Wednesday, 28 October 2015

Reflection on Listening Skills (learnt from Pastoral Skills & Methods)




I am working as a full time GP. As I reflect back on my development of empathetic listening skills this semester, I felt doing the Pastoral Skills & Methods not only helped me work-wise, but also in my everyday interactions with family and friends. The other two units I took are Cross-Cultural Communications and Introduction to Christian Ethics. Although busy, these units worked in good synergy with each other: knowledge from one subject actually helps the other subject. I tried to be cautious about keeping a balance in life, as Stairs[1] notes that people are not going to feel heard by someone who is in a hurry. If we fail to suspend our own agenda, many opportunities for listening pass us by.[2]

Moodle videos:
Leadership Training
https://youtu.be/ESujTCel6lM

Everybody Loves Raymond
https://youtu.be/4VOubVB4CTU

Poor communication
https://youtu.be/W1RY_72O_LQ
The Moodle videos gave me important reminders. The video on leadership training reminded me that active listening is an empathetic way of reflecting back of the words and feelings the troubled person has expressed to see if I’ve understood correctly. Occupationally, I often reflect back the words and feelings of my patients to see if I’ve understood correctly, but probably not in a very empathetic way. I find it difficult to be empathetic when I am busy and behind schedule. The video “Everybody Loves Raymond” reminds me that sometimes judgmental comments can sometimes slip out of my tongue especially if I am stressed, which is obstructs communication. Another words, I am sometimes prone to falling into the trap of evaluative listening, where as I listen, I am judging what the other person is saying as good/bad, right/wrong, acceptable/unacceptable, likable/unlikable, relevant/irrelevant, etc. Therefore, I sometimes start challenging people prematurely. Egan[3] notes that while what comes out of the counsellor’s mouth might well be sound advice, but counselees should first be understood, then, if necessary, challenged or helped to challenge themselves. I find the video on “Poor Communication” very exaggerated. I am glad that we had some communication skills training in medical school and I haven’t seen any doctors communicating to people as poorly as the one in the video. 

My first observation sheet was on the topic of personal frustration. The opening was very difficult because the interviewee didn’t seem interested in talking. However, I think it was a good simulation of a scenario where the counselee was brought in against his/her will. It was a slow start where he only answered in monosyllables or even silence in response to open ended questions! So I had to resort to a more targeted form of questioning quite similar to the history taking I do with patients during my job as a doctor in order to collect enough facts to help me detect the underlying issue. I was aware that sometimes it is easy to fall into the trap of fact-centred listening where one is so focused on collecting the facts that one misses the person. Egan[4] believes the antidote to this is to listen to clients contextually, trying to focus on themes and key messages. I tried to focus on that, so the questions I asked and the reflective statements I made eventually led us closer to the issue, and the whole pace of the session got faster.

My second observation sheet was on the topic of a person who was getting stuck on the same matter. The evaluator probably thought I handled the session ok because most of the ticks were “pretty much there”. However, the “other person centred approach” and “sense of warmth and openness” were just “getting there”. The lecture that week was on confrontation and challenging, so I remembered trying to use the technique of challenging on the counselee, who was stuck on having a poor relationship with her mother. I think it can be difficult to challenge somebody and be warm and open at the same time. The counsellor needs to establish a good relationship with the counselee to build up enough trust, or else challenging will break the relationship. This level of relationship requires a number of sessions to build up. Pembroke[5] notes that in counselling, a personal quality and availability is more important than any skill or technique. We must have their trust, or they are not going to feel free to talk to us about intimate personal problems.[6] I believe empathetic listening is essential in building a trusting relationship. Empathetic listening centres on the kind of attending, observing, and listening needed to develop an understanding of clients and their worlds. The counsellor must put aside their own concerns to be fully with the counselee. Furthermore, Carl Rogers points out that these deeper understandings of the counselee remain sterile unless it is somehow communicated to them. Although the counselee can appreciate how intensely they are attended and listened to, they and their concerns still need to be understood.[7]

My third observation sheet was on the topic of a close Christian married friend who is having an affair. The evaluator thought I gave appropriate responses and listened well. The interviewee thought that I was quick to give advice and he would have wanted to get listened to more. I thought I listened and understood the issue quite quickly. However, I didn’t communicate this understanding in a way that made the counselee felt he was understood. Furthermore, I think I fell into the trap of playing a doctor role instead of a counsellor role in being quick to give advice, as doctors usually start explaining “management/treatment options” to the patients towards the end of the 15 minute consultations! Clinebell[8] believes counsellors should avoid falling into the trap of the need to prove one’s counselling competence by solving people’s problems quickly with wise advice. Instead of concentrating on solutions, caregivers should focus on understanding and being with people. I think this is something I should watch out for. Doctors are trained to recognise issues, eg. Recognising someone with depression. But to counsel or pastorally care for someone with depression is a different ability/skill: I may be able to recognise it and refer the person on, but I am not necessarily effective in counselling or motivating this person. This is something I can improve on.

Stairs[9] believes that we are listening for more than what is consciously expressed. Continual spiritual formation is critical. Listening for the soul means paying attention to the signs of God’s voice and graceful activity and inviting others to become more aware of God speaking through such signs.[10] A person can act as a vehicle for the Holy Spirit’s encouragement. The Scriptures describe the Holy Spirit as ‘another counsellor’[11]; the awesome power of God that brings lasting change which might never come otherwise.[12]

Interestingly, during my trip to Israel, a sister with a strong gift in intercession prayed for me using the following verse (even though she had no idea what subjects I am doing at Morling College):
The Sovereign Lord has given me a well-instructed tongue,
    to know the word that sustains the weary.
He wakens me morning by morning,
    wakens my ear to listen like one being instructed.
(Isaiah 50:4)
Guess this is an aspect God wants me to grow further in.

Bibliography:

Clinebell, Howard John and McKeever, Bridget Clare. Basic Types of Pastoral Care & Counseling: Resources for the Ministry of Healing and Growth. Updated and revised by Bridget Clare McKeever. Nashville: Abingdon Press, 2011.

Collins, Gary R. Christian Counseling. Nashville: Thomas Nelson, 2007.

Egan, Gerard. The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping. Belmont: Brooks/Cole, Cengage Learning, 2014.

Geldard, Kathryn and Geldard, David. Counselling Skills in Everyday Life. Basingstoke: Palgrave Macmillan, 2003.

McGilvray, Jill. God's Love in Action: Pastoral Care for Everyone. Brunswick East, Vic.: Acorn Press, 2009.

Pembroke, Neil. The Art of Listening. Grand Rapids: William B. Eerdmans Publishing Company, 2002.

Stairs, Jean. Listening for the Soul: Pastoral Care and Spiritual Direction.
Minneapolis: Fortress Press, 2000.

Wang, Ying-fan Yvonne. Dr Yvonne Wang’s Blabberings. Last modified October28, 2015. http://dryvonnewang.blogspot.com.au.





[1] Jean Stairs, Listening for the Soul: Pastoral Care and Spiritual Direction, (Minneapolis: Fortress Press, 2000), 20.
[2] Stairs, Listening for the Soul, 23.
[3] Gerard Egan. The Skilled Helper: A Problem-Management and Opportunity-Development Approach to Helping, (Belmont: Brooks/Cole, Cengage Learning, 2014), 101.
[4] Egan, The Skilled Helper, 102.
[5] Neil Pembroke, The Art of Listening, (Grand Rapids: William B. Eerdmans Publishing Company, 2002), 74.
[6] Kathryn Geldard and David Geldard. Counselling Skills in Everyday Life, (Basingstoke: Palgrave Macmillan, 2003), 29.
[7] Egan, The Skilled Helper, 82.
[8] Howard John Clinebell and Bridget Clare McKeever. Basic Types of Pastoral Care & Counseling: Resources for the Ministry of Healing and Growth, (Nashville: Abingdon Press, 2011), 74.
[9] Stairs, Listening for the Soul, 17.
[10] Stairs, Listening for the Soul, 29.
[11] Jill McGilvray, God's Love in Action: Pastoral Care for Everyone, (Brunswick East, Vic.: Acorn Press, 2009), 22.
[12] Gary R. Collins, Christian Counseling, (Nashville: Thomas Nelson, 2007), 10. A comment made by Collins based on his own experience: It does not take long for Christian counsellors to see what God can and does do, usually in his own ways in his own timing.

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