Social and emotional intelligence
Social intelligence relates to what happens as we interact and connect with each other. Professionals need to have a feel for how to behave in a consultation with their patients; they need to have a feel for what to say and do and when to say and do it; in other words, they need to ‘act wisely’ (Thorndike 1920) in order for their interactions to be successful. Emotional intelligence relates to our individual human capacities that help us manage emotions and build those relationships with others. On occasion wc may find ourselves overwhelmed by our own emotions and feeling as if we arc swimming against the tide. Sometimes wc need to acknowledge the need for help and support and may even need to take a break in order to remain effective in practice. Emotions can influence how we react and respond to and treat other people, and emotional intelligence helps us recognise that challenging dimension of our work and develop and maintain the skills necessary to handle the diversity of emotions in a professional manner. In practical terms, it means being aware that emotions can influence behaviour and impact people (positively and negatively) - and learning how to manage those emotions, especially when wc arc under pressure, supports better outcomes for everyone involved.
Activity
Emotion can be overt or hidden. Make a list of the number of different emotions you have felt today. Write down why you felt this way and what you did about it. Is there anything else you could have done to relieve any negative emotions?
Emotional intelligence as conceptualised by Mayer and Salovcy (1997) is presented as a 16-stcp developmental model that can be summarised within four themes (sec Figure 2.2).
Utilising self-awareness
It is useful to reflect on the model in Figure 2.2. In healthcare we should all be able to recognise emotions accurately; many professionals can use emotion to guide care planning.
Perception, appraisal and expression of emotion...
emotionally intelligent individuals can, through physical and mental processes, recognise how they and other people feel and discriminate between honest and dishonest expressions of emotion. Secondly, they can use emotions to facilitate thinking.
Emotional facilitation of thinking...
emotionally intelligent individuals can use emotion as an aid to better judgement and reasoning and as a tool for problem solving and prioritising important information.
Understanding and analysing emotions and employing emotional knowledge...
emotionally intelligent individuals can understand the complexity of emotions such as love and hate; they can recognise transition from one emotion to another—such as anger to shame—and interpret the meaning emotions convey within relationships, such as anxiety associated with receiving bad news.
Reflective regulation of emotions to promote emotional and intellectual growth...
emotionally intelligent individuals can recognise and understand the relationship between emotion and events. For example, they know that they feel sad because someone has died. They can monitor and manage emotion whilst staying open to feelings whether positive or negative.
Figure 2.2 Emotional intelligence 16-step model categorised into four themes (adapted from Mayer and Salovey 1997)
Basic cues, such as words or phrases suggesting particular emotions, and non-verbal cues including expressions of emotion, such as sighing or frowning (Del Piccolo ct al. 2006), can be picked up on. Taking the cue seriously will validate the patient’s concerns and therefore help build trust that enables the concern to be addressed. If we shrink away when emotions arc at the fore, people are less likely to have respect for or confidence in us, whereas ‘weathering the storm’ builds respect and professional confidence (Thompson 2006, p. 133). In face-to-face interactions with patients, we arc well placed to spot these important cues - Egan’s (1998) SOLER technique is a useful tool to help (sec Chapter 4).
In healthcare, the more people who arc involved in a situation, the more emotionally charged things can become. There is a tendency to panic in these volatile or emotionally charged situations, but responding with fear or anger can serve to make things worse. The emotionally intelligent individual working at the highest level will be able to manage emotions properly, but for many of us still developing the skills associated with emotional intelligence, tools such as SAGE and THYME (see Table 2.2), a mnemonic that acts as an aide-memoire for a structured conversation with a person in distress or
Table 2.2 Sage and Thyme mnemonic - an aide-memoire for a structured conversation with a person in distress (adapted from the SAGE and THYME model (UHSM 2012))
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S - Setting |
The environment can aid or diminish dialogue. Create some privacy. Ensure people can sit down. Consider her feelings. She may be upset, shocked and angry. Is the room private and free from interruptions? Is seating conducive to therapeutic dialogue? |
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A - Ask |
You need to let people get things off their chest. Ask them what they are concerned about. As Moss (2012) says, 'some people just need a good listening to’. Acknowledge her feelings and begin by inviting her to talk about these. Be mindful of your non-verbal messaging. Listen well. |
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G - Gather |
Gather all of the concerns. Keep notes. Explain this helps you remember what they have said. It demonstrates you are taking this seriously. People may have many concerns, and the most important concern may be the last they tell you. As they tell you something, ask, ‘Is there something else you are concemed/worried/angry/upset about?’ Keep asking until all her concerns have been expressed. Keep notes and explain why; you don’t want to forget anything and want to make sure everything of concern is recorded |
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E - Empathy |
Recognise and acknowledge what they are feeling. Respond sensitively. Try to avoid losing your 'professional balance' (Moss 2012) by becoming part of their problem. Offer undivided attention. Don’t trivialise her feelings. Respond to the words and the emotions behind the words. Allow quiet times and don’t feel you have to have an |
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and |
immediate answer. Reflect back and ask clarifying questions. |
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T - Talk |
Find out about any existing support systems they have. As care staff we cannot do it all and patients will need to make use of other support mechanisms. 'Who do you have to talk to or support you?’ Who can she talk to when she leaves the clinic? |
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H - Help |
Find out how these support mechanisms/people have helped already. It is useful to know what has been effective and what you can recommend as part of an ongoing system of care and support. What has she found helpful in her past when she has been upset, angry or anxious? Signpost appropriately to services that will help her adjust to her diagnosis. |
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Y-You |
People have knowledge about themselves, so invite them to tell you what they think would help them in that situation. Let her be a partner in care. Be empowering in your approach |
(Continued)
Table 2.2 (Cont.)
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M - Me |
You might be able to help in ways previously unknown. Ask the person what they would like you to do. You may need to signpost to other services as the best sources of support whilst being honest about the limits of your role. You may devise a plan of action that leads to you concluding the conversation. Be honest about what is available and consider the skills of the wider interdisciplinary team. One person will not meet all her needs. Get practical by writing things down for her, giving other information such as contact details of services, leaflets, web addresses and so on. |
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E-End |
Summarise and close. Ask, ‘Can we leave it there?’ Notice how emotions have changed. Acknowledge her feelings once more. Offer reassurances about services that can help. Arrange a follow-up as appropriate. |
with concerns, can help (UHSM 2012). ‘SAGE’ gets the user into the conversation and ‘THYME’ helps them to create a good ending.
