in both English and Spanish.  Brain Support Network volunteer Denise Dagan is reading the book and will be sharing the highlights, chapter by chapter.

The title of chapter three is “Communicating Effectively with Others.”  Topics addressed include listening, assertive communication, and Aikido-style communication.

This chapter contains lots of useful worksheets.  You’ll need to purchase the book ($30) to obtain the worksheets.

Here’s Denise’s report on chapter three.


Notes by Denise

The Caregiver Helpbook
Chapter Three – Communicating Effectively with Others

Listening well is at the heart of good communication and it takes conscious effort.

Good listening tools include:

* Keep an open mind.  Shift your assumptions about another person’s motives or behavior.
– If someone is annoying you, they are probably doing the best they can given limitations of illness, or communication.
– If someone doesn’t seem able to communicate due to a stroke or Parkinson’s disease.  Given time to formulate a reply, they may have a lot to say.

* Reduce listening barriers.
– Ensure you are in a quiet space that’s free of distractions.
– Consider postponing an intense conversation until all parties are rested, fed, and hydrated.
– If strong emotions distract from listening, address those first by asking, “Are you feeling…?” and/or postpone the conversation until parties are calmer.

* Create a safe haven for openness.
– Assure the person you are speaking to that you want to hear their point of view without judgement or anger.
– Make certain all concerns have been heard, even encourage bringing up sensitive issues by asking, “What troubles you that we haven’t touched on, yet?”
– Deal with emotions before addressing problems to be solved.  “Tone of voice and how loudly, softly, quickly, or slowly a person speaks often reveals his true feelings.”  Reflect feelings back with, “Are you feeling…?”

* Confirm what you hear.
– Ask open-ended questions like, “Give me an example of…,” or “Could you tell me more about…”
– Paraphrase, or restate what you heard them say like, “Are you saying that…?” or “Is it that you feel…?”
– Be aware words like “may,” “might,” “perhaps,” “ordinarily,” “perhaps,” and “maybe.”  These disclaimers indicate a ‘but’ belongs on the end of the sentence.  Ask for explanations, “What do you mean by, ’the treatment may help?”

* Give your undivided attention.
– Stop what you’re doing.
– Reduce distractions.
– Use good eye contact.
– Encourage people to speak with short comments like, “I see,” “um-hum,” and “right.”

To become a more effective listener, apply “The Golden Rule of Listening.”  It says, “Listen to others as you would have them listen to you.”  If you do this, your listening effectiveness should improve.

The flip side of the communication coin:  Expressing yourself effectively.

“Some caregivers hope and hint, rather than ask for help or set limits.  To avoid feeling hurt and to be fair to others we have to communicate directly.  Assertiveness is a specific, direct communication tool for expressing ourselves.”

A worksheet on page 51 will help you determine if you need to work on being more assertive.

“I” Statements are the foundation of assertiveness.
– Starting a statement with “You” can sound blaming or bossy, as in, “You didn’t,” “You said,” or “You should.”
– Use “I” statements to own your feelings, thoughts, concerns, needs, and motives, and clarify where you stand.
– Say, “I feel…,” “I need…,” “I am frustrated…,” “I expect…,” or “I am worried about…,” etc.
– It’s less contentious and you are respecting the rights of others to disagree and express themselves.

The trick is to catch a “you” statement before you say it.  Take the “oops” challenge.  Every time you are about to say “you,” think, “Oops!” and change the “you” to “I.”

There is an exercise on page 49 to practice changing “You” to “I” statements, and more about their use.

The Four Steps of Assertiveness.  Page 53 has a worksheet to practice assertive “I” statements.

1. Describe:  Use “I” statements to describe what happened or what is bothering you without emotion, evaluation, or exaggeration.  Example:  “I received a call from Dad’s doctor yesterday.  He missed his appointment.  I’m wondering what happened.”

2. Express:  Use an “I” statement to express how you feel.  Example:  “I’m concerned Dad won’t make the appointment hat has been rescheduled for next Thursday.”

3. Specify:  Use an “I” statement to tell the other person specifically what needs to happen or what needs to be done.  Example:  “I need to know if you can pick Dad up and take him to the doctor next Thursday morning.  He has to be there by 10am.”

4. Consequences:  Close with an “I” statement explaining what you will do or what will happen if the person does and/or does not follow through.  Avoid blaming, bluffing, or threatening.  Examples:  “If you can’t take Dad, he will have to hire a cab, which puts a strain on his budget,” or “If you can’t take him, would you please make other arrangements for his transportation?” or “I’ll be happy to take him next time if you can take him to this one.”

An alternative style of communication is Aikido, “patterned after the principles of the aikido martial arts.  These principles state that rather than fight with another person, you try to move with the person’s energy.  This is called alignment…”

“Aikido regards anyone who behaves aggressively as “not balanced.” … The goal is to help the person regain balance by meeting some of his needs. … Use your energy to look at the situation from his perspective, not to fight back or give in.  You try to help the other person feel heard so he has no more reason to argue or resist.”  Then, you can move toward problem solving.

To use the Aikido style, follow these steps:

1. Align.  Empathize and build rapport.
– Especially in emotionally charged situations, you may have to use a breathing exercise to stay calm and focused.
– While you’re breathing, ask yourself, “How would I feel in his/her place?” and “What does he/she need from me to feel better?”
– Then, as him/her, “I don’t know exactly what you need.  Give me an example of something I can do for you,” or “I want to understand your point of view about…”

2. Agree; find areas of common ground to support alignment.
– Listen for goals, feelings, needs, and motives you share.  Then,
– State agreement like, “I share your concerns about …,” even just, “If I were you I would feel the same way.”

3. Redirect energies to focus discussion on the goals and concerns you share.
– Example: “We both want to do what is best.  Now, all we have to do is…,” or “I believe we agree we have a problem.  What do we need to begin working on it?”

4. Resolve problems by using “I” messages.  Remember, you may have to compromise or “agree to disagree.”
– Example: “I can learn from your experience.  What would you do about…?”

“You can also use alignment as a tool to encourage people to cooperate with a treatment or accept help.”  Aikido communication gets both parties to the point of finding common ground, listening to each other, and problem solving together to overcome obstacles to treatment or accepting help.