Effective communication must be cultivated

As a healthcare provider, I feel compelled to comment after last week’s incident of communication conflict between Governor Palin, state Rep. John Harris and state Sen. Lyda Green over scheduling of the State of the State address this past week.

This seemingly small incident, but unresolved communication conflict, appears to have culminated in belittling of Senator Green by two Anchorage radio announcers in the presence of Governor Palin, to which she did not stop or disagree with the insults, but just laughed. Such errors in communication have been known to cause unnecessary interpersonal conflicts.

Communication error and misunderstandings between individuals account for nearly 70 percent of the conflicts, loss of productivity, job dissatisfaction and loss of personal well-being in the workplace. The U.S. Department of Health and Human Services has determined that workplace conflict with loss of personal sense of well-being contributes to incidences of depression, obesity and low fitness levels. Nearly 10 million U.S. workers complain each year of work-related head and neck pains. One of the main causes cited for such pains are the consequences of improper communication.

Over the last 50 years, the terms “health” and “healthcare” have undergone changes in definition and application. Health, once defined as absence of disease, is now defined as a physical, mental and social process of an individual to enjoy quality of life and satisfaction. Healthcare systems now favor an active rather than passive process by which patients are encouraged to become more aware of factors that relate to healthy living and to participate in demonstrating choices and behaviors that promote a more successful existence.

In December 2007, the governor’s Alaskan Health Care Strategies Planning Council identified a key healthcare goal of promoting personal health responsibility. Governor Palin reiterated the importance of personal health responsibility in her recent State of the State address. Practicing effective interpersonal communication skills are essential behaviors that directly promote health and well-being. Ineffective communication skills, on the other hand, are detriments to health.

Ineffective communication may take the form of mechanical error, in that the speaker may not wait to obtain feedback the listener actually heard or understood the message or request. Or, the listener may be so intent on getting a message heard he or she is not perceiving what is being said to them. In both cases there is an expectancy of being heard by the other and little or no effort put into making sure the message was understood. This is the old I-assumed-you-heard-me communication error. In this case, misunderstandings could be avoided by making sure the message is clear and understandable, that the listener is attentive and receptive, and that adequate feedback is obtained.

Other barriers to effective communication take the form of attitude bias. It appears human nature for people to form prejudgments and expectancies of how others should or will behave, and to be upset when things do not turn out as expected. Once expectancies are formed in a person’s mind, the prejudgments become the filter through which the individual chooses to view communication exchanges. Therefore, the communication process becomes erroneous because the emotional aspects of prejudgment prevented the listener from actually hearing, perceiving and weighing the merits of the objective evidence presented by the speaker.

I am not proposing a person totally ignore previous judgments and perceptions; rather, to separate the emotional from the actual message, weigh the two for their merits, ask questions and seek feedback for clarifications, then make a decision based on evidence, not emotion.

Assuring proper mechanics of communication by actively stopping to reflect upon a preexisting emotional bias while separating away the objective message is an essential skill required in healthy interpersonal exchanges, promotion of healthy behaviors and leadership.

The last essence of proper communication is contained within the intent and delivery of the speaker. My mentor and friend, the late Louise Kellogg of the Spring Creek Farm in Palmer, taught me three principles she used for effective communication: 1. Seek to understand before demanding to be understood; 2. Honor those who are not present; 3. Determine whether the communication effort will promote goodwill and positive outcomes for all involved. These are good principles to live by indeed.

Improvements of cooperation and communication skills have been identified as essential issues to work on this year by legislators, the governor and residents. Like any behavior, it must be patiently nurtured and practiced by all as old habits are replaced. This will be a slow process, but an effective one. As Mark Twain wrote in 1896, “Habits are not to be thrown out the upstairs window, but coaxed down the stairs one step at a time.”

Catherine Mormile is a Wasilla resident, a doctor of physical therapy and board certified orthopedic specialist. She’s the owner of a physical therapy private practice, is a medical author and medical illustrator.