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Doctors at Work Podcast.

Episode #32

How to manage conflicts at work. With Adrian Piggot

Mat Daniel


All of us face conflict at work. Adrian tells me that expecting perfect agreement all the time just isn’t realistic. Conflict can actually be essential for high performing teams. He differentiates between functional conflict that helps teams grow, and dysfunctional conflict that is driven by emotions and lack of understanding.

Podcast Transcript

[00:00:00] Mat: Welcome to Doctors at Work. My name’s Mat Daniel, and this podcast is about doctors’ careers. Today, we’re talking about conflict at work. All of us face conflict. Adrian Piggott tells me that expecting perfect agreement all the time just isn’t realistic. Conflict could actually be essential for high performing teams.

Adrian differentiates between functional conflict that helps teams grow, and dysfunctional conflict that is driven by emotions and lack of understanding. In this episode, he shares his understanding of how and why conflict arises and gives his top tips for managing conflict at work. I particularly like the idea of approaching our interactions with curiosity, compassion, and collaboration.

I hope it’s useful.

Welcome, Adrian. Tell me a little bit about yourself.

[00:01:02] Adrian: Morning, Mat. So my name is Adrian Piggott, and I’m an organizational development specialist. Most people don’t know what organizational development is. So just a very brief, it’s a behavioural science. So we spend a lot of our time trying to understand why people do what they do, and how do we leverage that in organizations to create individuals that are happy and productive, teams that are happy and productive, and organizations that are happy and productive.

So we work at different levels, so the individual, group, service, organization, and even society. Obviously within my role within Nottingham University Hospitals, where I lead organizational development, we lead on culture development, leadership development and team development. So we use a lot of the behavioural science, particularly around psychology, bit of anthropology, social sciences, and really understanding how people come together and how we can help them come together well.

[00:02:00] Mat: Thank you

very much. And all of those things sound very relevant to today’s topic, which is conflict. So what is conflict?

[00:02:08] Adrian: Yeah, I’d say conflict is the number one thing that draws myself and my team into group work or individual work, whether it’s coaching, mentoring, team coaching. So I suppose the definition, and to use a specific definition that we use within our team, it’s an express struggle between at least two independent parties.

Who perceive incompatible goals, scarce resources, and interference with the other party from achieving their goals. So that’s one bit. The other bit is a process when one party perceives, and there’s a very strong word there in perceives, another party is having a negative effect on them. And that could be a personal, it could be a professional, it could be an organizational perception.

[00:02:54] Mat: Okay, can we go back to the first one? Just break those individual bits down for me and tell me what they all mean.

[00:03:00] Adrian: Yeah so conflict, So there’s a bit of a pyramid with it in terms of I’ll go into conflict with somebody if there’s a sense of competition, basically. I’m trying to achieve something whether that’s a personal or professional goal, and the other person is getting in the way of me having my needs met, or that goal met, is pretty much what conflict’s about.

And that could be from very theoretical thoughts, ideas, all the way to competition for resources. It comes from a perspective that I’m right here, potentially, and we are not agreeing on what is right here. So therefore, either from a relationship point of view or a task point of view, we are now at odds with each other.

So there’s some sort of high stake. We care about this. Usually conflict has an emotional component. There’s a feeling that’s been trying to transgressed here. And there’s a difference of opinion or goal. So once those three elements are in place, we know that we’re in a conflict arena.

[00:04:08] Mat: I think there’s quite a lot of conflict in the NHS and If I think of what I’ve seen and what experienced often it is about resources and about time and capacity and it’s all of us, or each one of us as individualist team, we have our own agenda.

And somebody else has their own agenda, and then there’s a bumfight about whose agenda wins. So there’s your I’m right and I need to win thing. From your experience, what would be the kind of the common reasons why conflict arises?

[00:04:39] Adrian: So there’s a bit of a model.

In fact, just before we go into why conflicts exists and starts to come out, particularly in health care. I think that what’s useful is just to consider what’s functional and dysfunctional conflict. Okay. I find in the NHS in particular, and I think it’s probably because we predominantly are a caring service.

So high levels of compassion and in that environment, sometimes I think conflict is seen and perceived as always being dysfunctional. So we are conflict averse. And I’ve found that so much in the 18 years that I’ve been working in NHS. Whereas when I’ve done consultancy work with people from different countries or different organizations like private sector, there’s a different perspective to conflict.

So working with American colleagues, much more open about actually having a bit of a, an argument and not seeing that as a negative thing. Whereas in the LHS, the dominant thing is conflict is a bad thing and should be eradicated. And I think there’s a real risk in that. So I take an OD takes what we call a integrationist view, which is actually conflict is absolutely necessary for high performance.

So the first thing, so a functional conflict, and you’re in a functional conflict space is where the outcome of this is generates new ideas or new understanding. It creates some sort of growth. And if nothing else, a functional conflict just creates clarity. Even though I might not agree with what you’re saying, doing, behaving, at least we are now clear on what that is.

So that for me is functional and healthy. And I think we need to create a lot more space for people to go into that space and sit with the discomfort that can come from that disagreement that you can have. You’ll know that you’re in a dysfunctional conflict situation where It’s feeling that it’s degenerating that you’re coming worse off, that we’re veering more and more away from clarity into, this is just muddying the water.

And also that I’m coming out that with a sense of negative feeling. So a negative feeling could be frustration, anger, annoyance, feeling like a victim. So I think first of all what would be really helpful, and I do find this a lot with medical colleagues Actually, no that’s unfair, because I find it even more acute with nursing colleagues who think conflict is not nice.

With medical colleagues, the feedback I tend to get when we talk about, let’s create a space where we can go into conflict, is more of a sort of professional threat. This is not going to help the work. So let’s not talk about that. So those are the kinds of things that I experienced and I can’t generalize for the whole profession.

So first of all, just being clear on is this good or bad is a really good start for anybody going into. understanding what conflict’s about. As a, we run a mediation service and I’m a qualified mediator and when we are working with predominantly two people that have got to a position where the conflict has become so embedded.

So it’s usually, by the time we’ve picked up the case, the conflict’s been going on for 6 months, 12 months, 18 months. And relationship has completely broken down. And so one of the things that we’ll do with both parties separately, is first of all get them clear on what is the conflict actually about.

And I’ll be using quite a lot of models to refer to in this. And the reason I use models is that conflict kicks off the more emotional part of our brains, so that amygdala, less rational part. And actually, if I want to go into conflict well, or understand other people in conflict, I have to go to a more logical space.

And models and tools are such a great bone for that. So I’ll mention a few tools that I’d certainly be recommending to anybody to, to have in their back pocket to get them into that more cognitive space. So the first thing is that there’s four main reasons for conflict and this is evidence based research.

It’s relational. So there’s a personal disagreement. So I don’t, so that’s where behaviours would come in. I don’t like how you’re talking to me. I don’t like the microaggressions I might be perceiving from you. It might be that we’ve just got very different values and views of the world. And ultimately that comes down to, I don’t like you.

So that’s what’s driving that. I just don’t like you. I don’t like how you’re doing this, whatever. And obviously within that are a number of biases and discriminations that could kick off. And there’s another model that really brings forward what the relational issue would be. The next thing is task conflict.

So this is really common, particularly with medical colleagues. So relationship conflict does emerge, but I tend to find most of it is around task and process. So this is about disagreeing around how you are doing something and why you’re doing something in that way. And certainly in team coaching, the conflict I’ve seen between medical colleagues usually is in disagreement about professional opinions about how something should be done and also who gets to do what.

So you’ve got task and process conflict. So we, I don’t care about you as such. I care about how you are doing it, which can lead into relationship conflict. So for instance, in mediation, some of my experiences have been, I no longer respect my colleagues professional abilities because of the way that they do things.

And that always comes from task and process issues. So quite often when we’re working with teams in conflict, we almost always start with Roles and responsibilities. Are people clear on what they shouldn’t, what their powers are within the, their duties? And how is that role and responsibility being discharged?

And certainly using the stuff from Michael West, who’s a bit of a researcher in this field. A lot of the interpersonal relationship comes from that. Comes from the gradual irritation that I don’t think this is how we should be doing this. And then the final thing, again, which shows up again, quite often with medical colleagues, given the medical leadership model that we have is status.

So are you challenging my authority or my professional status? By challenging this opinion, or challenging this idea, or the way of doing something. It’s almost, do you have the right to be challenging me, and to be in conflict with me? Or, by questioning something, are you undermining my status? And that could be at an individual, group, or professional level.

You’re challenging us as a professional group, how dare you? Quite often on a team and inter team basis, status comes in a lot. The conflict between teams is usually who’s got the power within that. And you’re challenging our position as a team by saying that we have to do something that perhaps we don’t want to do.

So those are the four reasons. Relationship, task, process, and status. And it’s really helpful to do a self diagnostic. or to talk somebody through with it to work out what is this? What am I actually really peed off about? That’s causing me to go into conflict with another

[00:12:26] Mat: I really like that. If I think that some of the conflicts that I have been or am involved with immediately when you talked about relationships that we’re going to say, Yeah, it’s about the relationship.

But actually, as you talked, I said, No it’s just it’s about the processes. And, the relationship, then the relationship conflict arises, is. From something that fundamentally is a process. But actually I would’ve said that if I found myself in the middle of a process conflict, I say that’s fine.

Let’s have a discussion about how we do stuff. But clearly I can think of at least one example where that was the conflict, but that’s now become much more about the relationship and that when you don’t like somebody, you don’t like their values, you don’t like what they stand for. I think that’s.

That seems much more difficult. I think, I can see, discussing processes, yes. That’s okay. We can hopefully have that positive conflict. But dealing with relationship much more difficult. I hope you’re enjoying the show. If you like it, please click subscribe so you will be notified when new episodes come out.

This podcast is part of my mission to help doctors create successful and meaningful careers. You can be part of that mission too by forwarding this show to one person who you think might benefit from listening. Thank you. Now on with the show. Maybe if I can go back to this idea that conflict isn’t bad because I think to at least some, if not many people listening, people are going to be surprised that actually it’s possible to have good conflict.

And yeah I’m interested that perhaps we’re all very, we’re all very caring and we’re all very collegiate and we all want to get on with each other. And, and that, that creates around us this idea that we want to build consensus all the time, we couldn’t possibly have disagreement because we’re all lovely and we’re all caring.

But actually, we do need to have, we do need to have constructive conflict or positive conflict or good conflict, whatever, however one phrases it. How do. You’ve outlined how you, the kind of the difference between the two, but I’m thinking in practical terms. I find myself in the middle, I don’t know, let’s imagine it’s something about rota, who does which on call, who does which list, that’s a kind of.

fairly common but nothing particularly personal about that. So how do you, how do we convert a, an argument disagreement conflict about who does which on call and who does which shift and who gets which theatre list? How would you convert those things and make sure that’s a constructive argument challenge rather than something that becomes destructive.

[00:14:57] Adrian: So I suppose we’re jumping into to the how you start to resolve conflict. I do just want to before we go into that, because I think there’s something around. So we will as a team almost always create or stimulate a conversation of conflict in our teamwork. We do that deliberately and basically what we’re talking about and what we’re trying to surface with people is it’s impossible to go through your day as an individual agreeing with everybody else and agreeing with everything that’s decided.

It just doesn’t happen. So people are holding this stuff irrelevant of whether you go into conflict or not. And so what we try to do is at least surface clarity on what people are feeling and why they’re feeling it. That doesn’t mean resolution in terms of outcome, but at least you’re clear. So conflict, deep conflict that becomes really dysfunctional is where people have been holding on to stuff and they can’t be open and honest because it doesn’t feel safe.

And I know we’re coming to psychological safety. So before going into conflict, certainly with the one you’re talking about, most mediation tools, which you can use on any time, any space, it’s just being clear on the goal. So always keep the goal in the mind. So starting a conversation about what are we trying to achieve that we can all agree on?

So for that, it’s the things are covered and the it’s fair. Again, another model I tend to even teach people before they go into conflict on even an operational thing like that is there’s something called the scarf model. So first of all, you’re thinking what’s the potential conflict? Is it task process status relationship here?

But what’s likely to trigger people into a conflict space? And again, scarf covers status, who’s got the power to make the decision about rotors, ultimately. And that’s always a conversation that we, we emerge about. If you’re, if we get to a point where we can’t agree, who’s the arbitrator going to be?

What you don’t want in a functional conflict conversation is lack of clarity at the end of it. So somebody somewhere needs to make the final decision where ultimately our needs are going to clash because there’s always going to be that you’re never going to get a rotor that everything, oh, this is the perfect rotor for everybody.

Somebody is going to lose out something. So it’s part of the framing of it. So why are we talking about this and what’s the outcome? ultimate outcome we’re trying to work towards. So when you’re facilitating a conversation where things start to get tricky and people are getting a bit more terse, you can always go back to, can we just remind ourselves what the goal is here?

So within SCARF you’ve got that sort of status of who gets the right to choose. Certainty. So what kicks off for people is uncertainty is the worst area for conflict because it triggers our amygdala. We go into that fight, flight, freeze. We get flooded with chemicals that then get us into a, my, my needs are at risk here.

Autonomy is the A. S C A. Autonomy is sense of control. Now that doesn’t mean that. I get to decide, but I have had my view heard. So there’s some sense of control in this conversation. I’m not being done to it’s a bit like having a kid and saying, eat your dinner or eat your greens, as opposed to which do you want to eat first, your greens or your meat?

So any sense of autonomy helps calm down the temperature, because you know that even though you might do compromise, But on what you want, you’ve had a say in that relatedness. So we talk about bringing in that sort of move from friend or foe into the what we’re trying to meet here is that the needs of the service with the needs of the individuals.

So we are a team here. How can we negotiate on what’s well. And the final thing that we need to surface, particularly in that conversation, is fairness. But within that, so people will go out of that meeting really pissed off if they think that it wasn’t fair. So I would almost bring into the conversation what is fair enough look like?

What does compromise enough look like? Ultimately you may have two people that are digging their heels. I will not do that and I will not do this. That’s why you need an ultimate person saying this is the ultimate fairness for everybody. At least they’ve had their opportunity to articulate what FAIR would look like for them, and they’ve had a sense of autonomy, and everybody’s leaving that clear.

We usually set up those conflict things with you won’t get everything you want, but we’ll make sure you get some of what you want. So your needs will be met to a certain degree. So that autonomy is probably one of the most important elements. That you’ve had your voice heard, even if you don’t necessarily win all the needs that you have.

So that’s where you can horse trade. I can’t give you this, but I could give you that. And if you can get people into a mindset of, what are you willing to give in order to get what you want? All right, I’ll do a Tuesday, which isn’t really the day I want to be doing. But in return, I’ll give you the Thursday.

It’s getting people into that space of keep clear on the goal, keep clear on the relationship. This is about us all getting as much as what we can possibly get. Given the fact we’re going to have to force trade and getting some honesty out, even as a model, and this goes to a future podcast on meetings what you want in those kinds of conversations is some really clear what rules to the discussion, really simple rules.

One of the things is, are we clear on what we’re trying to achieve? What is good? What would good look like? And then you just do rounds. And it only takes a few minutes, which is. Each person takes their turn to say what good looks like for them, what fair would look like for them, so that everybody’s had their opportunity to be heard.

And then you go to the, okay, so now we know six of you, what is that you’re looking for? Let’s put it up. How do we, what’s the best model that we can achieve? That’s not a guarantee. You might have somebody that’s digging in their heels, isn’t a team player. Their needs, their status is higher than everybody else’s.

But at least what you’ll get is clarity of that’s what the issue is. And it gives you something to work with. So I would then be having a separate conversation with that person about. actually being a team player and which is why and then the medical leadership model is a bit tricky that ultimately you need an arbitrator.

[00:21:59] Mat: And actually that you know the last point about again if I think of the conflicts that I’ve been part of where at least my perception is that somebody isn’t a team player and no matter what they don’t want to be part of that. So I like that model actually that seems that seems very comprehensive. And I also am recognizing why it so often is difficult for us because the reality is we don’t talk. Yeah. What you’ve outlined is you’ve outlined a group of people sitting down and saying, let’s just have a discussion. Yeah. And that just doesn’t happen, at least not in my world, at least not that often.

But actually what you’ve outlined is. A framework when people can sit down and say okay, there’s a conflict here. Let’s have a think about how we make this something that, that is functional. And I like that framework.

[00:22:48] Adrian: Yeah. Just to add to one of the things that’s come out recently that we’re embedding into all of our work and it’s being so helpful for team conflict.

So I used it with a group of medical colleagues in a particular area. I just want to keep that confidentiality that we’re really starting to fall out quite seriously about quite small things of task. And it was task and process ultimately. And it wrote us came into it as part of the people complaining.

It doesn’t feel fair. And actually what we introduced to them is the NHS leadership way. So this is a new structure that’s come out from the NHS for all leaders. And we’re finding it so useful for everything. And one is creating conversations that are about curiosity, compassion and collaboration. So what I took this group through.

And I left them to it and they did it brilliantly. Was that just some simple rules. So the first thing is mindset. So you have to go into this conversation with curiosity. You need to understand the other. So what is it they want and why do they want it? Now we know that we have much more functional conflict with people that we understand and know.

Don’t even need to like them. We just need to understand what their needs are, what their drivers are, why they are asking for what they ask. And you can only get that from curiosity. So we actually did a pre session, which they didn’t quite get at first, but then loved it. Which was just some getting to know each other rounds.

How well do you actually understand the person you’re working with? And what might be driving their needs and goals? So particularly like with rotas, there might be a rationale that you do not know that’s driving their desire to have the rota in their particular way. It might be family commitments, clinical commitments.

Their study commitments, whatever it might be. Whereas actually you just see the surface, you just see what it is they’re asking for, you don’t like that. So you’re more likely to move into compassion. Once you understand what their needs, wants, and goals are. So you go, all right, okay, so we might have some alignment here.

And I can really understand that why that might be difficult, why you’re asking for that. And then the final thing is the collaboration, which is, okay, so how do we work together to solve this? And that’s all I taught them. And then I taught them the model of doing rounds. So you pose a question, each person gets their say, and you do that once or twice, depending on the.

trickiness of the thing. So everybody has had their voice and then you open up to debate and discussion. And it’s a bit like you’re opening the conversation up, you’re creating some boundary and then you close it because what are we going to agree on? Most of the conflict that I find, I’d say probably about nine out of ten, most of it is because there wasn’t clarity.

Nobody actually sat down to ask some questions to understand what’s going on. And it’s so therefore it’s all built on biases or perception. And actually, as soon as you can get people to go, do you understand the other person, why they’re asking for that, it shifts massively.

[00:26:05] Mat: I’m actually thinking maybe a link into assertiveness, perhaps what each of us individuals, when we find ourselves what we can do, we need to also clearly articulate what we need, because I know that’s perhaps more about assertiveness rather than conflict, but I don’t think that we’re very good at articulating.

what it is that we need. We assume that everybody else knows what we need. And actually what you’ve outlined based on that model is that other people, they have no idea what I need and what I want. So of course, I’m not going to get what I want because they have no idea what I need and want.

[00:26:41] Adrian: And as a facilitator. I’d say most of my work is just getting them to have clarity. What are you even disagreeing on? What is this actually about? What conversations are you not having? It’s all about that clarity. And we tend to get people when they’re going to go into a conflict scenario to do that curiosity, compassion and collaboration with themselves first.

What is it that they want and need? Where’s that coming from? How can they be compassionate to themselves about their own particular needs? And the collaboration bit is, what are you prepared to then go into negotiation on? So 100% the basis of assertiveness having done assertiveness training, there’s a bit of a bill of rights and responsibilities.

So What is okay for me? Do I actually even know? And then what am I asking for?

[00:27:32] Mat: Okay. You used the term psychological safety when we were discussing when you were talking about those discussions. So can you tell me a little bit more about that?

[00:27:41] Adrian: Yeah. So psychological safety, there is a terminology that’s used.

So if you want to look up for this stuff. This stuff, Amy Gallo is a great researcher and has published quite a few books on it. Brown has done some excellent work on psychological safety, but actually moving into a slightly different field, but it’s all about psychological safety, which is that am I safe enough to express what I think and need.

So am I safe enough to express? And safe enough means that if I say this need or want or idea or thought that there’s not going to be a negative consequence. for it, either in the immediate or long term. So the actual definition is around the belief that you won’t be punished or humiliated from speaking up about what your needs, ideas, or wants are for me, I think it misses a bit, which actually undermines certainly in English culture around this.

being polite and what we were talking about earlier about the NUH NHS not being a bit sort of conflict averse. Is it the psychological safety to speak up without upsetting somebody else? If I say, I wasn’t really happy about this, and you burst into tears, that’s no longer psychologically safe for me, because I’m now put into a sort of a villain, or I might be putting myself into a villain category.

So it’s the ability to say what you need to say without that fear of a negative consequence from it.

[00:29:19] Mat: And I can see how that links into conflict. And if I go back to one of the things you talked about earlier was status and I think a lot of people probably if they feel that something is very hierarchical, they won’t.

they won’t want to speak up and they won’t want to articulate what they need. There’s the, there’s a conflict and disagreement, but people are too afraid to speak up. And therefore, instead of getting it out into the open and having that functional conflict discussion leading towards resolution, you then have all of this.

undercurrents, where people are too afraid to say anything, but they’re deeply unhappy, but at the same time, they don’t feel safe enough to speak up and say what bothers them.

[00:30:02] Adrian: I’ve not seen specific research on this, but I’ve seen other bits of research that would give, that kind of fits how I’m feeling and what I’m experiencing.

I think psychological safety is the worst amongst medical colleagues. And after 18 years of experience, they’re the group that struggle with psychological safety the most. Great. Tell me more. I think that’s partly because of the medical leadership model. The power structure constantly changes.

So we have a head of service system at NUH. We’re a medically led organization. In a lot of places, who gets to make the decisions is on a rotational basis. So I might be a head of service and I’ve got the power to take away resources from you. I’ve got the power potentially to hinder your professional development.

Maybe I’m a mentor or a tutor or signing off your progression might be within my power, but I might only have that power for a couple of years and then we’ll open it up and somebody else would be the head of service. So talking to a lot of medical colleagues, they say I can’t go into conflict with that person and challenge.

Perhaps the way they’re leading or the decisions they’re making. Sorry. If I’m in a position of power, I won’t go into conflict with my colleagues because whilst I have the power at the moment, they might have the power in a couple of years and it’s just going to be revenge. Ah. So a lot of them are very nervous leaders in medical positions.

Oh, okay. So it really undermines this I don’t want to pee them off or upset them because, Ultimately, I don’t really have the power. My power is tenuous and short term.

[00:31:53] Mat: And actually, I would translate that into trainees as well, because obviously, we’re always signing trainees off for the competencies and progression.

But one of the things that that yeah, it’s interesting. One of the things that the trainees probably don’t realize is that As a trainer, I don’t want to piss off my trainee because that trainee works with me and I want to get the most from them and I want them to, I want them to deliver.

I want them to look after my patients or our patients. So yeah so it’s interesting because on one hand, it feels like this hierarchy, but on the other hand, that hierarchy isn’t forever, as you said. Okay. So what’s the solution to that?

[00:32:34] Adrian: If I knew the answer to that, I would be a much more senior level within the NHS.

Because it is a significant issue that we know that the people that are least likely to speak up even when there is clinical risks, are medical colleagues. And there is research to, to back that up. Even from medical school into sort of F1, F2 positions what they found from a study, it was quite old now was there was something like a 60 percent drop in their willingness to speak up, even if you thought that would harm, not speaking up would harm a patient.

So it’s just a massive drop about that confidence to challenge. to question, to, to speak up and say, this might be a risk. I’m still trying to dig into what other factors are in that. I think partly, I can never say this word, the peripatetic nature of a lot of medical colleagues is that they don’t, certainly below consultant level, is that they’re not part of a team.

in the way that nurses might be, or scientists, or admin, where they have a long time to build relationships, understand each other. So a sense of, a lack of sense of belonging or isolation undermines that assertiveness, because I don’t, it becomes more risky for me to speak up because I don’t really know you.

I don’t know what power you have, so therefore you’re more likely to be within. In established teams that meet regularly, discuss regularly, have shared objectives, it’s much easier to establish rules and understanding about how to work with each other. I think the other thing about psychological safety is that to a point you have to create that psychological safety ultimately you have to make a decision.

Is this risk worth me? going into conflict on this issue, and only you know that. But there are ways and tools about making it safe enough for the person to listen to what you need to say. And I think that’s something that is within our gift to do. And that’s based on, and there’s a model that I can share, but the first thing I think that’s really helpful for people to understand is that when you say something and you get a bad reaction, people are rarely defensive about what you are saying.

Thank you. They’re actually defensive about why you are saying it, and the why is the scarf model. Are you telling me, are you challenging my authority? Are you challenging my, my professionalism? Are you challenging me as an individual, as a human being? And we call it the hazard of half minute. You’ve got 30 seconds.

for that other person to understand why you are saying what you are saying before they make their own assumptions. So generally, when you say you might be challenging somebody, what you need to do is start with the intention. So can we have this conversation because and that intention has to be a positive one that they could engage with.

Maybe you’re really falling out with a colleague and you really want to have that conversation about it, you think, oh, but they might blow up. You start with your intention. So can we have a conversation about our relationship? Because I really want to have a good working relationship with you.

So that frames the conversation that we’re going to have. And what that does is it. It improves their psychological safety. It lowers their threat. Okay, so the frame of this conversation is a better relationship. So every time you feel that it’s starting to go off a bit, get a bit more heated, you just go back to the goal.

So the purpose of this isn’t for me to blame, shame, punish. do whatever the purpose of this so we can have a better relationship. So now you’ve got 30 seconds to convey that. After that point, their amygdala is kicked off, fight, flight, freeze, and they’re no longer listening to what you say. And a really good tip is just constantly go back to clarity.

So you can just, when you’re noticing someone becoming defensive or aggressive, Just say, just have a stop moment, just say, What do you think it is that I’ve just said? What is it that you think what I’m saying? Why do you think I’m saying what I’m saying? And I can guarantee you, ten out of ten, they will not give you back what you think you have said.

You’re saying I’m a bad… person. You’re saying I’m a crap doctor. You’re saying I’m a bad mum. But I’m like, where did you get that from? So clarity is your absolute golden thread through any conversation. Can we just start with being clear? What are we actually disagreeing on? Is it task, relationship, whatever?

What do you think it is that I’m saying? And so you move it constantly back to a psychological safe space of, actually, I’m not saying this because I think you’re a horrible person, I’m saying this because we want better patient care, better working environment, or whatever.

[00:37:37] Mat: Okay, so I’ll probably wrap us up now, Adrian, I’m thinking what are the key things that stood out?

For me, so maybe at the beginning, this idea that there’s such a thing as functional conflict as well as dysfunctional conflict. And that actually conflict isn’t necessarily a bad thing. So I think that was something that I think for a lot of people is going to be is going to be a bit of an eye opener.

And the fact that in health care. We are not as good as other sectors are at recognizing that actually, conflict is good and required for high performing teams. I really liked this idea that, the causes of conflict, that it might be the relationship, or it might be the task or the process.

And the status and I think that’s a way of understanding and maybe I’m going to ask you in a second about what your top tips for managing conflict would be. But I think for me that strikes me as a really useful thing to understand what the conflict is about and then the scarf model.

I really like that. And then also at the end, you talked about, the being very clear, what it is that we’re discussing and why. So maybe you tell me what would be your top tips for doctors at work facing conflict.

[00:38:48] Adrian: Frame it. Reframe it from a, this is going to be really awful and negative to actually there’s a real opportunity.

So reframing conflict into a positive space. The next thing is being really clear on what it is that you are in conflict about. So the task process being clear on what your ultimate goal is that you can share. So why am I having this conversation with this person? That could be a positive for us both.

So you’re starting off well. A tip I’d give is as part of that pre reflection about yourself. What is it? What am I feeling? Why am I feeling it? There’s a rule, which is you almost always be part of the problem. So there’s something about that self reflection before you go into it.

Then you need to start well, which is the start with intent. So the reason why we want this is whatever your positive intent is. Go into curiosity saying, I really want to understand you and your perspective. That is the number one way to, to decrease dysfunctional conflict and improve psychological safety.

Just be curious, saying, this is my goal, but I really want to understand you first. And I can guarantee you, you’ll have a better conversation. I can’t say it will resolve it. The conflict you have will be much healthier if they think that you’re on their side, because you genuinely want to understand their perspective.

[00:40:20] Mat: That’s great. Thank you very much, Adrian.

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