Deep Listening: Making the Unconscious Conscious During Difficult Decision-Making
Mary Browne, MSW, M.Div., BCC, ACPE Certified Educator, Director Spiritual Care and Chaplaincy Services, Memorial Hermann Southwest Hospital and Faculty of Clinical Pastoral Education Memorial Hermann Health System and Emily Owen, M.Div., Staff Chaplain, Memorial Hermann Southwest Hospital, Houston, Texas.
“Listening creates a holy silence. When you listen generously to people, they can hear truth in themselves, often for the first time.”
— Rachel Naomi Remen, MD
It happens daily in a variety of medical settings. A family is gathered to hear an update regarding a loved one’s condition, prognosis or diagnosis. Do we continue full code despite the bleak prognosis? Should we suggest a DNR or even a move to comfort measures? Is there talk about no escalation of treatment? Are they open to compassionate extubation? Or hospice? Are we prolonging life…or are we prolonging death? Is this the right time for this conversation? What are our goals of care?
Communication is a difficult thing among those you know and love most in this world. Adding in a mixture of different cultures, languages, religious traditions, family systems, personalities and the list goes on and on…only adds to the level of complexity when it comes to communication in highly emotional situations.
To communicate well, we must first listen well. The art, “science” and practice of deep listening helps us to hear beyond the spoken words of the patient and/or family and helps to make the unconscious conscious during these times of difficult decision making. It is often these unconscious motivations which lead us to make assumptions, or to draw the conclusions that then drive our responses, our behaviors and our decisions.
Though the medical team comes with gathered data and information, the family also comes with a deeply imbedded worldview, cultural traditions and ways of understanding hardship and suffering. Whether we identify as religious or not, every person has a way of making meaning out of their life and their situation. In this spirituality, which is present in all people, human beings have an unconscious way of dealing with all situations including challenge, trauma and crisis. Our goal is to listen to their souls, to the unconscious assumptions and desires that drive decision making.
During this workshop we will present and discuss how to make SPACE for deep listening for those in our care. SPACE is the acronym we use to remind us of the listening skills that are crucial for difficult conversations with patients and their loved ones. Seeking to understand, paying attention to our posture, acknowledging what we hear, cultivating an attitude of curiosity and providing an empathic response are all components of deep listening. It is through this way of listening that we help others to unpack what lies below the surface, making the unconscious conscious.
“Listening creates a holy silence. When you listen generously to people, they can hear truth in themselves, often for the first time.”
— Rachel Naomi Remen, MD
It happens daily in a variety of medical settings. A family is gathered to hear an update regarding a loved one’s condition, prognosis or diagnosis. Do we continue full code despite the bleak prognosis? Should we suggest a DNR or even a move to comfort measures? Is there talk about no escalation of treatment? Are they open to compassionate extubation? Or hospice? Are we prolonging life…or are we prolonging death? Is this the right time for this conversation? What are our goals of care?
Communication is a difficult thing among those you know and love most in this world. Adding in a mixture of different cultures, languages, religious traditions, family systems, personalities and the list goes on and on…only adds to the level of complexity when it comes to communication in highly emotional situations.
To communicate well, we must first listen well. The art, “science” and practice of deep listening helps us to hear beyond the spoken words of the patient and/or family and helps to make the unconscious conscious during these times of difficult decision making. It is often these unconscious motivations which lead us to make assumptions, or to draw the conclusions that then drive our responses, our behaviors and our decisions.
Though the medical team comes with gathered data and information, the family also comes with a deeply imbedded worldview, cultural traditions and ways of understanding hardship and suffering. Whether we identify as religious or not, every person has a way of making meaning out of their life and their situation. In this spirituality, which is present in all people, human beings have an unconscious way of dealing with all situations including challenge, trauma and crisis. Our goal is to listen to their souls, to the unconscious assumptions and desires that drive decision making.
During this workshop we will present and discuss how to make SPACE for deep listening for those in our care. SPACE is the acronym we use to remind us of the listening skills that are crucial for difficult conversations with patients and their loved ones. Seeking to understand, paying attention to our posture, acknowledging what we hear, cultivating an attitude of curiosity and providing an empathic response are all components of deep listening. It is through this way of listening that we help others to unpack what lies below the surface, making the unconscious conscious.