In her excellent article in CC Nov. 11, 2019, Amy MacLachlan made us painfully aware of the many ways in which professional psychiatric care is failing people struggling with mental illness. It often leaves individual sufferers with no choice but to fend for themselves as best they can, or become overly dependent on the help of friends and loved ones. This situation leaves those close to them feeling overwhelmed and under-equipped. The problem is so severe that we can speak of a mental health crisis. If nothing else, the current epidemic of youth suicides (according to the Government of Canada, suicide is the second-leading cause of death for people ages 15 to 24) ought to convince us that more needs to be done.
The question is therefore urgent whether ordinary, non-professional people can do anything to help individuals in emotional distress. As my many years as a trauma counsellor have shown me, I believe there is.
Ireland’s Health Service Executive recently partnered with a local organization called, Spun Out to create the Listening is Helping campaign. It equips young people with the skills they need to listen to friends and family going through a tough time. Their tagline is, “Lending an ear is lending a hand,” and I couldn’t agree more.
People in distress have a deep need to talk about their struggles and we can help them simply by listening. And while many people may be willing to provide a listening ear, they may feel inadequate when it comes to listening skills – particularly when listening to people who may be suffering deeply. After years of leading workshops in active listening, I’ve gathered a handful of instructions that I’m hoping prove helpful to those who want to improve their listening skills, and to give those struggling the listening ear they so desperately want and need.
A Listening Attitude
To be a good listener you must, first, adopt a listening attitude. In the long run you cannot pretend to be listening. Active listening is, first of all, wanting to hear what the other has to say.
But listening is also a matter of skill. Sometimes we want to listen, to respect and to understand the other, but we don’t seem to know how to do listening.
The first important step in learning to listen is to be quiet. I have a friend who has discovered the importance of listening. He talks about it all the time; so much so, that he doesn’t hear a word of what anyone is saying.
Whether a person opens up to you is also influenced by the kind of questions you ask. Open-ended questions are an invitation to talk; closed questions turn a conversation into an interrogation. Closed questions are okay when you want to collect a lot of facts about a person in a hurry, but not when you want to have a conversation. Open-ended questions like, “Tell me a little about yourself” give the speaker the freedom to say as little or as much as they want.
One of the quickest ways to kill a conversation is by making judgmental comments. So, avoid evaluative or judgmental statements. You are not asked to debate but to listen. Listening is trying to understand what is being said without necessarily agreeing or disagreeing.
Often the way people feel about what they are telling you is more important to them than what they are actually telling you. How they feel comes through in how they say what they say, and in their tone of voice. They may tell you what happened in a choked-up voice, for example. The proper response to their story may be: “It seems he hurt you so deeply that you are still upset about it now.”
You must also show that you are listening. You show interest by your body posture when leaning slightly forward and maintaining eye contact. Eye contact is always needed when you have a conversation, but staring at people makes them uncomfortable. The best posture is not to look at your discussion partner directly but to allow them to look into your eyes. In any case, you should listen with your body as well as your mind.
Relax! Don’t be too anxious about your performance. Let the conversation happen. Don’t be checking yourself all the time. Your job is to attend to the other.
Empathy is good. As you listen to the other, ask yourself: what does it feel like to be her? Try to walk in her shoes. Attempt to understand what is being said from the inside out rather than from the outside in.
One of my clients many years ago was highly suicidal and it was a struggle for me as well as her to keep her alive. As I was trying to understand the reason for her desire to die, she said: “I’m on the verge of losing it and if I do, I’ll have to be hospitalized again and I’d rather kill myself than go to the hospital.”
Then this highly intelligent, sophisticated, competent, professional woman told me about her previous experiences of being in the hospital. For her, being in a psychiatric hospital means being confused as you’re brought in, and being badgered with questions that make no sense to you by numerous professionals. It means being examined, poked, diagnosed, charted, catalogued, assigned to a place, being told what to do without explanation, being gowned, arm banded, drugged, and watched around the clock. It means that you lose your personal possessions, your privacy, and your human dignity.
I said to her, “Hospital was like a prison to you, right?” She said: “Yeah, and I’d rather die than suffer that indignity again.” Every hospital procedure she described to me was familiar to me as a professional therapist. But her experience of them was quite different from mine. Listening to her perspective and what she had gone through – and trying to understand how that influenced her current decisions – was an important part of active listening.
Active listening can also require self-disclosure. When the other tells of an experience that is similar to yours, it sometimes pays to say, “I think I know what you are saying. Is it like this. . .?” The response is often, “You too? I thought I was the only one who felt that way!”
A caveat: Use it sparingly. The purpose of listening is not to talk about yourself.
One component of listening is responding to what is being said in such a way that you encourage the speaker to go on, giving a nod, saying, “mmm hmm,” or “I hear you” at regular intervals, or some other encouraging, friendly gesture.
Paraphrasing what is said serves the same function. You can say, “So, if I get what you are saying you are telling me that. . .?”
You can also paraphrase an expression of feeling by saying something like, “Stuff like that really gets to you, eh? It makes you see red!”
One of the best ways of responding is summarizing what is being said in fresh words. From time to time, after large segments of the conversation, you may say something like, “Let me see if I follow you, are you saying. . .?” or “Do I hear you correctly, is this what you are saying?” Keep your statements evocative, for example, in question form, making your voice go up at the end of your summary. This means that you are asking rather than stating, and it shows that you expect to be corrected.
People who are willing to listen may be hesitant or anxious to approach someone who is going through a crisis or difficulty, thinking, “But I don’t know what to say! I don’t know how to help. I don’t have any answers.” Actually, what hurting people (and, really, all people) want is to be heard; for someone to ask, “How are you doing?” And to genuinely care about the response.
Mental Health First Aid USA puts it this way: “Most people experiencing distressing emotions and thoughts want an empathetic listener before being offered helpful options and resources.”
It helps the speaker, and you, the listener, at the end of the conversation to summarize the essence of what has been said. An advantage is that this summary can be repeated at the start of your next conversation. Then at the beginning of that second conversation you can say, “Well, as I remember it the last time we discussed. . .Where do you want to go with that this time around?” Taking notes of the conversation serves the same purpose.
These are just some suggestions that you can practise the next time you are asked to listen. Of course to become a really good listener you may need some training by participating in an active listening workshop. But the point of this article is to show that simply by listening well, we can indeed do something to help people in emotional distress.