“No one can ever be fully prepared for the
challenges of care-giving. The tasks and
responsibilities involved can be demanding, even
more so when caregivers themselves are frail, have
been thrust into their role unexpectedly or
reluctantly, or must care for someone who is
uncooperative or combative.” - The Merck Manual of
Health and Healing
Caregivers can face overwhelming physical,
financial, and emotional demands as a function of
their service. In the face of these challenges,
communication can sometimes be difficult. This
article presents techniques for compassionate
communication, as well as ideas for caregiver
self-care and empowerment.
Communication is a process that allows a cyclical
exchange of information through speaking and
listening. However, as we all know, communicating is
not as simple as that. Effective communication
requires clarity from the person who is speaking and
openness and attention from the person who is
listening. This takes great commitment.
And to be compassionate, the communication should
touch the heart. Compassionate communication can be
understood through a breathing exercise. Put a hand
on your heart; this is the center of compassionate
communications. Notice your state of well-being.
Imagine your whole being is entirely cared for. Take
a breath in, and imagine this as a listening breath.
Allow the breath to be touched by your heart, to be
oxygenated and returned out. As you breathe out,
imagine this as a speaking breath. And so is the
cycle of breath and communication – incoming breath
– touched by heart – and out going breath.
Compassionate communication includes:
1.Awareness
2.Speaking with Clarity
3.Listening with Openness and Attention.
1. Awareness
Compassionate communication begins with an
awareness of your own well being because when we
focus on our well-being we create a space for the
well-being of others around us. We create a space
for authentic listening and speaking.
Identify Needs and Values. To create a dialogue
of compassion, become familiar with your needs,
values, expectations, and motivations. How did the
role of caregiver come to you? Was it out of choice,
obligation or circumstance? Does this role fulfill
an underlying need or value to give or to feel
appreciated? What other needs or values may be
present for you? Perhaps there may be the need or
value for connection, sense of purpose, or financial
security. Marshall B. Rosenberg, Ph.D. describes a
list of “universal needs and values” that all humans
share. To become familiar with this list visit
http://www.cnvc.org/needs.htm.
Options for Meeting Needs and Values. Once you’ve
identified some of your core needs and values, you
can evaluate how you might have these needs met.
It’s possible that your needs are met through care
giving. It’s possible that you hope or expect these
needs to be met through care giving, but they are
not. Clarify for yourself what your expectations and
motivations are and then determine what is realistic
for this relationship. Use the “here and now” in
your determination, rather than remembering how
things were at one time or how you wish things to
be. Consider all of the ways your needs and values
can be met, including but not limited to this
relationship.
2. Speaking with Clarity
We all have many years of experience in speaking,
but may not have skills in expressing ourselves with
clarity. Here are some suggestions:
Use “I” statements. Probably the easiest tip for
compassionate communications is to use “I”
statements. These statements begin with the word “I”
and they clearly express something about our own
view, not something about the other person. For
example “I am finding it hard to believe what you
are saying” Notice the difference between the “I”
statement and the following “You” statement. “You
are lying!” When we start sentences with the word
“You” we tend to put the other person on the
defensive.
Use observations, not evaluations. An observation
is a statement of fact, similar to what might be
recorded on a video camera. For example, the
statement “Aunt Ann has been talking on the phone
for one hour”. An evaluation is a statement of fact
with an added value (a judgment of good or bad). The
statement “Aunt Ann talks too much on the phone” is
an evaluation.
Speak Authentically. There are times when we
choose to protect those we love from the truth about
our feelings. We are the best judges of the impact
of such non-disclosures. It’s possible that when we
choose not to share our feelings, an opportunity for
distance not closeness is created. Although it may
feel very risky, the loving and heart-centered
sharing of your feelings may be a beginning to more
open communications. Sharing of feelings could begin
with a sentence like “When you said [insert the
Observation], I felt [insert the feeling].” See
Marshall B. Rosenberg, Ph.D,
(http://www.cnvc.org/nvc.htm) for more tools for
authentic speaking.
Know many realities exist. If a group of five
people go to the same movie and each is asked the
question “what happened in the movie”, we would get
five each different stories. Each person’s story is
based on the unique backdrop of each person’s
perceptions. Many times our perceptions are based on
our values or experiences. Remember, your reality
belongs to you. Another person’s reality belongs to
them. Neither reality is “right” or “wrong.” We
simply perceive and interpret things based on our
own values.
3. Listening with Openness and Attention
Many communication breakdowns occur because of
difficulties in listening.
Waiting is not Listening. So often in our
conversations we are “waiting to speak” while the
other person is talking. We are formulating our
ideas in response to what is being said. We become
engaged in our own thoughts and their importance.
Anxiously waiting for the other person to stop
talking, we find that we are not listening.
Avoid Unspoken Stories. Another pitfall in
listening is when we interpret rather than listen.
While the other person is speaking, we create a
story about what is being said. For example, a
simple statement like “I think you look very nice
today” can be incorrectly interpreted to mean,
“Today, unlike any other day, you look very nice.”
So, you can see how easy it is to create your own a
story about someone’s communication.
Active Listening. Listening is truly an art. It
is a skill that can be acquired. One way to practice
this skill is through active listening. Active
listening is a technique in which the person
listening re-states his or her understanding of what
the speaker has said, before introducing their
response to what has been said. For example; “What I
heard you say is …,” followed by “Does that sound
about right?
Reframe Hostile or Difficult Communications. It’s
possible that the person you are caring for may
speak to you in anger. It may be helpful to consider
that their anger may be due to their own
frustrations, and not about you. For example, “You
are no good! You never help me!” This statement
might be reframed: “What I hear you saying is that
you are wanting help and it feels like I am not
helping now. Is that what you meant to say?” In
hostile or difficult communications, it is sometimes
helpful to involve a third neutral person to help
with this type of communication.
At the very heart of compassionate communication
is our desire to be collaborative in our
communications – to hold a balance between our needs
and the needs of the other. This is particularly
important for caregivers who are so often looking
after the needs of the other.
Resources
Nonviolent Communication: A Language of Life by
Marshall B. Rosenberg, Ph.D. (c) 2005 by Center for
Nonviolent Communication Website: www.cnvc.org,
Email: cnvc@cnvc.org
Phone: (818)957-9393.
Loving What Is by Byron Katie,
http://www.thework.com/TheTurnaround.asp
Elder Companion, by Elizabeth B. Bolton. Lesson
3: Communication. University of Florida, IFAS
Extension.
http://edis.ifas.ufl.edu/FY589
First National Symposium on Ethical Standards for
Elder Mediation, April 19-20, 2007,
http://www.paserver.net/mcmc/Symposium2007-04Registration.html
Mediation Resources For Caregivers, Help For
Those Taking Care Of The Seriously Ill,
http://www.cbsnews.com/stories/2007/02/19/fyi/main2492333.shtmlml.
Elder care mediators, http://www.eldercaremediators.com/
Jill Sarah Moscowitz has over twenty years combined
experience in the fields of healthcare and conflict
resolution. She offers training, mediation and
counseling services in the New York metropolitan
area. For more information,
http://moscowitzmediation.com
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