Mary L. Henrikson, I”, RNC

Dealing with Difficult People Tips and Techniques for Enhancing Communication

velyn, the charge nurse for the day shift, tensed as she saw Dr.

Crush step off the elevator. Dr. Crush had a reputation in the hos- E pital as being difficult to work with. He was known to verbally

attack nurses and bully them to get what he wanted. It had evolved to the

point where nurses were refusing to take care of his patients in order to

avoid contact with him.

The night before, Dr. Crush had admitted a patient who had an infection and who was five days postpartum. The patient was breastfeeding so she had brought her newborn with her and had agreed to hospital rules of bring- ing her own supplies plus a care- taker for the infant. Evelyn wasn’t taking care of Dr. Crush’s patient today but still cringed when she saw him head down the hall toward his patient’s room. In less than five minutes, Evelyn heard Dr. Crush ask the unit secretary who was in charge. Evelyn drew a deep breath and stepped forward. “I am,” she said. “What can I do for you Dr. Crush?”

Later, as Evelyn tearfully related the interaction to her nurse manag- er, she described how Dr. Crush began to yell at her about the hos- pital policy of not providing sup- plies for his patient’s infant. In the nurses’ station, he stood over Evelyn, pointed his finger at her, and raised his voice to the point of screaming. He demanded that she go talk to the patient with him and, once in the patient’s room, berated her and the rest of the nursing staff in front of the patient. Words like

Mary L. Henrikson, M N , RNC, is director, Prentice Women’s Hospital at Northwestern Memorial Hospital in Chicago, IL.

incompetent, cruel, uncaring, and stingy lashed out like a whip.

When asked how she respond- ed, Evelyn described how she was embarrassed, angry, and humiliat- ed. She quickly did what Dr. Crush wanted just to make him stop attacking her. “The only good thing I did,” she told her nurse manager, “was not to burst in to tears in front of him. I waited until he left and then went in to the lounge and cried.”

Difficult People Dr. Crush is one of the most chal- lenging types of difficult people one typically has to deal with in profes- sional and personal life. Difficult people are people whose behaviors

are chronic and affect most of the people they come in contact with. Often, they behave the way they do because they have learned they typ- ically get the results they want by doing so. They also seem to be immune to the more common methods used to encourage people to change their behavior. For exam- ple, when someone is chronically late for meetings, a reminder that the behavior is disruptive to the rest of the group will usually-out of courtesy and/or embarrassment - cause a change in behavior. Difficult people, however, won’t respond to this kind of reminder because their behavior is driven by an inner need that they believe their behavior is meeting.

Communication Strategies The following are techniques that work to enhance communication with all types of people, particularly those with difficult personalities. It’s important to note that dealing with certain types of difficult people often requires a planned approach.

action between you and another person can often largely be directed by one person. But your interaction and reaction to others are the only behaviors you can control.

Within communication, the inter-

Communication Strategia H Your behavior is the only behavior you can control

H Mirror the other person’s communication mode, speech patterns,

H Listen for the intent and purpose of their communication

Communicating with Difficult People

H Verbally reinforce the good behaviors and attributes of that person

H Assume the best of other people-look for their good intentions

H Learn to accept and appreciate criticism

and actions to harmonize your interaction

to soften communication

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One commonly used technique is to try and harmonize or align with the other person. Conflict occurs among people because of their differences. Harmonizing attempts to decrease those differ-

Understandinn Motive - Take your understanding to a deep- er level and try to identify the intent of the person’s communication. What good purpose is he or she try- ing to achieve? When applying this

You ako will enhance your communication ifyou remember that you get what you project

and expect. We reinforce otber people’s behavior by our reactions.

ences and increase rapport. Harmonizing can be both verbal and nonverbal. To harmonize, sub- tly mirror the other person’s body posture, facial expressions, rate of speech, tone of voice, and rate of breathing-but be careful not to lit- erally imitate the other person or this will destroy the affect.

listening for intent-try to really understand what the other person is trying to tell you. Start out by let- ting the other person talk first. While they talk, take harmonizing one step further and give visual and auditory evidence that what they have said makes sense to you. This may look like a nod or shake of your head, or a grimace or excla- mation of “Oh, my!” when responding to unpleasant informa- tion. When the person starts to repeat information-count to three-and then it’s time to give feedback. To enhance their listen- ing, repeat what they have said to you using their actual words rather than paraphrasing. Phrases like, “Let me get this right, ...” or “You said ...” will help.

When the person confirms that what you have repeated is what they said, move on for more clarifica- tion-this is when you seek to learn the “who, what, where, when, and how” facts. Keep probing for those facts until you think you’ve under- stood what the person has said. Then summarize. State, “SO if I understand you correctly (this is the problem; this is who it involved; this is when, where, and how it hap- pened).” Confirm the information by asking, “Did I get this right? Do you feel I understand? Is there any- thing else you need to tell me?”

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Another technique is to practice

technique to the situation described above you might assume that Dr. Crush’s positive intent was to make his patient’s hospitalization as easy as possible by ensuring that she did- n’t have to worry about managing the supplies needed to care for her baby. Try to identify what the other person values. Try to determine what’s motivating them to behave or respond in a certain way. Increased flexibility and coopera-

blame, or fear. One way to interrupt an interruption is to state the per- son’s name over and over in a factu- al way until you get their attention.

You also will enhance your com- munication if you remember that you get what you project and expect. We reinforce other people’s behavior by our reactions. There are three commonly used techniques to reinforce positive behavior:

Pygmalion power-we rise and fall to the expectations of others. When someone is behaving in a negative way state, “That’s not like you! You are capable of ... (describe the behavior you expect).” Reinforce positive behavior by stating, “That’s what I like about you! You ... (describe the positive behavior you just observed). ” Assume the best about people- use the information you obtained when you tried to reach a deeper understanding of the person’s intent by their communication or behavior. Whenever we tell some- one they are doing something

Once you realize you are being attacked calmly wait for tbeperson to run down. Remain in place

and focus on your breathing.

tion on your part are generated when you take time to identify the intent of the behavior.

Enhance Understanding Next, deliver your message in a way that enhances the receiver’s under- standing. Monitor your tone of voice. Make sure it matches the message you are trying to send. State your positive intent and use it to direct attention to where you want the message to go. Statements such as, “Because I feel so strongly that relationships and feelings stay positive ...,” give people a good rea- son to listen to you.

Another technique to enhance understanding is to interrupt inter- ruptions. The purpose is to distract the interrupting person long enough that they must stop talking to find out what you want. Be tactful in your interruption, without anger,

wrong we can usually expect a defensive reaction. Give people the benefit of the doubt and state it up front. “I know this project is very important to you and you want us to do well. I appreciate that you care so much, but ....” Learn to appreciate criticism, and role model that behavior. This is probably the most difficult of all but instead of reacting defensively end the critical remarks by verbal- ly appreciating them. Say, “Thank you for being honest with me, taking the time to let me know, (or) for caring so much.” This technique will usually surprise the person doing the criticizing and stop them cold.

Working with Difficult People So, what about Evelyn and Dr. Crush? How should Evelyn handle these attacks by Dr. Crush?

Volume 3, Issue 3

Dr. Crush is part of a difficult personality group known as Hostile Aggressive (Brinkman & Krischner, 1994). Specifically, he is a Tank. Tank behavior is manifested by ver- bal attacks that are abusive, abrupt, intimidating, and overwhelming. The attacks are arbitrary and often carry an arrogant tone. A full frontal attack that is loud and forceful is the usual mode, but they can also be quiet and intense. Some attack with cruelty and vulgarity, others with unrelenting criticism. The typical response by the victim of the attack is confusion, mental or physical flight, or a sense of help- lessness that leads to tears or tantrum-like rage. Unfortunately, any evidence of rage or weakness often stimulates the Tank to push on with the attack.

Why d o Tanks behave the way they do? What is their motivation? Tanks are people who have an intense drive to get things done. Their behavior is meant to push the other person into the course of action the Tank believes is best, or eliminate them as the obstacle he or she represents. Tanks have a strong sense of how others should behave and to prove their view of the situa- tion is right. They seem to lack the capacity to receive and accept feed- back, or the leavening of care and trust that prevents the overuse of aggression. They are contemptuous of their victims and consider them to be inferior people. They demean others to gain a sense of self-impor- tance and superiority. Tanks expect others to run from them. They value aggressiveness and confidence.

When being attacked by a Tank, it’s important to stand up for your- self and command respect. In inter- acting with a Tank, recognize that the fear and confusion you feel are natural, even appropriate reactions to being attacked. Your character is being tested. Realize that how you respond and what you reveal during your interaction will ultimately determine the Tank’s perception of you and his or her future behavior toward you.

Once you realize you are being attacked, calmly wait for the person to run down. Remain in place and focus on your breathing. Look directly a t the Tank. When he or she begins to lose momentum, jump in and interrupt the attack. Clearly,

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loudly, and assertively say that per- son’s name over and over. You could also try dropping a book or a pencil. Just make sure your action could not be perceived as a counterattack. Try to get the person to sit down. If they refuse to d o so, remain standing. This may also be a time when cut- ting the person off before they lose momentum may be appropriate. This is especially true if the attack is taking place in a public place.

just escalate their attack. Second, you could win the battle but lose the war. This is especially true if the Tank is your boss. Being defeated and overwhelmed does not cure this person. Instead, it leaves him or her seething and plotting, driven under- ground as snipers, or disoriented, highly anxious, and maybe danger- ous. An argument will also leave a very bad impression with others who may observe the interaction.

DifJicult peopk-like Tank-permeate our every day lives. Take every opportunity to practice your

communication techniques so that they don’t catch you offguurd with their surprising behavior.

Once you have begun speaking, backtrack to the main point and blend to the speed of the conversa- tion. Use words that that express self-assertiveness and your own points of view but don’t imply a direct attack on anything the person has said. Use phrases such as, “In my opinion ...” or “ I disagree with you,” versus, “You are wrong!”

Evelyn might have said, “Dr. Crush! Dr. Crush! Dr. Crush! I can see you have a problem with the hospital policy. I am willing to dis- cuss this with you but not if this is how you are going to treat me. When you are ready to speak to me with respect, I will take all the time you want to discuss this issue. Now would you like to go back to the office to discuss this further or come back when you are finished with your rounds?” And wait for the reaction. Never close the door in Tank’s face by walking away o r other dismissive type of action.

What should Evelyn d o if Dr. Crush interrupts her? Evelyn could interrupt the interruption by stating firmly and loudly, “Dr. Crush, you interrupted me! I listened to you and now I want you to listen to me.” If the Tank doesn’t stop, say it again, and then say it again.

Avoid verbal sparring. One of two things will happen. First, you could lose the battle. A fight is directed toward prevailing, winning, and forcing the opponent to back down. Tanks cannot give in; it will

Once the Tank has been con- fronted, but not personally defeated, he or she usually will see you as worthy of respect and make friendly overtures toward you. These feelings are genuine so be ready to be friend- ly back. Rarely, if ever, will the Tank attack you again. If so, repeat the above actions. Slowly but surely, you will cease to be their victim.

Difficult people-like Tanks- permeate our every day lives. Take every opportunity to practice your communication techniques so that they don’t catch you off guard with their surprising behavior. If you have a Tank in your life, rehearse over and over what you plan to say and how you plan to act the next time the Tank attacks. Rehearsal will help you stay calm and in control.

meet regularly to share stories of communication events you have experienced. Talk about your suc- cesses, failures, and what you would d o differently the next time. Last, realize you have choices and alternatives. Take charge of the situ- ation rather than be a victim. Remember that you can’t change anyone else but you can help others to change themselves. Have com- mitment and perseverance, and suc- cess will be yours. +

Team up with a partner. Plan to

Reference Brinkman, R., & Krischner, R. (1994).

Dealing with people you can’t stand. New York, NY: McCraw-Hill.

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