1) Listening is a key component of communication, with people spending up to 70% of their waking time communicating and nearly 45% of that time spent listening. 2) There is a difference between hearing and listening. Hearing is a physiological process, while listening is a psychological process that involves interpreting and understanding what is heard. 3) Effective listening involves attending behaviors like maintaining eye contact, positive body language, mirroring the other person, and verbal tracking to demonstrate following what they are saying.

1. Techniques for Empathetic
Listening
Rev. David Eisenmenger, MAMFT
Director of Education, Research and Programming
Signature HealthCARE, LLC
Spirituality Pillar

2. Our Lives are Spent
Communicating
• Study conducted
across a variety of
occupations
• Up to 70% of waking
time spent
communicating
Everything
else
Communicating

3. How Much Time Do You
Spend?
• Up to 70% of waking
time spent
communicating
• Nearly 45% of
communication time
spent listening
• Conclusion: Listening is
a key component to
every aspect of our
lives
Communicating
All other
communicating
Listening

4. Hearing vs. Listening
Hearing
• A physiological sensory process by which
sensations are received by the ears and
transmitted to the brain
Listening
• A psychological procedure involving interpreting
and understanding the significance of the sensory
process

5. Listen: An Etymology
Derived from two Old English words:
Hlystan, “hearing”
Hlosnian, “to wait in suspense”

6. Attending

7. Attending Behaviors have four
components
• Eye contact
• Body language
• Vocal qualities
• Verbal tracking

8. Eye Contact
• Get on the same level as the people you are
speaking with
• Give enough eye contact…but not too much
• Most patients:
– Will be comfortable with more eye contact when you’re
talking
– Less eye contact when they’re talking—but this can vary
• Cultures vary greatly in what is considered
appropriate eye contact

9. Body Language
• Positive body language
• Leaning slightly toward the patient
• Maintaining a relaxed but attentive posture
• Mirroring

10. Body Language: Mirroring
• Matching the patient’s facial expression
and body posture

11. Vocal Qualities
• Refers to the tone and inflections of your
voice
– Not the content of what you say, but how you
say it
• For example: Pacing
– Moving slightly toward matching the patient’s
vocal qualities
• You can also use your vocal qualities to lead
the patient

12. Verbal Tracking
• Using your words to demonstrate accurate
following
• Includes restating or summarizing

13. Too much of a good thing
• Positive attending behaviors can become
negative or annoying if you use them too
much
• Staring
• Leaning in
• Over tracking

14. Negative Attending Behaviors
• Infrequent eye contact
• Turning away from the patient
• Leaning back from the waist up
• Crossing your legs away from the patient
• Folding your arms

15. Individual and Cultural
Differences
• Every patient is unique
• Listening behaviors to accommodate
individuals

16. Following

17. Following Skills
• Door openers
– Open-ended questions
– Going up at the end of your sentence
• Minimal encouragers
• Infrequent questions
• Attentive silence

18. Door Openers
• Open ended
questions
• “Going up” on the end
of your sentences

19. Minimal Encourage
• Small words
– Convey that you are listening
– Offers an implied invitation to continue talking

20. Infrequent questions
• Less is more

21. Attentive Silence
• Sitting with the patient in the midst of
silence

22. Reflecting

23. Paraphrasing
• Summarize, repackage and return what
you hear
• Reflect the content
• Reflect the feelings

24. The Feeling Wheel
• Primary Emotion
• Secondary Emotion
• Tertiary Emotion

25. Listening for Feelings
Primary Emotions
• Sad
• Mad
• Scared
• Peaceful
• Powerful
• Joyful

26. Secondary Emotions
• Tertiary Emotion:
Relaxed
• Verbalization: “You
have such a
relaxing voice.”
• Secondary
Emotion: Content
• Primary Emotion:
Peaceful

27. Tertiary Emotions
• Tertiary Emotion:
Embarrassed
• Verbalization: “I
cant’ believe I did
that. What an
embarrassment.”
• Secondary
Emotion: Insecure
• Core Emotion:
Scared

29. Resources
• Bolton, R. (1979). People skills. New York, NY: Simon
• Ivey, A., et al (1997). Basic attending skills. North Amherst,
MA: Microtraining Associates
• Lanier, S. A. (2000). Foreign to familiar: a guide to
understanding hot- and cold-climate cultures. Hagerstown,
MD: McDougal Pub.
• Lipson, J. G., Minarik, P. A., & Dibble, S. L. (1996). Culture &
nursing care: a pocket guide. San Francisco: UCSF Nursing
Press.
• Wilcox, G. (Array). Feeling Wheel [ PDF ]. Retrieved from
http://med.emory.edu/excel/documents/Feeling Wheel.pdf