- Dececco & Richards

As a young man in my early 20’s I often envisioned "getting my life to gether." Generally that meant finishing college, working at a steady job, and being happy -- certainly worthy goals. What I really desired was order. I remember plotting out my life; I would teach high school students for a certain number of years, then attend graduate school, get married, have children, and continue to work in the field of education. Such dreams and visions are the stuff of life, but looking back 30 years later is to be filled with wonder and amazement. I have spent the past ten years working in health care and flying on airplanes, neither even remotely part of my earlier master plan. Life has been a series of surprises, many positive, others quite jarring and unsettling in their outcomes.

Most people, while desirous of stability and order, ultimately know their lives more often exist in ambiguity, uncertainty, and imperfection. We learn that change is a given, if not something to be relished, then certainly something to be expected. We discover that it is through our differences that we gain knowledge about each other and about ourselves.

On the other hand, few organizations have a predilection for change. They value stability, clarity, certainty, and order -- a permanence, even if that permanence is at the expense of creativity and the betterment of institutional well-being. With the shift towards managed care and the downsizing of staff, and the drive towards collaborating with families as equals, few times have been more challenging for health care organizations. It is a recipe for conflict. Ronald Lippitt says that "Problems are a natural side effect of the change process." Surprisingly, not only are such problems and resultant conflict inevitable, they may be desirable if growth is to occur.

Family members and professionals alike are often startled about how seemingly good ideas (i.e., family-centered care) are met with resistance and negativity. Johnson and Johnson, in Joining Together, conclude that "avoidance of conflicts has been found to be characteristic of hospitals, mental health centers, schools, churches, and social agencies." 1 This should not be surprising in that social service agencies are often driven by people with passion and high ideals, caretakers who put the well being of others ahead of themselves. Learning from each other’s differences are frequently covered over, and the results are too often smoldering resentments, incessant backbiting, and layers of blame and fear. Differences and disagreements are not valued for learning; they are more likely to be stifled and crushed.

A primary task for any individual or organization is to respond creatively to change and the attendant conflict that comes with it. Yet few individuals or organizations have positive models for working with conflict. Many of us grew up in homes where conflict was to be avoided -- "be pleasant" was the message. Others learned that conflicts resulted in a power struggle where the goal was to control, coerce, and manipulate others. A climate of fear often prevailed. Looking for victims to blame was often the name of the game. Peter Senge says that "People don’t resist change, they resist being changed." 2

It is not heresy to say that conflict is natural and to be expected. From our differences we learn from each other. Managing conflict (note the word managing, not necessarily resolving) can be a source of strength and energy, and can lead to superior problem-solving and learning. Conversely, "Conflicts that are not expressed and constructively resolved will be expressed indirectly at great cost to the group or organization, and the indirect expression of conflicts will persist far longer than would open confrontation and settlement of the conflict." 3

Personal self-awareness is always the starting point for conflict management. What do I bring to the table when differences exist? What did I learn in growing up that will help or hinder my valuing differences? How does my culture (ethnic, racial, religious, geographic) impact my working with others? What patterns of behavior do I employ when the going gets rough? Do I assert myself and face the person with whom I differ, or do I triangulate and seek allies to comfort and soothe me in my hurt and pain?

What are the key elements of managing conflict where the outcomes are positive and life-enhancing?

- Differences are handled in a "timely" manner, as close to the actual event as possible, not sandbagged for later.

- People stay in the present, the "here and now," not the past, not the "then and there."

- People are able to separate the event from the person; they focus their energy on the incident at hand, not the personalities.

- Each party takes responsibility for their part in co-creating the problem;
few if any problems are the sole repository of one person.

- "I" language is used, not "you," "we" or "they." People speak from their own experience and their own voice, and take responsibility for personal ideas and feelings.

- There is care in making inferences or drawing conclusions. Each party needs to state the event as s/he perceived it, the feelings that accompanied the experience, and what specific changes one would like to see occur. Descriptive rather than prescriptive language will help focus the discussion. ("When I was unable to finish my idea, I felt angry, as if you didn’t care to listen to or respect my opinions. I would appreciate it if you would let me complete my thoughts.")

- Listening is paramount. Climb into the other person’s shoes; try to under- stand where they are coming from, no matter how foreign to one’s way of thinking. Remember -- others feel as passionate about their ideas and
feelings as you do!

- Affirm and acknowledge each other -- for the efforts put forth, for the willingness to engage, care, and be involved with another.

This is hard work. Valuing and learning the skills of effective conflict management is essential for people to embrace and welcome the ongoing change in their lives.

REFERENCES

1 Johnson, David & Johnson, Frank (1991). Joining Together, Prentice-Hall: Englewood Cliffs, NJ.
2 Senge, Peter (1990). The Fifth Discipline, Doubleday/Currency: New York, NY.
3 Walton, Richard (1969). Interpersonal Peacemaking, Addison-Wesley: Reading, MA.

Published in Advances in Family-Centered Care, Institute for Family-Centered Care, Fall, 1995. We thank them for their permission to reprint this article.

© 1995 - all rights to this text belong to James May, jmay@seanet.com