Next in the series Speaker Academy, which started here.
After a day off for Trevor Torres’s Q&A on selling, we resume with the third of Randi Oster’s takeaways from our phone conversation.
Randi’s an experienced business person with speaking experience, so her #3 observation is not necessarily what a newbie would prioritize. But it’s an important point, as you’ll see. I’ve heavily edited Randi’s notes. Randi, thank you for your work; your words per se aren’t here, but this lesson exists because of your work:
Competent patients can cause cognitive dissonance. The speaker must deal with it.
“Cognitive dissonance” is a geeky psychological term; all you really need to know is this:
- “Cognitive” is about how people experience life: what they see and how they interpret it.
- “Dissonance” is when it seems two things couldn’t possibly belong together, or are uncomfortable together.
- When people see something with their own eyes
that simply isn’t possible given everything they believe,
or if it puts them in an unsolvable bind,
that’s cognitive dissonance. - It’s uncomfortable – as uncomfortable as two musical notes that don’t belong together.
- People do something to relieve the tension. (More on this in a moment.)
In my talks about patients as partners, the most common cognitive dissonance I’ve encountered is:
Medical training is important
and really hard,
and we patients haven’t had it.
So how could we know anything useful?
(Don’t argue with me about this; it’s what I’ve seen, and this is a free course – you don’t have to agree.:-))
And as I said a moment ago, here’s the thing to realize:
Tension seeks resolution.
It’s a universal truth: in music, psychology, and elsewhere, tension wants to be resolved. This is important to understand because when your message conflicts with people’s beliefs, they will be involuntarily driven to do something about it, and “something” may be to reject you and your message because you make no sense.
It’s your job to deal with this – to make sense in your audience’s world.
Wikipedia lists three common ways people resolve this tension:
- Alter existing cognitions [Change their view, their beliefs]
- Add new [cognitions] to create a consistent belief system [Add additional information]
- Reduce the importance of any one of the dissonant elements [Decide something’s not important after all.]
#3 is in Aesop’s Fables: the fox wanted some grapes but couldn’t get them. Uncomfortable, he resolved the tension by deciding, “They were probably sour anyway.” (He reduced the tension by diminishing one of his feelings.)
#1 is really, really hard – getting people to change what they believe in. (When’s the last time you changed a belief?)
#2 is my usual approach: to add new information that explains the conflict, so they understand things without having to reject what they’ve built their career on.
When you succeed at that, people have genuinely learned something. You’ve rocked their world.
And here’s why you have to do this:
If you say something that makes no sense to the audience,
and you don’t resolve it via #2,
they’ll do a special #3 on you (“reduce the importance of one of the conflicting beliefs”):
they’ll reduce the tension by saying “Ridiculous” or “BS” (out loud or to themselves)
and they’ll tune you out.*
When that happens, your goose is cooked.
Your takeaway from this lesson:
If you want to change things,
it’s your job to present your thoughts
in a way that realizes and respects the audience’s views
and gives people a new way of looking at things
so the dissonance is relieved
and things make sense in a new way.
If you can reduce the dissonance – the tension between their view and your new ideas – then not only have you been genuinely persuasive, they come away with a new view of life. And boy is that valuable; how many speeches have you ever heard that produce that result?
Later on we’ll get into the specific facts I introduce in almost every speech that add to the audience’s current view. But it’d be useless to introduce that before you understand why it’s important.
Now, I hope, you can see why lesson 1 said “it’s about understanding your audience and their concerns“ and lesson 2 was “learn what matters to each audience.”
Next in the series: #5: Knock it out of the park
_________
* At MIT I knew a physics major who couldn’t tolerate the news that sometimes light acts like a wave of energy, and sometimes it acts like a particle that smacks into things. One of his beliefs was “things are one thing or another – not both”; then a new cognition came along – “Sorry, kid, light is both.” Know what he did? He quit physics. Couldn’t stand the tension, and changed his major.
A wise sax player told me, decades ago when we were both in the notorious Denver group the Jupiter Rey Band (that means king of the gods band, which lends a little insight into the cats behind the scene) that there are no wrong notes, just wrong connections. This relates to resolving dissonance. Musically it happens in a split second in real time while improvising. The hearing (as audience) and the doing (as player) are the delight.
Well said, Bart.
You’re a pretty crafty speaker yourself. :-) Could you paste in the link to your recent successful TEDx Talk?
With great delight, Dave: http://goo.gl/116g7
Dave, thanks for another great lesson in engaging and moving audiences, applicable regardless of audience type.
Question: with all the hard work and money being churned into culture change in health care, what about the cognitive dissonance in non-medical audiences? In any industry, it’s the USERS of a product or service who ultimately drive demand and become the pull-through for “better”. Historically, for various reasons, in health care, not so much. It’s frustrating for providers who are doing the right thing (as in “Why don’t consumers NOTICE our great HCAHPS scores?”), and a disservice we do to ourselves as patients. How do we make Joe & Betty Consumer care, and engage, before crisis smacks them upside the head?
(And while we’re addressing THEM, can we get the medical professionals who hear our message nodding their heads, too?)
My thinking, from years broadcasting the news:
1) Tell personal stories. They grip our emotions.
2) Use vivid and apt analogies. They can expose disconnects about things we’ve blindly accepted, or felt powerless to change.
3) Remember there are two sides to every story. Otherwise, no quicker way for someone to dismiss you.
4) Tell people what they can DO, if they’re moved by your message.
I put it all this stuff into my book, “Design To Survive: 9 Ways an IKEA Approach Can Fix Health Care & Save Lives”. I thank you for being among those who allowed me to tell their stories, and for sharing key things about patient engagement you’ve figured out.
Looking forward to more from these great posts on how to make my audiences care – and act.
Pat, AWESOME! That’s so generous of you! I’m gonna make that a post in this series right now.
And yes, re your book. People should get it on Amazon and read it. You do a masterful job of making your points in a way that gives folks a new way of viewing things.
I can’t wait to see you do a keynote about it for the first time. Seriously.
Absolutely true, Pat, and why sometimes our message is like the muffled trombone of an adult in a Charlie Brown movie. One method I have used is to acknowledge their expertise v. mine and empathize with their situation. I found in teaching communications to docs and nurses they are more accepting of the message when they hear what they do well first. They will tend to project poor behaviors as something someone else does, and we had great uptake of new behaviors (talk directly to the patient v. the parent, use simple terms, introduce yourself) when I co-present with a clinical colleague who models the behavior.
Hi Dave!
Thanks for this. I’m working to internalize some of these bits of advice as I try to speak up for our community women with BRCA, and help others do the same. Here’s my latest post: http://www.bravebosom.com/welcome-to-the-wild-west-of-brca-data-sharing/
Am I doing this right??
– Andrea
My brain hurts a little from this point but I almost 100% get it. It’s like in a sales pitch, you need to be prepared for all the “nos” in advance. Have all of your counter-points sorted in advance.
Thanks for being clear in your feedback! You’re the first to speak up and say that.
Let me ask a more fundamental question: what would you say is your own basic message? You and I may have different messages we’re trying to convey. Mine is “Let patients help heal healthcare. Patients are the ultimate stakeholder, yet they’re the most underused resource.” I talk about that in the context of health policy, health IT, clinical trials, and all kinds of things.
What’s the main message you plan to deliver to audiences that hire you?
Karen, separate from my other reply:
“It’s like in a sales pitch” is definitely not the point here.
The point is not primarily that you need to get ready for a hundred “nos” before you get a yes (as in sales), nor is it that you need to be prepared to handle objections.
The point is that when you’re advocating for a MAJOR change in culture, you need to understand that many people may see things differently from you, and if you say things that make no sense to them, they’ll stop listening and you’ll end up walking away confused and frustrated.
Not every patient speaker focuses on culture change. (Hence my question about what your message is.) But I suspect we still all need to be aware that we might sound CRAZY to some listeners when we propose that a patient could have anything useful to say, because it requires a complete rethink of the cultural assumption that since medical miracles come from medical professionals, there’s no reason to get guidance from anywhere else.
Remember, for some conferences and policy meetings, it’s a huge breakthrough to even invite patients to come AT THEIR OWN EXPENSE, never mind pay the expenses, let alone pay them for their time.
Anyone who wants to speak for free is of course welcome to. No problem. But someone who wants to be compensated needs to understand how to be SEEN as WORTH money. And that requires understanding differences between the speaker’s own mindset and the audience’s mindset.
Okay. Getting the point. :) Need to stew on this for a second though. I have a few messages to share but my best message will be one that is universal. My “idea worth sharing” so to speak. Thanks.
Without a doubt as time goes by and you gain experience your message will evolved…
Thanks for that vote of confidence.