5 minute read

I had the honor of consulting with a storyteller/filmmaker/documentarian and his staff last year. Many of the stories his team tells requires them to interview people who have been through or witnessed terrible things. I was asked to speak with the filmmaking team about considerations when interviewing trauma survivors.

This got me reflecting on the qualities of an interview with a patient that facilitates safety and trust. Drawing from patient centered care, trauma informed care, and third wave humanistic approaches I compiled a list of practical tips to share with the filmmakers. Here I share with you what I shared with the filmmakers as I realized that whether you are a filmmaker or primary care team member they all apply.

How you feel matters.

Are you uncomfortable? Nervous? Exhausted? Feeling rushed?  This is important because as humans we pick up on and mimic other people’s internal states. You have probably heard of mirror neurons. Mirror neurons are the neurons that are triggered in our brain when someone else is sad, angry, or scared. They are what allow us to feel the emotion that another person is feeling, also known as empathy. So before entering a patient room, take a moment, close your else and take a deep breath. Clear your mind, set your intention, and create space for what is about to take place. When a patient sees you relaxed, it is one signal that they can relax too.

Explain the process.

Humans fear the unknown. When a situation is ambiguous and unpredictable the threat detection center of our brains is activated. When this happens, people are less likely to offer personal information, opinions, and or anything they may perceive as a weakness or vulnerability. Let them know what to expect and explain it thoroughly. The more people know what to expect the less they have to worry about surprises.

Don’t underestimate the power of body language.

Researchers have found that communication is only 7 percent verbal and 93 percent non-verbal. The non-verbal component is made up of body language (55%) and tone of voice (38 %). So much of what we say is not about that words we use. So next time you are sitting with a patient take a step back and focus less on your questions and more on what you are communicating with your body and tone of voice. How are you communicating non-judgement, curiosity, intrigue, and most importantly safety? Even the height of your chair matters. Sit at eye level or below eye level to communicate a non-threatening stance.

Vulnerability takes courage.

Even people who think they are ready to tell you what has been going on can be hesitant to reveal their weaknesses and difficult struggles in their past. Most have us have had experiences of being vulnerable and having that vulnerability used against us as weakness or failing. Consciously or unconsciously people believe that being vulnerable invites judgment or rejection. Vulnerability requires trust. I define trust as consistency over time. What makes our work tricky is that we often don’t have a lot of time to demonstrate this. With little time, it is key to be as consistent and reliable as possible.

Shame is the ultimate conversation killer.

Often times people fear judgement about the things for which they feel shame. Noticing what people aren’t talking about might give you a clue to where they have unresolved feelings or shame. Often things that people feel shame about are things they don’t talk about.  Talking about these things can be extremely frightening and yet incredibly freeing. Shame and vulnerability researcher Brené Brown writes that the most powerful way to deconstruct shame is to speak of it. Making open-ended comments like, “I notice you haven’t mentioned your father during our conversation. I can imagine many reasons for this…” can establish a non-judgmental stance to create safety. Staying curious and inquisitive can help convey a non-judgmental stance. Reveling parts of oneself for which they have shame takes safety and trust.

Hone in on what is important to your patient.

I encourage you to find out what is important to the person across from you. What are their values? What motivates them? How is what you are talking about with them connected to what brings them meaning and purpose in their life? Who are their heroes? Their enemies? What were they taught growing up? What has caused them most pain? What brings them most joy? What does it mean to them to share their story? All of these questions allow you to learn more about who they are. Use contextual interviewing to get at this by soliciting information about the domains of work, play, and love.