III. Compassionate Communication Skills

Communication skills will help you help a patient or peer who may be experiencing a challenge, stress,  painful emotion, or conflict.

Compassionate Listening

Compassionate listening involves listening deeply to someone with the purpose of helping the person unload their suffering or empty their heart (Bird et al., 2020). It involves paying full attention to the other person while listening. Just the act of listening often relieves the storyteller of their suffering. 

The following steps have been identified for compassionate listening (Bird et al., 2020). They can be used by physicians to help relieve the suffering of patients and by medical students to help relieve the suffering of patients and peers. 

Steps for Compassionate Listening:

1. Take a deep breath and remind yourself that this is an opportunity to be completely present with the person before you.
2. As you listen, your mind may wander to what you want say to soothe them or solve their problem. If this happens, gently bring your attention back to the person’s voice, facial expression, or how they are sitting .
3. Try to look into the person’s eyes as they are speaking and acknowledge you are hearing their story by nodding, leaning in, and using appropriate facial expressions, eg., smile when they are saying something meant to be funny.
4. Repeat parts of their story to yourself to fully appreciate the details of the story.
5. Once the person ends their story, thank them for sharing. Let them know you are sorry they are dealing with something so challenging.
6. Let them know you are here for them if they need someone to listen.

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Active Listening

Active listening is similar to compassionate listening but more focused on the mechanics of how to listen well. 

• Give your peer your full attention.
• Use body language that shows you are actively listening (Patel, 2019):
  • Face the other person directly at the same eye level or sit beside them if they seem overwhelmed.
  • Use non-verbal communication of caring, including eye contact.
  • Maintain an open posture with your arms and legs uncrossed and avoid leaning backward.
  • Maintain an appropriate distance, sitting at the same level without a desk between you.
  • Use short verbal and non-verbal responses to show you are listening and responding: Nod your head or use responsive facial expressions or sounds.
    • Example: Softly blow out some air when the other person says something very emotional.
• Listen for the meaning and emotions behind the other person’s words. Look for non-verbal cues of distress or changes in the tone, pitch, and pacing of their speech. Check with the other person for the accuracy of any conclusions you draw, however.
• Provide verbal statements of acknowledgment (“That does sound challenging!”), validation (“I think anyone would feel that way”), and support (“That’s what I’m here for. Go right ahead.”)

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Reflective Listening

Reflective listening is a specific way of responding to what the other person says that helps them feel heard. It, too, is a skill that will support compassionate listening. 

• Reflective listening is when you convey your understanding of what the other person said by briefly paraphrasing it in your own words. It is important to:
  • Emphasize their thoughts and feelings.
  • Focus on what seems most important to them.
  • Check with the other person for the accuracy of your understanding.
• The following opening words might help you get started. Be careful not to use them too often in the same way, or you’ll trigger a feeling of being in therapy, rather than of support:

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Eliciting Information Openly

Using Open-Ended Questions Skillfully

When trying to draw out a patient or peer who has a concern, using open-ended questions can be more effective at getting them to open-up about what is bothering them.