Motivation and emotion/Book/2022/Difficult conversations and emotion

Overview
Relationships are necessary for survival; as humans, we experience emotions associated with our relationships that serve various adaptive functions to enhance and maintain our well-being. Sometimes these relationships require maintenance and encounter hurdles that need difficult conversations to overcome. How we navigate these unavoidable and necessary conversations will influence all types of relationships in our professional and personal lives.

Focus questions:
 * What are difficult conversations and why do we need them?
 * How can communication skills be improved?
 * What do psychological theories of emotion have to say?
 * What can I do if it starts to go wrong?

Difficult conversations
Building relationships in various contexts guarantees that clashes will occur between individuals that need to be addressed if the relationship is to continue in a positive direction. Positive outcomes of conversations bind people by promoting empathy and intimacy and bolstering feelings of self-worth regardless if the conversation may be difficult or not (Miller et al., 2004). Although it is impossible to completely eliminate negative aspects of difficult conversations, verbal and non-verbal communication strategies can help smooth the path and increase the likelihood of experiencing positive outcomes.

What characterises a difficult conversation?


A difficult conversation can be described as a high-tension event where the subject matter is sensitive, emotions run high, opinions vary, and the consequences are impactful (Overton & Lowry, 2013; Patterson et al., 2012). Hample and colleagues (2017) add that difficult conversations can and will occur in all relational contexts and are usually unscripted and subjective in their consequentiality, depending on different perspectives. Compared to positive outcomes, Patterson and colleagues (2012) found that potential adverse outcomes have more power to change the quality of life, where daily routines can be significantly altered. Positive outcomes include the quality of decision-making, improved understanding between individuals and groups, emotional validation and connectedness (Patterson et al., 2012).

Research conducted by Dibble and Levine (2010) on the Minimising Unpleasant Message effect (MUM effect) found that people are more hesitant and reluctant to share or discuss bad news, especially if there is not enough good news to counterbalance it. Although the risk of creating a tense situation makes hesitancy understandable when facing difficult conversations, a culture of avoidance also creates negative consequences that harm relationships and organisations over time (Pavlish et al., 2015). This means that avoidance occurs because a conversation might be difficult and complex, which is only compounded if avoidance continues. Take an example of a difficult conversation in which a manager is required to discuss performance issues but fears causing negative feelings for the employee. If, however, performance continues to decline, the organisation will suffer, and resentment can fester. The manager may attempt to “soften the blow” by acknowledging instances of good performance and encouraging professional development to counter any criticisms.

Examples of difficult conversations: "breaking bad news"
 * A manager discussing issues of performance with an employee.
 * A doctor telling a patient of a terminal diagnosis.
 * Romantic partners confront feeling unhappy in their relationship.
 * Members of a group project confront one another about workload imbalances.

Verbal cues
Given their unavoidable nature, research on communication strategies is valuable for insights into navigating difficult conversations. The caring feedback model developed by Leebov (2010) focuses on six script-based steps outlined below to find a balance between providing clear feedback and maintaining boundaries while being supportive and empathetic.


 * 1) State your purpose in positive terms, such as, “I know you care; I want to be helpful..."
 * 2) State the situation and specific behaviour in clear, simple terms.
 * 3) State the consequences for you, your team, your patients and your organisation.
 * 4) Use a touch of empathy, such as “I know you work hard and had a lot of patients that day ...”
 * 5) Make it a dialogue. Let the employee respond, ask them questions and listen.
 * 6) State your request or expectation in clear terms.

(Leebov, 2010, as cited in Polito, 2013, p. 147).

This model paves the way to high-quality or active listening (see Figure 1) and open-minded conversations where autonomy is supported, and speakers are encouraged to engage in self-awareness non-defensively (Weinstein et al., 2021). The above model was developed for the context of workplace performance and attitude; however, the importance of conveying positive intention and genuine care for self-development are emphasised, which can be applied in many situations.

Non-verbal cues


Non-verbal communication is also crucial for difficult conversations. Humans are designed to read physical cues such as facial expressions, gestures, eye contact, posture and proximity to gauge emotions and intentions to inform a response (Weinstein et al., 2021). Seminal research by Paul Ekman studying facial kinesics (see Figure 2) has dramatically assisted in measuring these non-verbal cues, which can be applied strategically in conversations. Despite knowing that genuine facial expressions are mostly involuntary (Bonaccio et al., 2016), gestures such as nodding, smiling and even gentle touch can be controlled to emotionally tune in and convey positive intention. Conversely, gestures such as eye rolling, lip pursing and turning away can signal contempt, frustration and defensiveness (Bonaccio et al., 2016). Core emotions expressed on the face were found by Ekman (1972) to be universally recognisable; however, it must be stressed that gestures vary across cultures and from workplace to intimate relationship contexts where the appropriateness of touch and eye contact, in particular, must be gauged (Sorokowska et al., 2021; Uono & Hietanen, 2015).

 Aiden has been feeling frustrated recently because his partner Amy is not contributing equally to chores around the house. He confronts Amy with this and uses empathy to convey that he understands she has recently been under pressure with university work. During this conversation, Amy begins to feel defensive but later does apologise. Aiden notes that Amy rolled her eyes while apologising, which signals to him that the apology was not genuine.

Select the correct answer. {What is the MUM effect? + Minimising unpleasant emotions. - Positive emotions from seeing your mother. - Negative emotions from seeing your mother.
 * type=""}

{What are some key characteristics of difficult conversations? - Subjective and unscripted. - Sensitive subjects, strong emotions, varied opinions and impactful consequences. + Both answers above are correct.
 * type=""}

{True or false: genuine facial expressions are involuntary. - False. + True. - True, but people can't usually read them. - Usually false depending on the type of expression.
 * type=""}

{Core emotions expressed on the face are NOT universally recognisable. + False. - True.
 * type=""}

The role of emotions
Difficult conversations are identified as such primarily because they are emotional. Nevertheless, intervention research appears to be primarily oriented toward boosting communication skills with scriptural suggestions rather than relieving negative emotions (Hample et al., 2017). While frameworks, steps and scripts can help to ease anxiety towards broaching certain subjects (Hample et al., 2017), it is not uncommon that scripts cannot keep up with the unpredictable nature of emotions (Cheng et al., 2017). So what can biological and cognitive theory and research about our emotions tell us about what happens when we have difficult conversations and how can we get things back on track?

Biological perspectives
In the timeline of prominent emotional research (See Figure 3), two primary schools of thought emerged: the biological and cognitive perspectives. Darwin proposed in 1872 that emotions exist and adapt primarily for survival and that humans evolved to be able to read and communicate other humans' emotions to avoid danger and reproduce (Hess & Thibault, 2009). Not long after, the James-Lange theory (1884) emerged, which supports that the physical experience of emotions generates a cognitive interpretation of bodily sensations. According to these theories, emotions cannot occur without there being a physical stimulus first. The Cannon-Bard theory takes a less causal approach. It posits that the physical and psychological experiences of emotion happen at the same time as the thalamus sends sensory signals to and receives input from cortical regions (Dror, 2013).



Applying the physiological theories of emotion to difficult conversations, feelings of fear, anger and sadness serve to prevent relationship breakdown, social isolation and rejection (Oliver et al., 2017). The cognitive processing and identification of emotions then occur after or simultaneously with physiological signals such as trembling, crying, muscle tension and increased heart rate. A difficult conversation might not carry the same type of threat as coming across a grizzly bear in the woods, however social fears have been known to cause the same physical sensations in varying degrees of intensity (Brody, 2017).

Cognitive perspectives
The cognitive perspectives of emotion seek to understand nuances of emotional experience that biological perspectives cannot explain. For example, trembling and increased heart rate can occur in anger, fear and excitement. This means that cognition has to be involved in differentiating our experiences across time and based on situational evaluations. To address this, the Schachter-Singer two-factor theory (1962) deduces that physiological arousal informs the intensity of various emotions and cognitions attempt to find a label for them. For example, emotions such as gratitude, pride and shame can be considered social emotions, which are identified through subjective cognitive processes or cognitive appraisals involving analysis of situational cues (Sznycer et al., 2021). Lazarus further broke down cognitive appraisals into primary and secondary appraisals where a situation is analysed for risk factors first and then abilities to cope with the situation and emotions are analysed second (Folkman et al., 1986). In the context of a difficult conversation, confrontations are usually stressful events plagued with risks to self-esteem and devaluations by others (Sznycer et al., 2021). Appraisal theories recognise that all appraisals are subject to individual differences; therefore, attacks on an individual's values, goals, needs and beliefs are likely antecedents to difficult conversations (Moors et al., 2013).

Emotional regulation strategies
Although learning verbal and non-verbal communication strategies that follow a step-based framework can undoubtedly provide valuable insights, the above theories of emotion support the use of emotional regulation strategies, which can aid in adapting to emotions' unpredictable and complex nature. For example, Luff and colleagues (2016) report using self-care techniques and support from trusted people to manage emotions before, during and after difficult conversations. Self-monitoring or mindfulness techniques may also be a valuable skill for helping people to navigate high-stakes conversations, according to Cheng and colleagues (2017). Self-monitoring involves curiosity about our thoughts, feelings and behavioural patterns with a willingness to use these insights to improve communication and problem-solving skills in future, which can include consciously identifying fears about possible consequences of a difficult conversation (Cheng et al., 2017; Overton and Lowry, 2013). Overton and Lowry (2013) also suggest that looking at as many different perspectives as possible is an effective reappraisal technique to reduce any tension that attempts to reframe a situation in a more positive light.



Charlie is a health practitioner in training about to discuss a terminal diagnosis with a patient. Charlie begins to feel a tightness in his chest and his palms are beginning to sweat which are tell-tale signs that he is nervous. He is now imagining many devastating outcomes of the conversation which inevitably makes him more nervous and he wishes he could just send an email and take the day off. Instead, he approaches his supervisor for support and she offers an empathetic response along with some breathing exercises. She also offers to debrief after the conversation with the patient and suggests a reflective practice to address improvements in communication strategies.

Select the correct answer. {Physiological and psychological experiences of emotion happen simultaneously according to the ______ theory of emotion. - Darwinian + Cannon-Bard - James-Lange
 * type=""}

{Lazarus broke down cognitive appraisals into two categories: ____ and ____. - first and second. + primary and secondary. - physiological and psychological.
 * type=""}

{Increased heart rate and blood pressure are biological indicators of anger only. + False. - True.
 * type=""}

Conclusion
In summary, difficult conversations occur when there are sensitive subjects to discuss with the potential for emotions to run high and differences in opinions to emerge. Both positive and negative consequences are impactful though negative consequences tend to have more power to change quality of daily life. Despite being unpleasant, research shows it is best not to prolong difficult conversations even if there are not enough positive messages to counter the negative. What matters is that there is hope to improve how difficult conversations are navigated by understanding verbal and non-verbal communication strategies which can provide useful scripts and help to ease anxiety in anticipation of a conversation. For optimal progress in communication strategies, biological and cognitive theories of emotion provide an understanding of how emotions serve an important and adaptive function which can be controlled with emotional regulation strategies. Key strategies to practice involve mindfulness, support seeking and self-awareness in confronting fears of a negative outcome. Ultimately there are many more techniques to emotionally regulate and of course they are all easier said than done however practice and exposure to having difficult conversations over time will provide more opportunities for improvement.