Using a Formula to Communicate Empathy
Chapter 5
EMPATHIC RESPONDING: WORK AT MUTUAL UNDERSTANDING
The payoff of attending and listening lies in the ability to communicate to clients an understanding of their stories, points of view, decisions, and intentions, together with the feelings and emotions they generate. Responding with empathy to the key messages the client is trying to get across is one way of communicating your understanding. It is one important way in which you translate the value of empathy discussed in Chapter 3 into behavior. Responding with empathy is a skill you need throughout the helping model. It is critical for establishing and developing relationships with clients, helping them clarify both problem situations and unexploited opportunities, setting goals, and developing and implementing strategies and plans. Read Chapter 5 in the text before doing the following exercises.
EXERCISE 5.1: LEARN NOT TO CONFUSE SUBJECTIVE EMPATHY WITH INTERPERSONAL EMPATHY
What do people in general think of when they hear the term “empathy”? Read the vast literature on empathy and you will soon discover that there are many possible answers to that question. However, in The Skilled Helper empathy means interpersonal empathy, the ability to get inside a client’s frame of reference and understand what the client is thinking and feeling together with the ability to communicate this understanding without prejudice to the client. Subjective empathy is different. As Clarke (2010a) notes, “subjective empathy enables a person who is talking to another person to momentarily identify with that person through instinctive reactions and fleetingly imagine and experience what it is like to be a client” (p. 349). This kind of understanding of the client comes from the understanding of oneself and one’s exposure in reality or in imagination to experiences similar to those of the client.
Let’s say that you are with a client who is a victim of torture. The torture ended months ago, but the experience is still alive in him. In staying in touch with what is happening in the world, you have read accounts of horrific torture. You avoid reading such accounts now because the first hint of torture sends chills down your spine and gives rise to feelings of utter helplessness. As your client recounts his experiences, these feelings flood into you. But the client also talks about how his experience of torture has made him afraid to meet new people or even reconnect with old friends because he feels that the torture has scarred him psychologically and made him “ugly,” even though physically he is not ugly at all.
1. What might your supervisor say if your first response to him was something like this? “When you began telling me what they did to you, I had to keep myself from shaking. I almost wanted you to stop.”
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2. Comment on the following response: “So the horror of all this is still so alive that reconnecting with your world seems practically impossible.”
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3. In what ways might subjective empathy help the therapy process?
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4. In what ways might subjective empathy hinder the helping process?
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5. Discuss in class or with a learning partner the distinctions among compassion, sympathy, and subjective empathy, especially as they relate to interpersonal empathy, and their possible roles in therapy.
EXERCISE 5.2: IDENTIFY CORE MESSAGES IN CLIENTS’ STORIES
The rest of these exercises deal with interpersonal empathy. In this exercise, you are asked to identify clients’ key experiences, behaviors, and/or feelings and then translate them into a core message each client is trying to communicate.
1. Listen carefully to the client’s statement.
2. Identify key experiences, behaviors, and the feelings they generate.
3. Pull them together in a statement of the client’s core message.
4. After finishing, compare your responses with those of your learning partner. Then see if the two of you can improve upon your combined responses.
Example: Roula is recovering from a bad car accident in a rehabilitation facility. She is a week or two into a program that could well go on for a few months. In talking with one of the rehabilitation specialists, she says, “You told me it would be tough going. And I thought that I had prepared myself for it. I thought I had some courage in me. But now I can’t find any grit at all. Doing even the smallest things takes so much effort! I keep breaking down and crying when I’m alone. I just keep giving in. … I’m just inches down a path that seems miles long. It seems endless.”
Key experience(s): finding the rehabilitation program so difficult
Key behavior(s): failing to tap into the courage she thought she had; giving in to discouragement
Key feelings/emotions: disappointment, discouragement, despair
Core message: Roula seems disappointed almost to the point of despair because she has failed to tap into the “stuff” within her that would keep her going during a very tough rehabilitation program. Now do the same for the following cases.
1. This woman is about to go to her daughter’s graduation from college. She is talking with one of the ministers of her church: “I never thought that my daughter would make it through. I’ve invested a lot of money in her education. It meant scrimping and saving and not having some of the things I wanted. But money is certainly not the issue. More to the point, I’ve put a lot of emotion into making this day happen. I had to do a lot of hand-holding to help her get through. There were times when neither of us thought this day would come. But the day has arrived!”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Core message:
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2. This older man has just had his wallet stolen. He became disoriented and was taken to a hospital. He’s talking with a social worker. “I had just cashed my paycheck and the money was in the wallet. I’ve had a streak of bad luck. My sister was in an auto accident last week. And I was on my way to visit my nephew. Ironically, he was detained by the police for a minor theft earlier this week. Now he’s probably thinking I’ve given up on him, when I haven’t. There has not been much good news at all for a while.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Core message:
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3. This woman is waiting for the results of medical tests. She is talking to a hospital volunteer: “I’ve been losing weight for about two months and feeling tired and listless all the time. I’m afraid of what these tests are going to say. I know I’ve been putting them off. I just hate hospitals and this kind of stuff. Well, now the waiting is getting to me. I … well, I just don’t know where I stand. Nobody said anything to me during the tests. I don’t think that’s a good sign. It’s all so impersonal, anyway.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Core message:
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4. A client’s prospective employer has just found out that the client has a criminal record: “I had hoped that I would get the job and prove myself before anyone found out about my record. I guess I was just stupid. I’ve just received a call from him telling me that I’m no longer being considered for the job. Well, I did what I thought was right. I never had the intention of deceiving anyone. I mean that I didn’t think that I was doing anything wrong.… Well, even though I’m branded because of my record, I’m going to make it, somehow. I have to.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Core message:
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5. This woman has just lost a custody case for her only son. During the interview with a counselor she seems almost in a daze: “I never dreamed that the court would award custody to my husband. I may not be a perfect mother, but I’ve done all the work in raising him so far. My husband has done nothing but give me a hard time over the years. He’s so selfish and spiteful. I’ve been racking my brains trying to come up with something I can do. … Now he’s won. … It’s all over.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Core message:
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EXERCISE 5.3: USE A “FORMULA” TO COMMUNICATE EMPATHY
Empathy focuses on the client’s core messages—key experiences and/or key behaviors, key points of view, key decisions, key intentions—plus the feelings and emotions they generate. In this exercise, you are asked to use the formula explained in the text: “You feel …” (followed by the right emotion and some indication of its intensity) “because …” (followed by the key experiences and/or behaviors that give rise to the emotion).
Please note that the use of a “formula” is merely a starting place to learn and practice the skill. It should not be taken literally; counseling cannot be reduced to formulas. In the next exercise (5.4), you will build on this skill by putting it in your own words.
1. Identify for yourself the speaker’s key experiences, behaviors, points of view, decisions, intentions, and the feelings associated with them.
2. Formulate an empathic response. Even though you are writing the response, picture yourself actually talking to the person.
Example: A woman in a self-help group is talking about a relationship with a man. She says: “About a couple of months ago, he began being abusive, calling me names, describing my defects. To tell you the truth, that’s why I joined this group, but I haven’t had the courage to talk about it till now. The couple times I’ve tried to stand up for myself, he became even more abusive. He hasn’t hit me or anything, but, anyway. So I’ve been just taking it, just sitting there taking it … like a dog or something. Do you think that this is just his bizarre way of getting rid of me? Why doesn’t he just tell me?”
Key experience(s): being abused by companion, escalation in abuse
Key behavior(s): trying to stand up for herself, becoming passive, trying to figure out if this is his way of getting rid of her
Key feelings/emotions: distraught, confused, angry
Empathic response (using formula): You feel angry and confused because the abuse came from out of the blue and now you’re wondering whether this is just his strange way of ending the relationship.
1. A first-year college student is talking to a counselor in the Center for Student Services. She has been talking about some of the difficulties of adjusting to college life. She comes from a small town and is attending a large state university. She speaks openly and seems to be in good spirits; she even smiles at times: “My new friends seem so much worldlier and confident than me. Most of them have traveled out of the country, have the latest greatest smartphones and computers, and act like college is no big deal. I mean, I am the first one in my family to go to college and sometimes I feel like I landed on the moon! This IS a big deal for me, plus I don’t want to let my family down. I think with a little help I can figure it out, but right now I just feel like the only one who doesn’t have it figured out yet—like I am playing catch-up.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Empathic response (formula):
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2. A 66-year-old man is talking to a mental health counselor: “My wife died last year, and this year my youngest son went away to college. The other children are married. So now that I’m retired, I spend a lot of time rambling around a house that’s … (pauses, looks out the window for a while) … really too big for me.… You know, when I was working, there was a certain fullness to life. I always knew what to do. I, well … I made a difference. Now that I’ve got a comfortable retirement, I .…”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Empathic response (formula):
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3. A 33-year-old woman has been working with a counselor to find ways of handling sex discrimination at work. The company seems to preach one philosophy but implement another. Up to this point she has had some modest success, but now she wants to discuss a setback: “It seems they let me push as long as I stayed with the little stuff and did it quietly. But last week I brought up discrimination in our monthly team meeting … and my boss clammed up. And he’s not one of the worst offenders. He’s been quite cool since then and always seems to be busy. All of a sudden there’s quite a different atmosphere in the office.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Empathic response (formula):
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4. A young woman, 25, is talking about her current boyfriend with a counselor: “I can’t quite figure him out. I still can’t tell if he really cares about me, or if it’s just about sex. It leaves everything up in the air. He’s pleasant enough, but I’m not finding the substance that I thought was there. I do try to talk about serious things, things that interest me like what’s happening in the world. The next thing I know we’re back into trivia. I’ve been tempted to talk about this directly, but something holds me back.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Empathic response (formula):
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5. This young man has just been abandoned by his wife after only a year of marriage: “We’ve been married for about a year.… She left a note saying that this has not been working out. Just like that. You know, I thought that things were going fairly well. Not perfect, of course. We had our ups and downs, but everyone does. Maybe I was so busy at work that there were things I didn’t notice. I don’t know if there’s someone else. I really don’t know why.… I must really sound stupid. I have no idea what to do to get her back. You can’t make someone love you.”
Key experience(s):
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Key behavior(s):
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Key feelings/emotions:
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Empathic response (formula):
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EXERCISE 5.4: USE YOUR OWN WORDS IN EMPATHIC RESPONSES
In this exercise, you are asked to do two things:
1. First, use the “you feel … because …” formula to communicate understanding to the client.
2. Then, recast your response in your own words while still identifying both the “feel” and the “because” part of empathy
Example: A married woman, 31, is having a “solo” meeting with a marriage counselor to review how things have been going from her point of view. At one point, she says: “I can’t believe it! You know when Tom and I were here last week we made a contract that said that he would be home for supper every evening and on time. Well, he came home on time every day this past week. I never dreamed that he would live up to his part of the bargain so completely! I’ve even begun making better meals!”
Formula. “You feel great because he really stuck to the contract!”
Nonformula. “Making good on his word has given you quite a boost!”
3. Now imagine yourself listening intently to each of the clients quoted below. First, use the “You feel … because …” formula; then use your own words. Try to make the second response sound as natural (as much like yourself) as possible. After you use your own words, check to see if you have both a “you feel” part and a “because” part in your response.
1. A 28-year-old woman is talking about her job with a colleague: “It’s not a big thing. But this is the third time this month I’ve been asked to change hours with her. I said yes, of course. But it certainly seems to indicate who is more important there. Why does it always have to be me who defers to her?”
Use the formula.
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Use your own words.
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2. A man who has been suffering from depression for a number of months is talking with a psychologist: “I’ve seen my doctor a couple of times. But now, since the depression isn’t getting any better, he wants to give me this drug.… But I don’t even take aspirin if I don’t have to. Somehow drugs and I don’t mix. If I had pneumonia or some infection, it would be one thing. But this is all in my head. I don’t want to be taking psycho medication. I’m not crazy!”
Use the formula.
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Use your own words.
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3. A counseling trainee is talking to her instructor. The training group has just been introduced to the skill of inviting clients to challenge themselves. They have practiced self-challenge and have just begun using invitations to self-challenge with one another: “For the first time in this program I am having trouble and it’s bothering me. What I’ve found out is that I have no problem with self-challenge. In some ways I have been doing that for years. But now I see that maybe I’ve been picking on myself, you know, being too much of a perfectionist. And I’m finding it really hard to challenge the members of my group. Oh, I know the theory. But doing it is hard. It’s almost as if they won’t like me if I do it well.”
Use the formula.
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Use your own words.
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4. A fellow trainee has been talking with you about the counselor training program. He calls you up and says he wants to talk with you right away. When you meet, he says: “You know, tomorrow we’re going to start talking about our own problems. Well, the kinds of things that could stand in the way of being good helpers.… Well, there are things I’d rather not say in the group.… I barely had the courage to talk with you.… You know, a couple of issues I’d rather not talk about could stand in the way of my being the kind of counselor I should be.… But I’m just not ready. I could be dishonest.”
Use the formula.
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Use your own words.
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5. A man, Frank, is being forced out of the company where he has held a senior position for almost twenty years: “It came out of nowhere. I came in two days ago and there on my desk was a notice from the venture capital group that bought us saying that I was terminated. It was as impersonal as that.… I kept reading it over and over again like I was in some dream. I tried to call my boss but couldn’t get her. Later I found out that she had been let go, too. The notice said I get some outplacement help. What kind of word is that! It’s a fancy word for dumping.”
Use the formula.
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Use your own words.
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EXERCISE 5.5: USE EMPATHIC RESPONSES WITH CLIENTS FACING DILEMMAS
Clients often talk about complicated issues. When this is the case, it is essential to listen even more carefully in order to pick up and respond to core messages. For example, clients often talk about conflicting values, complicated experiences, behaviors, points of view, decisions, intentions, and complex emotions. Responding with empathy means picking up the uncertainties and communicating an understanding of the conflict.
1. Identify the conflict or dilemma.
2. Use the empathic response formula to communicate understanding.
3. Express the response in your own words.
Example: A 32-year-old woman is talking to a counselor about adopting a child: “I’m going back and forth, back and forth. I say to myself, ‘I really want a child,’ but then I think about Bill [her husband] and his reluctance. He really wants our own child and is so reluctant to raise someone else’s. We don’t even know why we can’t have children. But the fertility specialists don’t offer us much hope. At times when I really want to be a mother I think I should marry someone who would be willing to adopt a child. But I love Bill and don’t want to point an accusing finger at him.”
The conflict or dilemma. She believes that she runs the risk of alienating her husband if she insists on adopting a child, even though she strongly favors adoption.
Formula. “You feel trapped between your desire to be a mother and your love for your husband.”
You own words. “You’re caught in the middle. Adopting a child would solve your problem but perhaps create one for your husband.”
1. A 30-year-old factory worker is talking to a counselor about his job: “Work is okay. I do make a good living, and both my family and I like the money. Me and my wife are both from poor homes, and we’re living much better than we did when we were growing up. But the work I do is the same thing day after day. I may not be the world’s brightest person, but there’s a lot more to me than just running those machines.”
The conflict.
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Empathic response (formula):
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Your own words.
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2. A mental hospital patient, 54, who has spent five years in the hospital, is talking to the members of an ongoing therapy group. Some of the members have been asking him what he’s doing to get out. He says, “I don’t know why you’re trying to push me out of here. To tell the truth, I like it here. I’m safe and secure. So why are so many people here so damn eager to see me leave? … Is it a crime because I feel comfortable here? (Pause, then in a more conciliatory voice.) I know you’re all interested in me. I see that you care. But do I have to please you by doing something I don’t want to do?”
The conflict.
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The formula.
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Your own words.
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3. A juvenile probation officer is speaking to a colleague: “These kids drive me up the wall. Sometimes I think I’m really stupid for doing this kind of work. They taunt me. They push me as far as they can. To some of them I’m just another ‘pig.’ But every time I think of quitting—and this gets me—I know I’d miss the work and even miss the kids one way or another. When I wake up in the morning, I know the day’s going to be full and it’s going to demand everything I’ve got.”
The conflict.
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The formula.
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Your own words.
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EXERCISE 5.6: SEE YOURSELF ON VIDEO
One of the benefits of the universal availability of video is that you can see yourself in action. Extensive use of video is a must in training programs. Because empathy is such an important therapeutic communication skill, seeing how well you respond with empathy is a good place to start.
1. View a video of someone who is a master at communicating empathy. For example, on YouTube you will find a video of Carl Rogers in a therapy session with Gloria, the client. He makes extensive use of empathy in this session.
2. Prepare for the video session by choosing some problem situation with which you are currently grappling, one that you are willing to speak about with a learning partner. Your partner will do the same.
3. Before turning on the video, the client should say a few words to put his or her problem situation in context.
4. Roll the camera and engage in a 7- to 10-minute session in which you respond to the client almost exclusively with empathy, as Rogers does in the Gloria video.
5. After the session, take the lead in giving yourself feedback as you and your learning partner debrief the session. What have you learned from watching yourself?
6. Reverse roles and repeat the process.
EXERCISE 5.7: INCREASE EMPATHIC RESPONDING IN EVERYDAY LIFE
If communicating empathy is to become a part of your natural communication style, you will have to practice it outside formal training sessions. That is, it must become part of your everyday communication style or it will tend to lack genuineness in helping situations. Practicing empathic communication “out there” is a relatively simple process.
1. The improbability of empathic responding. Responding to others with empathy is not a normative response in everyday conversations, even among people who otherwise put into practice the value of empathy. For instance, sometimes people use phrases such as “I know how you are feeling” or “I get you” or minimal encouragers like “oh-uh-huh” to convey empathy, but these phrases may not truly express empathy. Find this out for yourself. Observe everyday conversations. Count how many times interpersonal empathy is used as a response in any given conversation.
2. Your own use of empathy. Next try to observe how often you yourself use empathy as part of your normal style. In the beginning, don’t necessarily try to increase the number of times you do so. Merely observe your usual behavior. What part does empathic responding normally play in your interpersonal communication style?
3. Increasing your empathic responses. Begin to increase the number of times you respond to others with empathy. Be as natural as possible. Do not overwhelm others with this response; rather, try to incorporate it gradually into your style. You will probably discover that there are quite a few opportunities for responding with empathy without being phony. Find some way of keeping track of your progress.
4. The impact of empathy. Observe the impact your use of empathy has on others. Don’t use others for the purpose of experimentation, but, as you gradually increase your use of this communication skill naturally, notice how it influences and enriches your conversations. What impact does it have on you? What impact does it have on others?
5. Learnings. In a forum set up by the instructor, discuss with your fellow trainees what you are learning from this experiment.