Behavioral Health Minute

May 2008 - Anchor conversations in patients' language

The short summary
Picking up on or eliciting patients’ language for how they want to be different can be a rich source of information and positive energy in helping them to make changes.

The modestly longer reflection

One of the most powerful and intriguing techniques I often use in working with people on positive changes is to look for or elicit their language for where they want to be going.  I ask “How would you put into words…

• what you would like to accomplish?”
• how you would like to change?”
• how you would like to be different?”
• what would tell us that you are moving forward?”

… and I pay close attention to the language they use in what they say.

In the last week, people have answered these questions…

• I want to figure out “who Donna really is.”
• I want to separate myself from my children’s problems.
• I need to stay in the present time
• I think I can handle all of this as long as I concentrate on doing the right thing.
• I need to work on bettering myself.

Let me point out, by the way, that these are not cream-off-the-top, articulate, collage-educated, existentially-oriented intellectuals; they are regular folk who are putting into words what they want for their lives.

When people say things like this, I pay attention and I frequently anchor conversations in their language.  I do this for two reasons.  First, patients’ language has richness of meaning and information.  I don’t have any idea what “who Donna is” means or what “doing the right thing” means, but patients do, and they are saying this because it matters to them.  Second, there is a very different energy in orienting conversations to what is meaningful for patients rather than what is meaningful to me.  “How are you doing with you effort to better yourself?” has very different energy than “How are you doing with your bipolar disorder NOS?”

One more specific, by the way… people will sometimes answer the questions I illustrate above with reference to feelings.  “I want to be happy,” or “I don’t want to be depressed or anxious.”  This is good because they are saying that they want to be different, but it really helps to ask some follow up question (“What is your sense about how you will get there?” “What do you think will be the key for you in getting there?”) that elicits their language about what they could be putting energy into, as in the examples above.

Follow-up

Notice patients’ language about what they want to be changing or working on and play this back to them.

Fred Craigie, PhD, 5/08