Conversations Worth Having summary

Alisha Patel works at a busy medical center in New England, and she’s about to have an important conversation. There’ve been some negative patient satisfaction reports from one of her hospital units; it seems a recent change in management and increase in workload has left the staff overworked, stressed, and unengaged. Alisha is here to talk to the tired and tense group of nurses. Could something as simple as the right conversation be enough to turn the situation around and improve morale? The answer is yes.

But before we look at Alisha’s organization-changing conversation, let’s see what she used to say in these situations – before she learned to tune in to the specific type of conversation she was having. There was a time when she would have said, “These reports aren’t satisfactory. Every quarter it’s the same or worse. You’ve clearly done nothing to improve!” This would result in defensive excuses from the staff and they’d leave demoralized with no idea how to fix the issue.

These types of conversations are what we call depreciative – they devalue the situation. Alisha would just focus on stating the problem, with no investigation as to why there’s a problem in the first place or what the staff think of it. These conversations are unproductive and lead to defensiveness and disengagement.

So, what does Alisha do now? She uses Appreciative Inquiry – a technique based on adding value and asking questions. She asks the nurses what’s been working well in the unit and for examples of satisfied patients.

After the initial shock of such an unexpectedly positive direction of conversation, the nurses share their stories – and they discover several common themes and actions which can help them improve patient satisfaction. Alisha’s success is confirmed after the meeting when one nurse exclaims, “This was so effective. I know things are going to improve after just one meeting with you!”

While not every interaction will go this well, this type of conversation is what you want to strive for when trying to create positive change at work, in your relationships, or in the community. And there’s one important thing you need to do before you can have this conversation: you need to tune in to the unseen influences of the situation.

Think of it as an iceberg – on the surface we have our visible behaviors and actions in the form of conversations. However, hidden beneath are the unconscious drivers of those conversations. Things like our beliefs, expectations, stress, biases, world-view, how much sleep we got last night – everything that can affect what we say.

And just like with the Titanic, if you’re not aware of what’s floating beneath the surface, this iceberg can sink a relationship.

Conversations which are driven by these unseen factors are often of the depreciative type mentioned before. If you want to turn the discussion into a conversation worth having, you need to find a way to bring these unseen influences into the light. Luckily, there’s a very simple technique you can use to tune in. It involves three steps: pause, breathe, and get curious.

So the next time you find yourself on the verge of a depreciative conversation, the first thing you should do is pause. This stops the current momentum before things get out of control.

Use this moment to breathe. Breathing stimulates the parasympathetic nervous system, reducing stress. The effect is strongest if you take a deep breath, hold it for a short time, then let it out slowly, and repeat.

Finally, get curious. Ask questions which allow you to consciously take charge of what’s going on in your head. What’s the bigger picture? What assumptions am I making? What don’t I know that might be important? What emotions am I experiencing?

This simple exercise stops you from being controlled by those unseen influences and allows you to get in the driver's seat and deliberately foster the conversation you want to have – one based on Appreciative Inquiry.

In the next chapter, we’ll take a closer look at this concept, and the two basic practices that it involves.