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InFocus

“Have you got five minutes?”

The biggest barriers to starting the mental health conversation are that people don’t know what to say, how to bring the topic of mental health up or they are worried they might make the situation worse

A conversation about someone’s mental health can start when you least expect it, so you can’t always plan it. Yet, we know that the biggest barriers to starting the mental health conversation are that people don’t know what to say, how to bring the topic of mental health up or they are worried they might make the situation worse.

So, keep it simple – if someone wants to talk, all they are asking you to do is listen. But listening is a skill that needs to be learned and practiced. Actually listening to someone is very different from having a conversation. When you are truly listening to another person, you are giving them your full attention. You can allow them to express themselves or think through a problem. The core skill is our ability to give quality attention to the other person.

Do you have time?

In our busy lives we might not always have five minutes to give our full attention to our colleagues immediately. Or, you may have exactly five minutes between consultations. So, be honest up front.

If you can’t devote a slot there and then to high quality listening, you would be better to be say so, and make an arrangement: “Actually, I’m running late in my consults right now, but I will be free in an hour. Let’s meet up then.”

Or, if you only have five minutes, tell them that, “To be honest, yes – I have exactly five minutes. Can we start this conversation now, and pick it up after I’m finished surgery?” and let your colleague decide.

Are you a good listener?

We think we listen, but we don’t. In everyday conversations we listen to each other to wait for the gaps in which we can begin to speak again. What we are really doing is listening to our internal monologue, we follow our own agenda, share our own thoughts, experiences and give advice. When we listen like this, the quality of our attention is internal – what’s going on for us, what these words mean for our own experience.

Listening to each other is different. It requires discipline to give your full attention to another person. There is a whole skillset called “active listening” and it takes practice. When you actively listen to someone, you stop listening to your own internal voice, but instead laser focus on your colleague. Now you are following their agenda, listening to what they say, how they say it, what they don’t say, the tone of their voice and their emotions. When you are actively listening to someone else you are creating a space for them to express themselves, to think, to say whatever is on their minds, to let their thoughts flow to wherever they need to go. If you want to help someone, all you need to do is actively listen to them.

What can you prepare?

Of course, you don’t know the content of the conversation, but you can still think about how you can help. To really listen deeply to someone, you need to be really interested in them.

  • You need to be empathetic and suspend your own judgements. Your opinions and criticism will make people defensive and discourage them from talking
  • You need to say very little. Be encouraging, ask them to tell you more. Try not to jump in with suggestions, or solutions too early in the conversation

There are a number of simple techniques you can use to be a great active listener:

  • Mirroring – saying someone’s exact words back to them
  • Summarising – briefly repeating back what has been said
  • Clarifying – asking them to clarify or provide a clarification and ask them if this is correct
  • Encouraging self-expression – it’s important that people are allowed to express themselves in a safe and open way. This may mean showing vulnerable emotions, crying, shouting or anger. If it’s safe to do so, and they need to do this, support them as they do so

Safe space

If you are going to listen to someone talking about themselves, you need to create a safe space where you can both relax and tune into each other. A busy corridor at work won’t do it. You need a quiet space where you can both feel at ease. The ideal space is somewhere where your partner can feel that they belong, somewhere they matter. Not always easy in practice, where space is often crowded and clinical, but you could ask, “where would you like to go where you can feel most relaxed now?”

Body language

The role of the listener is to be interested and show it. Face your partner and give them your full attention. You need to have a look of encouragement on your face, so your partner feels emboldened to keep talking.

Eye contact is vital. Although your partner’s eyes may roam any number of places, you should keep your eyes fixed on theirs. This is a basic indicator of both respect and attention, and a demonstration to your partner that you are deeply, intensely listening to them.

What to ask

Remember, your role here is to listen. You do not need to ask clever questions to help your partner. Ask simple open questions that can help your partner think more deeply around a subject. An open question will usually start with what, where, how, who – and require more than a yes or no answer. Examples may include:

  • What else do you think about this?
  • Tell me more about…
  • What would you like to happen?
  • What would be a good outcome?

Silence

In our everyday conversations, we abhor silences – they make us feel awkward and we rush to fill them, often saying the first thing that comes into our heads. This may not be useful for the person who you are trying to listen to, as anything you have to say will knock them off their stream of thought. So, don’t rush into saying anything. If the person you are talking to has gone quiet, they may be thinking or processing information. Leave the silence as long as you can, even if you feel uncomfortable.

If you need to, you could ask an open question such as “what’s happening now?”, or “what are you thinking about?” Otherwise, your role here is to just be supportive and let the person have the space until they are ready to speak again.

What about solutions?

You may well have a different perspective to offer or a different way to look at the subject. However, it may not be the appropriate time to offer your words of wisdom. Keep them to yourself, unless your partner is looking for your input.

It may be really obvious to you what your colleague should do. You may have the experience to solve their problems. But that might not be what they need in the moment. As soon as you start to offer solutions, you have stopped listening to your partner. Your solutions may have been amazing for you, but you are better to keep them to yourself and just keep listening. This is hard; we are trained to offer solutions to our clients to fix any number of animal related ailments, but these are often problems that people need to find their own solutions for.

So, keep quiet and let your partner think through things themselves. If you still have the urge to share your solution, you could offer it as an idea that may or may not be right and give your partner the choice as to whether they might like to accept it or not.

What’s a good outcome?

As your conversation draws to a close, you should ask your partner what they would like to take away from your discussion. Do they have any fresh thoughts, insights or plans? Have they got a new way forwards or would they like to meet up again, either with you or with someone else, to talk further?

There will not always been a concrete “next step”, and often just being listened to is enough for people to feel the load a little lightened. So, ask “what will you do/say/feel differently now?”

Follow up

There might be some accountability that comes from the conversation. How will you know if your colleague has done what they said they would? For example, they might have decided to seek help from someone else or speak to a different friend or colleague. Ask, “how will I know that you’ve done this?” They may commit to letting you know.

If not, touch base with them. We know that mental health conversations are not clear cut, you can’t solve them in five minutes. The first step is talking and you have just demonstrated what a great listener you are. Following up is a powerful way to keep the conversation alive and for your colleague to know that you are still there for them.

Mark Tabachnik

Mark Tabachnik, BVM&S, BSc, CertEP, PGCertVBM, MRCVS, is a clinical director at Wright & Morten Equine Clinic in Cheshire. He is also a coach, with a specialist interest in developing people in veterinary practice by promoting learning and development of interpersonal skills and self-awareness.


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