How radical listening can transform patients’ thinking: facing cancer with courage and grace

skills Nov 24, 2018

I’ve been doing a lot of thinking lately. Thinking about thinking. And the quality of our thoughts. And how our thoughts dictate our emotions, our actions, and ultimately, our connections with one another.

I’m sure it won’t come as a surprise to you to hear that I’ve been reading a book about the topic too (did I mention I’m an avid reader?!) In fact, quite ridiculously, I’ve currently got about 6 different books on the go, so perhaps the quality of my thoughts is somewhat fractured! But hey, sometimes I like to let my butterfly brain flit wherever its whim and fancy takes me – it makes for an interesting life anyway ;-)

 

So, the book I’ve been reading is called “Time to think” by Nancy Kline. I actually downloaded it a few years ago on Kindle, but then about a month ago my husband was given a copy as a gift from a colleague and so I picked it up and start flicking through it again. I’d forgotten just how many gems and insights are packed inside!

National Day of Listening

Yesterday was the National Day of Listening, and of course with everything I do and everything I read, I naturally find myself relating it back to my passion – beating cancer. So, today’s post is about developing the art of listening to those living with and beyond cancer. It’s really quite a simple concept – but it can be surprisingly hard to adopt (at first).

The basic idea is this: everything we DO is dependent on the quality of the thinking we do about it first. And the quality of our thinking depends on the attention we give each other.

Think about this for a second: when did you ever DO something without first THINKING about doing it? Apart from breathing and other involuntary reactions, I’d hazard a guess that the answer is, “not very often”, am I right?

Can you think of a time when you did DO something that you didn’t really think deeply about first and soon regretted DOING what you did? If I had a dollar for every time I’d done something without thinking properly first, I’d be rolling in it by now. I am very much a “jump first, think later”-type person. I wouldn’t recommend it!

Now, I want you to think of a time when you had to make a difficult decision and you talked about it with a close friend or a colleague. Really picture it in your head right now. Got it? Great.

How did that conversation go? How well did they listen to you? Did they listen to you without interrupting? (guilty!) Without finishing your sentences for you? (guilty!) Without letting their gaze drift away over your shoulder? (guilty!) Without checking their watch? (guilty – albeit surreptitiously!)

Perhaps you’ve had experiences of people who DO listen well to you. I have a wonderful friend who is probably the best listener I have ever met (you know who you are!). I never feel rushed. I never feel stupid. I never feel small. I never feel insignificant. Not when I’m talking to her. She is a MASTER at creating a good Thinking Environment.

But what makes a good Thinking Environment? There are ten conditions outlined in Kline’s book under which we humans can optimally think for ourselves – “with rigour, imagination, courage and grace” (p12).

The ten components of a Thinking Environment:

  1. Attention
  2. Incisive questions
  3. Equality
  4. Appreciation
  5. Ease
  6. Encouragement
  7. Feelings
  8. Information
  9. Place
  10. Diversity

I couldn’t possibly do them each justice in one single blog post, and frankly I couldn’t put it any better than Kline has so I’m just going to go ahead and recommend you read her book*!

But I do want to pull out a few key points that I think are relevant for working with those affected by cancer.

Attention

I cannot stress enough the importance of this first characteristic of the Thinking Environment. It seems obvious, yes, but by giving someone your undivided attention – listening with respect, showing genuine interest and even fascination with what they’re saying – you are creating a safe space for them to open up and pour out their thoughts about what they are feeling at that time.

Incisive questions

So many of us hold ourselves back because of limiting beliefs and assumptions about what is and what can (or can’t) be. It’s no different with disease – we all have our own beliefs about diseases like cancer, and they’re so closely intermingled with our worldly beliefs, it’s sometimes hard to separate them. For instance, a disproportionate number of patients believe they somehow did something to cause their cancer, or that it was somehow their fault, or that they can now do something to make it go away (kind of like the proverbial bargaining with God: “if you take this away, I promise I’ll be really good from now on!”). By asking incisive questions, you can help your patients understand that they likely didn’t do anything to cause their cancer, and that yes, they can do lots of things to reduce their risk of getting a secondary cancer, but it’s not quite as cut and dried as that. Incisive questions are ones that start something along the lines of…”If you knew…” or “If you were to…” and they encourage the ‘thinker’ to open their minds to the possibilities of what might be. So, for example, you might ask your patient, “If you knew that you couldn’t have done anything differently to avoid getting cancer, how would you approach living your life now?”

Ease

In our overstretched, overworked, overloaded society, we rush through jobs and appointments and meetings and tasks at a rate of knots, with a deep sense of urgency to get. Things. DONE! But rush and urgency doesn’t lend itself well to quality thinking. And if we want patients to think clearly and think for themselves, we need to give them time and space to air their thoughts; unhurried, unrushed, with ease. As Kline says, “Ease is the space a Thinking Environment needs to stay intact…Urgency keeps people from thinking clearly.” (pp67 & 69). When we give someone time and space to think, to really, clearly think for themselves, they will be much more likely to be able to see a solution, an answer, a way to address their current situation. When their minds are freed from the tangled mess of (usually imagined) worst-case scenarios, they are free to think their way through a given problem. Now, whilst someone living with cancer won’t necessarily be able to come up with a cure to their disease, or magically feel happier, they can think of a way forward, a way to live the best life they can while they can.

Feelings

The tumble of emotions and feelings that come with a cancer diagnosis is unfathomable to most, unless you’ve been there or seen it close at hand. And even though the seriousness of the disease is plain to see, a patient may find themselves shunning fear and worry and tears and upset – “pull yourself together”, they may think to themselves. “Get a grip!”

But what might not be so obvious is that giving them a safe space to express their feelings actually helps them to think more clearly. When we are upset, we don’t think clearly. But if we are allowed to express those emotions just enough, our thinking is allowed to start again.

By giving your patients sufficient time and space to release their emotions, you can help them rebuild and restore thinking, and they’ll be much more inclined to take action on the things you advise them. 

Information

Another key component of the Thinking Environment is giving the thinker the information they need – but only when the time is right. Resist the urge to dump the facts in the middle of their sentence when you spot a misunderstanding. Let them speak, hear them out, and then furnish them with the facts when they’ve finished speaking. 

One of the early stages of the grieving process that many cancer patients face is denial. “Surely this can’t be real?” or “This can’t be happening to me, can it?” are common thoughts that surface. But denial is the antithesis of reality. Thinking works best in the presence of reality, and that involves having accurate information about what is real, even if that is painful or distressing. The human mind is incredibly resilient and has the capacity to handle anything, but it can’t do it if it’s presented with lies. Help your patients by presenting them with a full and accurate picture of their reality, in a gentle way that doesn’t conjure up fear.

Place

The final point I want to cover that I think is essential to cultivating a generous Thinking Environment in which to bring forth your patients’ healing is that of place. Interestingly, this is less about the décor and the furnishings as it is about the “feel” of the space. What is crucial in creating a safe place for patients to open up to the possibility of healing is creating a physical environment that says back to them, “You matter.” What would have to change about your work space or clinic or wherever you meet patients for it to say back to them, “You matter”? (p86) 

Time to think

By developing this art of listening – of really, truly hearing what your patients are going through – you are giving them the best gift you can: time to think. From that gift, clarity and action will spring forth. Listening can ignite the mind, so I say, let’s get out the matches.

If you’d like to learn more, download the free guide, The Incredibly Simple 3-Step System to Living Well With Cancer, where I break down three things that you can use to help your patients to be as healthy as possible whilst being sick. You can download your copy of the guide here.

*Full disclosure: I receive a small affiliate commission for sales received through my affiliate link here.

Parting thoughts

As you know, for the month of November I’ve been taking part in Cancer Research UK’s #VegPledge challenge and going vegetarian for a month. With one last week to go, I’ve decided to try going vegan. Any and all advice gratefully received – I’m not gonna lie – I’m a little scared of this bit of the challenge!

If anyone else is doing it I’d love to hear how you’re getting on! Tag me in your posts on social media (@essentialcancereducation on Facebook and Instagram, @mhairimorris on Twitter, and Mhairi (“Vari”) Morris on LinkedIn) and use the hashtag: #VegPledge.

One more thing!

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