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Breathe, Listen, Get Curious: Managing Team Conflicts

Office worker meditating

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

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.