by Wendy McBrair, MS, BSN, CHES
Although you often hear it said that someone doesn’t have very good communication skills or that his or her communication needs improvement, you may not understand what good communication really means. When you have arthritis, it is essential to tell others clearly how you feel, what you need and want, and what you are able to do so that they can act accordingly. In other words, good communication is essential to getting the help and support you need.
But what seems like a simple concept in theory — to express your thoughts, feelings, and capabilities so that others understand them — can be very difficult to achieve in practice. If you find yourself thinking, “I told my friends, family, doctor, and coworkers what is going on, but nothing seems to change,” then you may not be communicating effectively. Exploring communication techniques and developing your skills may make your discussions more successful. Let’s start by looking at the different types of communication.
There are four categories of communication: passive, aggressive, passive-aggressive, and assertive.
Passive communication. If you communicate in a passive style, you are often silent about your feelings and do not say what you want. Wishing to steer clear of conflict or to avoid displeasing the person you are talking to, you may speak in a quiet tone or in an unsure, hesitant manner. Although passive communication may help you avoid an argument, chances are it will not help you get what you need.
For an example, let’s take Kathy, who has heard that three of her friends are going to the movies but have not invited her. Kathy’s arthritis has been flaring up lately, and so she says to herself, “Oh, I would only hold them back. They probably don’t even want to include me.” Her feelings are hurt, but she says nothing about it to her friends. Instead, she avoids them for weeks and misses out on fun conversations and other social events. Kathy’s friends, meanwhile, figure she is too busy, isn’t interested in going out, or doesn’t feel well. In the absence of communication from Kathy, they may wonder what is going on with her, but no one talks about the situation.
In this example, both Kathy and her friends exhibit passive communication, and as a result, everyone is left in the dark. Passive communication can lead to confusion and resentment, and it can do harm to relationships. When there is no discussion about needs, problems, or feelings, there is no opportunity to develop solutions.
Aggressive communication. This style can be seen as the opposite of passive communication. If you communicate aggressively, you tend to express yourself forcefully, often raising your voice or using language that belittles the other person’s point of view. Aggressive communication often focuses on the other person, incorporating “you” statements such as “You aren’t helpful” or “You don’t get it.” It may involve some expression of anger or hostility, such as name-calling, swearing, or even physical violence or the threat of violence. This style does not account for the feelings of the other person.
For example, a man named Tom cannot move a box by himself, and he is frustrated that he needs help. Tom glares at his son and says loudly, “Get over here and move this box! You never come to help me. You are lazy and selfish.”
In certain situations, raising your voice and sounding angry may seem to be an effective way to communicate. You may have even learned this type of communication from your family. You might think of it as a way to protect yourself or vent your frustrations. In fact, using aggressive communication can be counterproductive and usually leads to more aggressiveness. At best, your language or tone may put the other person on the defensive and make him or her less likely to help you. At worst, the person you’re speaking with may have feelings of discomfort, frustration, hurt, or anger. If you use aggressive communication too often, you may harm your relationship with the person.
Passive-aggressive communication. In passive-aggressive communication, you express your feelings indirectly instead of discussing them openly. If you use this style, you may you say one thing but do another. As the name suggests, this style is a combination of passive and aggressive behavior. You may passively accept something that displeases you to avoid a confrontation, but then act aggressively in a way that shows your displeasure. Often, it involves showing your displeasure to people other than the person with whom you are upset.
For example, Jim suggested to his boss a way to improve the flow of work in the office. When his boss discounted the idea, Jim responded by forcing a smile and saying, “You’re right. Things are fine the way they are.” Instead of continuing the discussion with his boss, Jim vented his frustration to coworkers, criticizing his boss’s unwillingness to change and poor leadership skills. Jim’s boss heard from coworkers about Jim’s negative comments and gave Jim a poor review. Clearly, Jim’s passive-aggressive communication backfired.
Last Reviewed on July 13, 2011
Wendy McBrair spent 30 years as a health-care professional in the fields of rheumatology and orthopedics, where she specialized in patient and community service, patient education, and advocacy.
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