Becoming an Evolved Listener - Research Paper Example

Becoming an Evolved Listener Within various professions involving close contact with people, especially service, care and social professions, it is important for practitioners to understand the best methods for interacting with clients. In the case of communication this is doubly important, since the quality of service to clientèle is totally dependent upon establishing an excellent rapport and maintaining highly functional communications lines with clients. To this end, professional researchers in medicine, social science and public administration have definitive methods for teaching and measuring these skills. Of the various theories impacting people centered professions, communications theories are of primary importance, and listening is possibly the most important, because it establishes a connection between the client and the professional, it validates the ideas of the client and establishes a bond of trust, or at least of rapport, between the two. Before we can explore listening as a concept we must define both the words: listening and concept. According to Wittgenstein, it is not enough to know what a word represents as an object or action, but one must know something about its context, normal usage, part of speech, the history of its use and its connections to other words. So let us look at these two words, “listening” and “concept”, most thoroughly first. What is listening? Listening is giving active attention to the spoken communication of another in an attempt to completely understand the other persons ideas and feelings concerning the subject. It is separate from, but dependent upon, hearing. Hearing is merely the physical processing of sound. You may hear a door close, but pay it no attention, so you do not listen. You may hear a person talking, but if you pay no attention, you are not listening. Active listening is, by definition, listening, attempting to make meaning and acknowledging the speaker with some form of feedback while you process what you hear. To be an active listener requires that you pay attention, let the speaker know that you are paying attention and confirm that you understand what they say. Listening is half of the exchange in oral communication. Because it is part of communication, it is required to meet the standards of oral communication. Hearing without understanding is not listening. Therefore it is incumbent upon the listener to know several things about what he or she hears. These include: the object, action or concept usually attached by most people to the words; the background and understanding the speaker has of the words (this might require knowing something about the speaker); and the context within which the words are used. Therefore, the listener must have the same knowledge about the other words with which this word or phrase is used (context). Understanding total meaning goes beyond even this in that the listener has to understand how the speaker feels about what he or she says, and finally, what reaction he or she seeks in the listener, what response he or she expects and how will he or she respond to the expected response or an unexpected response. This sounds complicated, but it is not really. Most of us do this at least part of the time by habit. However, there are things one can do to insure all these requirements are met, which we will discuss later in the context of examining the process of active listening. (Della, T. (Ed.). 1995) (Kohlberg, L. 1981). A concept is a shared understanding of something which can be stated clearly in words to have certain attributes and follow certain rules. It can be described and defined so that the meaning and implications of the named concept will be shared easily among a group with each member having a similar comprehension of the idea. Meleis defines a concept as ‘a label used to describe a phenomenon or a group of phenomena’ (1991: 12). Therefore, when we put a name to a phenomenon we are identifying concepts. In this paper we are defining the concept of listening according to a chosen theory in order to describe its use within three chosen disciplines: nursing, social science and psychology. We shall develop our concept of listening within this paper by establishing a theoretical base, defining it and related words, and illustrating its application within three chosen disciplines: nursing, social work and psychology. (Meleis, A.I. & Lipson, J. 2003). There are a number of methods for developing, defining and analyzing concepts. We have chosen the evolutionary method of concept development as defined by Rodgers, B.L., & Knafl, K.A. and modified it where noted as needed. The evolutionary method for concept development depends upon a rather circular model for concept design. One develops a theory, in this case integrated with work done by Toulmin and Wittgenstein, then tests and validates that theory, applies it, tests and validates the results, submits it to others for testing and validation, and finally articulates it into a stated concept. (Toulmin, Stephen E. 1963) (Wittgenstein, Ludwig, 1999) (Rodgers, B.L., & Knafl, K.A. 2000) So using this evolutionary theory of concept analysis, let us look at the concept of listening. As defined earlier, listening is more than simply hearing. In order to qualify as listening the “hearer” must be paying attention and attempting to understand the meaning the speaker intends. By “paying attention” we are referring to an active listening stance where the listener is being attentive to the speakers words and other modes of communication, trying to make meaning from the communication. How do we pay attention? First, we look at the speaker and make occasional eye contact. We do not divide our attention between the speaker and anything else. We are attentive to clues to meaning from the speaker, which includes voice timbre and volume, facial expression and body language. This kind of attention helps us to acquire the most information possible and to signal the speaker that we are paying attention. The evolutionary method of analysis is circular, with each step requiring some form of validation. According to Lawrences communication theory, even more validation works better. “Active listening techniques have been touted as deterrents to misunderstandings and their deleterious consequences (e.g., conflict escalation). By explicating how a prior complaint, for example, was understood, misunderstanding and defensiveness presumably become less likely. Recall, however, that the obligation of the turn system is for next speakers to display some analysis of the prior turn, and the partial character of these analyses is not a defect but a principled feature of turn-by-turn talk that enables next speakers to shape the course of the interaction” (Lawrence Communication Theory) Let us look at a possible example for active listening by a nurse to a patient. Patient: I told the morning nurse I was in pain, but she didnt hear me. Nurse: Do you mean that you said you were in pain and the morning nurse did not respond with an appropriate suggestion? Did she not offer you anything for the pain? Patient: No she didnt , and Im still in pain. Nurse: Oh I am so sorry. So you still need something for pain right now? Patient: Yes, thats right. Nurse, Ok, could you please tell me something about the pain so I can decide what would work best for you?. Where does it hurt? Is it a fluctuating pain or is it steady? Patient: It is constant here. (points) Nurse: Oh dear, right at the temples. And on a scale of one to ten, with one being the least amount of pain and ten being the most, how do you rate this pain? Patient: It is not too bad, about a six. Nurse: Oh that is certainly bad enough. Let me get you something for that. In this example, the nurse expresses sympathy, identifies and confirms the need and then uses a concrete method for identifying the degree of pain. While no two people have the same pain threshold and we know that they will give different numbers for the same degree of pain, it is also true that we can tell by the range of the number if the pain is light, medium or severe, which can give the nurse some idea of how much medication is needed. In addition to validating the patient’s feelings, by presenting an analysis in the form of a question if she needs pain medication now, rephrasing in active listening pattern. When the nurse asks the patient to describe the pain so the right medication might be chosen, the patient knows that the pain is being taken seriously. Listening is a matter of perception. Unfortunately, perception is individual, according to what each person brings to the communication. These will never be the same, because of two factors: our shared definitions and our individual reactions to words. We can only share meaning orally, so the shared meaning is dependent upon the way it has been communicated with words. Communication depends upon the definitions we have for those words, and these are never the same. One interesting way to test this out is with color. When describing colors which are not pure people use different scales. To one person a given color between purple and pink is violet, while it may be mauve to another and even violet-pink to a third. We may not all see the colors the same either, but we certainly do not describe them the same. The second factor depends upon our past. Every one of us has past memories, either conscious or unconscious, attached to the functional words in our vocabulary, like nouns, verbs, adverbs and adjectives. Each words used causes a different reaction in each of us because of the past which we attach to it. Rosenblatt described it thoroughly in her books as “efferent” meaning. That is the sun total of the meaning we attach to any word or phrase, which includes our entire experience with that word. While most words are rather neutral and se share enough meaning among ourselves to communicate effectively, there are some words which carry a lot of emotional content for most people: words like love, pain, alone, left and shame. These are just a few examples of emotionally loaded words. A good communicator is aware of their own loaded words and careful of the commonly loaded words. In addition, they have a sense for “hearing” which words are loaded for the others with whom they speak. It is a matter of perception. (Rosenblatt, Louise 1978) “Focusing on perception is one of the advantages of a communication perspective for the study of organizations. Because the living system of an organization, by definition, can include a large number of variables, the behaviors we choose to "pay attention to" or select from the available data become the determining factors in our own behavior within the organization. Our view of reality, both in an organization and during our entire lives, is based on our perceptions.” ( Altman, Valenzi,(Harris 22) Language is simply a poor substitute for telepathy, which few of us seem to be able to develop at all. Language, the underpinning of verbal communication, allows us to assign meaning to things ( Condon, 1975, pp. 36-38). … we create individual realities based on language, so we can predict and control our own behavior. We are forced to decipher from a variety of clues what messages mean and which messages are important. As such, verbal communication provides the written and unwritten, spoken and unspoken rules and procedures. These lead to a common purpose, or a set of ground rules, which constitute the process of organizing the various subsystems. Understanding the nature of verbal communication can be difficult because "language is both commonplace and enigmatic, both superficially simple and infinitely complex" ( Bowman(Harris 93) So if we all have these obstacles to true communication, how do we overcome them in our work environment? That is where the concept of active listening becomes very important. When one listens to others, one must use more than just the ears or even do more than listen to the words. While listening, you must bring in everything you know about the speaker and put it together with what you see in order to extract the most possible meaning. Then you have to feed back what the speaker said in such a way as to confirm your understanding of their meaning. Although estimates of the impact of the nonverbal communication on a specific messages meaning vary from 93% ( Mehabian, 1981, p. 77) to 65% ( Birdwhistell, 1970, p. 158), the importance of nonverbal communication cannot be doubted. One summary concluded that nonverbal messages "can convey affiliation, positive regard, interest, dominance, credibility, or status; can reinforce or punish; [and can] affect what others learn, what attitudes develop, what approaches will be modeled, and what is expected" ( Tresch, Pearson, Hunter, Wyld,(Harris 123) This is all related to how we understand what we hear and understand when we are listening.. Understanding goes far beyond what the speaker says to include how they feel about it. By watching for and understanding non-verbal clues, facial expression, body language, posture and tone of voice, we can go further to understanding exactly what our clients mean, including how they feel about it. Your face provides vital information regarding your own internal views about how things are going. One estimate is that 55% of feeling is communicated through facial expression ( Frank, 1982, p. 118). With no formal training, observers of facial expressions can distinguish a variety of emotions including interest/excitement, enjoyment/joy, surprise/startle, distress/anguish, shame/humiliation, anger/rage, contempt/disgust, and fear/terror ( Tomkins, 1962). In organizations, we tend to work toward less facial expression so that we can control the setting. Showing too much excitement, joy, rage, or humiliation is not professional. One consultant advises: "Your object should be to showcase your positive feelings and to disguise your negative feelings, unless letting them show will help you get something accomplished" ( Gray, 1983, p. 28).(Harris 128) The smile is a useful example of how the face is used. Although a smile can be indicative of a wide range of feelings ranging from happiness to nervousness, in the business world smiles generally are considered positive communication behaviors. In sales, smiles not only create rapport, they also have been linked to success ( Lau, 1982; Moore, 1982). Smiling people are perceived as more intelligent than those who do not smile ( Grazian, 1987). People who smile are judged to have an honest face ( Hickson(Harris 129) Eye contact may indicate a liking for the other person. It also serves as simultaneous communication because eye contact allows people to send and receive messages at the same time.Direct eye contact is seen as an indication of honesty and credibility ( Burgoon(Harris 132) In seminars we have conducted with professional interviewers, they are convinced that direct eye contact, which should be distinguished from staring, is an indication of self-confidence and forthrightness. Eye contact ranks second only to dress as an important nonverbal factor in an interview ( Burgoon, Buller, & Woodall, 1989, p. 452). Status and power are shown by eye contact. In meetings, organizational members with the most power will be looked at more often ( Duncan, 1975). Leaders can gaze more directly and with greater frequency than subordinates ( Richmond, McCroskey, & Payne, 1987, p. 230). Showing deference to power often is accomplished through diminished eye contact by subordinates. Interestingly, speakers attribute more control and power to receivers who do not look at them ( Burgoon & Saine, 1978, p. 181). This may be due to the lack of simultaneous feedback. A total elimination of eye contact with reflective sunglasses creates a "Darth Vadar" effect, which causes fear and resentment in the receiver ( Boyanowsky & Griffiths, 1982). Because all possibility for feedback is eliminated, receivers feel as if they have lost control of the transaction. You are seen as being more confident if, as the sender, you maintain eye contact ( Frank, 1982, p. 118). However, once you achieve high status and power, you can choose not to use eye contact and this decision will have little impact, because the power differential is already known ( Hickson & Stacks, 1985, p. 202). Eye contact also is used to control interactions. This regulating of the flow of the transactions can be simply failing to acknowledge someones presence. Clearly, the potential for a response from someone is decreased if the amount of eye contact is minimal. Studies indicate eye contact is diminished during the telling of bad news or the providing of critical feedback ( Frank, 1982, p. 118). Eye contact is used to monitor feedback. Listeners and speakers tend to look away when a difficult subject is being discussed ( Knapp, 1978, p. 299). The type of eyeglasses you wear also sends a message. In the business world, your eyeglasses should make you look older, traditional, and authoritarian. Molloy ( 1975) suggested that men and women wear heavy plastic glasses (p. 123), and counseled women to consider contacts for social occasions ( Molloy, 1977, p. 89). In general, eye contact is a powerful means for establishing relationships and indicating an open, honest approach. Once you become more familiar with the specific cultural requirements, you can better judge how to use eye gestures. Certainly, it is a must in an interview situation. Any presentation will be assigned greater credibility if you use eye contact. However, staring is not an acceptable norm in most organizations. Beyond our personal experience (baggage), we also carry cultural experience, a collective understanding of words and phrases and even of whole ideas. Toulmin discussed process related to socialization within discipline, yet term enculturation appropriate to describe process regardless of specific context. Forms of expression acquired along with concept enable sharing publicly. Expression usually discursive or linguistic…however may be non-discursive forms such as artistic…music, dance or visual arts So it is even important to understand how much of this type of information we share. Of course, over time, within one’s profession one will acquire additional information to keep adding to the store, so that with each communication we become better at communicating with the next person. Each time we successfully understand completely what a client is trying to communicate, is adds to our ability to understand. This idea is reflected in Toulmin’s observation that “concepts acquire a meaning through serving the relevant human purpose in actual practical cases”. PRINCIPLES OF NONVERBAL COMMUNICATION “The eight guiding principles for all nonverbal communication are: 1. The quality of relationships is judged through nonverbal cues ( Hickson & Stacks, 1985, p. 228). When people try and determine if they have a good, bad, or mediocre relationship, nonverbal cues provide the supporting information that indicates the strength of the bond. For example, although handshakes are standard fare in business transactions, how the handshake is given, including other concurrent nonverbal behaviors, gives the participants information about the relationship. 2. Nonverbal communication is more likely to be believed than is verbal communication when there is an inconsistency or incongruence between the two message systems ( Knapp, 1972, pp. 22-23; Malandro & Barker, 1983, p. 12; Mehrabian, 1981, pp. 74-88). What someone says can be overridden by what is done. The expression "actions speak louder than words" is fundamentally correct. Members of organizations are sometimes criticized because they "talk the talk but dont walk the walk." Waterman ( 1987), in his analysis of the renewal factors required for companies, concluded, "Visible management attention, rather than management exhortations, gets things done. Action may start with words, but it has to be backed by symbolic behavior that makes those words come alive" (emphasis added; p. 11). 3. Nonverbal communication can be assigned meaning if only one of the parties chooses to do so ( Hickson & Stacks, 1985, p. 228; Smith & Williamson, 1985, p. 192). Perception is the key term, as we discussed in chapter 2. Inadvertent actions on the part of one person still can be very meaningful to the other person. With the complexity of most organizations, there is vast potential for nonverbal behaviors to become meaningful, even when there is no intent on the part of an individual. Fortunately, the overriding parameters for our behaviors, provided by the cultural norms, prevent a large number of miscues. 4. Because perception is the key variable, forward leans, relaxed posture, decreased distance, increased touching, and enhanced attention all seem to provide positive messages in a transaction ( Hackman & Johnson, 1991, p. 163; Johns, 1988, p. 366). By doing the opposite, negative messages are perceived. 5. The rules for nonverbal behavior vary depending on the age, sex, and the various cultures involved ( Berko, Wolvin, & Wolvin, 1985, pp. 82-83, 100; Knapp, 1972, pp. 125, 244-246, 336-367). These cultures can include group, regional, organizational, national, and international and all the possible combinations of these five cultures. Therefore, the nonverbal rules in a group or organization are likely to be idiosyncratic. 6. The context, social situation, and power relationships help determine the rules and roles for nonverbal communication ( Hickson & Stacks, 1985, p. 228; Knapp, 1972, pp. 75, 127, 339-340; Mehrabian, 1981, pp. 2-7; Richmond, McCroskey, & Payne, 1987, pp. 262-277). Where the behavior occurs and with whom it occurs are vital to interpreting the nonverbal communication. 7. Women are generally more sensitive to nonverbal cues and more accurate in sending nonverbal messages ( Hickson & Stacks, 1985, p. 228; Knapp, 1972, p. 22). 8. Although people can learn to interpret others nonverbal cues more accurately, greater success will be achieved by concentrating on our own nonverbal behavior to make it consistent with our desired message(s) ( Hackman & Johnson, 1991, pp. 96-97, 162-163; Hickson & Stacks, 1985, p. 228).(Hickson( Harris 126)) So what does all of this mean for the nursing profession? It means that we have a method where-by we can serve our clients better by simply learning to listen. The goal must be established from the beginning of the communication and adhered to during the entire interaction by the listener. The goal must be based upon the needs of the patient, not the needs of the practitioner or the organization. In order to fully understand what patients say, the listening must be centered upon understanding the needs of that patient individually. In addition, those needs should not be judged while listening. There should be no subjective judgment made as to the value of the need as the patient perceives it, but only as to the value of the understanding of the listener. Once we actively listen to a client and give enough feedback to ascertain that we truly understood the communication, we must take one more step: validation. Validation is putting into practice what we understand from the communication and then watching to confirm that we were correct in our interpretation. In the final analysis, the whole process of listening is quite circular and extends beyond the actual communication at the time. It is an ongoing thing and notes should actually be made on an ongoing basis to include the individual communications sessions, what was understood, how it was validated and what the outcome was for each. In nursing this can enhance the care level of the patient, the self esteem of the health professional and the public perception of the medical institution. Listening skills are central to the total understanding of patient needs, and those needs are best fulfilled in the light of total understanding of both identified concrete needs and the patient’s perception of their needs. When the health care professional understands just how critical this is to total patient care then the professional finds it much easier to learn to subjugate their own needs while listening to patients. In the area of social work, this concept is also just as critical, but may include areas of living which extend into the surrounding community. In health care, the needs for medical care are fairly concrete, while the needs in a context of social work may be practically intangible. Social work is, after all, a profession rooted in the functioning of society. Social interaction and communication is such a huge field that there are professionals who concentrate only on that one area with the larger context. We think we know how to listen until we try listening from our own context to someone with a life so far removed from our own that understanding fails utterly. Toni Morrison illustrated this in her book The Bluest Eye (Morrison, Toni 1970) in a powerful way that communicates the ideas with far more than the words. It is with works like these that the social work professional gains understanding outside his or her own life experience. Then this learning can be constantly augmented while serving the needs of clients by carefully listening to what they say, giving feedback to insure that we understood, and following up with action to validate both the meaning of what we understood and its truth, and also to validate the client’s communication and our listening as we take action upon it. It is absolutely necessary to take some kind of action based upon the perception of what was heard and understood, or we negate that communication entirely. In addition, by taking action upon what was heard and allowing the client to see what action was taken we validate the worth of that client, which is something added that every client of social work needs. How we act upon what the client communicates to us will build or destroy the relationship between client and social work professional. If we fail to take action on what the client says on more than one occasion, then our credibility will suffer in the eyes of the client. That credibility is an absolute necessity if the needs of the client are to be served, as the trust between client and worker depend upon it. In the area of psychiatry everything discussed for nursing and social work apply in triplicate. However, it is hoped that the psychiatric professional is well educated in the area of listening. After all, it is from this discipline that the body of current knowledge is created. In psychiatry there is the added dimension of the possibility that the perceptions of the client are not rooted in reality, but have reality for the client. It is doubly difficult to walk in the shoes of someone whose perception has been damages by emotional trauma or mental illness. This in compounded geometrically by the fact that few psychiatric professional have been sufferers of the illnesses and deviations they are attempting to help the patient correct or adjust to. Therefore the understanding is almost totally second-hand, acquired by reading and listening. Even more important is the concept that the psychiatric professional must be able to listen and make notes without applying any kind of judgment at the time or the understanding will be less than optimal. In all of these professions the importance of listening skills is primary to serving the needs of the client. The degree of attention that must be paid to certain aspect of listening deffer among professions. In nursing the instant feedback is probably the most important for the development of a rapport between patient and health professional. It is also critical to the care of the patient that the nurse understand totally what the patient means. In social work it is much more necessary for the understood communication to be acted upon in some manner which validates the value of the client. The relationship between the client and the social worker is ongoing over a much longer term, so the trust must be built and the communications between them will improve over time as the worker gains a complete understanding of the perception of the client. In this way, it is the application of the understodd communications which is primary to the profession. In the area of psychiatry, it is in the area of total listening without applying any sort of judgment that the professional will be able to gather enough informati0on to be of service to the client. Because the nature of the relationship is progressively more and more intimate, time must be allowed for complete understanding to develop. One cannot simply base perception upon past experience with other clients, because each one is critically different form every other one. In the nursing profession, Listening is immediate and often impacts the patient in a very immediate way. In the social work profession the communication process is allowed more time to develop and the understanding must be on a deeper level while the professional develops a relationship that will be ongoing with the client. Because of this, it is critical that the professional can adjust to changes in the relationship and change the method of validation as required. In psychiatry, the long term essence of the relationship makes it incumbent upon the professional to maintain as much as possible an open mind stance to listening to the patient. In all of these professions, listening skills are a primary factor in filling the needs of the client, which is why we are here. Therefore, every avenue for increasing understanding while listening must be applied. Listening must include paying attention, giving feedback, analyzing the meaning in context of what is known about the speaker, suspension of judgment while listening and taking action upon what is understood from the communication. 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