And why I won't be giving up my day job to become a cartoonist!
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Issue 11
Oct 2014

Thinking and Listening  - The Ultimate Juggling Act!
Tuning into our Clients Part 5

I am delighted to report back to Pavestone readers about the Essential Counselling Skills Workshop that ran this month for the first time on Oct 9 & 10. I had the great fortune of experiencing the company of 10 enthusiastic and engaged APDs on the workshop. Their commitment to professional development and openness to new ideas was fabulous and so encouraging for me to experience as a trainer. After so much work going into the content I was rewarded by their participation with an experience that, for me, was a career highlight.  I'd like to also say a huge THANKS to Fresh @ Crows Nest for their delicious catering and delightful alfresco luncheons. You can read attendees feedback about their experience on my website HERE. 

The workshop will be running again in 2015 and I will be announcing dates in November Pavestones. It's looking like Sydney as early as February so watch this space!

This issue of Pavestones is the final issue in the Attending Series. I will be exploring the use of 'mind' in attending to our clients. Thinking is an essential part of our job - how might it help and how might it hinder the tuning in process?

As always if you are short on time scroll down to the Pavestone at the end..........happy reading!

Have you every experienced a period of grace 
where your brain just takes a seat behind your face?

Paul Simon

Most people don't listen with the intent to understand;
they listen with the intent to reply

Stephen Covey

I remind myself every morning;
Nothing I say this day will teach me anything.
So if I'm going to learn I must do it by listening

Larry King


As health professionals, we are trained to use our minds in the listening process to listen evaluatively. Listening evaluatively enables us to perform two very important functions within the medical model of patient care:

1. Assess our client's nutritional health

2. Formulate an appropriate intervention, education or prescription.

Our skill as evaluative listeners is a hand in glove match for performing the role of helper in the medical model. However, when we start to segue into the client centered model, evaluative listening can often prove to be something of a hindrance. Let's explore why.

Through our training, we are often oriented towards spending valuable listening energy formulating responses and advice whilst our client is talking.
Our busy and eager 'helping mind' can really get in the way of effectively attending to our clients' messages. This can cost us valuable engagement and can also set us up to work much harder than our client.

Let's consider too that when our clients are struggling it can be so tempting to step out of listening and engage in some quick 'installation therapy' i.e. telling the client what we know to make them 'better'. And we often know a lot of really useful stuff! But as many of us have learned the hard way, installation therapy rarely works..........

.......our client may simply not be ready to hear what we know
......what we know may be irrelevant (ouch)
...........or our client may have a much better idea of what they need to do!
I'd like to add here as an aside, that giving
advice is not a 'no-no'. It's our timing that matters.
If you'd like to review Issue 2 on giving advice
'client centered style', you can have a read

So when we need to be listening, what are we to do with our expert knowledge and urge to help? Neither are wrong, it's just how we harness them that keeps them useful.  As a place to start, it can be helpful to remember the power of keeping our client front and center and our ideas second place.


Gerard Egan in his book The Skilled Helper talks about the need to first understand a client, their experience and point of view in the context of productive evaluative listening. He goes on to say (with my emphasis): 

'Evaluative listening, translated into advice giving will just put clients off. [...] It is  practically impossible to suspend judgment completely. Nevertheless, it is possible to set one's judgments aside for the time being in the interest of understanding clients, their worlds and their points of view.'
........and I would add in the interest of assisting our clients to understand their own possible solutions to the problem too!

So what does harnessing our active mind in the listening process look like/sound like in Dietetic work? I had some fun this issue and have dabbled in cartooning an illustration to bring this juggling act to life.  
I chose snails because it is all I can quickly and (semi) convincingly draw, but what a match for the importance of reminding our mind to S...L...O...W Down.

To help you read 'A Snail's Tale' below, I have numbered the bubbles to illustrate the rhythm and sequence of this skill and how it might play out. Typically, in an engaged listening process, it follows that:
  1. Firstly our client speaks
  2. Secondly our mind will step in with an evaluation, important offering or solution . PAUSE HERE!
  3. Thirdly we can choose to respond by returning to listening to our client despite the urgency of ideas appearing in step 2. 


One of the most challenging aspects of slowing down our mind's interjections in the listening process is handling the silences that may follow as we give our client space to tell us more.

Here's a cute fact. Did you know that the words SILENT and LISTEN are made up of the same letters.........?

Such a handy reminder to ZIP IT when our task is to attend to our client.

Instead of a sound track for this month, I have a clip on this very topic from Marie Forleo. Marie is an inspirational life and business coach. I have to say I'm not usually a great fan of such types but Marie doesn't take herself too seriously and so I find what she has to say quite fun and useful.

In this clip, Marie talks about the importance of what she calls the IAP Intentional Awkward Pause. Marie uses the IAP to manage her own urge to interrupt and give advice. She shares a little story to illustrate the effects of the IAP which has lots of relevance to our work as Dietitians.

If you have 5 minutes to spare - have a listen and Enjoy! Click on Marie or HERE


Issue 11: The Role of Mind in the Listening Process

Nutrition is a science. Eating is a behaviour.

Behaviour change is difficult.

Active Listening is a fundamental skill, core to the process of understanding our client's experience, inviting their trust and building the helping alliance

Active Listening is only possible when we truly attend to our clients. Attending may be thought of as our 'whole-hearted' and 'whole-brained' attention

When we attend to our clients we pay attention to both their verbal and non-verbal messages, our own embodied resonances and our thinking processes.

Our thinking processes are foundational to the task of evaluative listening, important in the medical model

Our thinking processes can also hinder our ability to attend to our client by interjecting with our own solutions and formulations 

Learning to put our mind's activity to one side whilst we engage with our client is an essential part of the active listening process

Learning to pause and tolerate silence are key skills in active listening. 

Suggestions for Reflection

Marie's offering for this issue: 'What is your worst listening habit?'

How could you use the skill of pausing to assist in your client engagement and listening process?

What would you find challenging about managing short silences in your client conversations? 

I'd love to hear your thoughts, curiosities, insights. Please email me to let me know.

Enjoy experimenting!
Keep reflecting!


Archives of Previous Newsletters

New subscriber or want to find an old Pavestones edition?

Full collection Issues 1-10 available HERE


Motivational Interviewing Introduction Course ONLINE

This course is appropriate for health care providers with direct client care responsibilities, who can provide conversation/consultation about behavioural changes across a range of health related issues. 

Dates for 2015:
Jan 12 - March 10  and June 1 - July 29

For more info access the website HERE

NAAFA Publishes Guidelines for Nutritionists and Dietitians

Weight Stigma has been a hot topic for APDs active on the DAA listserves this month.
It is great timing that NAAFA have published these guidelines for Dietitians.
Co-Authored by  Professors Dawn Clifford, PhD, RD and Michelle Neyman Morris, PhD, RD of Chico State University’s Department of Nutrition & Food Sciences, it is a thought provoking read for those new to considering the prevalence and effects of weight stigma and what we can do as professionals to minimise harm.

The guidelines can be accessed HERE


Body Positive Yoga Retreat 1
18-22 April 2015

Fiona Sutherland and Sarah Harry of Body Positive Australia will be running their very popular Body Positive Retreat again in the beautiful hinterlands of Byron Bay. Here's what they say:

'Our first Body Positive Retreat was in Byron Bay April 2014, we had an absolute ball with 12 incredible and inspiring women. This years retreat was a sell-out and we expect that 2015 will be very popular also.'

You can read more on their retreat website HERE
Feeling a bit overwhelmed?

Ever thought about Supervision? ..........or up-skilling with some counselling skills training?
One of the most effective ways to enhance your learning and adoption of new skills is to receive supervision/mentoring for your work. If you would like to learn more about this you are welcome to have a look at my my service. Why not consider sharing supervision with a colleague and practice together between sessions?
Don't forget to consider my training - registrations close September 9 for this round.
About Tara MacGregor
Tara MacGregor is a dual qualified Accredited Practising Dietitian and Counsellor & Psychotherapist in private practice. Graduating from Sydney University in 1991 she has worked in a broad spectrum of clinical areas in public and private hospitals until specialising in disordered eating in 2004. Tara works exclusively in the non-diet paradigm and is passionate about teaching and promoting the Health At Every Size (R) philosophy. Tara provides skills training and mentoring in the form of clinical supervision for Dietitians and enjoys tremendously the exciting opportunities, insights and growth this offers both herself and supervisees.

Make an enquiry about supervision and mentoring with Tara

Make an enquiry about supervision and mentoring with Tara

Tara MacGregor PACFA Reg. 21520 BSc MSc H.Nut & Diet. G.Dip Couns

Counsellor & Psychotherapist Accredited Practising Dietitian

Suite 3, 780a Pacific Highway Gordon NSW 2072
M 0459 991 788
Copyright © 2014 Tara MacGregor, All rights reserved.

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