High Stakes Dialogue High Stakes Dialogue Learning the Art Learning the Art

of of Crucial ConversationsCrucial Conversations

Rebekah HackbuschRebekah Hackbusch

Doug LongstaffeDoug Longstaffe

Martin RoversMartin Rovers

Welcome and IntroductionsWelcome and Introductions

What are we doing here?What are we doing here?

Interprofessional Interprofessional Practice TeamsPractice Teams

Crucial Crucial Conversations in Conversations in Health CareHealth Care

Getting StuckGetting Stuck

Cognitive Cognitive DistortionsDistortions

See the Whole See the Whole PicturePicture

VideoVideo

Getting StuckGetting StuckBiasBias

AwarenessAwareness

What we sayWhat we say

What we hearWhat we hear

What we seeWhat we see

Case studyCase study

Training in Self-AwarenessTraining in Self-Awareness

The art of the The art of the Ministry of Ministry of PresencePresence

Martin Buber: founder of Martin Buber: founder of Inter-professional practice?Inter-professional practice?

““I do not accept any absolute formulas for I do not accept any absolute formulas for living. No preconceived code can see living. No preconceived code can see ahead to everything that can happen in a ahead to everything that can happen in a man’s life. As we live, we grow and our man’s life. As we live, we grow and our beliefs change. They must change. So I beliefs change. They must change. So I think we should live with this constant think we should live with this constant discovery. We should be open to this discovery. We should be open to this adventure in heightened awareness of adventure in heightened awareness of living. We should stake our whole living. We should stake our whole existence on our willingness to explore existence on our willingness to explore and experience.” and experience.”

BuberBuber

I-Thou.I-Thou.

Meeting of SoulsMeeting of SoulsNot found by Not found by seeking but by seeking but by GRACE.GRACE.

We are CALLED to We are CALLED to genuine dialogue genuine dialogue rather than actively rather than actively searching for it… searching for it…

Between stimulus and response Between stimulus and response there is a space. In that space is our there is a space. In that space is our power to choose our response. In our power to choose our response. In our response lies our growth and our response lies our growth and our freedom.freedom.Viktor E. Viktor E. FranklFrankl

Attentive silenceAttentive silence

True Dialogue True Dialogue is an address of the heart.is an address of the heart.

Forms of DialogueForms of Dialogue

What form do you What form do you invite?invite?

Technical dialogueTechnical dialogue

MonologueMonologue

A distorted A distorted

form of dialogue; form of dialogue;

words are said words are said

with little or with little or

no connection. no connection.

True Dialogue True Dialogue requires presencerequires presence

What does Presence require?What does Presence require?

Bringing all that you are Bringing all that you are

to all that is.to all that is.

PresencePresence

PresencePresence

““Sawu Bona”Sawu Bona”

Clinical teamsClinical teams

““For the meaning of life differs from For the meaning of life differs from humanhuman to to humanhuman, from day to day , from day to day and from hour to hour. What and from hour to hour. What matters, therefore, is not the matters, therefore, is not the meaning of life in general but rather meaning of life in general but rather the specific meaning of a person’s the specific meaning of a person’s life at a given moment.”life at a given moment.”

Victor FranklVictor Frankl

Spiritual Care: the heart of team Spiritual Care: the heart of team dialoguedialogue

PatternsPatterns

Being StuckBeing Stuck DictatingDictating

Talking Talking PolitelyPolitely

Reflective Reflective ListeningListening

Reflective ListeningReflective Listening

Inter-professional PracticeInter-professional Practice

Generative DialogueGenerative Dialogue

Reaching a deeper region of Reaching a deeper region of consciousnessconsciousness

Presence: Human purpose and the Presence: Human purpose and the field of the future.field of the future.

We’ve come to believe that the core capacity needed for We’ve come to believe that the core capacity needed for accessing the field to the future is presence. We first accessing the field to the future is presence. We first thought of presence as being fully conscious and aware in thought of presence as being fully conscious and aware in the present moment. Then we began to appreciate the present moment. Then we began to appreciate presence as deep listening of being open beyond one’s presence as deep listening of being open beyond one’s preconceptions and historical ways of making sense. We preconceptions and historical ways of making sense. We came to see the importance of letting go of old identities came to see the importance of letting go of old identities and the need to control… Ultimately, we came to see all and the need to control… Ultimately, we came to see all aspects of presence as leading to a state of “letting come,” aspects of presence as leading to a state of “letting come,” of consciously participating in a larger field of change. of consciously participating in a larger field of change. When this happens, the field shifts, and the forces shaping When this happens, the field shifts, and the forces shaping a situation can shift from re-creating the past to a situation can shift from re-creating the past to manifesting or realizing an emerging future. p.125manifesting or realizing an emerging future. p.125

Peter Senge, Otto Scharmer, Joseph Jaworski, Betty Sue Peter Senge, Otto Scharmer, Joseph Jaworski, Betty Sue Flowers. Flowers.

APPLYING OLD SKILLS IN NEW APPLYING OLD SKILLS IN NEW WAYSWAYS

Stage 1 Stage 1 Internal Stories Internal Stories

Told with lightning speedTold with lightning speed

Interpretation based on assumptionInterpretation based on assumption

Spoken with emotion or told only to Spoken with emotion or told only to one’s self with silent disdainone’s self with silent disdain

Stage 2 Stage 2 The Pool of Shared MeaningThe Pool of Shared Meaning

Pool DumpersPool Dumpers

attacking, labeling, controllingattacking, labeling, controlling

Pool “Shunners”Pool “Shunners”

avoiding, masking, withdrawingavoiding, masking, withdrawing

STAGE 3STAGE 3Creating SafetyCreating Safety

Establish Mutual Purpose throughEstablish Mutual Purpose through

Starting with heartStarting with heart

Saying what you wantSaying what you want

Saying what you don’t wantSaying what you don’t want

Stage 3 -Safety - continuedStage 3 -Safety - continuedAsk for the others story (again)Ask for the others story (again)

Acknowledge their feelings and conclusionAcknowledge their feelings and conclusion

Ask to review their observations ie their Ask to review their observations ie their FACTSFACTS

Look for agreement or commonalityLook for agreement or commonality

Stage 4 – Share Your StoryStage 4 – Share Your Story

Tell your facts having reviewed them Tell your facts having reviewed them for accuracyfor accuracy

Tell your story of interpretation with Tell your story of interpretation with “feelings” not unrestrained emotion“feelings” not unrestrained emotion

Talk tentatively but not wimpyTalk tentatively but not wimpy

(Goldilocks method)(Goldilocks method)

Seek Common GroundSeek Common Ground

AgreeingAgreeing

RepairingRepairing

BuildingBuilding

Role PlayRole Play

5 people5 people

patient care team managerpatient care team manager

registered nurseregistered nurse

speech language pathologistspeech language pathologist

PhysicianPhysician

spiritual care workerspiritual care worker

QUESTIONS ???????QUESTIONS ???????

Blessings on your crucial Blessings on your crucial conversations!!!!!!!conversations!!!!!!!

ReferencesReferencesCrucial Conversations - Kerry Patterson et Crucial Conversations - Kerry Patterson et al - McGraw-Hill copyright 2002 al - McGraw-Hill copyright 2002 Crucial Confrontations- Kerry Patterson et Crucial Confrontations- Kerry Patterson et al - McGraw-Hill copyright 2005al - McGraw-Hill copyright 2005Solving Tough Problems: An open way of Solving Tough Problems: An open way of talking, listening, and creating new talking, listening, and creating new realities. – Adam Kahane – Berrett-Koehler realities. – Adam Kahane – Berrett-Koehler Publishers, Inc. 2004Publishers, Inc. 2004Martin Buber on education Martin Buber on education http://www.infed.org/thinkers/er-http://www.infed.org/thinkers/er-buber.htmbuber.htm