At any one moment, we operate within a framework that guides our decisions: what is our budget, is it covered by insurance, how the system has always worked. When a patient visits the clinic, it’s understood that time with a clinician is a limited resource. We also carry around a set of pressures that weigh on us: tension with a coworker, the impending tax deadline, and a never ending list of to-dos. All of these inform how we navigate our world; they motivate us to apologize to the colleague and come prepared with three questions to ask our nurse practitioner during an appointment.
However, our understanding of the world and what happens in it can sometimes block us from fully listening to others and it tends to get in the way of our ability to see new solutions to existing problems.
Here’s how it happens in conversation. When we first start talking to someone, we often begin with a gentle question and a polite or expected answer. Q: How are you? A: Fine, thank you. There tends to be a lot of downloading as both people hold their own ideas and beliefs tightly. In order to draw out new ideas and change how we think about a problem, empathy and self reflection need to be injected. When this happens, the conversation moves into what we call reflective dialogue. Even better is when both members are fully present in the conversation, each appreciating the other’s perspective. It’s here, in what what we call generative dialogue, that we experience a moment of collective understanding crucial for initiatives that require deep change. (Learn more about downloading, reflective and generative dialogue here.) However, none of this thoughtful conversation can happen when we’re penned in by our previous experiences or preoccupied by the other things on a to-do list.
When participants come to Flip the Clinic Labs, the session’s facilitators, Brenna Atnikov and Joe McCarron, ask attendees to write down what they need to suspend—those preoccupying topics weighing on us—in order to get to the more generative forms of conversation. In Phoenix, this prompted one participant to lean back in his chair, away from the table and the other three people sitting around it. His table mates put aside things like negative personal experiences, the idea that big medicine/education can’t change, and the obstacle that one’s organization didn’t have enough resources. Another wrote how proud she was that her oldest child was moving on to college and another shared concerns over his mother’s lab results. As the lists grew longer, the man reclining drew closer to the table. Looking around, he picked up a pen and began a list of his own. In that moment—even silently—the day’s conversations were shifting, self-assurance giving way to self-reflection.
“There’s something about making our thinking visible and permanent that makes the experience go from the individual to the collective,” says Atnikov. “Seeing where there is alignment across a group of people shows that our experiences are often more alike than dissimilar.” Furthermore, Atnikov explains, displaying the things we need to suspend publically to the whole group rapidly advances the way we talk to each other, allowing us to enter more generative forms of conversation more quickly.
In the Phoenix Lab, ideas lept forward. But the implications of suspending our mental background noise are much much broader. Conversations with colleagues benefit from a clear and open mind just as much as check-ins with friends do. Finding more engaged modes of conversation in high-pressure meetings or in a particularly tough chat in a medical practice can lead us to surprisingly productive and innovative conclusions.
Image by Marc Wathieu.