This is Hidden Brain.
I'm Shankar Vedanta.
Have you ever been frustrated with someone who never seems to change their behavior?
You remind your partner, again, not to leave dirty dishes in the sink.
You've had this conversation before.
Maybe you snap at them.
Maybe you roll your eyes and do it yourself.
Or maybe you get frustrated and throw up your hands.
Or maybe it's your child who melts down in the middle of the grocery store, or a co-worker who fails to meet deadlines in spite of endless reminders.
No matter how many times we bring it up or how many strategies we try, nothing gets them to change.
Before long, resentment sets in.
The temptation is to push harder.
More reminders, more rules, more consequences.
We tell ourselves they must be stubborn, defiant, oppositional.
This week on Hidden Brain research that explains why the techniques we use to get people to change their behavior are often strikingly ineffective.
And we look at better ways to help the people we care about make lasting change.
It can be frustrating when people do things we don't want them to.
A friend cancels plans at the last minute.
A loud coworker dominates every meeting.
A child refuses to get dressed for school.
What goes through our minds in those moments?
And how do our mindsets affect our ability to influence others to change?
At Harvard Medical School, psychologist Stuart Ablon studies the science of helping people change.
Stuart Ablon, welcome to Hidden Brain.
Thank you very much.
It's a pleasure to be here.
I appreciate you having me.
Stuart, you first became interested in psychology during your senior year of high school.
You got a job working with kids.
Tell me about the work you were doing.
Yeah, I in high school.
One of my first you know, more serious jobs was working on an inpatient psychiatry unit for kids and adolescents.
So this is where kids and adolescents go when they their behavior is really out of control and they are isolated, at risk of hurting themself or someone else.
And they're usually admitted against their will.
And I had an internship there, really.
And I had no idea what to expect.
And I remember on my first day I was supervising, along with some other staff, kids out on the playground.
And this young man started to get upset, really frustrated, and lose his cool.
And he could tell I was the new person.
And he said all kinds of awful things to me. went to try to attack me really.
And he spat in my face and he kicked me where you don't want to be kicked.
And I was incredibly taken aback.
And one of the sort of more senior staff members approached quickly to rescue me.
And he said, let me show you how this is done here.
And he sort of grabbed this young man and wheeled him around and and wrapped his arm around him and sort of like what we call a physical hold, a restraint, so that he couldn't spit at him or he couldn't kick him, and things like that.
And this was my first on-the-job training about how to perform a physical restraint.
I mean you must have been 16 or 17 years old at the time, and the kid couldn't have been much younger than you.
It's a very good point.
I forget whether I was 17 or may have just turned 18.
But to be honest, I'm actually getting goosebumps talking about it, even though I've talked about it a lot, because it was awful.
So you head home that evening.
The next day, I understand you run into this young man again.
His name is Jason.
What happens to it?
I was particularly on guard as I passed by the room where Jason was, and nervous.
And he called out to me.
I remember I was trying to walk by pretty swiftly actually, so I wouldn't have to engage with him for fear of what might happen.
And he called my name and I sort of turned around and I looked at him and he looked at me and he, he said to me hey I'm, I'm sorry.
I'm sorry about what I said.
I really didn't mean it.
I just lose control like that.
And I don't even know what I'm saying.
And I just looked at him and I said, okay, it's all right.
I accept your apology.
It's okay.
What went through your mind at that point, Stuart?
Because in some ways it was not just surprising, but I think in some ways it was also revelatory what happened in that moment.
Yeah, what went through my mind again.
I mean just retelling this, Shankar.
I'm emotional, just retelling it because you know this kid I had this horrific interaction with and he said these awful things to me and I was trying to avoid him as soon as I arrived.
And he's apologized to me, clearly.
This kid deeply regretted his behavior, and this was just one tiny instance.
I can only imagine what had gone on to get him to this inpatient psychiatry unit in the first place.
And here he is clearly feeling terribly about this behavior, which...
As he's explaining to me, you know, he just can't control.
So you eventually become a clinical psychologist, and some years later you're interviewing another young man who is in a correctional facility.
Tell me the story.
What was he in for?
So this young man was in for attempted murder.
He had shot someone.
And I had next to no experience working in correctional facilities.
So frankly, while I had the credentials at that point, it felt pretty similar to that interaction with Jason.
And I remember sitting very close across a bench from him.
So our faces were pretty close to each other.
And I asked him.
I said you know, if you don't mind, would you mind telling me like what you were thinking when you did this?
And I'll never forget this, because he leaned in real close to me and he said to me that is the stupidest question anybody's ever asked me.
And one thing I can say about myself is I don't tend to be particularly defensive.
So I said to him, you know, that might be right.
That might be the stupidest question anybody's ever asked you.
But do you mind telling me why that's such a stupid question?
And he looked at me and he leaned in even closer and he said do you think if I was thinking I would have done that?
You moron?
And I remember thinking to myself God yeah, of course that is the stupidest questions anybody's ever asked.
Because why would he do this if he were thinking?
To me that was an important moment and reminded me honestly of you know, in graduate school we learned about aggressive responses and the difference between proactive aggression and reactive aggression, and And most people think that horribly aggressive acts are like planned acts, where the vast majority of them are poor responses to frustration and not thinking things through.
You know, many years ago, I remember speaking with some researchers who are doing work in Chicago and there was this sociologist, Harold Pollack, at the University of Chicago.
He looked through all the homicide cases that he could find in the city and then looked at what led to the homicide.
And again, his belief was that homicides happen because of premeditated gang violence.
But what he found was very much what you're talking about Stuart, which is there were interactions that went wrong.
People lost their tempers.
Things escalated.
Someone had access to a gun and someone got shot.
And over and over, what he found was that if people could pause, take a deep breath and count to ten Yes, that's impulse control.
Literally, the definition of impulse control is taking a few seconds to think about the likely consequences of your actions before you act.
And I always tell people, if we didn't have that we humans, if we didn't have impulse control, if we just did the first thing that came to our mind, said the first thing that came to our mind, the world would be an ugly place.
I usually tell people, if you want to do a little experiment, go through a day where you imagine you did or said the first thing that came to your mind throughout the course of the day.
You'll amuse yourself, but you'll also be horrified about what the world would be like.
When people do bad things, we often think it's because they're bad people, or they're being stubborn, or they're simply not trying hard enough.
We attempt to help them fix this behavior through rewards and punishments.
Or we just encourage them to try harder.
When we come back, a psychological insight into a better way.
You're listening to Hidden Brain.
I'm Shankar Vedant.
It's easy to believe that our behavior is a matter of incentives.
If I want to be healthy, I'll get some exercise.
If I want to get more done at work or school, I'll stop playing video games or watching so much TV.
When people act in certain ways or misbehave in certain ways, we feel it's because those are choices they are making.
At Harvard Medical School, psychologist Stuart Ablon has tested the veracity of this belief.
Stuart, early in your career, you began working with a psychologist, Ross Green.
He was developing a new approach to treating children with behavior problems.
Tell me a little bit about what you did together.
Yes.
I had the good fortune of coming for my postdoctoral fellowship at Mass General Hospital in the Department of Psychiatry there.
And he was just getting started there as well.
And he was my clinical supervisor for a year or so.
And then we went on to work together for about 10 years.
And what he was writing about as he was writing this book.
The Explosive Child is decades of research that had shown that kids with very challenging explosive behavior, that they struggled in certain areas of what we call neurocognitive skill or thinking skills.
And so he was putting these ideas out there that the way I talk about it is that these kids seem to lack skill rather than will, which was a bit of a revelation when you think of how we tend to respond to challenging behavior, because it all revolves around trying to motivate people to behave better, safe in the assumption that the reason they're not behaving well is because they lack the motivation to do so.
I want to drill down into this because I think this is such a pervasive belief, which is that when we're trying to change someone and they don't change, almost automatically the thought comes to our mind this person knows what they need to do.
They know what's going to be good for them to do.
They've agreed that it's the good thing for them to do, and they're not doing it.
Clearly, it's a lack of will.
Yeah, absolutely.
And I think one of the main reasons, though, that that thought kicks in for us so quickly is it's really aggravating when people don't do what we want them to do. whether that's our child, our partner, our colleague, you name it, we get frustrated.
And when we're frustrated.
We humans don't tend to have as good access to the smart part of our brain.
And frankly, we sort of reach very quickly for power and control to try to re-stabilize things.
So I think that's part of the reason.
We've sort of long believed this.
There's sort of a conventional wisdom around this that behavior is all about motivation.
But then you layer on top when people don't do what we want them to do or do things we don't want them to do.
It frustrates us.
It triggers us.
And that makes it hard for us to have an empathic understanding, or even an accurate understanding, about what might be getting in that person's way.
I'm also curious about the fact that I think, when we reach for that very quick conclusion and I appreciate what you just said, which is that we reach for the conclusion in some ways because we are upset, we are frustrated, and the conclusion in some ways helps us deal with our own frustration, to say okay, this person is just not doing what they know is the right thing to do.
But of course, once we get into that mindset Now, we locate the problem entirely in the other person.
And in some ways, what we're doing is we're giving up our own capacity to potentially help them because we're saying it's no longer anything that we can do.
That would be helpful.
The problem is entirely with this other person.
That's right.
It's not about me.
It's about them.
And that's where a lot of blame happens.
We sort of absolve ourselves, take ourselves off the hook, and we just blame the other person.
And the other thing that you're bringing up for me here is when you look at challenging behavior, It doesn't ever happen out of the blue, for no reason.
People don't explode or implode for no reason.
There's something that happens.
There's some context.
There's some situation.
There's some trigger.
And often, it takes two to tango.
It's what you're asking the person to do, how you're asking the person to do it, in what way, et cetera.
So it's not just as simple as the other person's fault.
But again, that can make us feel better.
I want to talk about some of the skills that might lead to people not being able to change in the way we would like them to change.
You sometimes work with children in your practice as a clinical psychologist.
You once had a teenage patient who was very hard to get him to open up.
Anytime you would try to engage with him in conversation, he would say the same thing over and over again.
Tell me about this, Charles Stewart.
So this young man, whenever I would really ask him for information about something.
For instance, there was something that happened at school, an incident, and I wanted his perspective on it and get his side of the story.
And when I would say to him, So can you tell me, you know, what happened?
He would say, I don't care.
Often before I even got a chance to finish my question.
And you know I said well, you know, I'm just sort of curious, if you don't mind, because I want to hear your side of the story.
So if you can stop, stop me in the middle.
I don't give a ****.
And I said, well, you know, you may not give a, but I sort of do.
So I would love to just get your, I don't care.
And it just occurred to me that he was sort of heading this off at the pass very quickly, and oftentimes I hadn't even finished my question.
Much less could he possibly have had any time to think about what I was asking him.
I actually just said that to him.
I said you know, I just noticed.
You say I don't care, really quickly, like before you even have time to think.
So can you do me a favor?
Like, can I ask you the question and...
I'm going to give you a chance to think.
And after you think about it for a while, if you really don't care, don't give a then tell me that.
Okay.
And I'll believe you, but give it a chance.
And so I asked him the same question.
And I said to myself in my head, count to like 45.
And so I waited counted, and somewhere past 30, before 45, he started filling me in a little bit about what happened.
And I said to him so wait a sec.
You told me you didn't care before, but it sounds like actually maybe you do.
And he said, yeah, I just said that.
I was like, oh, well, I've noticed you say that a lot.
Why do you think you do that?
And he's like, I don't know.
And I decided, let's do the same thing again.
But we'll think about it for a sec.
Because if you really don't know, that's okay.
We can try to figure it out together.
But think about, why do you think when somebody asks you something, you just say, I don't care.
I'm going to give you a minute.
And he says well, nobody's going to wait long enough until I've thought about things, until I know what I'm going to say.
So, you know, I might as well just stop it now.
So basically what he was doing with I don't care, I don't give a was basically saying let's call this off now, because it's going to take me a while to process this and come up with my thought and articulate it in spoken language.
So you say this is an example of how language and communication skills can influence behavior.
Say more about this, Stuart.
Well, language and communication skills are just crucial.
You know, I always tell people, think about a time when most kids are poorly behaved.
You know, when they have a lot of meltdowns, throw a lot of fits, and everybody says oh, two or three, you know the terrible twos right.
And think about when kids are two.
There's a bunch of things that they're really bad at.
And we don't get worried yet because, you know, they're not supposed to be good at those things.
But they're horribly inflexible.
They can't tolerate frustration and they have terrible problem solving skills.
And one of the reasons they have terrible problem solving skills is they're just learning how to communicate with words, which is why you see them communicate in all kinds of other ways.
But as they get better at knowing what's bothering them, putting it into words, engaging in a back and forth to try to solve a problem, their behavior improves as well.
Now the reality is with this young man.
He was a lot older than two, but his language skills hadn't really caught up with the average kid his age.
You know, it can look lots of different ways.
I mean, it can look like a lot of swearing like this kid.
A lot of times it looks like kids or adults who are silent.
You might ask them to do something and they just sort of look at you quietly.
And this is where what we talked about earlier comes in, because that's when we jump to conclusions and we have these biases.
We think to ourselves, oh, they're refusing to respond.
Maybe we think they're being passive aggressive.
Maybe they're not being passive aggressive.
Maybe they're just thinking.
Thank you.
You know, we have a segment on the show called Your Questions Answered, where we ask listeners to send in questions.
And I remember a question that came in recently from this woman and she said I feel like every time I start a conversation he parries me, he basically blocks me, he doesn't want to engage in the conversation.
Every time I bring up, you know, why is it that we're not having a good conversation?
He blocks me off at the pass, he doesn't talk to me again.
And I feel like I'm being stonewalled.
You know, I've been stonewalled for years and years and years.
And I feel like I don't have a good relationship anymore and I don't know what to do about it.
But in some ways...
Of course, the specifics might be different.
We don't know what's happening with that particular family, but I'm hearing echoes, in some ways, of the story you just told me, with somebody who might be decades younger.
Yes, and this is where I say to myself, try not to jump to conclusions that are blaming.
And instead, think skill, not will.
Think maybe this person has a hard time engaging in those conversations.
Maybe they're not stonewalling intentionally.
And the other possibility is maybe they have some reasonable concerns about having these conversations, but they're not very good at expressing those concerns.
So it comes out as stonewalling.
Hmm.
Another skill that can affect the way we behave and respond in situations is our working memory.
Describe what you mean by working memory and how it plays a role here, Stuart.
Sure.
Working memory.
It's not like trying to remember what you had for lunch a couple of days ago or things like that.
Working memory is what neuropsychologists call the cognitive shelf, the shelf we have in our brain where we can put something up on that shelf.
We can still see it.
We can grab it when we need it.
And we are much more reliant on our working memory than we have any idea.
I always tell people just having a conversation like we are right now.
As I'm talking, what you're hopefully doing is listening and thinking to yourself.
Hmm, what do I think about what he's saying?
So you're holding one piece of information is, what is he saying?
Another piece is, what am I thinking about what he's saying?
Then hopefully, you're also saying to yourself, I wonder how I might respond to what he's saying.
And if you're really behaving in the most adaptive way.
And by the way, I haven't stopped talking at the same time.
So you're holding all this information in your head and you have to keep all those files open in your head at one time.
I often notice this about myself.
You know, I'm trying to get something and I say, OK, I need to get this piece of information.
And this piece of information is in this other file over here.
So I go to that file.
But I realize there's something there that's missing or that I need something else in order to get that information.
And now I'm suddenly three steps down the rabbit hole and I have to remember how to climb my way back to the problem I had in the first place.
And all of that is working memory.
It is, and what you're also pointing out here is that working memory is incredibly closely related to other skills that have to do with attention and organization.
And this is why, when we study working memory, we often sort of lump it together with attentional skills, because those they sort of go together and they all amount to our ability to stay organized as well, which is again a skill.
And the fancy term for some of these skills is what we call executive functioning skills, the sort of CEO of your brain, if you will.
So when we want someone to do something complex, you know we want a kid to work hard in a class and study, for example.
There might be a whole set of study skills that are involved before you can actually get to what the class is even about.
You got it.
Absolutely.
And, you know, we take these things for granted.
A kid I worked with, his room was always a mess like many other kids.
And his parents were furious and would tell him to go clean his room.
And you'd go into his room and there'd be like heaps of laundry on the floor.
The place was like, looked like a bomb hit it.
And he would go up to the above his desk, where he had some shelves, and he would start like dusting his action figures on the top corner of the shelf, where you know The biggest bang for your buck would be.
Take all the laundry and put it in the laundry basket.
Take it three seconds.
It'll whole place will look a lot better.
But this kid that he had a hard time thinking big picture and organizing like that.
And that's a skill.
My mom used to tell me the story when she was, I think, in either high school or college and she was having real trouble in various classes.
And it took actually several months for people to realize that what was happening was she was developing myopia and she simply couldn't see what was happening on the board.
I mean, that's a very practical kind of skill that we need, the ability to see clearly.
But in some ways, what you're talking about is the psychological analogy for that, which is that when we can't do something, it could be because we're simply not able to do it.
Yes, and to use that analogy, if you tell somebody who can't see something like, for instance, when I wear my contact lenses, I can't read very small print.
You could offer me the biggest incentive in the world or tell me that I've got the biggest consequence coming if I don't read it.
It will not help.
And, in fact, it'll decrease my performance, because it'll be incredibly frustrating to be more motivated but still unable to do it.
Not to mention...
That when you try to motivate people to do things that they struggle to do, you also send them the not so subtle message that you don't think they're trying hard enough.
Or else why would you be trying to motivate them?
And with kids, I can tell you that has caused so much damage to so many kids' self-esteem.
I mean, in some ways I think it's easier to see the problem when the problem is a physical problem of some kind, right?
So in other words, if someone can't see the board, you can say I can take them to the optometrist, I can give them a test, I can tell that they can't see the board, and here's the fix, and so forth.
I think partly because some of these skills that you're talking about are subtler and they're psychological, they're not immediately visible.
And so all we see is the outcome, which is the kid doesn't seem to be cleaning his room.
Absolutely.
Absolutely.
And yet the interesting thing is, if we line up 100 people who struggle with their behavior and 100 people who don't, and I brought them Back to our Department of Psychiatry here at Mass General Hospital, where I work, and gave them all neuropsychological evaluations, tests just like an optometrist might test your eyes.
Guess what you'll see?
You'll see the people who struggle with their behavior have huge differences in skills.
And we're starting to cover those now.
One of the other areas you've looked at, Stuart, is emotion regulation.
Talk about this skill.
So emotion regulation, that refers to our skills at controlling or managing our emotions.
And you know, one of the things we know about us humans is that there's sort of like a negative correlation between feeling and thinking.
That the more we're flooded by feeling, the less clearly we are able to think.
And feeling is good.
Feeling tells us when there's problems we need to solve, but it doesn't tend to solve problems.
We need our thinking skills.
And so emotion regulation skills are our skills at being able to sort of tamp down or manage or control our emotional response so that we can think straight.
And that may be emotional response to frustration. to anger, to disappointment.
It could be our emotional response to excitement, to joy, nervousness, worry, et cetera.
And those are skills.
Talk about the category of skills that fall into the domain of the social our relationships with others, our ability to deal well with others, to negotiate well with others.
Talk about this as being a skill.
Again, I think many of us assume some people just have it, some people don't have it.
Some people know how to get along with others, some people don't.
Talk about this as a skill, Stuart.
Yes, sure.
And I refer to these as social thinking skills, really.
And these are everything from things that seem really basic for some people, like how do you start a conversation with somebody?
Or you see a group of people that you want to join doing something.
How do you join that group without sort of upsetting the apple cart?
To more complicated skills like how do you know how you're coming across or how your behavior is impacting somebody else.
I call it your feedback loop because we're all hugely dependent on it.
We all do things and we scan and we see, how did that go across?
And we sort of change our behavior accordingly.
But I've worked with lots of people who have a broken feedback loop.
They sort of don't get the feedback from the environment.
So they might keep doing something that's annoying to other people or off-putting.
And I would say Some of the most complicated social thinking skills are things like perspective taking, putting yourself in somebody else's shoes and empathy.
Empathy may be the most complicated social thinking skill.
So one of your central ideas is that people do well if they can do well, not if they want to do well.
Talk about this distinction.
Yeah, sure.
This is sort of the core foundational idea behind our work.
The notion, the philosophy that we taught, which we still teach today, is kids do well if they can.
Applied to adults, adults do well if they can.
In other words, people do well if they can.
What people do well if they can suggest is, you know what?
Don't we all want to do well?
Like, show me the person who prefers doing poorly in the world.
I've never met that person who prefers that things are going poorly at work, who prefers their partner is upset with them, who prefers that their parents are constantly or teachers are upset.
No, people do well if they can.
If they can, they will.
Now, that's a stark contrast to the notion of people do well if they want to.
Because what people do well, if they want to, suggests is, if they're not doing well, it must be because they don't want to.
What we need to do is make them want to.
And, you know, if it only were as simple as that, my thought is people do well if they can.
If they could, they would.
And if they're not, let's use what we've learned in the last 50 years in terms of what might be getting in their way.
One of the things that I'm taking away from our conversation Stuart, is that it's possible that there might be situations where, in fact, people can do something but they don't want to do something.
It's possible that in some ways it's a problem of will.
But I think the problem that arises when we assume that it's a problem of will as opposed to a problem of skill is it deprives us of our ability to do anything to help them.
As you're talking and as you're describing these various skills, I'm thinking about various issues and various problems, relationships that I have and people whom I know, and things that I would like to see changed.
And suddenly I'm thinking about them differently.
I'm thinking about them as saying you know what if I could help this person develop this skill, as opposed to what if I could just get into this person's thick skull what they need to be doing.
It's a very different mindset.
It's a huge shift in thinking.
And what it does, as you're articulating beautifully is it positions you in a much more empathic understanding place.
And empathy is the bedrock of being able to help anyone.
So you know, instead of blaming and wanting to control, it puts you in a solid place of nonjudgmental empathy, acceptance and interest in in what's going on for this person.
When we come back.
How to inspire change by focusing on skill building instead of battles of will, not just in children, but in grown-ups too.
You're listening to Hidden Brain.
I'm Shankar Vedantam.
This is Hidden Brain.
I'm Shankar Vedant.
When we encounter bad behavior our instinct is often to discipline the behavior.
We try to impose our will using rewards and consequences to force the behavior change.
Sometimes this works.
Sometimes it doesn't.
Psychologist Stuart Ablon is the author of the book, Changeable, How Collaborative Problem Solving Changes Lives at Home.
Stuart, you say the standard approach we use to change people's behavior is something you call Plan A.
Define Plan A for me.
Sure.
Plan A is basically when you try to impose your will to make somebody do what you want them to do.
So you know, whether it's harshly gently, anything in between.
If you're really just trying to make that person do what you want them to do, we call that plan A.
So planning sounds pretty good on paper.
I mean, if you can actually get someone to change their behavior and this behavior is irritating what's the downside?
It's fascinating because, whether you're talking to a preschool teacher, a correctional facility guard, a police officer, someone in the corporate world you name it people always say the same thing, which is that trying to impose your will is an attempt to get your expectations met, but often isn't successful, often escalates poor behavior, doesn't actually build any rapport or relationship and the problem tends to live on.
Also, if this is a person struggling with any skills, those skills don't get practiced or built when you try to impose your will as well.
So, before we get to plan B, I want to shake things up a little bit and have you tell me what plan C is in this rubric that you've created, Stuart.
Sure.
Plan C is when you decide to drop your expectation or to solve the problem the way the other person wants it solved, which very important clarification here is not quote giving in, because that's what people fear it is.
It's not giving in.
Giving in is when you try plan A.
You try to impose your will and you can't pull it off and you bail.
And you sort of just give up.
That's not plan C. That's failed plan A leading to bailing.
Plan C is when you are planful.
It's a strategic decision.
You are deciding, I'm not going to pursue this, at least right now.
Maybe this is not forever.
Just for now I'm not going to, or I'm going to, solve it for now, the way the other person wants it solved.
And the reason you might do that is to keep the calm.
Plan C can decrease challenging behavior.
If you drop an expectation that leads to challenging behavior, you're going to get less challenging behavior.
Now you haven't solved the problem.
You haven't gotten your expectations met, but you've avoided a challenge, for instance.
And there's a place for that.
Is there a better way than either plan A or plan C?
Absolutely.
And here's the thing.
People so often get stuck, whether it's in a home, a school, a workplace, in what I call the AC split.
In a two-parent household.
For instance, the AC split is one parent's the plan A parent and one parent's the plan C parent.
But this happens in workplaces as well.
And what I like to say is you don't get plan B by the average of A and C.
And there is another option, and that's plan B. Plan B is collaborative problem solving.
It is working together to solve a problem in mutually satisfactory ways, and it has a clear set of guideposts to it that have been refined over years of practice and studies.
What are these guideposts to it?
Basically, there's three steps, or I prefer to call them ingredients.
And just to be clear at the outset, you can't use plan B on someone.
This is a process that you do with someone, but it has clear guideposts.
And feel free to share those guideposts with the person that you are doing this with.
There's nothing hidden about this.
This is transparent.
So the guideposts, these three ingredients are first ingredient, the empathy ingredient.
And that is where you try to understand the other person's concern perspective, point of view or what's hard about a situation.
And only once you've done that that first ingredient, the empathy ingredient do you move to the second ingredient, where you get to share your concern, your perspective, your point of view or what you're worried about.
And only once you have two sets of concerns on the table Do you go to the third ingredient, where you invite that person to work together, to collaborate with you to solve the problem.
You must have both parties' concerns on the table.
When you genuinely ask that question.
I think there's an element of courage that's required when you do this, because I think very often I'm not sure we actually want to know What's preventing someone from doing the thing that we want them to do.
We don't want to know that there's a genuine problem, a genuine roadblock.
And what you're saying is that that empathy is actually really an important first step.
Absolutely.
And there's a stance.
When people hear the word empathy, by the way, they often misunderstand it.
They think empathy means to show you care and that you can empathize by saying I really want to work this out with you.
That's empathy.
That's not empathy.
If anything, it's like drive-by empathy.
But real empathy, the definition of the word empathy is to understand.
And you have to work hard to try to understand somebody else's point of view and perspective.
And you're right that sometimes we may not like what we're going to hear.
And There's a really important lesson in here, which is I'm constantly trying to remind myself and others that empathy doesn't mean to agree or to disagree.
Empathy is not agreeing or disagreeing.
It is simply understanding.
And actually believe it or not.
You could completely and totally disagree with somebody's perspective and point of view, and you can still empathize by understanding.
And frankly, I think this has become something that we've gotten worse and worse at, which is, when you don't agree with somebody, can you still understand and listen to them?
Let's just drill down a moment into that first point that you're making Stuart, the idea of being empathetic and curious.
You say that even here, there are actually multiple elements to this prong.
What do they involve?
Well, so as I mentioned, empathy is hard.
It's not what people think it is.
Empathy is understanding.
And it's really hard for people to do.
And I've had the opportunity to watch so many people in so many different places try to do collaborative problem solving and the first ingredient is the hardest.
And so what I did is I actually started to take all these recordings audio video recordings of all these attempts that people made at doing collaborative problem solving and just studying the first ingredient.
And of course, my own attempts as well.
And what I found is fascinating.
That when it goes well, when we're doing a good job empathizing, we're doing four things, and four things only.
These four things are like any good detective would asking a lot of questions.
Clarifying questions.
If you're not getting information, educated guessing.
That's the second thing.
If you get any information, either in response to your question or in response to an educated guess, you reflect back in your own words what you've heard from the person.
We call that reflective listening, okay?
And that shows you're listening, okay?
And the fourth thing is reassurance.
And what reassurance is?
Is your way of saying this is not some tricky form of plan A.
So it's you saying things like don't worry, you're not in trouble.
Or I'm just trying to understand.
Or one of my personal favorites, I know there must be an important reason that...
Fill in the blank, okay?
Because what I always remind myself is I may not love the person's behavior, but I'm sure they've got a good reason, a good concern, a good perspective.
That's what you're on the hunt for.
And the last thing I would say about this is your stance should be one of curiosity.
It is way too easy to enter a conversation with preconceived notions and judgments.
Suspend those ask questions, take guesses, reflect what you've heard, reassure if necessary, and you'll learn a lot.
So the second step that you suggested a second ago is that once you've done the necessary empathizing you've tried to understand where the other person is coming from you put your own perspective on the table.
But I can see how this might backfire, Stuart.
I listen to you very carefully.
I'm patient.
I'm genuinely curious.
I try and understand where you're coming from.
And once I've understood it, I say, all right, that's all well and good, but here's what I think.
Could that be a problem?
It could be a problem.
And the first thing I'm going to suggest is a little tweak in wording.
Not that there's magic words out there, but the word but It almost sort of implies okay, I heard you, but guess what?
My perspective is different or more important than yours.
I always encourage people to say once you've heard the other person out, first of all summarize what you've heard from them so that you really are showing you've heard it, and then use the word and instead.
And just say, and, you know, here's my point of view or here's my concern or my perspective.
Now what you're saying is the person might get upset with that or sort of you know, it might go off the rails a little bit.
Yes.
And guess what that would tell you?
That this person may have some difficulty with perspective taking or emotion regulation skills, or they may have just had a lot of Plan A interactions and assume that right after you've heard them, here comes Plan A.
So you know, it's not magic.
It's going to take some repetition.
Again, collaborative problem solving has three big steps.
First, empathize with the other party's concerns.
Once you've understood where they're coming from and they agree you have understood their point of view.
Here are my concerns.
When it comes to the third step, which is coming up with a collaborative solution, Stuart says it's important not to make the first move.
Once you've clarified the problem to solve, which is, once you've identified the respective concerns, there's a lot of reasons you want to invite the other person to take first crack at solutions.
First of all, when you invite that person to come up with an idea, you are giving them ownership autonomy.
You know they're co-author of a solution as opposed to you, sort of even if you're trying to do it in the best of collaborative spirits, if you're the one suggesting the first solution, it might feel imposed upon them.
And if they're co-author, they're going to be much more invested in that.
But beyond that, this is an opportunity to actually get a chance to see how that person does, what their skills are like, coming up with a solution that is theoretically mutually satisfactory, realistic and doable.
I work with lots of people who they'll come up with a solution, but it's not mutually satisfactory or it's not realistic or it's not doable.
And so they need practice.
Well, guess how you're going to practice and develop that skill?
Not by watching somebody else solve problems.
I mean, when you teach a kid to ride a bike, do you hop on the bike and say, all right, watch me ride.
You got it?
Here you go.
You should be good now.
No, watching someone else come up with ideas doesn't help somebody practice and develop problem-solving skills.
I think some people might hear this approach Stuart, and say all right, this is actually perhaps a clever way into manipulating this other person to doing what I really want them to do.
So I listen to them very carefully.
I offer them my perspective.
I let them come up with the idea.
And all the while I'm trying to keep in mind what it is that I finally want, the outcome that I finally want, and try and push and nudge to get to that outcome.
It's just sort of a sneaky, psychological way of getting to what I want in the first place.
I think you're actually suggesting something different, that in fact, collaborative problem solving is not just a backdoor way into manipulating someone to get what you want all along.
Not at all.
In fact, I would call that tricky plan A, not plan B, Because what a really important distinction here is.
You actually shouldn't know what the solution is going to be.
If you already know what the solution is and you're just trying to get the person there.
Yeah, that's plan A.
That's just a tricky form of plan A.
Now, what you need to do is you need to think of what is your concern?
What are you worried about?
What's your point of view?
What is wanting you to come up with that solution?
What are you worried about?
And you hold on tight to that.
You don't relinquish that.
And the solution has to address your concern. but it also has to address the other party's concern.
That's the difference.
That's collaborative problem solving.
And of course, partly what all of this is pointing to Stuart is humility.
Because I think very often I think when we're trying to change someone, we are so confident that we know why they're not doing what they should be doing.
We're so confident that we know what they should be doing and how they should be doing it.
That one reason we don't stop to actually ask, well, what's going on in your head?
What could be happening in your mind?
Is that we don't have the humility to accept that, in fact, we might not have all the answers ourselves.
That's right.
That's right.
And when we can suspend those assumptions and be really curious, we learn so much.
And not only do we learn so much, but it really connects us to people.
People ask me that all the time.
They say, how do you really get somebody to listen to you?
And I say, by listening to them.
Listen to them really hard, really well, really effectively, and they'll be a whole lot more likely to listen to you.
When we come back, collaborative problem solving in action.
You're listening to Hidden Brain.
I'm Shankar Vedantam.
This is Hidden Brain.
I'm Shankar Vedantam.
Whether it's an unruly child, a spouse who forgets important dates or a coworker who says inappropriate things at meetings, it can be hard to get people to behave the way you want them to.
Psychologist Stuart Ablon says the solution is collaborative problem solving, coming to mutually agreeable solutions together.
One of the places he tested his ideas was a state psychiatric hospital.
It was infamous because it was the setting for a disturbing movie about the mistreatment of patients.
I always tell people the Oregon State Hospital, I ask people, do you know it?
Everybody says no.
And I said, well, actually, you do, because it was featured in One Flew Over the Cuckoo's Nest.
Now, that original hospital has been torn down.
There's a beautiful, big, hulking new hospital.
But I have to tell you, from having spent some time there, the sort of traumas of the past almost echo through the walls there.
And we were contacted because staff were being assaulted at alarming rates and all kinds of injuries of their patients, the clients there and the staff as well.
I remember at one point the staff had actually set up a Facebook page to post the pictures of their injuries to try to get people to pay attention to that.
Something was really wrong here.
And we were brought in to try to change that dynamic.
So when you call this a hospital, the image that I have is sort of doctors and nurses walking around and people holding charts.
That's not quite the right picture, is it, Stuart?
No, this is a state psychiatric hospital with over 1000 patients, but the vast majority of them are guilty, if not for insanity.
They are there for having committed rather serious crimes.
And it's somewhere between what you might think of as a hospital, but probably closer to what a correctional facility is.
Looks like, you know, you've got to be buzzed in and out of several doors to get in there.
It's maximum security.
You know, the restrooms have a fixed toilet with nothing that could be ripped off and used as a weapon or anything like that.
It's a pretty tough place.
So the hospital wanted to improve conditions.
I would have imagined that this would be a difficult place to think about collaborative problem solving.
Describe for me the work that you did and what you found.
Well, you're right.
It is a difficult place, was a difficult place.
But I have to say I found a decent amount of receptivity there from folks, because it's people who work in those situations that know firsthand that levying rewards and punishments really is not very effective and creates all kinds of hostility and makes for a pretty miserable job.
So they were eager to learn something else, but I will also say skeptical and for good reason.
And so it took a little while to really have people begin to shift their mindsets.
Because you can't come right in and just teach people a new way of doing things.
You first have to help them understand why would you do something differently in the first place?
And that's that shift.
From it's not as simple as people do well if they want to, we just got to make them want to.
It's people do well if they can.
And we have a lot of research that shows these people are here because they're struggling with a lack of skill, not a lack of will.
So you tell the story of one middle-aged patient who suffered from a history of schizophrenia.
Tell me his story, Stuart.
This was a man who had actually been refusing to attend any of the therapeutic elements of the program.
So they would...
The patients would stay in their cell blocks, but they would come down to what they called the treatment mall to have individual and group therapy.
And this guy would refuse to come down there.
Now, you can imagine what they would typically try.
They would typically try some form of plan A to try to impose their will to get him down there, which is if you don't come, you will lose this privilege, etc.
If you do, you get these privileges.
And believe it or not, the hospital itself works. was designed around these principles.
Even the building.
The building has a store.
That was built where people could accrue rewards and things like that.
So they had tried this, and frankly, it got ugly.
There were several assaults trying to get this rather large man down to the treatment mall.
And so what they started to do was plan C, which is say you know what, it's just not worth all of this.
So I guess he won't attend.
And we began to teach them what an alternative would look like, what plan B collaborative problem solving would look like.
And this one nurse decided to try Plan B with him.
And, by the way, one important distinction here is there's a difference between what I like to call emergency collaborative problem solving and proactive collaborative problem solving.
The best time to solve a problem is not right in the middle of it.
So it's not when you're trying to force this guy to go to the treatment mall.
So she sits down with him and says, hey, so I've noticed you haven't been going to groups.
And she knew he was very volatile.
So she front loaded with reassurance.
Don't worry.
I'm not going to try to force you to go to group.
That's not what this conversation is about.
Basically saying, this is not plan A.
I just want to understand.
I bet you have a really good reason why you're not going.
Can you tell me?
And of course, he thinks this is still plan A. What does he do?
He says, you're not going to make me go.
You just try.
You're not going to make me.
She goes right to reflective listening.
I'm not going to.
You're absolutely right.
I'm not going to, OK?
And I'm sure you have a good reason why you're not going, more reassurance.
And I'm just curious.
I bet there's a good reason.
I just wonder if you could help me understand.
And he said, I'm not going and sit in some little room with a bunch of people.
She goes right to reflective listening.
Anytime you hear something, as a good detective, go to reflective listening and then look for more.
So she says, so you don't want to go sit in a room with a bunch of people, a small room?
How come?
Because I'm not going to do it.
You're not going to make me.
You're absolutely right.
I'm not going to make you.
I just want to understand.
And it sounds like there's something about being in a small room with people.
Yeah, because they can hear my every thought.
Oh, they can hear your every thought.
And this, by the way, is a good example of you don't have to agree with what the person is saying to understand it.
Just go to reflective listening.
They can hear your every thought.
How come?
Because of the brainwaves that are coming out of my brain.
And this is an actively delusional person with paranoid schizophrenia, who has a delusion that actually the FBI has planted information in his head and that other people can hear the information, and things like that.
And this nurse does the best job of empathizing because what she says is, oh, wow.
So you're saying when people are close to you they can hear information, your every thought, and so you don't want to go down into the therapy, the treatment mall and sit in a small room where everybody could hear everything you're thinking.
And the guy's like yeah, would you want everybody hearing what you're thinking?
And she says absolutely not.
So she doesn't have to agree, but now she's understanding where he's coming from And he's beginning to regulate because she's understanding him.
That's ingredient one.
She moves on to ingredient two after summarizing.
So it sounds like you're not wanting to go down to the treatment mall because you don't want everybody to hear your every thought, which I can totally understand.
I wouldn't want everybody hearing my every thought either.
And not.
But she says and I guess I just worried that then you don't get to participate and benefit from any of the treatment.
He think she's about to go plan a.
So what does he do?
He said you're not going to make me go.
She goes right back with a little reassurance.
You're absolutely right.
I'm not going to force you to go.
That would be dumb.
Why would i want to force you to go somewhere where you say everybody can hear your every thought?
That sounds terrible.
I don't want to make you do that.
I'm just worried that you're not able to benefit from the treatment.
Two sets of concerns on the table, ready to go to the third ingredient.
So I wonder if there's a way that you could benefit from the treatment groups and not have to worry about anybody hearing your every thought, because that sounds terrible.
And then just what we said, ask him to take first crack at a solution.
Do you have any ideas what we could do?
She waits a little bit and he says, I got an idea.
What's your idea?
I could put tinfoil on my head.
And she does just what we teach people to do, which is to respond to any idea by saying that's an idea.
Let's think about it together.
So you put tinfoil on your head.
That would help with the brainwaves.
Yeah, that would block them so nobody could hear what I was saying.
Aha.
So you would then go to the group?
Well, if it worked, yeah, I would go.
Huh.
Well, and do you think we could do that?
And he's like, I've seen the tinfoil you have in the kitchen.
And would it cause any problems?
I don't think so.
And she says well, I'm a little worried about the other folks might think it's a little odd or make fun of you or something like that.
And he laughs and he says, no, no, no, no, no.
I'm not going to just have the tinfoil on my head.
We can put it like on my head, but then I'll put my beanie on, so only you and I will know that it's under there.
And, you know, there you have it.
What do you have?
You have a solution where who wins there?
Everybody.
Who loses?
Nobody.
Problem solved, relationship built, challenging behavior decreased and this guy, who hasn't gone to treatment in literally years, starts going to treatment.
Not magic, hard work, but three ingredients, and she did a beautiful job with it.
I'm wondering if one reason we find it difficult to do the Stuart is that, Perhaps without even articulating it to ourselves, we very often don't just want people to change, but we want people to change for our reasons.
Yes, and you know, here's the thing.
It's okay for you to have your reasons for why you want them to change, but that can't be the only thing that needs to be taken into account.
I mean, she had her own reasons in this case.
Her reasons were, I'm a nurse.
This is a psychiatric hospital.
I want you to get treatment.
It's okay for her to not only have those, but to pursue them.
But his concerns have to have equal weight as well.
And I think that's the beauty of collaborative problem solving.
It's not that you need to relinquish your concerns or your desires.
You don't have to.
You can pursue them, but that can't be the only thing you're pursuing, or else you're doing that tricky form of plan A.
You've done some research looking at the effectiveness of using collaborative problem solving on the skills that people develop.
One of the studies you conducted was at a children's center in Ottawa.
Tell me what you found, Stuart.
Yeah, so I'm talking here about solving problems decreasing challenging behavior, improving relationships but the other thing is skill building.
And what we found in this study in Ottawa, for instance, is that kids who received collaborative problem solving the adults in their lives, who were using collaborative problem solving those kids, not only did their behaviors their challenging behaviors decrease more substantially compared to kids across the province who were treated with other approaches, but the kids started to develop skills self-regulation skills like impulse control, cognitive flexibility skills.
The things that we talked about earlier, they started to develop those skills.
So it's not just about solving problems in a more compassionate, effective way.
It's also about building skills.
Talk about the benefits for the people who are doing the intervening the parent, the manager, the friend not just for the person who's receiving the intervention.
So this is one of my favorite findings from our research group.
Our program, where we do this work, is based in the Department of Psychiatry at Mass General Hospital, which is a big research institution.
We study everything.
It was exciting to see that kids develop skills when adults use this process and practice with them.
But perhaps the most exciting thing, as you're alluding to here, guess who else starts to develop those very same skills when they utilize this process with kids, or adults, for that matter.
So in other words, when parents learn how to do this, they start to become better problem solvers.
They develop better perspective taking skills, better empathizing skills, more cognitive flexibility, which is great news for people like us, because what it says is you know, even when the brain is less malleable when you're an adult, when you're middle-aged like me, you can still teach an old dog new tricks.
What I like about what you just said is that, even as we're in conversation with other people people we're trying to help it's also the case that in some ways, these are both parties, in some ways, that are going through the process.
So I think very often we imagine ourselves, let's say, I'm in the role of a parent or I'm in the role of a manager.
I imagine that I'm the one who's trying to influence the other person.
I'm the one who's trying to change the other person.
What you're really saying is that it's more of a dyadic relationship.
Perhaps I need to work on things and I need to be curious about myself and perhaps even empathetic toward myself.
Absolutely.
And, for instance, if you're a manager, is it very helpful to have a sense of the strengths and weaknesses of your team members across these different domains of skill.
Absolutely.
It is equally, if not more, important for you to have a grasp on your own skills and where your strengths and weaknesses are.
And as you're pointing out too, be empathic with yourself.
When I say people do well if they can, that applies to all of us.
I like to remind myself and others we're all doing the best we can at any given moment with what the world is throwing at us.
And the skills we're able to bring to bear.
And you know, at different times in our lives there's going to be much more than we have to handle than others.
Some people have to handle much more than others.
And at different times, we're going to have better or worse access to our skills.
But ultimately, you know, you got to give yourself some grace, because we are all doing the best we can.
I'm wondering whether you ever get pushback from people who say this sounds all well and good in theory, but in fact there really are some people who are bad actors.
There are people who actually are.
You know their heart is not in the right place, and being overly empathetic to them just opens you up to exploitation.
Yeah, well, it's interesting.
I remember that first juvenile detention facility that I worked in that I told you about earlier.
When we first started working there, that was a big question that came up.
And I remember the first introductory presentation about this, one of the sort of senior guards there.
He said you know, this is really interesting.
I think this really does apply to about 5% of the inmates here.
Not the other 95, because they're hardened criminals, but 5%, I think that's right.
Somewhere three to five years later, which is about how long implementation in a system takes.
I remember a conversation where he said you know what?
I want to change my calculation there.
I think this applies to about 95% of the people we got here.
Maybe 5%, I'm not sure about.
And perhaps those are the 5% you're asking about.
But I guess what I would say is I don't think those folks were born that way.
And likely one of the causes of them getting to where they got is exposure to real stress, chronic toxic stress and trauma in their lives, which is not an excuse, just to be clear, for bad behavior, but it is an explanation.
Because we do know that exposure to chronic stress and trauma impacts brain development.
And guess what it impacts?
Brain development in the parts of the brain that help us with these exact skills that we're talking about with each other today.
Stuart says people sometimes feel collaborative problem solving is about ignoring bad behavior, being soft.
People have a misconception that when you're doing collaborative problem solving, it sort of means anything goes or you're not setting any limits or boundaries.
And that's the furthest thing from the truth.
You are still setting expectations.
You have boundaries.
There are things that people are required to do.
It's just that what you're thinking about is when they don't do those things.
When there's a problem, you have more than one option, or more than two options.
Instead of just either trying to impose your will or forget it, you actually have another, more powerful option.
But you know, I think the other thing is that people will often say to me they'll say okay, that's fine, but how is somebody gonna learn how to take responsibility for their actions?
I mean, when are you gonna, how are you gonna hold people accountable when you do collaborative problem solving?
And you know usually what they mean by that is like don't you need consequences to hold people accountable and have them take responsibility?
And I've thought a lot about this and I've realized that we're we've gotten really misguided notions around this.
Like the notion that somebody getting a consequence, that that's taking responsibility for your actions, just like putting up with the consequence, suffering through it, that's taking responsibility.
That's being held accountable.
That's like a really lame way to hold somebody accountable.
And isn't ultimately the sort of most powerful way to hold somebody accountable and have them take responsibility for their actions?
Isn't that that person being on the hook for solving the problem so that it doesn't keep occurring?
Isn't that the ultimate form of taking responsibility?
I mean, in some ways I think the model we have is almost borrowed from the criminal justice system, where you say someone has done something wrong.
Taking accountability means you're levying a punishment or a fine.
And I suppose it makes sense in the criminal justice system because you know what options do judges have?
Judges are.
I'm not sure judges can do collaborative problem solving with people who come before them, but many problems in the world are not about crimes.
Well, and this goes back to a larger question, which is where did our love affair with rewards and consequences come from in the first place?
You know, it didn't emerge out of nowhere.
When you look at like school discipline and things like that or correctional systems.
Where did that come from?
And where it came from is from operant psychology.
And what's interesting about this is there's been a ton of research on what we call contingency management approaches or token economy systems, which are like really organized ways of using rewards and consequences to try to shape behavior.
And what all that research has shown is.
It's not like rewards and consequences are bad and you should never use them, but they're good at some things and not good at other things.
They're good at reminding people what's expected of them, what's right and what's wrong.
And they're good at motivating people to do those things.
What are they not good at?
They're not good at building neurocognitive skills.
It's not their fault.
They just were never intended to be used that way.
They're not good at building a helping relationship between one person and another.
And ultimately, they're not good at helping people stay calm in the midst of frustration, as we talked about.
There's very clear research, thousands of studies that have shown beyond the shadow of a doubt that when you use a tangible external reinforcer reward to try to get somebody to do something, there's a strong negative correlation with the development of intrinsic driver motivation.
In other words, the more we try to motivate somebody with something externally, we eat away at that person's internal drive.
I'm wondering when you step back and look at this body of work, Stuart.
Obviously you're working with individual patients, you have individual case studies, but I think you're making, in some ways, perhaps even a larger moral argument here about how we need to interact with others.
Talk about...
Talk about that bigger picture.
What do you see about the benefits of this approach versus the conventional approach writ large?
Well, it is really a moral argument, but it's a scientifically based one.
When I say people do well if they can, people say, well, that's a very nice philosophy.
I said.
Well, it may be an empathic and compassionate one, but it is also one rooted in science, in understanding the brain.
And it has enormous implications when it comes to the human cost, when it comes to actual financial costs.
If we could rethink behavior, If we could move away from punitive interventions when people are struggling, with skill instead of will, it could have dramatic implications in terms of billions of dollars of cost savings and, more importantly, human lives that are saved.
So yes, this is a, you know, this means something much larger.
Stuart Ablon is a psychologist at Harvard Medical School.
He is the author of Changeable How Collaborative Problem Solving Changes Lives, at Home, at School and at Work.
Stuart Ablon, thank you so much for joining me today on Hidden Brain.
It was truly my pleasure.
I really appreciate you having this conversation and being interested in our work.
Thanks so much for sharing it.
Hidden Brain is produced by Hidden Brain Media.
Our audio production team includes Annie Murphy-Paul, Kristen Wong, Laura Querell, Ryan Katz, Autumn Barnes, Andrew Chadwick and Nick Woodbury.
Tara Boyle is our executive producer.
I'm Hidden Brain's executive editor.
If you love Hidden Brain and want more of our work, please consider joining our podcast subscription.
Hidden Brain Plus.
It's where you'll find conversations and insights you won't hear anywhere else.
Plus, you'll be playing a vital role in helping to fund the writing, research and audio production that go into every episode of the show.
To try Hidden Brain Plus with a free seven day trial, go to support.hiddenbrain.org.
If you're using an Apple device, go to apple.co slash hiddenbrain.
We truly appreciate your support.
I'm Shankar Vedantam.
See you soon.
