Difficult conversations can happen in all aspects of daily life and can certainly take place during the working life of a farm animal veterinary surgeon. Examples might include having to give bad news to a farmer about their tuberculosis (TB) test result, being told that the treatment you advised did not work and the animal is still unwell or maybe even dead, or discussing herd health plans and trying to agree a new management practice on farm, such as lameness scoring. Conversations involve both verbal and nonverbal communication. Nonverbal behaviours tend to occur subconsciously, reflecting an emotional response, and it is often when we are feeling emotional that conversations become difficult. Becoming skilled in both aspects of communication will increase the chances that difficult conversations can have positive outcomes.
Background to writing the article
All hands were raised at the 2021 British Cattle Veterinary Association Congress (BCVA) workshop when participants were asked, ‘who has experienced a difficult conversation?’. The workshop aimed to delve into those experiences and discover just what made those conversations ‘difficult’. A consistent feature reported by those recounting instances of having difficult conversations was that they experienced strong feelings, such as anger, fear, anxiety or even despair. It was also noted that the other person in the conversation — farmer/client/boss — appeared to be similarly affected by emotions, with changes being noted in their facial expression and body posture.
Galvanised by the strong interest shown in this topic at the BCVA Congress workshop and new research exploring nonverbal communication between farmers and veterinary surgeons (MacGillivray et al, 2022), the following article aims to provide some insight into difficult conversations and how an understanding of nonverbal communication can help improve experiences of these situations and achieve better outcomes.
What is a difficult conversation?
Difficult = not easy; hard to do; not easy to deal with (The Chambers Dictionary 13th edition).
A difficult conversation feels hard to have and/or it can feel that the person to whom you are speaking may not be easy to deal with. It is possible that only one person finds the conversation ‘difficult’, but in many cases both people will find the interaction to be challenging. The reasons behind difficult conversations are linked to each person's perception of how the topic impacts or influences them.
What makes them difficult?
‘There is nothing either good or bad but thinking makes it so’ (Hamlet (Act 2, Scene 2), Shakespeare).
By thinking about a situation, person or event, we might attach emotion/s to it/them, and it is the emotional attachment that causes us to experience feelings such as frustration, anger, sadness or helplessness during conversations on the subject. A conversation can feel difficult whenever the topic or subject matter concerns something that is important to us and the person to whom we are speaking disagrees with our opinion or belief. It can also feel difficult if it seems that the person speaking to us is challenging something that we have done or said, which appears irrational or unfounded based on our own recollection of the situation in discussion. Box 1 presents examples of situations that might occur in practice, with corresponding responses of the farmer and veterinary surgeon. Each person would then approach the conversation with their own viewpoint of that situation.
Box 1.Examples of situations that could lead to difficult conversationsSituation 1The veterinary surgeon advises a treatment regimen for individual animal based on their clinical knowledge. There is a poor clinical outcome.
- Veterinary response = there was a lack of commitment by the farmer.
- Farmer response = there were unrealistic expectations from the veterinary surgeon: I can't stick to the regimen because we're short-staffed/don't have enough time/have other priorities (possibly personal) that the vet doesn't know about.
Situation 2The farmer contacts practice to order antimicrobials for a pneumonia outbreak with an expectation that this is a reasonable thing to do.
- Practice response = advises that the animals need to be examined by the veterinary surgeon.
- Farmer perception = practice unwilling to help, they want to generate income from a visit, there's a lack of flexibility in their system.
Great expectations
When considering examples of difficult conversations and the impact they can have, it is useful to refer to research findings within human healthcare and relate this to veterinary practice, as there are many similarities between the two fields. When asked about their experience with difficult conversations, healthcare clinicians reported feeling emotional distress prior to giving difficult news, described as a sense of failure and frustration where poor clinical outcomes occurred and a desire to avoid interacting with patients to escape having negative feelings (Luff et al, 2016). Fear of being blamed or of not knowing all the answers, such as when dealing with difficult-to-diagnose and/or treat conditions (McDermott et al, 2015), have also been cited as examples of difficult conversations with clients.
Two fundamental categories responsible for causing conflict between veterinary surgeons and farmers were recognised by Mays (2012): misalignment of expectations and/or a lack of flexibility between both parties to resolve an issue. When considering how difficult conversations between farmer and veterinary surgeon might arise, a central factor is animal welfare and how each person thinks and feels this should be achieved. Each will have their individual perceptual filter that defines expectations and beliefs about how the veterinary-farmer relationship should work.
When emotions take over — why this happens
Difficult conversations tend to elicit strong emotions in the person who is finding the conversation difficult. The way we think about a situation or topic of conversation is what triggers our emotional responses. Emotions elicit internal changes that prepare us to respond to events or conditions, both physically and mentally. Our emotions galvanise us to engage in behaviours to adapt to the event that triggered the emotion (Ekman et al, 1983; Matsumoto et al, 2013). Physiological responses can include increased heart rate, diversion of blood supply from the gastrointestinal tract to the upper or lower body and reduced saliva production. We subjectively experience emotions as feelings and emotions initiate behaviours that contribute to nonverbal communication. The triggers for different emotions and feelings associated with difficult conversations stem from either having different expectations of a situation or outcome, or an inflexibility in the response to addressing the difficult issue.
Emotions are generated from activity in the limbic system (Torre and Lieberman, 2018). They provide a rapid information processing system, to allow the body to adapt in response to internal and external elements perceived as a threat to welfare (Levenson, 1999; Matsumoto and Hwang, 2011). Table 1 explains how anger and fear can be triggered based on our perceptions of a situation, the resulting internal responses and their intended outcomes. It is from this system that we experience the well-known responses to perceived attack: freeze, flight and fight. The limbic system becomes stimulated whenever we perceive an ‘attack’ to something we care about, which could also apply to situations where it feels as though our professional knowledge and capability are being questioned. Emotional responses to cues or triggers often occur rapidly and without having been consciously summoned.
Table 1. Emotional triggers with associated responses and intended outcomes
| Emotion | Trigger | Response | Outcome |
|---|---|---|---|
| Anger | Perceived disregard for one's values or beliefs, ‘that's not fair’ | Prepares the body to fight | To remove the perceived obstacle or threat |
| Fear | Threat to physical/psychological wellbeing or status quo | Prepares the body to freeze or take flight | To avoid the perceived threat and thus reduce harm |
adapted from Matsumoto et al (2013)
Situations that might pre-empt a difficult conversation
Impacts YOU/YOUR WORLD, e.g. job dissatisfaction
How this might look: you feel there is a lack of progression within the practice/issues with other members of staff/unable to develop your area/s of interest within the practice
Exploring this further: you might feel that the opportunities within the practice are limited for your personal or professional development, potentially causing resentment towards those in charge, possibly making you feel helpless to do anything to change the situation, especially if the possibility of moving to another practice is not an option because of personal circumstances.
Impacts OTHERS/THEIR WORLD, e.g. change/s on farm required
How this might look: the farmer has been advised to change or implement management practice/s to manage or control disease/one or more animals must be culled after testing positive for TB or bovine viral diarrhoea.
Exploring this further: spending more time on management practices (e.g. sorting animals into groups, more frequent bedding changes, lameness scoring) might mean less time is available to be with the family or to spend on fixing or improving farm buildings etc. This could evoke feelings of frustration, guilt and anxiety.
What can this look like?
Nonverbal behaviours are the physical manifestation of emotions that we see as facial expressions and body movements.
The face is often the first part of the body to show signs of a person's emotional state (Argyle, 1988), followed by body movements and altered vocal expression, such as pace and pitch. Research conducted in the 1960s and 70s, to explore Darwin's original suggestion that facial expressions of emotion are universal, provided strong evidence that there are seven basic emotions universally recognised through facial expressions (Matsumoto and Hwang, 2011). These biologically innate emotions are happiness, sadness, anger, fear, surprise, disgust and contempt. Nonverbal behaviours are innate responses and form an important part of interpersonal and social interactions (Matsumoto et al, 2008).
Although we no longer face the same life or death situations our ancestors did, who benefitted from the limbic system's rapid processing and subsequent response of freeze, flight or fight, we retain the infrastructure that creates emotions and their associated biological changes. This can cause problems for communication when the topic is perceived as ‘difficult’. Emotions such as anger, frustration and fear tend to drive apart the position that each person in the conversation holds. Being in an emotional state also reduces our chance to effectively listen to what is being said or assimilate what elements of nonverbal communication are being displayed.
When speaking to someone who is feeling strong emotions, the following might be detected:
- Emotion: ANGER — preparing to fight
- Physiological changes — increased heart rate, blood diverted to face and arms
- Visible effects — flushed face, tense posture, narrowed eyes, lips pressed together
- Emotion: FRUSTRATION/UPSET — freeze response
- Physiological changes — increased heart rate and breathing
- Visible effects — avoids eye contact, closed body posture (arms and/or legs crossed), stands or sits further away from you
- Emotion: FEAR – preparing for flight
- Physiological changes — increased heart rate, blood diverted to lower limbs ready for movement
- Visible effects — pale or drained face, rigid body posture, wide eyes.
Why it matters to improve our response to difficult conversations
With an understanding of why difficult conversations can arise and how those involved may respond, the opportunity is presented to gain a better understanding of clients, colleagues and ourselves. It is possible to develop and master communication skills that improve outcomes and the experience of having such conversations (Bateman, 2007; Meyer et al, 2009; Polito, 2013).
Understanding how the mind works and strategies to help manage it
Several popular analogies have been created to help simplify the complex way that the brain functions and describe and explain why and how emotions affect us. These include the concept of ‘elephant’ (our emotional side) and ‘rider’ (our rational side), developed by the psychologist Jonathan Haidt (2006). This suggests that the elephant is being controlled by the rider, yet in circumstances where there is disagreement between them, it is often the elephant that controls the situation.
Another model, conceived by consultant psychiatrist Professor Steve Peters while teaching neuroscience to medical undergraduates, is described in the book ‘The Chimp Paradox’ (2012). The ‘Chimp Model’ attempts to explain how the mind works and proposes that we have ‘human’, ‘chimp’ and ‘computer’ systems within the brain. It offers a simplified explanation of how and why the mind works in certain situations, such as when we have difficult conversations, with the objective of providing a way of managing thoughts. Our minds can think logically and rationally (the ‘human’), but also emotionally (the ‘chimp’). Logic and reasoning take place in the prefrontal cortex of the brain, termed the ‘human’ part of the brain in this model. The ‘chimp’ is the term used for the limbic system. It is important to recognise that, once emotions are triggered, our ability to think logically and objectively is significantly reduced. This is because the limbic system diverts blood flow away from the prefrontal cortex, which is where we make logical decisions and take a constructive approach to resolve a difficult situation. Professor Peters uses the analogy that, just as a chimpanzee has five times the strength of a human, the ‘chimp’ part of our brain acts more quickly and is more powerful than the ‘human’ part. It is therefore more effective to manage the emotional part rather than trying to control it.
Watch what you're saying
‘…people will forget what you said and what you did but will never forget how you made them feel.’ Maya Angelou
Remembering that our nonverbal behaviours stem from the emotions we are experiencing (Figure 1), is there a way to modify or overcome the potentially negative or unwanted messages we might be transmitting during difficult conversations? Strategies to manage emotions may increase confidence and capabilities when having to engage in difficult conversations (Luff et al, 2016).
Studies have demonstrated that emotion regulation, defined as a manipulation of the quality, duration or intensity of an emotion, is possible (Berkman and Lieberman, 2009). Two approaches to emotion regulation are mentioned. The first is reappraisal, which focuses on recognising and understanding what triggers result in emotional states and their associated nonverbal behaviours, so we can reframe our reaction to those triggers. The second is suppression, in response to the emotion being evoked, where attempts are made to modify the behavioural response already triggered.
Example of how reappraisal can be applied
- Trigger: you received the test results from a disease investigation and need to report these to the farmer
- Emotion: you are worried this will upset or anger the farmer
- Resulting behaviour: you might procrastinate about contacting the farmer to discuss the results, you might avoid eye contact while having the conversation about the results
- Reappraisal: one way to alter the emotional response to the trigger in this situation could be to add the sentiment ‘OK, now we know the results, we can discuss what to do next’.
Using reappraisal to reframe the mindset could help replace worry and anxiety with a sense of wanting to share the information with the farmer then having the opportunity to make plans to address how to manage the situation together.
Consider what might be a typical trigger for you and try to formulate a course of action or process of thinking that helps avoid the unwanted emotional response to that trigger. Decide on a word or sentence to say to yourself to stop going into a deeper emotional state, for example ‘STOP’, or ‘I don't want this’, or even something abstract like ‘ORANGE’. This is where the ‘computer’ part of the brain comes in — training your mind to recognise what could trigger certain unwanted or unhelpful emotions, then constructing a simple, clearly defined and preferred response to that trigger, that offers an alternative response when certain situations occur. The planned reaction to a trigger is stored in the ‘computer’ and this will act as a reference point before an emotion is triggered. With practice, the ideal outcome is that the process happens automatically, without the need for consideration or effort.
Another approach to emotion regulation suggests that writing down or verbalising ours and other's emotions — called ‘affect labelling’ — can help us to regulate our response to triggers (Lieberman, 2007). In other words, putting feelings into words. For example, ‘she is angry’ or ‘I feel anxious’. Affect labelling has been shown to reduce amygdala activity (the ‘chimp’ part of the brain) and increase prefrontal cortex (‘human’) activity, leading to a reduction of the conscious experience, physiological response and behaviours resulting from negative emotional states. The benefits of taking this approach were noted in terms of immediate reduced autonomic responses, such as reduced cardiac output and decreased heart rate in those who had expressed anger but subsequently moved away from that state (Torre and Lieberman, 2018).
Altering our emotional state can subsequently lead to more positive and constructive nonverbal behaviours being displayed during conversations, such as making more eye contact. It also allows us to watch for emotional responses and reflect those back to the other person.
Making difficult conversations feel less difficult
Take time to collect your thoughts, acknowledge your feelings about the situation and take some deep breaths. If it is possible, try to remove yourself from the situation if you feel the conversation is unlikely to end well. If you cannot take time away from the situation, remember that the use of silence during conversations can help when you feel that emotions are running high.
To develop and strengthen your communication skills and help improve the outcome of difficult conversations, practise and preparation are key. To assist with this, the author has developed the 5 Ps, which offer a framework to help build communication skills in this area.
The 5 Ps of effective communication in difficult conversations
- Prepare — think about what it is that you want to achieve from the conversation and how a best-case scenario might look. Consider how the other person might feel about the situation or circumstances and factor this in when deciding how you would like the conversation to progress.
- Practise — ask a friend or close colleague to listen and watch you run through what you would like to say, and ask them for feedback. If that feels uncomfortable, try recording yourself on camera and note any verbal and nonverbal communication you would like to alter.
- Plan — where and when to have the conversation. Try to avoid being somewhere that distractions are likely to occur, such as in the parlour if other people are around, or in the practice office.
- Peace — recognise your emotions about the subject or situation. Explore why this is the case ahead of the conversation to give you time to consider how you might reappraise the situation.
- Positive — with your preparation done, you now stand a good chance of turning a difficult conversation into a positive one, having already explored your feelings and why you have them. Recognise that the other person may need to ‘vent’ their emotions before you can both start to have a constructive discussion about resolution or next steps.
Show that you are listening and understand
Remember that the other person is likely to be experiencing the effects of emotion about what is being discussed. Trying to recognise those emotions and to understand why they might be experiencing them should give you the opportunity to demonstrate empathy, allowing the other person to feel ‘heard’ or ‘seen’. Expressing empathy through statements such as ‘it sounds like you find that difficult’ or ‘you seem to be worried about that, can you tell me what you're thinking?’ can encourage the other person to explain the reasons behind their emotions, which in turn helps you better understand why they feel the way they do and their understanding of the situation. It is worth clarifying that empathy is not trying to evoke the same feelings that the other person is experiencing, which is sympathy.
How nonverbal communication can improve the outcome of a difficult conversation
Many articles that discuss effective communication (Shaw et al, 2006; Bateman 2007; Carson, 2007; Cornell and Kopcha, 2007; Mays, 2012), including those with a focus on difficult conversations, refer to the importance of nonverbal skills in achieving a positive outcome. It is worth pointing out that nonverbal skills apply both to detecting the silent messages coming from those we are talking to (‘reading’ what is being said) and to the messages we might be sending in return (being aware of how our facial expressions and body movements might be interpreted).
Nonverbal communication in farm animal practice
The next time you experience a difficult conversation, it is worth considering the following aspects of nonverbal communication to help achieve more positive outcomes:
- Making eye contact demonstrates that you are focused on the other person and what they are saying. Avoid turning your attention to computer or mobile phone screens as this can be perceived as a lack of attention or interest. Staring is not recommended as this can be perceived as confrontational and evoke an angry or fearful response in the other person.
- Vertical height differences can infer unequal status during the conversation; standing over the other person can imply dominance and superiority.
- Recognise the personal space requirement of the other person and be respectful of this. You can usually get a sense for this, if you recognise that standing or sitting close to the other person causes them to move away or they cross their arms or legs as a means of protecting the space they have available to them.
- Positioning yourself face to face or with your body positioned slightly at an angle towards the other person can enhance the sense of perceived empathy.
It is your choice
Do not avoid having difficult conversations as this can lead to unresolved issues, dissatisfaction and underlying tensions that are likely to escalate and fester. Instead, start practising a positive and constructive approach to engaging in difficult conversations and you will become more skilled in handling these situations. And remember, it is not just the words you say but also the silent messages, sent via facial and bodily movements, that communicate what you are thinking and feeling. You can choose how you want to respond next time you have a difficult conversation.
Conclusions
The reality is that we are likely to continue to experience difficult conversations, whether they be in our professional or personal life. Being able to recognise what circumstances might trigger an emotional response can help us consider how we might reframe our thoughts and therefore modify or regulate our emotions. The way we are feeling is likely to be picked up by others, through our facial expressions and body movements, which can exacerbate the situation and increase the chances of poor outcomes. Being aware of and focusing on our nonverbal communication can therefore help difficult conversations become less difficult, leaving you feeling calmer and more positive about the experience.
KEY POINTS
- Difficult conversations are a part of life but it is possible to make them feel less difficult.
- Having different expectations about a situation or person can lead to difficult conversations.
- How we think about something or someone will influence the way we feel.
- Feeling emotional about someone or something can manifest through nonverbal behaviours (facial expressions and body movements), and this is true for both people in the conversation.
- Mind management can help us to think about things differently, which means we can also manage our feelings and emotional responses.
- Understanding emotions and the part they play in difficult conversations can help us change the way we communicate, both verbally and nonverbally.