MHM Magazine

24 | MENTAL HEALTH MATTERS | 2023 | Issue 2 MHM In Maya Angelou’s wise words ‘I’ve learned that people will forget what you said, people will forget what you did, but people will never forget how you made them feel.’ As doctors who are often working against the clock, it can be very tempting to rush through our appointments. Keen to make a swift diagnosis, we can easily overlook the primary need of our patient to be seen and heard as a human being, not just a problem to be solved. Deep listening is one of the tools at our disposal that can enhance trust and increase empathy. If you were lucky enough to be read to as a child, deep listening will not be an alien concept to you. Perhaps you remember that cosiness, that safety as you settled in for the next fairy tale or instalment of a long-running narrative? The wonder you probably experienced in those moments was not just due to the skill of the storyteller, but because every atom of you was listening without judgment. Jump forward to medical school, where we were taught to listen very differently. Gone is the sense of wonder and exploration, in its place a radical efficiency. Our training prepares us to ask questions, recognise patterns and solve problems. When we take a patient history, any trace of imagination or subjective emotion is brushed aside in favour of objective evidence. As we hurtle down the route of diagnostic questions our only aim is to eliminate possibilities and come to a feasible conclusion as quickly as possible. This mechanistic approach gives us a valuable skill that can be very effective. It’s also a skill that can be carried out by a computer! The real treasure lies in our ability to connect as people, which is where the art of healing meets the science of medicine. When two human beings meet with the time and presence available to form a bond, the healing potential of that experience is augmented. That’s because a resonant field is created between the two people. With the practice of deep listening, both doctor and patient enter a therapeutic alliance, an agreement to be fully seen and heard. Deep listening vs active listening Drawing out important information from people doesn’t just depend on the questions you ask; it also depends on the attitude you bring to the listening. Whereas active listening is defined as using your language to affirm that you’ve fully heard what the other person is communicating, deep listening involves paying attention with all of you, not just your mind. In my book ‘Dare to Care’ I share the story of Tina, one of my patients who presented with a myriad of symptoms. Her mother was perplexed, and keen to get to the heart of her daughter’s various conditions. Tina shuffled into my practice staring at the floor, her body language clearly indicating that she felt uncomfortable being put ‘under the microscope’. Over the course of two appointments with her, I took a patient history, performed a full examination and ordered lab tests but nothing was conclusive. I had a distinct gut feeling that we were not asking the right questions. We scheduled Tina’s third appointment for the end of the day when I knew we would have more time together. I decided to take an unconventional approach. ‘Tina, we’ve only known each other for a few hours but I feel there is something you know that I don’t which might explain a lot of your suffering. Is that possible?’ Dr Jan Bonhoeffer University Children’s Hospital in Basel, Switzerland contact@heartbasedmedicine.org EMPATHY OVER AUTHORITY: WHAT PATIENTS REALLY NEED