Psychology
20 Dec 2018

Communication only truly flourishes in an atmosphere of trust

If there is no trust between conversational partners, even the most casual chat can turn into a battle -- an interview with the psychiatrist Bogdan de Barbaro 

Wysokie Obcasy
Agnieszka Jucewicz Wysokie Obcasy, Global
Communication only truly flourishes in an atmosphere of trust - NewsMavens
Couple, Pexels

The following fragments from Agnieszka Jucewicz’s interview with Professor Bogdan de Barbaro appeared in the Polish weekly “Wysokie Obcasy” in May 2016.

Agnieszka Jucewicz: What would you call a good conversation?

Professor Bogdan de Barbaro:  One that leaves its participants smarter, more sensitive to each other, and overall better. It’s an exchange of thoughts with the aim of not arguing or imposing our opinion on another person but rather creating a sense of deep, mutual enrichment.

AJ: Do you remember when you last had a conversation like that?

We had a crisis lately in the team where I work. It probably resulted from the fact that we suppressed difficult emotions. At some point hostilities came to a head and we realized quite quickly that we had to get along.

AJ: So an honest conversation was a common goal. What happened next?

We made room for everyone to express their feelings -- including dissatisfaction and anxiety -- and for careful listening. Therapists are trained to speak in a nonconfrontational way, so the dialogue remained productive. And everyone took responsibility for themselves , that is to say, they committed themselves to doing their best to achieve a common goal.

In the end, a fair and open exchange took place and everyone's needs and expectations were addressed. At the moment when somebody admitted, "I was hurt I was afraid to say it."; someone else was able to respond: "Well, now that I understand how I made you feel,  I'll be more careful next time."

AJ: However, sometimes a common goal is missing. And it feels like the person on the other side of the table speaks a completely different language. Is there no chance of getting along in these cases?

Apparently there is a reason why these two sides decided to talk despite everything, It's possible that you have to start by asking -- why did they start a conversation? What is the context?

AJ: Listening is one of the most essential tools in psychotherapy. Do therapists need to learn how to listen?

Careful listening is the foundation of every worthy conversation.

One of the methods we use with future therapists is the analysis of recorded fragments of different therapy sessions. We pause the tape and ask them: “In your opinion, what was that patient talking about?” “What happened here?” Their ability to accurately summarize these statements is important.

AJ: Meaning?

We always need to make sure that we correctly understand what the other person is saying. If I fail to confirm that by saying "X" and "Y" that they meant "this" and "that", I will end up getting caught up in my own reasoning and drifting away from my patient’s train of thought.

AJ: And after five years of training do these young therapists truly become more empathic?

Hopefully, they at least become more humble. The major ingredient of careful listening is compassionate attention. Let’s say that a patient says…

AJ: “I feel depressed and rejected by the world?”

Sure. In that case, first of all I need to get some more information in order to understand their statement. So I say something banal, like: “Could you elaborate?”. My intention is to stop myself from making any premature judgements. If the patient says: “I feel down” and I immediately decide to prescribe Prozac, my diagnosis might be too hasty and superficial.

There’s a chance that after an hour of conversation I will stick to my initial conclusion, but, firstly -- I highly doubt it, and secondly -- creating a comfortable space for my patient is a priority. My knowledge about the patient is in the process of being confronted by their knowledge about themselves and only the synthesis of those two perspectives can bring satisfying results. Every therapist must remember that they are not omniscient.

AJ: Do not you think that one of the problems in conversations is that we "know" things too early? We are already summarizing, and we are already making conclusions about the speaker.

It is a strong temptation, because, as Foucault wrote, knowledge is also power.

A good conversation is one in which the participants are able to recognize that they can be wrong. 

AJ: Psychotherapy is often called a “healing conversation”. How does it work?

There is a substantial amount of optimism in every therapeutic conversation. By listening and showing an interest, the therapist assures their patient that he or she is willing to help. They construct their questions and thoughts carefully to make the patient feel more secure and comfortable. This is why a therapist’s office is often the first place where people are able to open up and speak about matters they never shared with anyone before. The therapist and patient become connected by a unique bond of trust.

If there is no trust between conversational partners, even the most casual chat can be a battle, as both participants try to constantly defend themselves from their “opponent’s” potential attack. Words have a great power and used inappropriately they can have terrible consequences. The evidence of this is most visible during couples therapy.

AJ: You said once that if two people argue, it means they still care about each other.

That might have come out a little too optimistic. There are gentle squabbles but then there are rows leading to physical violence or homicide. Therapists often wonder where to draw the line and say: “Enough!” There’s a huge difference between an everyday quarrel and a regular, long-lasting hatred.

AJ: When do you say: "Enough!"?

When a husband says to his wife (or a wife to her husband): “You are nobody!” Contempt and humiliation are nothing else but forms of violence. When this happens, I ask: “Could you look inside yourself and try to re-phrase your last sentence?”

AJ: And what kinds of thing do they say?

“I really don’t like you right now. You’ve hurt me.” That’s a statement I’m willing to accept. Then we try to find out when and what exactly made this person suffer; if it’s definitely their spouse who caused it or whether it’s some incident from the past -- perhaps the patient’s parents mistreated them as a child? Locating the source of the problem and making the patient realize the difference between the present and the past is one key to couples therapy.

AJ: But sometimes conflicted partners or friends stop talking to each other completely and carry on living in silence for years.

Hostile silence is never a solution. It’s a severe and dangerous toxin as each person persistently nurtures the negative picture of the other and stubbornly solidifies their bitter feelings and hostile attitude.

Luckily, between “killing” each other and toxic silence, there is a third, more reasonable solution -- a dialogue.

AJ: What should I do when my conversational partner attacks me?

When an aggressive patient comes to my office, I ask them: “What do you feel now?” However, I’m a therapist. If a journalist used the same question in a political interview, their guest would probably get irritated and might even leave the studio.

AJ: Perhaps that’s exactly the kind of question we should be asking, then?

“What do you feel now?” Maybe. The problem is, people are rarely in touch with their feelings. Perhaps if you and me took over the world...

AJ: I’m not after any kind of power or control so I’m gladly giving up my share to you.

Alright. If I had the power, I would take all loud and quarrelsome politicians and send them to a survival camp, where they would be forced to work together in order to stay alive. Then I would make them drink a lot of vodka, and hopefully, after all that, they would finally be able to drop their pretence, loosen their ties and have a deep, meaningful conversation?

AJ: Some time ago, I had a seemingly senseless discussion. It was a stream of mutual blame and pretension. I was sure it had been a completely unnecessary and pointless incident, but with time…

It began to sprout? In therapy, we often sow ideas and thoughts, hoping they bear fruit later. Even if initially a patient rejects my perception of their problem, it often stays in the back of their mind, and later, after therapy, they might get back to it, think it over and even put it into action.

AJ: In that case, perhaps there are no pointless conversations?

As long as each of participant speaks for themselves and about themselves, without putting their own words and opinions in another’s mouth, yes. It’s also crucial that they don’t presume bad intentions, but try and believe in their adversary's goodwill and decency. 

***

Professor Bogdan de Barbaro is a psychiatrist and psychotherapist, and President of the Psychiatry Department of Jagiellonian University.

Translated from Polish by Martyna Kardach

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