Tuesday, December 4, 2012

Words That Work

It’s not what you say, it’s what people hear

I coach my psychotherapy patients about techniques for empathically confronting close family-of-origin members about traumatizing repetitive, dysfunctional interactions. The goal is to devise a strategy to put a stop to them.  I use role playing as a technique. It is useful in accomplishing two goals: learning more about how the targeted Other is likely to react, and trying out various strategies for my patients to use that are likely to be effective in keeping the task (metacommunicationon track.  

I start with something called role reversal. The patient plays their significant other - the target of the metacommunication - and I try out various approaches to see what they are up against and to see what might work.  

After I find something that seems promising, we then trade places, and the patients play themselves (direct role play).  The patient practices the strategies we devised earlier, while I play the significant other.  I usually play the Other as a sort of worst case scenario, consistent with the prior behavior and sensitivities of that person.  

To get in character to play the targeted other, I can usually predict how they might behave from my patient’s description of them during the process of therapy, as well as from how they have been portrayed in the initial role reversal stage. Usually I am more difficult in the role play than the Other eventually turns out to be (although sometimes the Other does turn out to act as badly as I had), so that the patient finds it easier than they thought it would be to succeed at our goals (or, alternatively, is prepared for the worst). 

Almost invariably during the direct role play, when the patient first tries out the strategy we came up with, they immediately forget what I have shown them and revert to some of their usual ways of trying to solve their family problem – you know, the ones that have not worked because the Other becomes angry, abusive, defensive, or silent in response.  I then stop the role play and try to educate the patient about how what they have just said will torpedo metacommunication because of how it is likely to be heard by the other.

Often, the patient will at some point become somewhat exasperated and ask, “Do I have to be careful of every single word I say???

Well, yes, unfortunately you do.

In a book by Dr. Frank Luntz called Words That Work, the author goes into a great deal of detail as to how words with different connotations can lead to very different reactions from people.  He discusses mostly advertising and political speech.  

He repeatedly makes the point, “It’s not what you say, it’s what people hear.”  The world of advertising and political speech may seem to be a world away from the world of intimate family conversations, but the principles of effective opinion shaping are often the same.

Frank Luntz is a frequently-employed master political consultant. He was the one who turned the estate tax into the death tax and drilling for oil into exploring for energy. No matter how you feel about the author’s political beliefs, the book is a fascinating introduction to the power of using different words and phrases to get people to come over to your point of view.

He learned his trade by using focus groups as a research tool, in a way that most “evidenced-based psychology/psychiatry” advocates would label “unscientific.”  But the proof is in the pudding.

For example, take the issue of medical care for illegal immigrants. Luntz found that potential voters responded quite differently to whether a politician spoke about not giving them care versus denying them care, even though both phrases mean essentially the same thing. While only 38% of Americans would deny emergency care to these immigrants, fully 55% would not give it! 

The reason is that giving care conjures up images in people’s minds of freeloaders sponging off of the rest of us, while denying care conjures up images of unfortunate souls being coldly turned away like the character in Oliver Twist who dares to ask for more soup.

Likewise, inheritance tax conjures up images of Paris Hilton squandering away her famous family’s money on frivolous pursuits while death tax…well, you get the picture.

Luntz lists ten basic principles of word usage for maximum effect, some of which apply very much to making talks to recalcitrant relatives about sensitive topics more effective:  

1. Use small words. 
2. Be brief - the shorter what you say is, the better. 
3. Be credible.  If you sound defensive, repeat things you've said a million times already as if the person never heard you before, or ignore important aspects of whatever problem you are bringing up that the Other may feel to be important, you will not be believed.
4. Be consistent.  Stick to your point and do not go off on tangents. 
5. Offer a new way of looking at things. 
6. Sound and texture matter.
7.  Speak aspirationally. Say things in a way that elevates the person listening to you, not in a way that puts them down.  People will forget what you say, but remember how you made them feel.
8. Paint a vivid picture that people can visualize. 
9.  Ask rhetorical questions when possible rather than make statements. This allows the Other to interact with both you and your message. 
10. Provide a context and explain the relevance of your point of view.

Verrrrrry interesting. I recommend reading this fascinating book.


  1. Thank you Dr. Allen. Love the Oliver Twist reference. I feel like I may agree with you, and very true. It's what people hear but in it's up to the person speaking to make sure they hear it right. Thanks again for the great post.

  2. This book is very fitting for those who are working in the counselling industry. Counselor's words matters a lot thus it needs to be credible all the times.
    child psychologist Denver