Dear Crucial Skills,

I struggle with the attitude I find in acute care hospitals in regards to pain. Sometimes I hear employees and others discussing a patient’s pain and their need for treatment in a very judgmental, non-mission oriented manner. I am struggling to find the right words to speak up on behalf of that patient and to use words that might resonate to improve acceptance of all patients’ pain reports.

For example, standing outside an ICU room during rounds, the nurse will report the patients’ unrelieved pain. Invariably, the pharmacist or physician will comment about “addiction” or “drug seeking.” By the end of the discussion, almost everyone has made a disparaging comment and dismissed the patient’s pain. I have to speak up. I became a nurse to help end suffering, not to encourage it during one of the most stressful and painful periods in a person’s life. Can you help me find the right words to speak up to physicians who dismiss a patient’s pain?

Pained by Unfair Judgments

Dear Pained,

Thanks for noticing and caring. All of us are likely to be patients someday, and knowing that caregivers will help to reduce our pain and discomfort is very reassuring. So, what can you do if you aren’t satisfied with your colleague’s attention to pain management?

First, try to avoid feelings of righteous indignation. Try for humility instead. I know this is tough when you don’t think others are showing a caring attitude, but do your best to model a combination of confidence and respect without making accusations.

You described the problem very nicely. You made it clear that this isn’t a problem with a single caregiver or a single kind of pain management issue. Instead, it’s more systemic and involves multiple caregivers and multiple differences of opinion.

Systemic problems require systemic solutions. Since there is too much variance in how caregivers manage pain, the first focus needs to be on the pain-management protocol itself. Then you can more easily improve compliance with the protocol.

Structural Motivation. You might think improving your hospital’s pain-management protocol is too big a job for you to take on, and you’re right. Fixing this problem will require a team approach, but I think you’ll discover you have many willing allies.

Patients’ hospital experiences are now measured using a nation-wide survey called HCAHPS which asks specifically about pain control. Hospital’s scores are public and beginning in March these scores will impact the reimbursement they receive from Medicare and Medicaid. Poor scores can cost a hospital hundreds of thousands of dollars.

This structural incentive has the attention of hospital leaders everywhere. Most are actively seeking ways to improve their hospital’s scores and improving pain management is one of the strategies that has been shown to work. I think you will find hospital leaders very receptive to any improvement ideas you have. In fact, you may discover that your hospital already has a task force working on pain management.

Structural Ability. Your hospital isn’t alone in looking for ways to improve pain management. Many talented organizations, such as the Institute for Healthcare Improvement, are developing and testing strategies that work.

Involve your manager and others in your unit, or enlist a larger team from across the hospital, to develop a formal pain-management plan. Make sure you involve physicians who will help develop and champion this plan as well. Most pain-management systems include the following common elements:

Patient- and family-centered. Involve patients and their families in assessing pain levels and learning what their goals are for pain control.
Documented pain plan. Document pain levels, patient goals, and the pain plan on a white board in the patient’s room where it will be visible to the patient and caregivers.
Track and update. Check in with the patient at least hourly. Update the white board.
Analyze and adjust. Update the pain-management plan at least daily, based on whether the current plan has been working. Record any changes to the plan on the white board.

Make sure every caregiver understands and commits to the new system. Use your manager and physician champions to reach out to every caregiver who needs to understand and employ it.

Personal Ability. Once you have a system in place and have secured verbal buy-in to the system, it is important to cue, remind, and hold others accountable for managing patients’ pain in caring ways. Here are some simple reminders:

“Remember, we need every patient to answer ‘always’ on the HCAHPS survey.”

“I think you forgot to check the white board.”

“Could you help me with this patient? Her pain-management plan hasn’t helped her today. I think she needs you.”

If you get pushback on these simple reminders, you can escalate by explaining the gap between what the person has committed to and what you’re seeing:

“We all agreed to put the patient’s goals at the center of the plan. What you just said about drug-seeking behavior sounds like you disagree with the patient.”

“We all committed to use the white board and to keep it current. Are you changing your mind about that?”

If a caregiver continues to resist following the system, then bring in the manager or physician champion for your unit. I hate to say it, but sometimes the messenger is just as important as the message. Having a senior physician take the person to coffee and discuss the issue in a factual and friendly way will do a lot to get his or her buy-in. Ask the champion to close the loop with you so you can have confidence the person will accept your reminders in the future.

VitalSmarts has done quite a bit of work with hospitals that are working to improve their patient experiences and HCAHPS scores. We have a web seminar coming up on March 8 to discuss this very topic. I encourage you to join.

David

Dear Crucial Skills,

One of my coworkers has been harassing me for more than three months. I have expressed that I am only interested in maintaining a professional relationship and asked him to refrain from touching me or making further advances. When he ignored my request I complained to company management, but six weeks later the sexual harassment has continued and expanded to include other forms of harassment.

I filed another complaint and he has been talked to again but not terminated. I have been told that if there are future problems, he will be let go. In the meantime, I find myself in a job I love but where I no longer feel safe. I am required to work with this individual and maintain a professional relationship. After reporting the problem twice without seeing any results, I do not feel the harassing party will ever stop and I am not confident the company will protect me. I’m considering a job change. Do you have any advice for dealing with sexual harassment in the workplace?

Harassed

Dear Harassed,

Sexual harassment is very hurtful and scary, and it can be very challenging to resolve. My heart goes out to you. My first and most important piece of advice is to stay safe. Don’t allow yourself to be in a position where you can be harmed. Your safety needs to be your first concern.Next, I’ll try to answer your questions.

As you know, sexual harassment has legal implications and I want to make it clear up front that I’m not an attorney. Please don’t consider any of my suggestions as legal advice. I’ll focus on three elements:

1. Understand the law and your organization’s policies.
2. Be clear in words and actions that this person’s advances are unwanted.
3. Have a crucial conversation with human resources.

Understand policies and laws. If you haven’t already, get a copy of your organization’s sexual harassment policy. Read it carefully, write down questions it raises, and then meet with HR to get answers to your questions. Remember that the people in HR have to walk a careful line. They don’t want to permit harassment, but they also need to follow due process. They’ve told you they are monitoring the situation. Do your best to help them do their job.

If you have questions about laws that protect against sexual harassment, you should seek advice from an attorney with expertise on this issue. The basic law prohibits harassment and requires employers to maintain workplaces that are safe and free of harassment. However, the interpretation and enforcement of this law leaves many victims of harassment dissatisfied. Likewise, the interpretation presents challenges for people who believe they are wrongfully accused of harassment when they were trying to be friendly or just joking around.

The law would be clear if you were fired for refusing sexual advances. However, your experience is better described as a “hostile” work environment and people—even judges—don’t always agree on what “hostile” means.

Be clear in words and actions. You share that you’re required to work with this person and maintain a professional relationship. This is very typical of harassment situations and it’s incredibly tough to do. You need to stay professional while keeping yourself safe from someone you no longer trust. Know that others are watching you as well as your harasser. Behave as if your interactions are being videotaped and picked apart by a skeptical jury. Be on your best behavior.

Often, a harasser’s defense boils down to “it was a misunderstanding,” and this defense will sometimes win—both with HR and in court. Make sure your message is clear, unambiguous, and public. If your coworker is inappropriate when others are around, be quick to ask him to stop. You want others to witness two events: his bad behavior and your immediate, professional, and unambiguous response. If possible, avoid being alone with your coworker to avoid any “he said, she said” situations. Keep a journal with dates, times, and details of any inappropriate actions—including quotes of what was said—and report incidents to your manager and to HR immediately. Build a case that will refute any claim of misunderstanding.

Avoid behaviors that could be seen as flirting and don’t take part in bawdy conversations or jokes. Don’t initiate or accept invitations to be alone with your coworker in situations that he or others might interpret to be social or a date.

Have a crucial conversation with HR. It appears that you have already had a crucial conversation with HR and that HR believes it is following the letter of its sexual harassment policy. This policy probably involves verbal and written warnings. Again, based on your description, it sounds as if HR has made it clear that further harassment will result in termination. Since the harassment is continuing, I suggest you promptly have a second crucial conversation with HR. Here are a few ideas for this next conversation.

Share your facts. Detail exactly what has happened since your last conversation with HR. If you’ve taken notes, use your notes and provide them at the end of your conversation. Describe the circumstances, exactly what was said or done, who may have witnessed the incident, etc. If there have been multiple incidents, describe each of the incidents in detail. With harassment, there is often some ambiguity—what politicians call “plausible deniability.” Do your best to provide enough details to make the facts undeniable.
Tell your story. After you have detailed the facts, tell your story. Explain how these facts fit together into a pattern of continuing harassment. You say the harassment has expanded into new forms of workplace harassment. Make sure to describe the common thread that ties these incidents together. Make sure HR understand that you no longer feel safe at work.
Ask for others’ paths. Stop and ask the HR professionals for their help. Know that HR can’t violate the confidentiality involved in the formal disciplinary system, so don’t ask them to tell you exactly what they will do to your harasser. Instead, ask for how they can help you. Ask them to prevent the harassment and ensure your safety.
Talk tentatively. Avoid accusing HR of not doing their job. They must give due process to both you and your harasser. Be open to ideas that will work to solve the situation, but also be honest about ideas that won’t work for you.
Encourage testing. As you share your facts and tell your story, stop to check for understanding and agreement. Encourage HR to ask you questions and even to play devil’s advocate. You want to hear any concerns they have while you are still in the room and able to respond to them. Ask HR to give you advice and to share what the next steps will be. Have a note pad with you and write down the response.

I want to conclude my response by reiterating that regardless of the course of action you take, first and foremost do what is necessary to stay safe. Incidents of harassment can quickly escalate into an assault. Finally, if you don’t think the situation is being handled appropriately by HR, seek advice from an attorney.

David

Dear Crucial Skills,

I often find that I, as a consultant, am brought in as an expert, but as I attempt to guide clients toward a different way of thinking or problem-solving, they take it as a threat to how they currently do things. A power struggle ensues because they think my recommendations are an attempt to change them. Isn’t that what they hired me to do?

How can I get them to understand that my recommendations are meant to help, that we are heading toward the same goals, and that they hired me to help them fix something that isn’t working? How should I respond when someone asks for my advice then gets offended when I give suggestions?

Signed,
Trying to Help

 Dear Trying,

You’ve come to the right guy! After years of answering questions, I finally get someone asking me about consulting! Thank you, thank you.

In addition to the ideas I’ll share below, I encourage you to read the reader comments below my response. I know many of our 169,000+ subscribers are consultants (internal or external), so I hope they’ll share a boatload of wisdom as well.

So how can you increase the chance that your ultimate recommendations will be seen as helpful thoughts rather than annoying criticisms? Here are a few practices I use:

Contract up front for commitment from the real leaders. When you’re contracting for the work, be sure you’re reporting to a group that wants change. Often, at the front end of a project, I talk with a senior person who is motivated to lead change, but as things progress the work gets delegated to those with more parochial agendas. I’ve learned that I have more influence before I promise to take on a project. After that, you begin to get consumed within the system that everyone else gets stifled by. So, I take advantage of that “influence window” to contract with the real leaders of change for the amount of time and access I will need in order to accomplish the result they are asking of me. Then I hold them to it.

Clarify and document the mission. I’ve found that in longer-term projects you can easily get mission drift—especially in my work. Leaders say, “We want to change the culture.” With a charter a mile wide like “changing culture,” you’re bound to get people who criticize most anything you do—as it doesn’t match their image of what these vague “results” mean. I am very careful to ask leaders up front to clearly articulate, publish, and document the mission. What behaviors are you trying to change? Why do you want them to change? What results will that produce? How will we measure success? If I’m sloppy about clarifying, documenting, and socializing the results at the front end, it’s easy for people to take offense or disagree with what we ultimately produce.

Honor what’s working before talking about change. In Crucial Conversations, we teach a skill called contrasting. Essentially, we teach people to avoid giving unnecessary offense by helping others understand not just what you mean but also what you don’t mean. When someone like you or I comes in spouting off about change, it’s easy for people to feel like their important contributions are about to be lambasted. That’s not your intention. You aren’t trying to show disrespect for the thousand positive things that are working well. You’re trying to offer ideas for how to improve a dozen or so things that aren’t.

Be sure to explicitly acknowledge best practices that are working well as a way of contrasting to ensure you maintain a sense of mutual respect and mutual purpose with those who have created what you are criticizing. If you sincerely acknowledge what’s working, you make it easier for them to see that your motive is to help, not just to make yourself look like the only smart person in the room.

Build motivation by calibrating to their ability. This is a tricky one. You want to be sure you’re honest about what needs to change, but if your recommendations seem overwhelming, even well-intended leaders will lose motivation to consider them. You have to calibrate your recommendations to their ability to absorb them. Sometimes their rejection of your proposals is a reflection of your failure to present them in a hopeful way rather than an overwhelming concern that leads to more work.

Involve them in the journey. I left this one for last because it’s one I want you to remember. As I said in the previous suggestion, your job is not just to offer right-headed ideas, but to do so in a way that builds motivation to address them. The best way to do this is to involve your clients in the discovery process. If you do too much of the diagnosis with little or no involvement on their part, then you’ll be left to use verbal persuasion—PowerPoint presentations filled with sterling logic and compelling data—to make your case. And as we teach in Influencer, verbal persuasion is the least effective tool you can use. Direct experience is the best.

When VitalSmarts conducts assessments, we never do interviews without partnering with the leaders who will be responsible to implement findings. We know that having them hear key concerns firsthand affects them emotionally in a way PowerPoint never can. Be sure your consulting process builds motivation along the way and you’re less likely to be surprised by resistance at the end.

Best wishes,
Joseph

Dear Crucial Skills,

I read about your career-limiting habits survey and immediately realized a career-limiting habit has held me back from a promotion I’ve wanted for several years. You could say I have two of them. First, I have the one you describe as “short-term focus.” I focus on urgent tasks and let some of the long-term priorities slide. Second, I sometimes get caught in the “too little too late” trap—I’ve procrastinated on a long-term priority, and now I take shortcuts or miss deadlines.

I want this year to be the year I finally meet my goal. Do you have any advice for overcoming my career-limiting habits so I can finally get the promotion I’ve been working so hard to earn?

Career-Limited

 Dear Career-Limited,

Congratulations on seeing yourself with such steely-eyed objectivity. Most of us have trouble recognizing our faults, but the career-limiting habits you’ve recognized put you in great company. They are among the most common career-limiting habits we see in workplaces. The good news is that you can overcome them.

I’ll suggest some ways to make progress on habits in general, and on yours in particular.

Escape the Willpower Trap. The most common mistake we make is to rely too much on willpower alone. Of course, willpower is important. If you aren’t determined and resolute in your desire to improve, then you won’t. However, while willpower may be the spark to get you started, it won’t be enough to carry you through the dog days of change.

The problem is that your status quo, your career-limiting habit, is held in place by several of the six sources of influence, and you may not even see them. Here are a few that might keep you working on short-term tasks instead of focusing on long-term priorities:

Source 1: Love What You Hate. It’s personally satisfying to take a job to its completion. This is more possible with short-term tasks than with long-term priorities.
Source 2: Do What You Can’t. It’s difficult to say “no” to some short-term tasks. You may need to master this new skill.
Sources 3 and 4: Turn Accomplices Into Friends. Your manager and others probably rely on you because you deliver on short-term tasks. They may push you to keep your short-term focus. Others may also be more willing to help on short-term tasks because the commitment is smaller.
Source 5: Invert the Economy. The rewards for completing short-term tasks are immediate; the punishments for missing long-term priorities are in the future.
Source 6: Control Your Space. Technology is constantly reminding you of your short-term tasks. For example, most instant messages, e-mails, and phone calls focus on short-term projects.

Instead of just trying harder, take control of these sources of influence. Get them pulling for you, instead of against you.

Be the scientist and the subject. Setbacks are as predictable as death and taxes. You will experience them. Your success will be determined by how you respond to them. People who are caught in the Willpower Trap respond by blaming themselves—their character, their steadfastness, and their ability to “stick to it.”

Successful changers respond as scientists would—with curiosity instead of blame. Instead of blaming themselves, they treat their setbacks as data—they use them to examine and improve their plan. We call it “turning bad days into good data.”

Here’s how you can use your setbacks as good data. When you realize you’ve slipped back into your habit, stop and ask yourself when, where, and how it happened. Find the crucial moment—the circumstances—that led to your slip up. One of my crucial moments is when I tell myself a clever story—a story that lets me off the hook for acting on my bad habit. Once you find these crucial moments, decide how to handle them. I often need to change my clever story to one that’s less clever, but more true.

Use all six sources of influence. We’ve collected data on the tactics people use to overcome career-limiting habits. The biggest mistake people make is to rely on willpower alone or in combination with just one or two other tactics. People who combined tactics from four or more of the six sources of influence were up to ten times more likely to get rid of bad habits and improve their chances of advancement.

Here are a few tactics the people we surveyed use to help them overcome career-limiting habits:

Source 1: Love What You Hate. Focus on the positive things that could happen if you change your bad habit, or focus on the bad things that could happen if you don’t change.
Source 2: Do What You Can’t. Skill up by reading books, articles, searching the internet, etc., then practice these better skills until they become your new habits.
Sources 3 and 4: Turn Accomplices into Friends. Get advice or coaching from someone you respect, or ask a coworker, manager, or family member to hold you accountable for changing.
Source 5: Invert the Economy. Reward yourself with a pat on the back or an actual incentive.
Source 6: Control Your Space. Rearrange your desk, computer, or workplace in a way that helps you stick to the change, or make changes to other aspects of your physical space—move chairs, put up reminders, remove distractions or temptations, etc.

The key is to try several tactics in combination and to track your success. Use setbacks as data, the way a scientist would. Seek out the crucial moments—the times, places, and circumstances when your plan needs to be reinforced—and focus your tactics on those moments.

David

  Dear Crucial Skills,

Mine is a story of conflicting priorities and unmade decisions. My bad habits at home support my bad habits at work, and these habits are all supported by behavior, social influences, and environmental infrastructure that need to change. When I try to pick one thing to work on, I find several others that undermine my efforts.

For example, we’re trying to remodel our kitchen but we ran out of money so we can’t hire someone to finish it. We eat out too often because our kitchen is torn apart and our house is always cluttered, but we don’t have time to exercise or clean because we’re too busy with work and school activities. We have very few friends because we don’t want to invite people to our house and we’re too busy juggling everything else. How do I know where to start when it seems that everything I’d like to change is interdependent or influenced by all the other things I’d like to change?

Where to Start

 Dear Where to Start,

I understand your concern. It reminds me of that old saying that tells us, “life comes at you fast.” Each little concern or unfinished bit of life can have a ripple effect, not only on our own life, but also on the lives of loved ones and friends. When we stop long enough to assess our circumstances, we conclude—as you did—that “mine is a story of conflicting priorities and unmade decisions.”

I’d like to talk to you like I’m your best friend. This means I care about you and I want to help you solve these issues. I’m going to be as honest as I can but I know I can’t make these changes for you. If I were your best friend, I’d be able to ask questions that would help us understand the real issues. Without being able to ask those questions I may miss the mark a bit, and I hope you and the tens of thousands of onlookers (no pressure) will cut me some slack.

I’ll start with a word you used in the first sentence of your question: “story.” We’ve been teaching people to master their clever stories for years. A clever story is what we tell ourselves to justify our own behaviors. So, as your best friend, I’m asking what stories you’re telling yourself that make it difficult for you to be as effective as you want to be? Here are some possible stories I see.

Problem: Your kitchen is in the middle of an unfinished remodel.
Story: You eat out too often because of the remodel.
Option: There are many ways to cook at home with only a fridge and a microwave. You and your family need to make the decision to eat at home.

Problem: You think your house is messy.
Story: You are too busy or tired to clean.
Option: For years, I tried to teach my children about the magic of five minutes. At the end of the day, after you’ve readied yourself for bed, take five minutes to straighten the bathroom, bedroom, and closet. Before you go to work, clean up the little mess you made getting ready. After any meal, clean up the mess and wash the dishes. In your case, you may want to set the foundation by having a magic half-day or full-day. Take a Saturday, remind everyone of the benefits of having a clean house, and then clean up. Creating a plan for regular cleaning takes away a lot of other problems.

Problem: You don’t have enough friends.
Story: You don’t invite people to your house because of the remodel and because you’re too busy juggling work and school activities.
Option: Invite others to do things outside of the house. There are many inexpensive activities you can do outside such as hikes, picnics, and so forth. You are certainly correct that a key step to making friends is initiating invitations, but you needn’t stop inviting people because of your house or your schedule.

Now remember, this advice is coming from your distant best friend. I may be missing the mark. I may cause you to counter every suggestion with a “yeah, but.” However, remember that clever stories are called clever because they are tricky. They are hard to see, they can morph quickly and they can call in more of their clever clan in nanoseconds. When we fall short of the results we want, or when we start feeling down and hopeless, we need to assess what we honestly have and what we really want.

You might need a friend to help you do this. What you don’t want at times of assessment and planning are accomplices. Remember, a friend is someone who helps us; an accomplice is someone who helps us get and/or stay in trouble. Accomplices help us spin clever stories; friends help us see our stories and find options out of them.

It’s clear from your question that you have an understanding of the six sources of influence. I agree that you have many sources of influence affecting your behaviors, and thus the results you are getting in your life. You do have—as we all have—some bad behaviors and unmade decisions, but you don’t have to stay there. I advise you to find the vital behaviors that will help you get what you really want and need. For example, your vital behaviors might include:
 
1. Cleaning the house every Saturday morning.
2. Practicing the magic five minutes at bedtime, before work, and after each meal.
3. Inviting a friend for an affordable outing each Friday night.

After you identify your vital behaviors, ask yourself, “How can I marshal enough influence to make sure I do these behaviors?” Then, ask the following questions to identify tactics in each of the six sources:

Source 1: Love What You Hate — Can you articulate the positive benefits you would get from changing your behavior?
Source 2: Do What You Can’t — Can you improve your organizing and cleaning skills? Can you learn about inexpensive activities to do with friends?
Sources 3 and 4: Turn Accomplices into Friends — Can you get buy-in from the people you live with? Can you ask a friend to hold you accountable to your clever stories or to help you analyze and adjust when your plan isn’t working?
Source 5: Invert the Economy — Can you identify an affordable reward that would be meaningful to you if you stick to your plan for a month? Can you set up a scorecard and report your performance to a coach or mentor?
Source 6: Control Your Space — Can you put up cues and reminders? In short, what can you do to change your surroundings and get the numbers in your favor?

Notice that I have said nothing about finishing the kitchen. Of course, it would be wonderful to complete this project, but it need not stand in the way of achieving many of the goals that are important to you. Often, we hold back in achieving our goals because we tell ourselves a clever story that justifies all the reasons we simply can’t succeed. I believe your kitchen remodel has become your Achilles heel to accomplishing other achievable goals like cleanliness and friendship. It’s time to change your story and start isolating one behavior challenge from the next.

As a friend, I’ve tried to give you a starting point. Begin by looking at the stories that affect your decisions. From that process, options will emerge. Then identify the vital behaviors that will get you to your desired goals, and marshal enough influence that you will be motivated and enabled to do the behaviors. Start small and then aim bigger. In that way, we are more likely to overwhelm our problems rather than simply be overwhelmed.

Best wishes,

Al

Dear Crucial Skills,

I recently realized we aren’t out of debt because we really don’t want to pay all the money to make it happen! We have been on a debt payoff plan for years but never follow through because it’s so painful to pay our bills when it seems like we are just giving money away. It’s just too hard to catch up when we don’t even know what the balance is for because it has accumulated over several years. As a result, we lose steam after a few months, spend money on a nice night out or an evening entertaining friends, and get off track.

Can you share some tips to help us address our personal motivation and learn to “Love What We Hate”? Do you have any tips for motivating ourselves to get out of debt by turning it into a game we can win and enjoy playing?

Sincerely,
Wanting Off the Hamster Wheel

 Dear Hamster,

What a frustrating and sad situation. Not only are you struggling financially, you are beating yourself up for your setbacks and failures. You’re blaming your character when you should blame your plan.

In our book Change Anything we describe your situation as “The Willpower Trap.” It happens when you over-rely on your willpower instead of employing all six sources of influence. Your willpower lets you down, you blame yourself, and you become discouraged and even less successful.

The way out of this trap is to involve all six sources of influence, not just those related to personal motivation. You specifically ask for ways to address your personal motivation—and I’ll get there—but that’s not where I’d like to start. Instead, I’ll begin with structural ability.

Structural Ability. If “a nice night out or an evening entertaining friends” is enough to throw you over the edge, then you’re living too close to the edge. I recommend you take a few steps back by lowering your fixed expenses. I know these are difficult steps to take, but they will do wonders to lower the pressure you’re feeling today.

Find ways to reduce regular monthly payments

• Reduce your rent or mortgage. Consider renting out a room in your house, moving to a smaller apartment, or moving in with a friend or relative.
• Reduce your transportation costs. Consider selling a car or trading in your current car for a less expensive car. Downsizing a car will save more than your car payments. It will reduce insurance, gas, and repairs.
• Cancel non-critical services. Reduce monthly payments by cancelling non-critical services like cable TV, cell phone data plans, and magazine or newspaper subscriptions.
• Sell unnecessary assets. Sell assets like boats, power toys, vacation homes, etc.

Make impulse buying more difficult

• Cut up or cancel credit cards.
• Make tempting locations “out of bounds.” For example, stop going to particular stores or malls, stop visiting eBay and other online retailers.
• Never shop without an actual shopping list and never buy items that aren’t on the list.

Keep score

• Keep a visible scorecard or chart that shows your progress—and update it every day or every week.

Add another paycheck

• Consider taking a second job. An evening or weekend job that brings in an extra $100 a week might give you that extra margin you need.

Personal Motivation. It sounds as if your motivation wanes when you think to the past—especially when you can’t remember where your money went in the first place. Motivation works better when you focus on the future—on where you want to get. Here are a few ideas:

Visit your default and desired futures

• Select a very specific debt-reduction target. Make it as detailed as possible. For example: pay off my highest-rate credit card, pay off my car, or pay off my student loan. Then dedicate your savings to that goal alone.
• Select a very specific purchase that your debt-reduction target will make possible. Don’t make this an “optional expense” like a vacation. Instead, make it mandatory, like dental work, tires, or a replacement car. This target will be your North Star, a motivator and a guide when your mood is dark.
• Think deeply about what will happen if you don’t make your savings goal—if you can’t get your dental care or new tires, or if you can’t afford medical care for your loved ones.

Create a personal mission statement

• Write down your saving and spending plan and note why it is important to you. Have every family member sign it, then keep copies you can see and read when you feel tempted to overspend.

Make it a game

I like to build four elements into a savings game: a reasonable challenge, clear rules, social interaction, and immediate feedback. Below is an example:

• Set a weekly goal. Perhaps you could decide on a set figure to pay toward a credit card.
• Establish clear rules. Maybe establish different rules each week. For example, “This week our payment has to come from new money one of us has earned. Next week it has to come from saved money, and it has to come from our food budget.”
• Use cooperation or competition. For example, “This week, we’ll cooperate to jointly achieve our goal. Next week, we’ll compete to see who can reach their part of the goal first.”
• Give feedback and fabulous prizes. Make a big chart that shows your progress. Create magnificent, but free, prizes like paper crowns and towel capes for the Sultan of Savings. Celebrate your very real achievements by writing notes to each other and putting them into a scrapbook.

These are a few ideas to try. None of them are magic and none are tailored to you and your unique situation. In addition, they only deal with two of the six sources of influence. I encourage you to select, modify, or invent your own tactics. Make sure you include actions within each of the six sources of influence and make them big, high-leverage actions.

Best wishes,
David

The following article was first published on November 17, 2010.

Dear Crucial Skills,

With the holidays quickly approaching, I have found myself caught in a sucker’s choice with my family. My wife and I have made it a tradition to travel to my parents’ home seven hours away for Thanksgiving. This year, my parents informed me that my sister will also stay there. My sister is a drug addict and has been in and out of jail for thirty years. Every time she gets out, she claims to clean up her life and my parents roll out the red carpet to help her. When she returns to her destructive patterns, they turn a blind eye.

For years, this has caused all kinds of problems between my parents and five siblings. I would love to keep my tradition of spending Thanksgiving with my parents, but I don’t feel comfortable staying in the same home with my sister. It’s a rural area so there are no hotels or other arrangements available.

I see only two options: either continue with the tradition and hate the experience (which could also be potentially dangerous), or forgo the tradition and hurt my relationship with my parents. I can’t find a win-win here. Please help.

Signed,
Stuck

  Dear Stuck,

If you’ll give me some latitude, I’m going to wax philosophical and share my perspective on the purpose of life. My goal is not to persuade you that my view of life is right, but simply to share one perspective that gives context to my suggestions.

In my view, life is about achieving intimacy with those we’re inseparably connected to. Family is first and foremost in that category.

Now, how is that relevant to my dialogue with you? Because I walk in your shoes. I have dear ones who also struggle with addiction. Some of the most searing pain of my life has been watching them destroy months of progress—only to land once again in jail or on the street. Almost equally painful is watching those who care about them behave in ways that positively enable their self-destruction. It’s agonizing. And my natural reflexes toggle between an overwhelming urge to either take control of the situation or to distance myself from it.

And yet, neither impulse is consistent with my view of the purpose of my life, which is to develop the character to achieve intimacy with imperfect people. When I try to take control or distance myself from my struggling loved ones, I find that my life is the poorer and my character weakens.

When I find myself in your shoes, the question now becomes, how can I remain close in a way that exerts positive influence on those who are the most troubled?

Enough with the philosophy. So what about your situation?

First of all, you made a reference to danger. If by that you mean you might take children into a situation when your sister is using, I would decline and explain this concern to your parents. And when doing so, cleanse yourself of any intention of using this decision as a threat to get them to exclude your sister. Simply explain that you can appreciate their desire to include your sister—and hope it is a good experience for them and her—but that your children give you other considerations. You may even want to make a call on Thanksgiving Day and wish your parents and sister well so they don’t misinterpret the decision.

If you choose to participate in the Thanksgiving tradition, there are a couple of crucial conversations you’ll need to have:

1. Motives. You need to change your motives. This year may not be about peace and harmony in the home. It may be filled with uncertainty and awkwardness, but it might still be meaningful. In fact, it could be more meaningful than many others. Your goal will not be to fix your sister or to correct your parents. It will be to improve your relationships with all of them—to try to achieve greater intimacy. Doing so may increase your positive influence in the future in all their lives.

2. Boundaries. You can’t control your sister or your parents, but you can control yourself. Decide in advance what kinds of situations may play out. Then ask yourself, “If what I really want is to be a positive influence on my sister and my parents, how will I respond?” Don’t wait until the resentment of the moment hits to make this decision. Think it through in advance.

Then discuss these boundary conditions with your parents. Let them know you love them and want to be part of this holiday, and that you have your own view of how to deal with some of the potential challenges. You don’t ask that they agree with you, you just want to explain your intentions so they can understand your motives in case you behave in a way they find jarring.

For example, if your sister uses, you may choose to leave or you may call the police. Before you arrive, discuss these boundaries with your parents and see if you can come to terms on them. If you disagree in important ways, you may elect not to participate. If that is the case, do not announce that decision in a punishing way. Don’t use your decision as a way of provoking your parents to concede to you on these points. Honor their right to disagree. Affirm them. Express your love. Ask if it’s okay if you arrange another visit with them when things are simpler.

If after working through these two conversations you find yourself at the family gathering, be as good as your word. Take small steps to show love to your sister. Expose yourself to the discomfort of possible disappointment or rejection. You may well find, in some future situation, that your improved relationship with her puts you in a position of influence to help her take a steadier step toward sobriety. It may be one step forward and two steps back (it certainly has been with some of those I love).

While these situations are complex and difficult, I can tell you that this Thanksgiving, one of the blessings I will feel most intensely is the intimacy I now have with one who looked the most helpless for the longest time.

I hope I haven’t been too presumptuous. If I’ve misunderstood your situation or imposed my own views inappropriately, please forgive me and don’t let my imperfection drive distance between you and me.

Sincerely,
Joseph

Dear Crucial Skills,

When my grandmother became very ill, my dad and his four siblings struggled to come to an agreement about what was best for their mother. My aunt (the oldest sibling) became very controlling and everyone had a difficult time staying in dialogue with her, including my dad who is exceptional at mastering his stories and building mutual respect and mutual purpose.

This conflict has now ruptured relationships such that after more than thirty years of tradition, we are cancelling my grandma’s family Christmas party. I would like to see my dad and his siblings forgive each other and focus on the needs of my grandmother, who is obviously affected the most. How can I help my family overcome past fights and come together for the holidays?

Signed,
Facilitating Forgiveness

 Dear Facilitating Forgiveness,

I was thinking about your question last week while I took my morning run in the National Mall in Washington, DC. As I ran past the wonderful new Martin Luther King memorial, I screeched to a halt in front of a granite inscription that read, “Darkness cannot drive out darkness; only light can do that. Hate cannot drive out hate; only love can do that.”

I’ve ruminated ever since on the implications of that powerful concept for your situation. Here are some thoughts I hope will help:

1. Patience is the most genuine expression of love. The first thing to keep in mind is that you cannot force forgiveness. You can’t compel other people to soften their hearts, examine their own faults, or modify their judgments of others. You have to wait until they want to.

Allowing them to go through the process of challenging their own emotions is an authentic expression of your love for them. It reflects your willingness to patiently wait for the family unity you crave so they can go through the natural process of human growth. Attempting to force the process is more likely to create resistance than reform. Watch—but wait—for signs that others feel some of the loss you feel, then make gentle attempts to help them move forward.

2. Forgiveness is the natural result of a new story. We can’t feel differently toward others until we think differently about them—and ourselves. Forgiveness is difficult because we stay stuck in the story we’ve told ourselves about what happened. As long as we maintain a picture of others’ villainy and our own virtue, we feel morally justified in our anger or frustration. We take delight in the suffering we hope the other person is feeling from our withheld affection because we perversely imagine they deserve to suffer or that the suffering is a learning experience. “Perhaps,” we reason, “this mutual misery will help them see the error of their ways and become a better human being. I’m a wonderful person for helping them have this life-changing experience!”

Until we intentionally examine our own faults and others’ virtues, we feel no need to forgive. The instant we begin this painful but wonderful process, the icy feelings inside us begin to melt. If we continue that process to its natural end, feelings of forgiveness are inevitable. Changing your story is the key to changing your feelings. Don’t try to get others to forgive. Instead, help them to challenge their stories. Forgiveness will follow.

3. We’ll challenge what we think when we change what we want. Given that challenging our stories is a painful process, why would anyone do so? We do it when our motives change. That’s why the first principle of Crucial Conversations is start with heart. When your motives change, your behavior follows naturally. People who resist forgiving are sometimes stuck in self-justifying stories—stories that protect them from the pain of reexamining their view of themselves and others. Sadly, the primary motivator that drags our story into the light is the acute experience of the pain of a lost relationship.

Now, I know your question wasn’t about helping yourself forgive, but about facilitating that process in others. So how can we use the principles I outlined above to influence others to forgive? First, don’t rush them. That just distracts them from experiencing the pain that could motivate them to change. Second, acknowledge their pain. Affirm the parts of their story you agree with and the hurt they legitimately feel. Third, invite motivation. Let them know you miss the family gatherings and guess they do, too. Tell them you think there is a way back to the former intimacy if they are open to discussion. Then be patient again. Periodically reaffirm the invitation, but don’t badger. When they’re ready, they’ll let you know.

One of two things might happen if you are patient and supportive. First, your family members may just bury the past and reconnect without resolving anything. Perhaps this is an acceptable compromise if all are happy with it. Second, they may respond to your invitation to help. If they take the second route, this will be your big opportunity for a crucial conversation. I’d suggest you invite them to share their story, then request the chance to share a different view of things. Be clear up front that your intent is to help them see what happened differently so they can feel differently, and gain their consent for this process before you dive into it. If they seem resistant, withdraw and assure them you aren’t trying to force your view on them. If they are going to change their minds, they will have to invite your influence in doing so.

Our judgments or demands of others won’t drive out their stories—just like hate cannot drive out hate and darkness cannot drive out darkness—only love and light can do that. While I don’t think there is any special brilliance in these modest suggestions, I hope you discern the heart of them—patience, love, and an appeal to what they really want is the only path to helping people reappraise their stories and reconnect with loved ones.

Happy holidays and peace to you and yours,
Joseph

The following article was first published on March 9, 2006.

Dear Crucial Skills,

How do you help “undo” a story that another person has held about you? Last fall, my husband went over to borrow an item from our next door neighbor of ten years. They’re very nice people—we wave and exchange pleasantries and small talk, we have sent their kids graduation cards, etc. My husband came back concerned. He said they’d received an anonymous hateful letter ten months earlier and they seemed quite convinced that I’d sent it. I was alarmed and went over right away to talk. The letter was truly awful—calling them morons about leaving their holiday lights up well past the holidays and being the laughingstock of the neighborhood. I didn’t write this letter and I told them so.

And yet, I still feel like there is an uncomfortable feeling between us. I’m acting as if the whole thing never happened, but feeling self-conscious about it—for example, sending over a dozen cookies when we’ve baked, acknowledging their kids’ accomplishments, etc. These are things we’ve done in the past that now I fear will be viewed in a different light—like I’m trying to make up for something.

Please help,
Uneasy Neighbor

Dear Neighbor,

First, congratulations. You said you “went over right away to talk.” We firmly believe that if you don’t talk it out, you act it out. So, way to go. If you had told yourself different stories, you would have acted differently. If you had become upset because you were wrongly accused and had withdrawn in indignation, you would have acted in ways that probably would not have helped—your feelings would have showed up in your facial expressions, in half-hearted greetings, etc. Because thoughts really cannot be held inside (they leak out), people often resort to gossip, and gossip has a hard time being contained—it seeks the lowest level. It has ripple effects that find their way to the person being talked about. So congratulations on telling yourself stories about the other person, about you, and about your relationship that allowed you to go talk about it. Adding to the pool of shared meaning was the right step to take.

There are two questions here that I’d like to address. First, how do we get over situations where we have been wrongly accused of something we didn’t do? Second, how can we help others “undo” their story that we wronged them when we really didn’t?

First, how do you deal with your emotions when you’ve been wrongly accused? Key to understanding your options is what we call the path to action. This model helps explain where emotions come from. A brief overview:

• We observe an event (i.e., we see and hear what happens with internal and environmental filters).
• We tell ourselves a story with whatever data we have (the events we observed). These stories can be helpful or harmful.
• We feel emotions based on the story we chose to tell.
• We then act based on our story and our emotions (we choose dialogue, silence, or violence).

The important thing is to explore why the emotions are still lingering. Why are you still worrying about how your neighbor is interpreting your actions and motives? Re-examine your path to action back to your actual observations. Are there more helpful stories you could be telling about what you’ve observed? Or do your observations point to the need for another crucial conversation?

When you’re deciding whether or not to bring up a subject, ask yourself if “that little voice in your head won’t go away,” or if you are “acting it out” even after you’ve re-examined your stories. If the answer is “yes” to either, you probably need to talk it out.

In your comments, you stated that you fear your neighbors still think you did write the letter. That could be the topic for another conversation. Mention the first conversation, and that you just want to check in and see how your neighbors are feeling now. Share your goal to be a good neighbor and have a positive relationship.

If you have observed actual behaviors that are leading you to believe there is still an issue (e.g., if you saw nonverbal clues like half-hearted greetings, lack of eye contact, or avoidance on your neighbors’ part), you may want to bring them up and hold a crucial conversation to address the story they may be holding onto. In that case, ask to talk to the other person and start by making it safe. Have a private talk. Don’t be emotional, be honestly inquisitive. Try to explore the other person’s path to action by starting with your observation. For example, “I’ve noticed that when we see each other in the neighborhood, you don’t look directly at me and you tend to hurry out of any conversation.” Don’t offer judgments about their emotions or motivations. Simply describe the facts. Then tentatively share your concern: “I’m beginning to wonder if you still have feelings about that letter you received. Can we talk?”

You are trying to learn what “story” your neighbors are telling—you are trying to understand their data. Then, when you’re in dialogue, you can share your perspective and your purpose.

The other alternative is to be patient. Suppose your neighbors say they don’t think you wrote the letter. Suppose you don’t see them acting it out. That means most of your energy around this issue is coming from your stories. In that case, wait. Continue with your strategy of being a good neighbor. Often, when we don’t have any additional data, our stories and emotions fade. Our worries decrease. That’s effectively self-managing your own path to action. Such an approach reminds me of the saying attributed to the great Anonymous: “At twenty, we worry about what others think of us; at forty, we don’t care about what others think of us; at sixty, we discover they haven’t been thinking about us at all.”

Thank you for your inquiry. Hopefully there is a lesson that we can find here that will help us get in touch with our own stories, cue us up when we need to talk, and be more patient with our emotions. All of these can lead us to dialogue.

Best wishes,
Al

  Dear Crucial Skills,

I own a furniture consignment shop. We have a new customer who is seventy-five years old, very lonely, and needy. He constantly comes in the shop or calls to talk about how he used to be a Hollywood star and a millionaire, or to tell us about each of his seven marriages.

I don’t know how to tell him we are busy, but we have each heard his story three or four times and it’s starting to make us all feel uncomfortable. How can I tell my needy customer that I don’t have time to talk without offending him?

At a Loss

 Dear Loss,

Thanks for the question and for your genuine concern for a person in need. Let me start by suggesting that this situation calls for a tactful discussion instead of a full-blown crucial conversation where you jointly brainstorm a solution.

You’re right in worrying about hurting the fellow’s feelings. He’s a human being and like all of us, he deserves to be treated with respect. Obviously, you don’t want to bluntly tell him to stop talking so much or repeating himself so frequently. And while it’s true that he may be lonely and is looking for simple conversation, even companionship, it’s not the responsibility of a shop owner to meet those needs (more on this later).

The kind thing to do is to pull the gentleman aside and set your ground rules. Explain that you appreciate his business and enjoy the conversation, yet you face a challenge. The shop requires your careful attention and does not allow you to carry on long conversations, enjoyable or otherwise. So you’re asking him to conduct his future business quickly—without lengthy discussions—so you can fulfill your responsibilities as a shop owner. Then thank him for his cooperation.

All of this should be done pleasantly, with a slight smile, and with genuine compassion for another person. You’re not opening the conversation up for debate, nor are you asking for suggestions. You’re professionally and politely defining the boundaries of your relationship.

Now, having said this, let me return to the issue of a lonely gentleman who appears to be looking for more than a simple purchase. Let me write, not just to you, but to all of us—myself included.

Not long ago, I was taking a brisk walk when I passed near an older fellow, a complete stranger, walking the other way. He signaled me to stop and when I did he chatted me up for a full five minutes. I was in a hurry to get back to work, but the gentleman seemed oblivious to the fact that I was trying to exit the conversation at every turn. Later that same day, I stood in line to buy a handful of groceries while an elderly woman in front of me wrote out and recorded a check—seemingly in slow motion—while casually chatting with the clerk. I almost climbed out of my skin.

At the end of the day, my mind turned to the intersection of two factors. One, my own lack of patience, and two, a growing number of elderly people who are likely to tax my ability to slow down and smell their roses. As I thought of these two events, I remembered the fact that as baby boomers age (and I’m one of them), they’ll put a massive burden on the healthcare system—leading to a huge shortage of healthcare professionals. I also recalled reading that, in 1950, for every person over 65 there were twelve people of working age, but in 2050, that number will drop to three—burdening social security. I was aware of both the medical and financial burden that will accompany the gray wave. We hear about those issues nearly every day. What I hadn’t thought about was the need for love, kindness, a gentle word, and yes—time—from those who will have so much of it on their hands.

The awkward situation at your shop provides evidence that there will come a clash between those who are frantically running about their daily tasks—stretched to do the job of two people—and those who will want to slowly write out a check, go on casual walks, and talk with shop owners about the old days.

And while it’s true that the shop owner can’t always meet the needs of aging customers, it is equally true that the rest of society will have to come to grips with living alongside a growing number of seniors who are finding their senior years more lonely than golden. As our life paces and interests come in conflict, we’ll continually face the question: What do I really want here?

I wrote earlier about my father who had largely gone blind, working on my pride and joy—the flowers in front of our house. Dad really wanted to contribute to the effort and eagerly put on his gloves every time I watered, mulched, or planted. Because dad couldn’t see all that well, he often damaged or even killed flowers every time he lent a hand. This bothered me until one day I asked: “What do I really want?” I decided I wanted my dad to work alongside me more than I wanted perfect flowers. We’ll be faced with the same question in years to come as more and more elderly people will ask for our time and attention at a stage in our lives when our free time will, if anything, be growing scarcer.

Hopefully, as we ask the question of what we want for ourselves and for others, we’ll find both the desire and the methods to spend time with those who have given us so much. Perhaps outside the shop someone will talk with your needy customer about the good old days. Maybe a neighbor will bring by a fresh-made loaf of bread, and then sit and chat for a while—doubling the gift. Perhaps his son will call with a short item of business, and then lengthen the conversation to cover whatever Dad wants to discuss. Perhaps all of us will learn to find ways to stop and smell the roses.

Kerry