Are You Really Listening? Lessons from Spiritual Direction in the Care of Nonverbal Patients
Anna Wright, MD, Medical Director, Community Hospice and Palliative Care
How can clinicians be with, hold space and listen to nonverbal patients such as those with ALS, cancer, dementia? As clinicians, we are often so busy diagnosing and prescribing that we fail to listen, usually interrupting patients 11 seconds into the story (Phillips). One study of physicians and patients revealed a mostly ‘managerial’ style of medical interviewing, with little to no exploration of patient emotions or expectations (Ruis-Moral). When clinicians focus solely on the diagnosis and cure, they become inattentive to the patient’s story and humanity. When clinicians quit trying to solve the problem and focus on the patient’s story, then the physician enters the sacred space where the narrative can be heard (Mohrman).
At the basis of all healing is a person being deeply, compassionately heard by another. The ministry of spiritual direction is generous listening that provides a safe space for a person to tell her sacred story. This ministry offers lessons for clinicians in the art of creating sacred listening spaces, generous listening and prayerful attention to patients.
Patients who have lost their voice through illness struggle to be heard and numerous barriers can arise in this clinical encounter. Clinicians and families often dominate the visit, leaving the voiceless patient unheard. Using principles from spiritual direction, stories of nonverbal patients will be shared with discussion on ways that clinicians can sit in the sacred space with patients, be present to the patient’s agenda, be aware of potential barriers and engage in generous, holy listening.
Bibliography
Mohrman, Margaret. Medicine as Ministry: Reflections on Suffering, Ethics and Hope. Cleveland: The Pilgrim Press, 1995.
Phillips, KA, Ospina, NS. "Physicians Interrupting Patients." JAMA. 2017: 398 (1):93-94.
Ruiz-Moral R, Pérez Rodríguez E, Pérula de Torres LA, de la Torre J. "Physician-patient communication: a study on the observed behaviours of specialty physicians and the ways their patients perceive them." Patient Educ Couns. 2006 Dec and 64(1-3):242-8.
At the basis of all healing is a person being deeply, compassionately heard by another. The ministry of spiritual direction is generous listening that provides a safe space for a person to tell her sacred story. This ministry offers lessons for clinicians in the art of creating sacred listening spaces, generous listening and prayerful attention to patients.
Patients who have lost their voice through illness struggle to be heard and numerous barriers can arise in this clinical encounter. Clinicians and families often dominate the visit, leaving the voiceless patient unheard. Using principles from spiritual direction, stories of nonverbal patients will be shared with discussion on ways that clinicians can sit in the sacred space with patients, be present to the patient’s agenda, be aware of potential barriers and engage in generous, holy listening.
Bibliography
Mohrman, Margaret. Medicine as Ministry: Reflections on Suffering, Ethics and Hope. Cleveland: The Pilgrim Press, 1995.
Phillips, KA, Ospina, NS. "Physicians Interrupting Patients." JAMA. 2017: 398 (1):93-94.
Ruiz-Moral R, Pérez Rodríguez E, Pérula de Torres LA, de la Torre J. "Physician-patient communication: a study on the observed behaviours of specialty physicians and the ways their patients perceive them." Patient Educ Couns. 2006 Dec and 64(1-3):242-8.