Chris Voss wasn’t really allowed to have a bad day at work. As a former FBI hostage negotiator, he couldn’t go through the motions, the stakes were just too high. While he was armed with a gun, his most powerful weapons had no bullets.
I read his book “Never Split the Difference” and had no idea that it would align so perfectly with what physical therapists and other healthcare providers need to do. Build a relationship quickly, get information, and arrive at an agreed-upon course of action.
His unique perspective on negotiation and communication was drawn from his experience as a former FBI hostage negotiator but I’m telling you, you can use these principles as a clinician to become a better PT.
Here are the three principles that you should learn: active listening, empathy, and labeling.
Active listening is one of the most important skills a physical therapist can have. We’re broadly taught to nod and maintain eye contact but there’s more behind that. By fully engaging with their patients and actively listening to their concerns and needs, therapists can gain a deeper understanding of what their patients are trying to communicate. This, in turn, helps the therapist tailor their treatment approach to better meet the patient’s needs. The importance of listening to the other person and trying to understand their perspective is vitally important. This same approach can be applied in physical therapy, where the therapist needs to understand the patient’s physical, mental, and emotional needs in order to provide effective treatment. Sound like bio-psycho-social at all?
Now be careful, you can’t go through the motions here, the active in active listening requires full concentration and focus on what the speaker is saying, both verbally and non-verbally, to understand the message being conveyed. It requires more than just hearing the words being spoken; it involves paying attention to the speaker’s tone, body language, and emotional state, and showing that the listener is engaged and invested in the conversation.
Active listening is important because it allows the listener to gain a deeper understanding of what the speaker is trying to communicate. It also helps to build rapport, trust, and understanding between the listener and the speaker and can lead to more effective communication and resolution of conflicts.
In practical terms, active listening involves several key steps.
- First, the listener must pay attention and focus on the speaker without distractions.
- Second, they must ask questions to clarify their understanding and show that they are engaged.
- Third, they must provide feedback, such as acknowledging what the speaker has said or summarizing their key points, to demonstrate their understanding.
- Fourth, they must reflect on their own thoughts and emotions, and how they may be impacting the conversation.
Active listening is a valuable skill for many professions, including physical therapy, where it is essential for building a therapeutic alliance with patients and understanding their needs. By actively listening to their patients, physical therapists can gain a deeper understanding of their physical, mental, and emotional state, which can help to tailor their treatment approach and lead to better outcomes.
Voss coined the term “Tactical Empathy”, it’s another important principle that can be applied to physical therapy. Here’s how it works, by putting themselves in their patient’s shoes, therapists can gain a deeper understanding of what they are going through and what they need to feel better. Keep in mind the difference between empathy and sympathy. Sympathy is I know what you’re feeling because I’ve felt it before, whereas empathy is being able to imagine how they might feel. Voss highlights the importance of empathy in negotiations, as it helps to build rapport and trust with the other person. In physical therapy, this can be accomplished by showing genuine concern for the patient’s well-being, understanding their pain, and being patient and compassionate. This, in turn, can help the patient feel more comfortable and willing to open up, leading to a better therapeutic alliance.
The goal of tactical empathy is to use the understanding you gain from it to influence and negotiate with them. In clinical situations, this can be really helpful in showing where the therapist is, in the role of a guide and not the hero of the story.
Tactical empathy is different from regular empathy in that it is not just about understanding the other person’s feelings and emotions, but also about using that understanding to achieve a specific goal or outcome. In negotiations, for example, tactical empathy can be used to build rapport and trust, identify common ground, and find creative solutions to conflicts.
In short, tactical empathy involves both understanding and using empathy in a strategic and tactical manner to achieve a desired outcome. It is a key component of effective communication and negotiation and can be applied to a wide range of fields, including physical therapy, business, and personal relationships.
By labeling the other person’s feelings and emotions, therapists can validate their perspective and show that they understand what they are going through. Voss explains how labeling can be used to diffuse difficult situations and create a more positive outcome. In physical therapy, labeling can help to build rapport with the patient, as it shows that the therapist is actively listening and understanding their needs. This can help the patient feel heard and valued, leading to a stronger therapeutic alliance.
In practical terms, labeling involves several key steps. First, the listener must accurately identify the speaker’s thoughts and feelings. A key here from Voss is to use phrases like, “It sounds like…” or “It feels like…” so as to not paint yourself into a corner if what you’re identifying is not what the person feels/means.
Second, they must summarize and restate these thoughts and feelings in their own words, using language that is clear, concise, and non-judgmental.
Third, they must ask the speaker to confirm their understanding, to ensure that they have accurately summarized their thoughts and feelings.
Repeating these steps brings both parties closer to understanding. Which is the goal of a conversation.
Here are some examples of using labeling in patient care:
Validating emotions: A physical therapist can use labeling to validate the emotions of the patient. For example, if a patient expresses frustration about their injury, the therapist can say, “I can see that you’re feeling frustrated about your injury.” This helps to build rapport, trust, and understanding between the patient and therapist.
Summarizing experiences: A physical therapist can use labeling to summarize the experiences of their patient. For example, if a patient describes difficulty with a certain movement or exercise, the therapist can say, “So, it sounds like you’re having trouble with that movement.” This helps to ensure that the therapist has a clear understanding of the patient’s experiences, and can tailor their treatment approach accordingly.
Reframing negative thoughts: A physical therapist can use labeling to reframe negative thoughts or emotions in a more positive light. For example, if a patient expresses fear about their injury, the therapist can say, “I understand that you’re feeling afraid, but that’s a normal part of the healing process.” This helps to reduce anxiety and increase confidence in the patient and can lead to better outcomes in their therapy.
Encouraging active participation: A physical therapist can use labeling to encourage active participation from their patient. For example, if a patient is reluctant to participate in a certain exercise, the therapist can say, “I can see that you’re feeling unsure about this exercise. Let’s work together to find a solution that you’re comfortable with.” This helps to build a collaborative and supportive relationship between the patient and therapist.
By using labeling in these ways, physical therapists can build better relationships with their patients, understand their needs and experiences more effectively, and tailor their treatment approach for better outcomes.
The principles of active listening, empathy, and labeling can be used in your physical therapy practice to help you get more and better information from your patients to build better relationships with them. By actively listening to their patients, showing empathy, and labeling their feelings, you can create a more positive and effective therapeutic alliance that can lead to better outcomes for their patients.