So, we've been talking about displaying receptive behaviors to signal to your patient or colleague that you want to understand why they believe what they believe. But sooner or later, you need to express your own perspective. Julia, what advice do we have for people who have done a great job at being curious and are ready to talk? Even when you're making your point, there are specific things you can do to continue signaling receptiveness. In our research, we analyzed thousands of conversational transcripts of people who are disagreeing with each other and used machine learning to find patterns in the language of the people who sound the most receptive. Four strategies work consistently well. And the way to remember them is by thinking of the acronym HEAR. The letters in HEAR stand for hedging your claims, emphasizing agreement, acknowledging the other perspective, and reframing to the positive. Let's go through the components one at a time. The H in HEAR stands for hedging. Most of us are confident in professional opinions. But no matter how true your statements are, including some hedging phrases might make you sound more thoughtful and may make patients less eager to argue with you. Hedging phrases include, I think it's possible that, this might happen because, some people tend to think. So instead of saying, we know that COVID vaccines are safe and effective, you could say, most physicians agree that COVID vaccines are quite safe and effective. The E in HEAR stands for emphasizing agreement. Even when you disagree with someone on a particular topic, it can be helpful to find something you do agree on. This doesn't mean compromising or misleading your patient about your beliefs. Instead, it means finding a broader set of ideas that you do find agreement on. So agreement phrases might include, I think we both want to, or I agree with some of what you're saying, or we're both concerned with. Even if you think a patient's fears about the vaccine aren't founded, you could say, for example, I agree that there has been a lot of confusing information coming out in the last few years, or we both want to make sure that you continue to stay healthy and protect your family. The A in HEAR stands for acknowledgement. Acknowledgement is demonstrating that you've heard the other person by restating what they said. Remember that acknowledging someone's words doesn't mean that you agree with them. Acknowledgement phrases include, I understand that, I see your point about, what I think you're saying is. For example, Dr. Hagen could have said, I understand that you had a difficult time with the first series of shots and you are not eager to repeat that experience. Or it sounds like you're not very concerned with getting COVID again because your first case was relatively mild. The R in HEAR stands for reframing to the positive. This means both using more positive emotion words as well as avoiding contradictory words such as no, can't, won't, or don't. Positive reframing phrases include, I think it's great when, or I really appreciate it when, or it would be so wonderful if. Instead of saying, I can't believe that you aren't sufficiently concerned for your family to protect them against a deadly virus, you could say, I would love for you to consider the benefits the booster might have for protecting your family. Now what I love about HEAR is that you can say exactly what you meant to say, but in a way that shows your patient that you're still engaging with their perspective, even as you're stating your own. Yes. And also notice that it doesn't take a lot of time. Most importantly, in study after study, we see that when people use HEAR, their counterparts find them to be more reasonable, more trustworthy, and they want to talk to them again. Interestingly, people seem to effortlessly imitate this style. If you use words that signal your receptiveness, your patient is more likely to adopt a more receptive tone as well. The HEAR framework keeps the conversations constructive while also letting you express yourself so that disagreement doesn't become a conflict. Learning how to incorporate HEAR into your conversations seems simple, but it takes time and practice to get to a point where you actually have this as your default behavior. The exercises that follow will give you a chance to start practicing.

receptive behaviors

HEAR framework

communication strategies

maintaining receptiveness

constructive conversations