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The outcomes of most conversations have been determined before we speak. This is because our minds and behaviours are programmed by past events, dating back to childhood. We make assumptions based on a person's size, gender, dress and demeanour. We do this before conversing, and we listen through these assumptions. You might say that what we get is what we expect. Also, the opinions and comments of others affect how we interact with people. It's understandable when someone becomes upset because the assumptions of others obstruct what this person is trying to say.
When consulting a health care worker, a homeless and disadvantaged person is in a disempowered position. This person usually doesn't have a network of supportive relationships. He/she has learnt that aggressive and threatening behaviour is often required to satisfy needs. Most of us don't do this. We cooperate to get what we want. So, in a new encounter, listening is critical. This means active listening, listening for what is being said, and listening for what is not being said.
As you have assumptions when conversing, so has the other person. Exposing these assumptions allows new heights of awareness. A space is cleared for a new level of discussion. If you realise that you aren't really in the conversation, try repeating the last comment made by the other person. This acts as a prompt, allowing discussion to develop further. Progress is enhanced by admitting to the other person any assumptions you are making about them.
In these situations a rapport between the patient and care person may occur. Rapport refers to the development of an understanding between the other person and yourself. This can develop quickly if you are willing to tell the other person something about yourself which might relate to their present situation or their background. Look for something you might have in common, and talk about this. Often this simply involves assessing their age, their place of birth, or where they went to school. Whether they are from the country or the city, if they have family, and who they barrack for in the footy, are other things you might ask about. Anything that comes up in the initial phase of the conversation may be used. Rapport allows the conversation to 'dance' in a way which allows freedom of expression and a release of emotion. But producing good rapport can be hard work and emotionally draining, and is thus not always possible.
It is also important to be aware of insincerity in the consultation. When insincerity is present it is usually felt and practised as much by you, as the person conducting the consultation, as it is by the client you are dealing with. There are different levels of sincerity and different 'scenarios' for sincerity. Sometimes there is not a demand for it. Sometimes it is best to simply trust your own feelings during the consultation.
Rapport is a very effective tool, but sometimes it is best to contain it and complete the consultation, especially if the client is becoming overly reliant on you. Some people develop such dependencies, and in effect are prone to living their life as a learnt abnormal behaviour. The desire to promote meaningful growth in such a person's life by pandering to such dependencies will not be ultimately productive. Newcomers to the field must guard against this.
At times I am called upon to respond to a person's psychological or emotional need. I don't understand how or why it is that I am able and willing to do so, but there usually seems to be plenty of consultation time to meet this need. At other times, the attempt to respond does not work. In these latter cases this apparent inability may appear if I feel that I am being manipulated. And in fact this is probably what is happening.
For the new player in the health care field, it is often difficult to know how to behave and react in the complex and emotionally charged situations which often arise.