Ruthie had been in the Care Center for 10 years. With each breath she took her chest moved up and down with exaggerated motion. A tracheotomy kept her alive. Her voice was raspy. Susan was Ruth's care giver, her friend. Ruth told Susan how the nurses had ignored her when she had told them she needed a clean gown. But they conversed with each other as if she wasn't in the room.

It took concentrated skill for Susan to understand Ruth. She listened carefully, "The nurses ignored me today," Ruth uttered in a strained voice.

"Go on," Susan responded.

"As they changed my sheets they talked about the movie they had seen."

"Hmm," Susan nodded.

"As I tried to speak, they paid no attention to me. Ruthie continued, "Avatar" was the best movie they had ever seen. That's all they cared about."

Susan responded, "So they didn't even acknowledge you?"

Ruth shook her head, "No."

Susan patted her shoulder then paused. Trying not to minimize Ruthie's experience and with sensitivity, she shared a similar experience.

"Nurses were preparing me for an angiogram," Susan said. "They ignored my attempt to ask questions as they discussed plans for getting together with friends. They talked about going on a boat trip for the weekend. Susan continued, "I felt more like a piece of machinery than a person."

Ruthie's eyes opened wide. She laid her head back on her pillow. Her facial appearance signified a silent reaction of satisfaction. Susan had understood. They continued to converse. Ruth's voice indicated joy as did Susan's.

1. The key to good listening is empathy. It is the heart and soul of communication

Dianne Schilling holds a master's degree in counseling and is a founding partner of WomensMedia.com. She writes about empathy:

"To experience empathy, you have to put yourself in the other person's place and allow yourself to feel what it is like to be her at that moment. This is not an easy thing to do. It takes energy and concentration. But it is a generous and helpful thing to do, and it facilitates communication like nothing else does.

There are other steps to guide us into becoming an affective listener:

2. Reflective Listening

Be natural with responses: (must be well-timed).

  • Summarize - "You were in an awkward situation. Sounds like he didn't pay attention to your opinion."

  • Paraphrase - "What you're saying is he refused to take you to the dance?"

  • Restate - "You didn't make the football squad? No wonder you're disappointed. I don't blame you."

  • Replay - "You made the gymnastic team? How thrilling."

  • Show you understand, "You're saying your sister ignores you?"

3. Avoid distractions

  • Don't look away, fidget, or watch TV.

  • Concentrate on the person speaking not on what you want to say.

  • Be attentive during your conversation, stay focused.

4. Body Language

How you stand, sit, move your arms and hands, establish eye contact are all important listening skills.

I was walking down the corridor in a hospital when I ran into my doctor walking briskly toward me. He stopped, smiled, and greeted me. Knowing he probably had a patient in 5 minutes I tried to make our conversation short. He folded his arms and casually leaned against the wall, facing me directly. He made eye contact and listened as if he had all the time in the world. It was evident he was interested in what I had to say. The conversation ended and he picked up his pace again and hurried toward his office.

5. Don't interrupt

  • Be patient, wait until the person finishes before interjecting your comments.

  • Don't change the subject.

  • Unless indicated, refrain from stating a solution.

  • Be cautious not to answer your phone or turn your attention to someone else.

6. Interject encouraging statements

  • "I can see you're happy about your new puppy."

  • During conversation occasionally say, "Hmm or uh huh,"

  • "You made the team? I'm thrilled."

  • "OK, go on."

  • "Oh?"

  • Nod your head from time to time

  • Simply state, "Tell me more."

  • Use positive statements, "Thank you for sharing"

  • "I like what you're telling me."

  • "I agree, your decision to stay home from the movie was wise."

7. Respond with emotion

  • Laugh with him or her

  • Smile in response to happy information

  • Return fearful reaction when fitting

  • Show positive facial expressions during cheerful statements.

  • Demonstrate enthusiasm

  • Express sadness when appropriate

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