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How Doctors Can Communicate Beyond Words to Patients

Humintell Director David Matsumoto recently appeared on the VA C20 podcast as a subject matter expert on facial expressions of emotion and nonverbal behavior.

C20 is a live interactive webinar hosted by Dr. Chad Kessler, Executive Director of Emergency Medicine for Veterans Affairs (VA).

The podcast was originally launched in April 2020 to provide up-to-the-minute COVID-19 news and resources quickly and efficiently to clinical employees across VHA. Today, C20 covers a variety of public health and medical topics and is available to all at VA.

It is designed to be a quick discussion where guests concisely present engaging and informative content to an audience of busy VA providers, clinicians, VA employees and Veterans.

What makes a good interaction between a physician or clinician and their patient?

Dr. Kessler and Dr. Matsumoto started by discussing physician or clinician body language as it relates to patient perception of their care.

Dr. Matsumoto believes it starts with the patient’s perceptions of how much the caregiver is interested in them.

We’ve all heard the term “active listening” but what concretely does this mean?

Spending a minute to sit down and make eye contact and ask someone how they’re doing can make a huge difference in perceived interest.

Dr. Matsumoto emphasizes there is a lot of nonverbal behavior that is centered around the concept of active listening and the “active” part of that term does not involve listening. It’s the engagement of our bodies with the individual.

Examples of engagement can include:

  • Sitting (getting down to the patient’s level)
  • Looking someone in the eye (pay attention to me)
  • Asking simple questions (like “how are you doing”)

In fact, there is research that shows those kinds of perceptions are related to many different things in the healthcare system such as treatment regime adherence, decreases in lawsuits, better assessments, etc.

Dr. Matsumoto emphasizes that feeling seen or heard is essential to getting any interaction off to a good start.

One Mistake To Avoid When Building Rapport

What’s one mistake you can avoid to build rapport in interactions?

Dr. Matsumoto speaks about the concept of “mirroring” which he describes as a double edged sword.

Studies have shown that when people organically start to mirror themselves, they have better rapport in interactions.

However, if a person perceives that the other individual is simulating their postures, this may have the opposite effect.

Dr. Matsumoto suggests not to try and mirror the other person’s body language. Just be genuine in the interaction; listen normally, naturally, and empathetically.

When you do so, one’s body will start to engage appropriately to the interaction.

What does building trust actually mean in an interaction?

Building trust means allowing a person to be vulnerable and that person knowing they won’t be judged, criticized or attacked.

Building trust starts with non-judgmental listening.

An important reminder before engaging in an important conversation may including taking a breath or two to calm your body and mind.

Dealing with Cultural Differences in Medicine

Doctors see patients from all walks of life. How do cultural differences fit into the connection and interaction?

Cultural differences are big in nonverbal behavior but one thing that is consistent across all people of all cultures are facial expressions of emotion.

We’re all generally pretty good at reading facial expressions in others since we learn how to do so in our every day lives.

With regard to other things like orientation, body posture, orientation and especially gaze and visual attention, there are differences.

In fact, people of other cultures may perceive healthcare workers as higher status and may avoid direct eye contact because of this fact.

While the cultural differences do exist in some behavior, they can be mitigated a lot by interest and engagement behaviors.

These interest and engagement behaviors are all the same across cultures:

  • Paying attention
  • Direct eye contact
  • Speaking nicely and empathetically
  • Using our own body postures and orientation

These behaviors will go a long way in mitigating cultural differences.

To listen to the entire episode, visit this page!

The post How Doctors Can Communicate Beyond Words to Patients first appeared on Humintell | Master the Art of Reading Body Language.

Why Every Interaction You Have Is A Negotiation

Every interaction is a negotiation

Whether we realize it or not, we’re all salespeople and every interaction is a negotiation in which we persuade and influence others.

Some of us do this professionally; sales people sell products and attempt to have people purchase those products; teachers sell knowledge and skills and attempt to persuade students to learn that knowledge and skills; law enforcement officers sell jail and attempt to persuade alleged criminals to buy jail time.

All of us do so as well in our personal lives; parents try to get their kids to clean their rooms and married couples get their partners to take out the trash.

Not only are we all salespeople trying to persuade and influence others; we’re all relatively good at it.

In fact, every individual needs to be at least somewhat successful in doing so because without some degree of success at persuading and influencing others, individuals would not survive.

Every group, society, and culture requires people and groups to persuade and influence others for the individual’s, group’s, society’s, and culture’s survival.

As John Donne once wrote in his famous poem, no man [person] is an island, and our ability to live and thrive in our families, communities, societies, and cultures is evidence of our ability to persuade and influence others.

Thus, people have learned or acquired a long time ago the basic skills necessary to persuade and influence others.

I say “acquired” because we don’t know the degree to which our abilities to influence others are hardwired into us as humans, or whether those skills are entirely learned from our cultures and communities.

I suspect that we have the biological hardware (brains) and some innate software in our minds to learn those skills from our families and communities. Regardless of their origins, however, we all persuade and influence others, and we’re relatively good at it.

Just look at the growth of the world’s population across time. If people weren’t good at persuading and influencing others, we wouldn’t get along and our societies and cultures, let alone marriages and families, would not survive and thrive.

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How does this persuasion and influence occur?

There’s a long history of research in psychology examining how people influence others.

For example, very classic research on conformity and compliance conducted by Solomon Asch demonstrated how groups can influence individuals to make obviously mistaken judgments or say obviously incorrect things.

Stanley Milgram’s classic research on obedience showed how average people will do drastic things against others on the basis of instruction from an authority figure.

Phil Zimbardo’s well-known prison study demonstrated how power assigned to a group of people made that group engage in demeaning behaviors against others who were not so assigned.

Perhaps the most well-known author in this area is Robert Cialdini. Through his own ingenious experiments and collating the results from many other studies, Cialdini extracted six universal principles of persuasion and influence that were at work when people persuade others to do something. (His more recent work identified a 7th principle as well.).

For example, consider the principle of reciprocity, which Cialdini suggested activated “the web of indebtedness.” When we receive something from someone, we have an obligation to give something back in return. This is true for getting a gift, receiving an invitation, or hearing a compliment.

Every society and culture is built on this principle; if this principle didn’t exist no society would function correctly and the alternative is social chaos.

Same is true for the principle of authority. Hierarchies exist in every society, culture, group, and organization, and if we didn’t comply to the wishes of authority, hierarchies would cease to exist and societies and cultures would not function properly. The alternative again is social chaos.

What is Tactical Social Influence?

Here at Humintell, we take that classic work on persuasion and influence and incorporate other scientific breakthroughs over the decades to deliver what we call Tactical Social Influence.

For example, one interesting aspect of all principles of persuasion and influence that is not discussed much is the fact that they all operate because of affect and emotion.

In reciprocity, for instance, when we receive something, we have the feeling of obligation to give something back, and not giving something back makes this feeling worse.

This unsettled feeling motivates us to do something to dissipate that unsettling feeling because feelings and emotions are at the root of motivation, an idea described by Sylvan Tomkins decades ago. (Tomkins is believed by many to be the “father” of most modern science about emotion.).

Thus, we give something back and feel relieved to do so. This unsettled feeling can be especially nerve wrecking if we receive something from someone whom we would rather not feel obligated to.

Authority Figures

Same is true for obeying the requests of authority figures. Because we all learn to respect and obey authority figures, we once again have the feeling of obligation to respect and obey their requests. This unsettled feeling can be especially nerve wracking if we don’t agree with the request. Thus, we comply in order to address the unsettled feeling.

The feelings and emotions that underlie the principles of persuasion and influence are associated with a concept called cognitive dissonance, a concept attributed to another classic author Leon Festinger.

Thus, although we speak of cognitive concepts like authority, reciprocity, compliance, and the like, in reality affect and emotions are at the heart of all principles of social influence because some actions create cognitive dissonance in us.

These principles are not evil mechanisms conjured up by wicked scientists in dark laboratories. They are a natural psychological process that has evolved because humans live in groups and group life is the heart of our survival.

Thus, learning about those principles can deepen our understanding of a unique and natural process of human social life. Learning how to consciously and strategically leverage those processes can give us an edge in negotiating life, and help to make our interactions with others more efficient and productive.

Humintell Tactical Social Influence’s 4 Major Pillars

  1. The first pillar is learning about and leveraging the universal principles of persuasion and influence.
  2. The second is about actively listening to and observing others, especially their emotions and other nonverbal behavior, so that we can get additional insights about the emotions and feelings of others.
  3. The third is learning how to use questions strategically in order to lead others to their own conclusions about what we want to persuade or influence them about.
  4. The final pillar is learning how to improve our personal effectiveness by regulating our own emotions, because many negotiations occur in difficult and emotional contexts in which we need to control or regulate our own emotions and not be controlled by them in order to achieve a desired outcome.

When we are able to be better at all four pillars of Tactical Social Influence, we can become extremely effective at persuading and influencing others.

Perhaps then, we can get our kids to clean their rooms and our spouses to take out the trash a little easier than before 🙂

The post Why Every Interaction You Have Is A Negotiation first appeared on Humintell | Master the Art of Reading Body Language.

Emotion Regulation Training to Prevent Postpartum Depression

New research presented at the 37th European College of Neuropsychopharmacology studied the activity in the brain’s amygdala during pregnancy.

The amygdala is part of the temporal lobe and part of a larger network in the brain called the limbic system.

When it comes to survival, the amygdala and limbic system are extremely important. These are parts of the brain that automatically detect danger and play a role in behavior, emotional control and learning.

The researchers found that pregnant women with higher amygdala activity struggled more with emotional regulation and reported more depression symptoms postpartum.

This discovery could lead to early identification and targeted emotion regulation training for at-risk mothers. While preliminary, the findings offer potential for new strategies to prevent postpartum depression.

1 in 7 Women Develop Postpartum Depression

During pregnancy and the postpartum period, rising hormone levels create a “psychoneuroendocrinological window of vulnerability” for mental health.

80% of women develop often transitory “baby blues,” and about one in seven develop more serious postpartum depression.

According to the Mayo Clinic, postpartum depression symptoms may include:

  • Depressed mood or severe mood swings
  • Difficulty bonding with your baby
  • Less interest and pleasure in activities you used to enjoy
  • Intense irritability and anger
  • Feelings of worthlessness, shame, guilt or inadequacy
  • Reduced ability to think clearly, concentrate or make decisions
  • Severe anxiety and panic attacks
  • Thoughts of harming yourself or your baby
  • Recurring thoughts of death or suicide

Symptoms usually develop within the first few weeks after giving birth. But they may begin earlier – during pregnancy – or later – up to a year after birth.

Untreated, postpartum depression may last for many months or longer.

Pregnancy Study

The research presented included 47 women — 15 pregnant women and 32 non-pregnant controls.

To examine brain activity, participants were asked to view negative emotional images while undergoing functional MRI. They were then asked to use cognitive reappraisal to regulate their emotional response to the images.

The findings suggested that both pregnant and non pregnant women were equally successful at emotional regulation, but this process involved different brain activity in pregnant vs their non pregnant counterpart.

All women had increased left middle frontal gyrus activity when regulating their emotions, but there was a difference in the amygdala between the pregnancy group and controls.

These results suggest that pregnant women may have to exert more neural effort in emotional regulation.

In addition, pregnant women with higher amygdala activity were less able to regulate their emotions successfully compared to those with less amygdala activity. Higher amygdala activity was also associated with higher depression scores.

Although the researchers stated they need to be cautious when interpreting their results because of the small sample size, they emphasized if the findings are confirmed by larger studies, pregnant women could be assessed “in the waiting room” using existing questionnaires that evaluate emotional regulation.

If a woman has difficulties with emotion regulation, there are adaptive strategies, like cognitive reappraisal that a counseling psychotherapist, group sessions or online courses could help with.

Research like this is crucial for gaining insight into one of the most intense physiological processes a human can undergo: Pregnancy. It’s remarkable how much remains unknown.

Recently, the FDA approved the first treatment for postpartum depression. However, experts emphasize that research like this is crucial for gaining insight into one of the most intense physiological processes a human can undergo: Pregnancy.

It’s remarkable how much remains unknown.

The post Emotion Regulation Training to Prevent Postpartum Depression first appeared on Humintell.