Embrace the Tiger:
   How to Enjoy
   Difficult Conversations
  with Your Staff & Patients
 Patricia L Raymond MD FACP FACG
 Rx for Sanity, Norfolk VA




                   RxForSanity.com
If we don't change,
       we don't grow.
     If we don't grow,
  we are not really living.
Growth demands a temporary
   surrender of security.
  ~ Gail Sheehy
                       Learners agreement

          RxForSanity.com
The Sylvia Technique

Don’t Mirror, Harmonize

Whiplash

                             Avoidance/misdirection

           RxForSanity.com
A appeaser is one
 who feeds a crocodile –
hoping it will eat him last.
  ~Winston Churchill



          RxForSanity.com
Carefront- Judith Briles

“When you ________, I felt ________
because _______ . Was it your intent
to _______?

          STOP: Wait for response

In the future, ________ .
If there isn’t a change, _______ .”
                                 Scripted confrontation
               RxForSanity.com
1. How do you feel
 about confrontation?



      RxForSanity.com
Interactions with others
often described as attacks
            •   Heart broken
            •   Butt kicked
            •   Ego bruised
            •   Stabbed in the back
            •   Crushed
            •   Stepped on
            •   Left hanging

                   RxForSanity.com
How do you feel about confrontation?
          • Hunker Down
          • The more I ignore things, the
            bigger they get.




               RxForSanity.com
Embrace the Tiger
Return to Mountain

   ~Tiger Form
   Tai Chi, Nam Hoa Temple

           RxForSanity.com
Conflict = Danger + Opportunity




            Potential
                                Pictogram, p95 qual confront
              RxForSanity.com
When women are depressed
they eat or go shopping. Men
invade another country. It’s a
whole different way of
thinking.
   ~ Elayne Boosler
                          Women p96 UN


             RxForSanity.com
Bonobos verses Chimpanzees




          RxForSanity.com
No One and
   Nothing
is against me.

        Car cuts you off in traffic, 2 A phone call

   RxForSanity.com
10 years private practice in a group


 No One and
   NothingGI Fellowship PGY 2-3


                            GI Fellowship PGY-1

is against me.    Internship/Residency in Internal Medicine

          Medical School


Chemistry Major- hate being in a lab by myself!


             RxForSanity.com
Do people– your spouse, children, colleagues,
staff, patients, friends, strangers in the street-
hold a measure of your well-being hostage?

How comfortable are you with conflict?

What kinds of situations put you on the
offensive?



                  RxForSanity.com
2. Chart your
past confrontation history
          (PCH)



       RxForSanity.com
What have you done to avoid conflict?

How do you avoid or prevent conflict?

What kinds of situations put you on
the offensive?



             RxForSanity.com
Do your obstacles have a theme?

 Have your obstacles made you
 stronger/wiser, or do you keep
 doing the same thing over and
             over?

          RxForSanity.com
Insanity:
doing the same thing
over and over again
and expecting different results
    ~ Albert Einstein


               RxForSanity.com
3. Recast conflict
    as a blessing



     RxForSanity.com
Eye of the Storm
   •Peace, calm, clarity, stillness.
   •Experience the storm without
   resisting or fighting it.

              RxForSanity.com
“All crises
  were not meant
  to be managed.
Embrace the chaos.”
~Susan Elizabeth Phillips,
Breathing Room


               RxForSanity.com
Recast your life experiences
   Choose to see it differently
   Be present in the moment

            RxForSanity.com
4. Next Confrontation
     -Did your sphincters tighten?
 -Keep trying to see conflict as blessing,
          potential, opportunity
         -If that doesn’t work…


             RxForSanity.com
Pull up
your big girl panties,
   & deal with it!
                ~ A cocktail napkin



        RxForSanity.com
Courage is
      like a muscle.
We strengthen it with use.


 ~ Ruth Gordon

         RxForSanity.com
Time to embrace the tiger
    -Ones you initiate
    -Ones that are thrust upon you


              RxForSanity.com
Embracing the tiger: Ones you start
           • First, get centered

           • Second, establish who you are
             wiling to be in the moment
             • Select three, and if you can get the other
               party to commit to three…)




                RxForSanity.com
Select three states of being
                •   Alert           •   Generous
                •   Appreciative    •   Gentle
                •   Attentive       •   Grateful
                •   Clear           •   Joyous
                •   Compassionate   •   Kind
                •   Courageous      •   Loving
                •   Creative        •   Open
                •   Empowering      •   Present
                •   Enthusiastic    •   Receptive
                •   Flexible        •   Supportive
                •   Focused         •   Truthful
                                    •   Vulnerable

                RxForSanity.com
Embracing the tiger:
Ones that are thrust upon you
            • Cultivate non-resistance
              • Martial arts, yielding
              • Don’t tense up!



                 Resistance is futile.
               Non-resistance is fertile.

                 RxForSanity.com
Embracing the tiger:
Ones that are thrust upon you
            • Only two sentences for you:


                   Tell me more.
                What do you need?
                        ~or~
               What’s missing for you?
                                   Mom work excuse
                 RxForSanity.com
LISTEN!
  “attend to them with the ear of your
  heart…”
       ~Prologue, Rules of St. Benedict


             RxForSanity.com
The Chinese character for "listening
attentively"
            • Consists of five characters:
              - the character for ear
              - for standing still
              - for ten
              - for eye, and
              - for heart and mind.
            • Listening attentively means:
            "When in stillness, one listens with the
              heart. The ear is worth ten eyes."
                   -- Zen Master Dae Gak, "The
              Practice of Listening"

                  RxForSanity.com
Now, Choose your next tigers!
          • If you had a magic wand, and
            could wave it over your
            staff/patients/colleagues and get
            them to do any one thing
            differently, what would you choose
            and why?
          • If the people in your office were
            singing a blues song about their
            job, what would they be singing
            about EXACTLY?
               RxForSanity.com
It was a high counsel
      that I once heard
 given to a young person,
        "Always do
what you are afraid to do."
  ~Ralph Waldo Emerson


           RxForSanity.com
You may be disappointed
       if you fail,
  but you are doomed
    if you don't try.

 ~ Beverly Sills

          RxForSanity.com
RxForSanity.com
III


RxForSanity.com
I am not afraid of storms,
         for I am
      learning how
     to sail my ship.

 ~ Louisa May Alcott

          RxForSanity.com
Pull up
your big girl panties,
   & deal with it!
 ~ A cocktail napkin

          RxForSanity.com

Embrace thetiger

  • 1.
    Embrace the Tiger: How to Enjoy Difficult Conversations with Your Staff & Patients Patricia L Raymond MD FACP FACG Rx for Sanity, Norfolk VA RxForSanity.com
  • 2.
    If we don'tchange, we don't grow. If we don't grow, we are not really living. Growth demands a temporary surrender of security. ~ Gail Sheehy Learners agreement RxForSanity.com
  • 3.
    The Sylvia Technique Don’tMirror, Harmonize Whiplash Avoidance/misdirection RxForSanity.com
  • 4.
    A appeaser isone who feeds a crocodile – hoping it will eat him last. ~Winston Churchill RxForSanity.com
  • 5.
    Carefront- Judith Briles “Whenyou ________, I felt ________ because _______ . Was it your intent to _______? STOP: Wait for response In the future, ________ . If there isn’t a change, _______ .” Scripted confrontation RxForSanity.com
  • 6.
    1. How doyou feel about confrontation? RxForSanity.com
  • 7.
    Interactions with others oftendescribed as attacks • Heart broken • Butt kicked • Ego bruised • Stabbed in the back • Crushed • Stepped on • Left hanging RxForSanity.com
  • 8.
    How do youfeel about confrontation? • Hunker Down • The more I ignore things, the bigger they get. RxForSanity.com
  • 9.
    Embrace the Tiger Returnto Mountain ~Tiger Form Tai Chi, Nam Hoa Temple RxForSanity.com
  • 10.
    Conflict = Danger+ Opportunity Potential Pictogram, p95 qual confront RxForSanity.com
  • 11.
    When women aredepressed they eat or go shopping. Men invade another country. It’s a whole different way of thinking. ~ Elayne Boosler Women p96 UN RxForSanity.com
  • 12.
  • 13.
    No One and Nothing is against me. Car cuts you off in traffic, 2 A phone call RxForSanity.com
  • 14.
    10 years privatepractice in a group No One and NothingGI Fellowship PGY 2-3 GI Fellowship PGY-1 is against me. Internship/Residency in Internal Medicine Medical School Chemistry Major- hate being in a lab by myself! RxForSanity.com
  • 15.
    Do people– yourspouse, children, colleagues, staff, patients, friends, strangers in the street- hold a measure of your well-being hostage? How comfortable are you with conflict? What kinds of situations put you on the offensive? RxForSanity.com
  • 16.
    2. Chart your pastconfrontation history (PCH) RxForSanity.com
  • 17.
    What have youdone to avoid conflict? How do you avoid or prevent conflict? What kinds of situations put you on the offensive? RxForSanity.com
  • 18.
    Do your obstacleshave a theme? Have your obstacles made you stronger/wiser, or do you keep doing the same thing over and over? RxForSanity.com
  • 19.
    Insanity: doing the samething over and over again and expecting different results ~ Albert Einstein RxForSanity.com
  • 20.
    3. Recast conflict as a blessing RxForSanity.com
  • 21.
    Eye of theStorm •Peace, calm, clarity, stillness. •Experience the storm without resisting or fighting it. RxForSanity.com
  • 22.
    “All crises were not meant to be managed. Embrace the chaos.” ~Susan Elizabeth Phillips, Breathing Room RxForSanity.com
  • 23.
    Recast your lifeexperiences Choose to see it differently Be present in the moment RxForSanity.com
  • 24.
    4. Next Confrontation -Did your sphincters tighten? -Keep trying to see conflict as blessing, potential, opportunity -If that doesn’t work… RxForSanity.com
  • 25.
    Pull up your biggirl panties, & deal with it! ~ A cocktail napkin RxForSanity.com
  • 26.
    Courage is like a muscle. We strengthen it with use. ~ Ruth Gordon RxForSanity.com
  • 27.
    Time to embracethe tiger -Ones you initiate -Ones that are thrust upon you RxForSanity.com
  • 28.
    Embracing the tiger:Ones you start • First, get centered • Second, establish who you are wiling to be in the moment • Select three, and if you can get the other party to commit to three…) RxForSanity.com
  • 29.
    Select three statesof being • Alert • Generous • Appreciative • Gentle • Attentive • Grateful • Clear • Joyous • Compassionate • Kind • Courageous • Loving • Creative • Open • Empowering • Present • Enthusiastic • Receptive • Flexible • Supportive • Focused • Truthful • Vulnerable RxForSanity.com
  • 30.
    Embracing the tiger: Onesthat are thrust upon you • Cultivate non-resistance • Martial arts, yielding • Don’t tense up! Resistance is futile. Non-resistance is fertile. RxForSanity.com
  • 31.
    Embracing the tiger: Onesthat are thrust upon you • Only two sentences for you: Tell me more. What do you need? ~or~ What’s missing for you? Mom work excuse RxForSanity.com
  • 32.
    LISTEN! “attendto them with the ear of your heart…” ~Prologue, Rules of St. Benedict RxForSanity.com
  • 33.
    The Chinese characterfor "listening attentively" • Consists of five characters: - the character for ear - for standing still - for ten - for eye, and - for heart and mind. • Listening attentively means: "When in stillness, one listens with the heart. The ear is worth ten eyes." -- Zen Master Dae Gak, "The Practice of Listening" RxForSanity.com
  • 34.
    Now, Choose yournext tigers! • If you had a magic wand, and could wave it over your staff/patients/colleagues and get them to do any one thing differently, what would you choose and why? • If the people in your office were singing a blues song about their job, what would they be singing about EXACTLY? RxForSanity.com
  • 35.
    It was ahigh counsel that I once heard given to a young person, "Always do what you are afraid to do." ~Ralph Waldo Emerson RxForSanity.com
  • 36.
    You may bedisappointed if you fail, but you are doomed if you don't try. ~ Beverly Sills RxForSanity.com
  • 37.
  • 38.
  • 39.
    I am notafraid of storms, for I am learning how to sail my ship. ~ Louisa May Alcott RxForSanity.com
  • 40.
    Pull up your biggirl panties, & deal with it! ~ A cocktail napkin RxForSanity.com