Breathe, Listen, Get Curious: Managing Team Conflicts

By Lori Dillon, MPA
We all deal with people – lots of them – every day.
That may be one of the things that drew us to the profession of physical therapy: the desire to connect with and help others. And dealing with people means sometimes dealing with conflict. It’s inevitable. In fact, managing conflict – rather than ignoring it – may actually be the key to success. Managing conflict can build trust and relationships within your team. It also contributes to staff retention and your own happiness and sustainability as a leader. This isn’t to suggest that conflict is easy or welcomed. Hopefully it’s rare. When those occasional moments do arise, you want to feel prepared to manage them with curiosity, generosity, grace, and strength. Of course, there are no universally successful approaches for dealing with conflicts. You have likely developed strategies over time that work for you and your team. In my experience (and oftentimes learned the hard way), there are some fairly reliable approaches that help defuse and potentially resolve conflict.
LISTEN (LIKE, REALLY LISTEN)
We all know what it’s like to listen to someone while having our own thoughts running in the background. We might be thinking about our next patient, what we need to pick up at the store on the way home, or even what advice we plan on giving this person once they are done talking. Multi-tasking is virtually a required skill for our role, right? The truth is, we all listen like this sometimes. We have to in order to sustain. Plus, not everything requires complete, focused attention on listening to someone to the exclusion of our own thoughts. But another kind of listening – sometimes called active listening, level II listening, or empathetic listening – is focused on the other person, listening for what is behind their words. When someone is struggling, and brings big emotion (be it anger, frustration, fear, sadness) to the surface, this kind of deep listening not only positions you to start understanding what is really going on, but often creates the space and tone for the other person to feel truly heard, thus allowing them to calm down. This kind of listening requires time (a little focused time goes a long way!), dedicated space (you don’t necessarily want to engage in this conversation in the hallway, between patient visits), and thoughtful reflection.
GET CURIOUS
Imagine you’re wrapping up a long day where you just treated 14 patients, conducted a performance review for an employee, and your HVAC stopped working. You’re tired and ready to leave for the day, but as you’re packing things up your front office coordinator approaches you, complains about not feeling valued, and threatens to leave if he is not given a raise. These are the moments when your emotions will tempt you to say or do things that you might regret later. However, these are the moments when you need to dig deep and get curious.
We all know about fight-or-flight mode as our natural reaction to threat. Research indicates that the threats that can push a person into fight or flight are not just physical fears like being chased by a bear. Perceived emotional threats can cause the same reaction. When faced with conflicts (either as a mediator or a participant), the people involved often experience amygdala hijack, i.e., fight or flight.1,2 To calm this mode and get to a place of rational thinking, take a brief pause, breathe, and get curious.
Back to our example of the front office coordinator who wants a raise: he could be in fight-or-flight mode for any number of reasons, and his reaction is to confront you in what you perceive to be a threatening way. You may be in fight or flight mode, feeling like this employee is questioning or even undermining the many benefits and opportunities you have offered him over time. All of the feelings and stories in your head could encourage you to “fight” back or run out of the clinic door. In this moment, you would be better served to pause and get curious. Your perspective of the situation is only part of the story. Try calming the amygdala hijack that both of you are experiencing by finding out more before you emotionally react, impart your advice, or impose your ruling. Start your reflections with statements like “Help me understand” or “Tell me more about what’s going on.” These responses generally lead to an opportunity for the people involved to share their perspective and feel heard. It also allows you to get clarity on what is at the heart of the issue.
REFLECT AND CORRECT
Motivational interviewing (MI) is a collaborative, goal-oriented style of communication with particular attention to the language of change.3 One of the many elements of MI is reflective listening, trying to understand what another person is saying by repeating, rephrasing, or offering a deeper guess about what is being communicated. Reflective listening4 is a specific way to “get curious” and gives you a chance to achieve clarity on what’s really going on.
Reflective listening statements like “It sounds like…,” “So you…,” and “You’re feeling…” allow you to share your impressions of what you hear from others and lets them confirm or deny those impressions. If they offer a variation of your interpretation, let yourself be corrected and then reflect again on what you hear. Why? This approach allows people to be seen and heard, which slows down that fight-or-flight mode and helps the other person feel more empowered. It allows you to understand the heart of the matter, not just the first impressions you have about a situation. More than anything, reflective listening supports real trust-building between you and your team. In the earlier example, you may initially invite your front office coordinator to “tell me more about what you need right now,” followed by a summary of what you think you heard from him. For example: “It sounds like you are struggling to make ends meet?” or “You’re not feeling that your pay aligns with the value that you bring to the team?”
DON’T WAIT
The easiest thing to do is to ignore conflict. Let’s be honest, we have plenty of things on our plate and managing conflict is not our favorite. Sometimes, dismissal is okay, but it’s almost always true that dealing with issues sooner rather than later is better. Letting things linger can progress to cultural decay, turnover, and, worst of all, a negative patient experience.
When conflict arises, and you are not comfortable confronting it, know that you are in good company. Take a deep breath. Think about what you want to ask (plan it out or even role play it with a trusted buddy if you have time). Be as curious and generous as you can. Reflect back what you hear, with an openness to being affirmed or corrected. You will be better off for it.
References:
1Rock D. Managing with the Brain in Mind. Strategy+Business. 2009;56:0926. https://www.psychologytoday.com/sites/default/files/attachments/31881/managingwbraininmind.pdf
2Holland K. Amygdala Hijack: When Emotion Takes Over. Healthline. https://www.healthline.com/health/stress/amygdala-hijack. Updated September 17, 2021.
3Motivational Interviewing Network of Trainers. Understanding Motivational Interviewing. MINT.com. https://motivationalinterviewing.org/understanding-motivational-interviewing. Accessed November 4, 2021.
4Hanson W. The Three Levels Of Listening. Bettermanager.com. https://www.bettermanager.us/post/levels-of-listening. Published June 13, 2018.

Lori Dillon, MPA, is a PPS Administrators’ Network member and Director of Professional Development for Therapeutic Associates. She is based in Seattle, Washington, and can be reached at ldillon@taipt.com.