Communication is the building block for almost all other encounter we have in our lives. It's how we get what we want, share what we feel, and connect to what other people's experiences are. In thinking about communicating as a person with diabetes, the same fundamental principles are present as with any other type of communication. It just sometimes feels like there is more at stake, which can result in miscommunication and conflict.
Important things to keep in mind as an effective communicator:
1. A time and a place.
Before starting any important conversation about your health, think critically about the best time and place to have this dialogue. Good times to avoid a conversation are: when there are distractions present (TV, work, computers, other people present), when you or the other person are hungry (this is a must, hungry and easily turn into hangry), right before bed or when you are otherwise tired, and at times of high stress. The key is to think through what might be good opportunities to have uninterrupted time to talk with limited distractions. This is different across families, but for our family good times are often: long car trips/commutes, Saturday morning after breakfast or over brunch, earlier in the week as opposed to Thursdays/Fridays, and when these options aren't available, I tend to use email to set up a planned time to have a conversation. This may seem ridiculous, but often just knowing that something is planned can let both people prepare and get into the "headspace" necessary for a lengthy conversation.
2. Game planning.
I believe it is the "IBM model" of presentation to "tell the audience what you are going to say, say what you are going to say, and tell them what you just said", or maybe I am mistaken about the source, but the point is, have a plan. In thinking about what you want to talk about, it usually goes best when you have some sort of an outline in your mind worked out about your goals for the conversation. For example, if you want to let your partner know that it sometimes bothers you when they buy and bring foods that you are trying to avoid in the house, it could easily turn into an argument. In that instance, I would think carefully about what main points I want to transmit before I start the conversation. For me, it would be the following: 1. It is important for me to feel supported in my dietary goals; and 2. When challenging foods are available, it's hard for me to stay focused on healthful eating. Although I might have a few secondary messages like 3. health is not only important for me because of my illness, but for our family as a whole; and 4. When this happens, I often end up resentful toward my partner, I would not necessarily try to bring those up in this first dialogue. The last two points have a very high chance of ending up in a fight, so in my Game Plan, if my goal of the conversation is to have my partner understand his/her role in bringing challenging foods into the house, I would plan to avoid the high-conflict messages. That can be brought up in a different conversation after the groundwork is made. All in all, the importance is to have an idea of what you would like to cover and to think carefully about the main goals so that even if the conversation changes paths, you will be able to come back to the main things you wanted to get across.
3. Listening is as important as talking.
Even if you are the person initiating the conversation and have picked the right time, place, and thought about your game plan, it is still a two-way street. In other words, actively try to listen. One skill that helps ensure you are listening is summarizing what you heard and think your partner's main point is, and then asking if you got it right. For instance, if your partner says: "I like to have a few sweets in the house in the event your blood sugars go low, and I bought these specific ones because they can double as a dessert for me" you might summarize and say back to them, "Okay, so what I think you are saying is that you get to eat dessert and I don't?" which may be way off base. By checking back in with your partner about what you think you heard, you both understand their message better and align yourself to be on the same page with them instead of on opposite sides of the dialogue courts. In addition, you may truly have misunderstood or heard something wrong, and by ensuring you go the message right, you can avoid unnecessary arguments. However, the most important thing is to allow the space and safety for the other person to have a say. This dovetails nicely from the first strategy of "A Time and A Place", because if you are planning a conversation, and give your partner a heads-up about the topic, they may come prepared with things they wanted to share as well. This can make communicating more effective and enjoyable for you both.
4. Knowing when to delay.
Finally, the most important part of communicating is knowing what it is you want to say, so there will be times when you just simply haven't thought enough about something to have a fruitful conversation. Letting your partner know in a respectful way that you value the conversation, but need time to think about it, is a great way to table communication that may end up in uncharted territory. The key here is coming back to it when you have thought more. If you use this strategy to simply avoid conversations, your partner will get savvy and likely not be open to delaying.
In sum, communication is important regardless of the topic, but sometimes conversations about health can be "loaded" making them more difficult to have without tension and arguments. Planning, being thoughtful and clear about your goals, listening, and reserving the right to "pass" can all help improve your communication and build deeper relationships with those around you.
Dr. Diana Naranjo is a Clinical Psychologist who works at the Madison Clinic for Pediatric Diabetes at the University of California, San Francisco.