CC BY-NC-ND 4.0 · Journal of Social Health and Diabetes 2018; 06(02): 104-105
DOI: 10.1055/s-0038-1675677
Brief Communication
NovoNordisk Education Foundation

Managing Difficult Conversation

Manoj Kalra
1   Financial Consultant, MRC Nagar, Chennai, India
› Author Affiliations
Further Information

Address for correspondence

Manoj Kalra, BCom, ACA
Block 7, 4A, Rani Meyyammai Towers, MRC Nagar, Chennai
India   

Publication History

Publication Date:
12 November 2018 (online)

 

The Challenge of Conversation

Conversation is the bedrock of human life. Without conversation, no meaningful social activity can take place. While most communication through this mode is pleasant, some conversations may turn out to be difficult. Such conversations can be characterized by any of the following: discomfort or distress prior to the interview, during the talk, or after completing the meeting. The “difficulty” of a conversation may be due to the topic of the discussion, the personal characteristics of the conversant, or perhaps the external environment. It is not necessary for every “optimal” conversation to end in agreement, neither is every interview marked by disagreement considered “difficult.” These features are universal. They apply to conversations in health care and diabetes care, just as they do in other professional and personal domains.


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Conversation Distress

Both psychosocial and physioenvironmental factors contribute to “conversation distress.” An uncomfortable physical ambience (e.g., hot temperatures), threatening environment (e.g., huge tables and long-backed chairs), and aggressive décor (e.g., brandishing weaponry, aggressive use of colors) may convert an otherwise innocuous conversation into a threatening one. Pleasing and relaxing surroundings, on the other hand, can convert a potentially challenging conversation into a pleasant one.


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The 5R Strategy to Manage Difficult Conversation

We suggest a 5R strategy to help manage difficult conversations. While this simple rubric is made for managers, it has universal appeal and relevance.[1] [2] [3] The 5R framework can be used in all professional and personal situations. It is of special use to professionals who practice motivational interviewing. This includes service providers in health care, human resources, and education ([Table 1]).

Table 1

Making difficult conversations simple: the 5R rubric

  • Reciprocal respect and relaxation

  • Repetition and rephrasing

  • Strategic retraction and soft rebuttal

  • Reaching and reinforcing common ground

  • Reassurance and revision/return


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Respect and Relax

“Respect thy Opponent”

Create an ambience of relaxation before and during every conversation. Approach each conversation with respect for the opposite party and for the topic being discussed. One must be able to convey, through words as well as nonverbal gestures, a feeling of respect to the other person, and one's viewpoint. Once this done, one can expect reciprocation of the same feelings: “Thank you for sparing time,” and “I appreciate your going out of the way to spare time for me.”


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Repeat and Rephrase

“Buy Time to Think; Repetition Makes Perfect”

Acknowledge the other conversant's stance by repeating what he/she has said, and then rephrase it in a milder form. This exercise allows one time to think and reflect, as well as gives the other person a feeling that he/she is being listened to. “You just said, ‘XYZ is an awful boss to work for’.” “What you actually mean, I guess, is, your work targets are way too high for you.”


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(Strategic) Retract and Rebut

“At Times, One May Lose a Battle to Win a War”

In a strategic manner, appear to retract from your initial position and reflect upon it. The difficult conversant should get a feeling that you are willing to take (and have taken) a step backward and are going to accommodate him. Verbalize your reflection, and rebuttal, by listing the pros and cons of the argument in a nonpersonal and nonthreatening manner. “I understand when you say that the targets are unachievable.” “If I understand correctly, the main issue is with the number of hours at work, not with the number of files.”


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Reach and Reinforce Common Ground

“Let's Be Friends”

While repeating rephrasing and retracting, identify and list the common ground that you share. It is not necessary to agree on every aspect of a matter; even a few similarities should suffice to set the ground for consensus. Reinforce mutually agreeable and pleasant points, while relegating issues of disagreement and negativity to lower down in the agenda. “Just to be sure, we don't mind the extra files, as long as we can complete them by weekend.” “Perhaps sharing an idea on Saturday of the expected work next week may help one plan better.” If things seem to be moving our way, continue to engage the conversant and create agreement. “Let's shelve this for the moment and have a fitness break. We can continue the conversation tomorrow.” “Let's wrap this up; we seem to be speaking the same thing, but in different languages.”


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Reassure and Return

“Tomorrow, Tomorrow, I Love You, Tomorrow”

Once concordance has been achieved on even one discussion point, review your game plan. You may wish to stop the conversation or to continue it. In either case, reassure the opposite person that you have heard and internalized his/her opinion and will work to achieve a solution that is acceptable to both. One may offer the promise of revising a decision later as well.

If the conversation is proving extremely difficult, a good strategy may be to discontinue the talk and return to it later. If things seem to be moving our way, continue to engage the conversant and create agreement. “Let's shelve this for the moment and have a fitness break. We can continue the conversation tomorrow.” “Let's wrap this up; we seem to be speaking the same thing, but in different languages.”


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Conflict of Interest

None.

  • References

  • 1 Kalra S, Kalra B. Coping with diabetes: the 15 S coping skills list. J Pak Med Assoc 2018; 68 (05) 814-818
  • 2 Guarnaccia CA. Self-determination theory and motivational interviewing interventions for type 2 diabetes prevention and treatment: a systematic review.. J Health Psychol 2017; DOI: 10.1177/1359105317737606.
  • 3 Keeley R, Engel M, Reed A, Brody D, Burke BL. Toward an emerging role for motivational interviewing in primary care. Curr Psychiatry Rep 2018; 20 (06) 41

Address for correspondence

Manoj Kalra, BCom, ACA
Block 7, 4A, Rani Meyyammai Towers, MRC Nagar, Chennai
India   

  • References

  • 1 Kalra S, Kalra B. Coping with diabetes: the 15 S coping skills list. J Pak Med Assoc 2018; 68 (05) 814-818
  • 2 Guarnaccia CA. Self-determination theory and motivational interviewing interventions for type 2 diabetes prevention and treatment: a systematic review.. J Health Psychol 2017; DOI: 10.1177/1359105317737606.
  • 3 Keeley R, Engel M, Reed A, Brody D, Burke BL. Toward an emerging role for motivational interviewing in primary care. Curr Psychiatry Rep 2018; 20 (06) 41