Dealing with Volcanic Eruptions

Angry people can be difficult to handle – especially when they are directing most of it at you. I don’t know if you’ve had the experience of exactly that happening. Someone comes into your consulting room at almost “blowing their top” intensity – perhaps about something you have or haven’t done, something one of your partners should have but didn’t, some complaint about how someone else in the NHS system has treated them, or possibly just angry about a life situation that “shouldn’t” be happening…

When anger is directed face to face at you there are some automatic responses that spring up reflexly. I don’t know about you but I’ve certainly experienced an involuntary fear response when my stomach goes up into my mouth as my heart hammers away inside my chest. A normal defensive reaction, especially when they are seated between you and your consulting room door and you have no escape!

I’ve also experienced the other main response – an angry reply in return, where the words and body language erupt in a vituperative response that you instantly wish you could claw back as the stream of invective leaves your mouth for good…or bad! Either way, the consultation can quickly reach an impasse then deteriorate rapidly with both parties ending up not getting what they want.

So what is the function of anger? Well, I find it useful to think about anger as a reaction that occurs when we perceive our boundaries have been violated in some way – physically, emotionally. We are usually so deeply identified with our beliefs that an attack on what we hold to be true for us can appear psychologically and physiologically to be like a “death threat”. And we respond automatically with the evolutionary useful fight or flight mechanism which was great when dealing with the sabre-toothed tiger but not so great when the “dangerous animal” is a patient!

So, in a sense, anger is a message about re-establishing effective boundaries. The trouble is, we usually attempt to do so by violating the other person’s boundaries in return. So how can you deal with this kind of situation in a way that is respectful to all concerned whilst maintaining your own sense of self?

The first thing to understand is that when someone appears to be angry and is directing that at you, deep down it’s not really about you at all. It’s about them – more specifically, their representations, their views and perspectives that are driving the show. It’s not “you” that is the issue, it’s how they are representing and interpreting that “you” in their mind’s eye. And whilst that may be their “truth” it is not The Truth, simply one of a number of possible perspectival frames that could be used to interpret the current information.

Have you ever tried to stop a volcano mid eruption? Not an easy task. Same with an angry patient. So what can you do instead? What at first might seem counter-intuitive is in fact a very effective strategy. And that is to allow the volcanic eruption to blow itself out – without it harming you. So how do you do this?

I’ve found that no matter what they say the most useful thing I can say in return is a version of the following:

“That’s interesting…can you tell me more…?”

And to use that iteratively with everything they say until they have literally nothing left to say!

“So, you’re angry that you didn’t get what you wanted…can you tell me more…?”
“So, you think I’m an a**hole…can you tell me more….?”
“And you’re really angry with my partner too…can you tell me more…?”
“So, you think you should have been referred earlier….can you tell me more…?”
“So, you think you should have been prescribed X….can you tell me more…?”

Your voice tone and body language are important hear…Try saying this slowly and placatory…and notice how that escalates the problem! The key is to match their voice tone and energy levels at about 80% intensity…if you are the same level or above then this is likely to be perceived as an attack and things will usually deteriorate. If you are a little below their intensity you can then pace and lead this down to a more comfortable level.

My experience with using this in many situations is that people rapidly get to the point where they are literally speechless. When someone has said all they have to say whilst you ask them to tell you more then they have gone beyond words and their state usually changes for the better (not always though). This leaves the situation open to changing direction and there are a number of ways you can go with this….

Often I ask:

“So what is it that you really want/need now…?” (or some other outcome based question)

Or:

“Is it Ok if I respond now with my perceptions…?”

Asking permission in this way clarifies whether or not they really have emptied themselves of all they needed to say. And in return, it is important not to attack what they have said directly. One useful way to take things further is to say:

“I can see how this has been very frustrating for you and I’m sorry that it has caused so much upset…in your shoes I’m sure I may well have perceived this in an identical way….from my perspective, here’s what I think we should do next….”

This statement has the effect of agreeing with how they have come to see things in the way they have, saying the magic words “I’m sorry” for their predicament, yet at the same time not necessarily accepting that you are in any way responsible…unless of course there is something that you have contributed to the situation that has made it go awry, and in that case a direct apology may well be in order.

Once both your sets of perceptions have been clarified in this way it opens up the space for some constructive dialogue to take place and there are many NLP tools you can use to move forward (see Consulting with NLP )

Do let me know how you get on…

Lewis

One Response to “Dealing with Volcanic Eruptions”

  1. Hi Lewis
    Thanks for this reminder about how useful the whole ” pace and lead” pattern is.
    I was particularly pleased to read your comment about how being ” slow and placatory” with our voice can inflame things further. Just yesterday in a workshop I had a usually very calm and quietly spoken anaesthetist try exactly that – and he was surprised and even more uncomfortable with the response. It seemed quite counter intuitive for him to have to initially raise his voice and energy – in order to help his patient know that he appreciated her concerns and was empathizing with her. And of course when he did he got a much better response!
    A medical analogy that seems helpful here is of “lancing a boil” – we know that for it to heal fully that it must be fully drained and that we can, in a controlled fashion, achieve this – but initially it can be quite unpleasant!! However provided we stick with it – and this includes being prepared to go back to redrain it – even very large, nasty looking, painful abcesses ………will heal themselves .
    Cheers Nigel