Bill Miller's Book, "Listening Well" is Worth a Post, and Read

It's been about a year and a half since I last posted here. I can't tell you why I have lapsed, though I have been preoccupied with work, my family and current events. All have contributed to the challenge of staying "posted" on developments in the world of empathy.

Plus, Ed Rutsch and his sites, Center for Building a Culture for Empathy, and Empathy and HealthCare are both awesome and comprehensive sources for posts and developments.

It was actually a post by Ed on Culture for Empathy that featured Bill Miller and his new book, Listening Well: The Art of Empathic Understanding that stimulated me to resume blogging and write this post.

Bill Miller is the primary force behind Motivational Interviewing, a highly effective motivational counseling method that features an empathic patient-centered style. I highly recommend Bill's little new book, which serves as a primer on the core empathic listening skills that are central elements of MI. There is so much wisdom in this little book, as well as great examples of empathic listening and valuable suggestions for skill practice.

Enjoy!

Empathy and Compassion Matters.

Marina Sampanes Peed, a friend and fellow person with a MPN, shared her reactions to the recent US election on her website. Marina's comments are compassionate and inspiring.

I shared her post on Facebook - see my embedded post below.

Why We Train & Coach Clinicians in Communication Skills and Motivational Interviewing

This video was developed by the Veteran Health Administration (VHA)'s National Center for Health Promotion and Disease Prevention (NCP) to help VHA clinicians and leaders recognize the value of participating in NCP's patient-centered communication training. NCP developed two training programs to meet clinicians' needs: 1) TEACH for Success (TEACH), which features basic communication skills in health education and health coaching: and 2) Motivational Interviewing (MI), a clinical method for identifying and building patients' motivation to actively engage in self-care and health behavior change. VHA's TEACH and MI programs were specifically designed for VHA primary care clinicians providing care in Patient Aligned Care Teams (PACT), VHA's version of the patient centered medical home.

The patient-centered communication skills featured in TEACH and MI training enhance clinicians' capacity to provide personalized, proactive, patient-driven care (PPPDC). These skills include relationship-building skills (e.g., open-ended questions to explore patient needs, values and concerns; reflections, empathy, respect); health education skills (e.g., sharing information, teach-back), shared decision making skills, and health behavior counseling skills (e.g., evoking change talk, goal setting, problem-solving).

In addition to participating in face-face, experiential TEACH and MI courses, clinicians are offered opportunities to participate in follow-up clinician coaching to help them apply TEACH and MI skills in clinical encounters with Veterans. To disseminate TEACH and MI training and follow-up clinician coaching, NCP trains and supports over 300 active TEACH and MI Facilitators, who are also extensively trained to provide learner-centered clinician coaching. TEACH and MI facilitators/coaches also serve as VHA facility-based Veterans Health Education Coordinators (VHECs), Health Behavior Coordinators (HBCs) and Health Promotion Disease Prevention Program Managers (HPDP PMs), and work collaboratively with PACT teams to integrate TEACH and MI skills with other tools, resources and programs that support PPPDC. These tools and resources include: an online health risk assessment tool, goal-setting and decision-making tools, an online Veterans Health Library; and access to VHA and community-based programs in tobacco cessation, weight management, self-management and other health behavior change areas.Training and clinician coaching in TEACH and MI is a key component of PACT's "roadmap" for operationalizing PPPDC in primary care.

In the "Why Train" video, PACT leaders, PACT clinicians and Veterans share reflections about the value and impact of TEACH and MI training on Veteran experience, the quality of care and health outcomes. Clinicians also share how training and coaching has enhanced their skills, their  morale and even their overall satisfaction with their work!

EmpathyWorks Reaches 25,000 Views!

Since my First Post on EmpathyWorks on July 11, 2009, the blog has now reached 25,000 views!

My 79 posts on EmpathyWorks have covered a range of topics that reflect my interest in the role of relationship-building in health care and the impacts of empathy, compassion and patient engagement on patient experience and health outcomes.

Some posts have shared new research findings on the value of clinician empathy or have featured the wisdom of  Carl Rogers, Jodi Halpern, Brené Brown, Bernie Lown, Jessie Gruman, and many others who have made empathy, compassion or patient engagement a focus of their professional careers. 

Other EmpathyWorks posts have featured the experience of people, like myself, who are coping with the challenges of living with a chronic condition. When I first started blogging, several posts were linked to a column I wrote for MPNforum, an online magazine for people, or loved ones of people, with myeloproliferative neoplasms (MPNs). 

My heart goes out to my fellow "MPNers", who regularly demonstrate empathy and compassion for others in their posts on support sites on Facebook, such as Polycythemia Supportive Friends, and MPN Foum.

Since I have started blogging, I have found many inspiring and helpful blogs, websites and social media sites that address the topics of empathy, compassion and patient engagement. Links to these sites are available in the right column of the EmpathyWorks blog page. I particularly recommend Edwin Rutsch's Culture of Empathy website, a treasure trove of links, resources and commentary on empathy and its application to a wide range of topics, from health care to education to international relations.

You will also find links to organizations that focus on training clinicians in patient-centered communication skills, such as the American Academy on Communication in Healthcare (AACH) and the Institute for Healthcare Communication (IHC). IHC and AACH have played critical roles in my personal and professional development as an educator and advocate for patient-centered communication training.

Other organizations, such as Center for Advancing Health and the Institute for Patient and Family-Centered Care offer approaches and resources for advancing patient and family engagement at all levels of health care, from patient involvement in self-care and self-management to patient and family engagement in health care policy and health system redesign.

I hope you will continue to visit EmpathyWorks and that you will also share your reactions, insights and resources.

Enjoy!

Michael

When Empathy Doesn't Work:The Paris Attacks

The recent bombings in Paris are maddening, sickening, disturbing and deeply troubling. The attacks targeted innocent unsuspecting people attending a concert, a soccer game, dining or simply enjoying a warm fall Paris evening at a local cafe or bistro.

And or course, it is natural to respond to these brutal senseless killings with fury, hate and a desire to inflict revenge upon those responsible. 

ISIS has taken responsibility for the carnage, so our anger and calls for retribution are directed at them...whoever and wherever they are.

I understand this....I too, feel pain and anger as well as disgust and worry, though of course, my pain and anger is only a fraction of what is experienced by those who have been directly impacted by the losses, or by the threats of further loss. 

My visit to Paris last month, my first visit to France, to the very hospital that is across the street from one of the cafes that was hit by the terrorists, has heightened these feelings,

I feel a connection to Paris that seems to grow stronger with each passing hour and each story that I hear or read about the tragedy. 

Yesterday, I sent an email to the physician and his assistant who generously consulted with me during my visit to Paris, letting them know my thoughts were with them.

I imagined what they might be feeling, and I was moved to reach out to them to let them know that I support them. 

This, I believe, is an attempt to express empathy. Hopefully, my attempt to express empathy was received and was experienced as helpful, as emphatic. If so, it's an example of how empathy can "work".

However, I am having difficulty understanding how humans, the terrorists who both planned and executed these acts of violence, could act so ruthlessly, with such blatant disregard for human life.

I can't even imagine this...how a human brain, a human heart, a human soul could allow someone, anyone, to act in this way. 

In this instance, empathy fails me. It's missing. It doesn't work. Perhaps, I am missing something?

For Empathy!

As a follow-up to a previous blog post, Against Empathy? , I would like to share a column by Denise Cummins, PhD, a cognitive scientist and author. Dr. Cummins is an elected Fellow of the Association for Psychological Science and her research specialty is decision-making and thinking.

In her column, which appeared in Psychology Today in 2013, Cummins argues that Bloom is wrong when he concludes "empathy is prone to biases that render moral judgment potentially harmful.” 

 As Cummins points out in her column, Bloom errs when he posits that empathy for the suffering of individual victims that we can identify with because they are "like us" produces biased and faulty moral reasoning that can lead to mass retribution and violence.

Cummins argues that Bloom places too much value on reasoning, which is certainly not immune from faulty  moral judgements. Cummins suggests that it is the pairing of empathy with "good" reasoning that leads to humanitarian actions.

"The answer is to expand our empathy to include those who are not like us. That is what drove so many white Americans to argue for the abolition of slavery, the end of Jim Crow laws, and the institution of civil rights.......It is precisely our ability to imagine the plight of the nameless and faceless that elicits our empathy and our desire to act."

Dr. Cummins ends her column with the following call for embracing both our capacity for empathy and our ability to reason when engaging in moral reasoning.

"Instead, it is the marriage of empathy to principle that has always been and will continue to be our salvation. It is our ability to generalize and to direct our empathy through the use of reason that is our saving grace. Without that, it is easy to create a holocaust, a crusade, or a jihad.

More on Dr. Cummins' illuminating views on the value of empathy can be found  on the Culture of Empathy website.

Dr. Cummins wrote Good Thinking: Seven Powerful Ideas that Influence the Way We Think (Cambridge University Press, 2012).

Hawking Identifies Empathy as Key to Civilization's Survival

See this AOL feature on Stephen Hawking's views about the importance of empathy as an antidote to aggression and a key to civilization's survival. Clearly, Hawking's brilliance extends beyond "hard science". Thanks to Vaughn Keller for sharing this piece on Facebook.