Why Do We Avoid Having Difficult Conversations?

Amy Spicer

ENG.1201.515 Research Essay

Professor Helmers

December 12, 2021

 Despite having daily conversations with various individuals, amid differing surroundings,

communicating can still pose a challenge. The presentation of the information is just as

important as the information itself. This is especially true when the conversation contains

sensitive information or is personal in nature. These conversations can be quite distressing to

someone with inadequate communication skills, causing immediate feelings of dread. Although

some professionals declare avoiding difficult conversations reveals character weakness, nearly

all research data indicates it is a fear driven reaction.

As human beings, one of the fundamental needs we all have is to be heard. To be listened

to and understood. However, in order to be heard, we must first learn to communicate. Defined

in the Merriam-Webster Dictionary as: “the transmittal of information, thought, or feeling so that

it is satisfactorily received or understood”. At birth, we begin building communication skills,

starting with listening to others. Communication is just as much non-verbal as it is verbal.

Acquiring conversational skills and etiquette are an important part of socialization and impact

our ability to build trust and connect with others. “Pro-social behavior is often referenced as the

very essence of human nature.” (Balboa PhD, Nicklaus) Conflicts are known to be the most

difficult of all conversations at the workplace. People have been known to go to extreme lengths

in order to avoid the confrontation that accompanies having a difficult conversation. In fact,

conflict resolution is one of the most researched interpersonal skills in the corporate world. The

consequence of poor communication when confronting a sensitive situation is the liklihood for

misunderstanding. Contributing to our underlying fear that we won’t be understood.

 The language we use to communicate is of the utmost importance, taking care to use the

right words in the right way. An article in Science Direct entitled, “Emotion:Current Opinion of

Psychologists,” explains how the biography of our emotions, and the backstory of our behavior

are directly affected by previous experiences with language. Outlining the direct connection

between our thinking, behavior, and emotions.

Realizing my own stalling efforts are perceived as procrastination, pushed me to find

answers into why, we avoid having difficult conversations. I admit, I will dodge a difficult

conversation for as long as I can get away with it. That applies to both my personal and

professional life. Despite having endured the consequences of postponing the inevitable, I

continue to do so. That is what lead me to choose this topic for my research. Painfully aware of

my own sensitive nature; I place half of the blame there, the other half is on fear. In perfect

alignment with the dozens of studies and researched literature I’ve reviewed, I’m certain fear is

the reason I avoid having difficult conversations. Well, fear and a huge dislike of confrontation. I

do all I can to prevent others from feeling anything other than good or happy. I sugar coat or

dance around giving negative feedback. I avoid or cautiously respond to questions that require an

opinion, so as not to offend anyone. I often find myself acting as a buffer between my teenagers

to protect their feelings. It only recently occurred to me what a disservice I have done to them.

The cruelty of this world requires one to have thick skin, In addition to, the ability to accept

constructive criticism. Seeking to evade confrontation, I have avoided phone calls and social

gatherings, in addition to wasting hours of time devising alternative ways to approach a sensitive

issue. This is limited to my personal life, for the most part. As several years ago, my younger,

less assertive self, learned a lesson It caused me great embarrassment and made me question my

own authority.......
 In anticipation of what would surely be uncomfortable, an unavoidable meeting with my

supervisor and others, taught me a valuable lesson about avoiding difficult conversations in the

workplace. My concern for the feelings of a co-worker, not wanting to make a big deal of a

minor infraction for fear of appearing like I was on a “power trip”. I allowed myself to turn a

blind eye to the bending of a rule in order to preserve the relationship between myself and my

co-worker, whom I sat next to and worked closely with every day, During the meeting, when

questioned about the incident, I was unable to defend my decision. I skirted around the severity

of the situation, I let my fear of confrontation and of how I would be viewed, prevent me from

standing my ground and enforcing company policy. It resulted in my appearing weak and unable

to take control of a situation. I proved I was unable to run the office without a direct supervisor

present. Something I had done flawlessly many times.

“A difficult conversation contains anything someone doesn’t want to talk

about,”(Garfinkle, Joel) such as delivering unwanted news or maybe discussing the birds and

bees with your children. Differences in beliefs, the neighbors barking dog, or loud screaming

music, are all examples of small issues where a conversation is needed for conflict resolution.

Conversations become difficult when painful or negative feelings are involved. The display of

anger, pain, frustration, hurt, and anxiety we see is a disguise for fear. Fear of what people may

think about you. Fear that you won’t know how to handle the repercussions. However, each of

them can also stand alone. People give many reasons for avoiding difficult conversations,

research reveals a measure of fear is in each one.

The tendency to avoid difficult conversations isn’t characteristic of social or economic

class. Nor is it limited to can be problematic for anyone. It may surprise you to know, a revered

scholarly individual is just as likely as the cook at McDonalds to be intimidated by an impending

difficult conversation. Our own, highly educated, well respected physicians and surgeons share

this struggle. Those trained to perform in stressful situations, whom we trust with our lives and

the lives of our loved ones, even they are not exempt.

Negative effects resulting from healthcare professional’s avoidance of difficult

conversations with each other can lead to serious negative consequences for patients. The 2020

article, Avoiding Difficult Conversations in the Australian Health Sector, published in SAGE

Open Nursing where Christine King, PhD, Tanya Edlington, MA, Brett Williams, PhD, discuss

the findings of a study done from the perspective of clinical supervisors who interact with a

broad range of students, peers, and colleagues in the health sector. An action research-based

interview method known as Convergent Interviewing Process was used. This method was

created to explore issues in under researched areas. According to Brett Williams, PhD, the

“Objective of the study was to identify the reasons why difficult conversations are avoided

between health-care professionals and to gain deeper insight into the phenomenon of avoiding

difficult conversations in general.” Twenty (20) health professionals took part in the study. Ten

(10) nurses (eight (8) allied health, five (5) speech pathologists, two (2) physiotherapists, and one

(1) community support worker), and two (2) were in medicine. Of the twenty (20) nurses, two

(2) were from the private sector, the remaining eighteen (18) were in the public sector.
 Figure 1: The Complexity of Avoiding Difficult Conversations. 9 themes emerged from the
Convergent Interviewing Process, briefly described below.

“The main reasons given for avoiding difficult conversations included the fear of

negative consequences, a dislike of confrontation, and a lack of confidence in their skills to have

such conversations. Contributing factors are complex and varied, as are the potential impacts to

patients when such conversations are avoided. Results of the convergent interviewing process

yielded the following nine (9) themes

1: Negative Consequences of the Conversation: were the most commonly discussed issue by all

participants. not wanting “any backlash” not wanting the person to feel hurt or disliked, etc.

2: Fear of Confrontation: people in their workplace are afraid or fear confrontation, want to avoid

conflict, and “keep the peace.

3: Lack of Skill: a lack of confidence brought about by a lack of skill in not only having a

difficult conversation but also in planning and reporting on this type of conversation.

4: Lack of Time: The time to plan and have a difficult conversation was another reason these

conversations were avoided. As one participant stated, “we are so busy often that we don’t really

have time to critique performance and then spend time talking about it later.”
5: Cultural Issues: a range of cultural issues including, a culture where people find it particularly

hard to report unprofessional behavior, a culture of making up for someone else’s “slack,” and a

culture of not wanting to take the lead and passing the responsibility of a difficult conversation

onto someone else. a nursing culture where senior nurses were not trained to embrace

professional supervision and conversations can be quite harsh

6: Individual Qualities: participants mentioned an individual’s personality type and

communication style as influencing whether or not a person was more likely to avoid a difficult

conversation.

7: Size of Workplace Size of the workplace was mentioned by participants in all professions as

influencing whether conversations were avoided; however, participants were divided about the

potential effects of workplace size. Both settings present unique challenges.

8: Types of Difficult Conversations: placed into two categories, those relating to clinical skills

and attitudes and behavior. Participants believed that conversations about someone’s attitudes

and behaviors were more difficult than those about their clinical skills and were therefore more

likely to be avoided.

9. More Difficult Conversations About Attitudes and Behavior: Are Heavily Influenced by

“Lack of Insight”

Avoiding these conversations is associated with higher rates of medical errors and poorer

patient outcomes. For example, “The “Silence Kills” study which focused on how

communication problems in hospitals affect patient safety. used focus groups, interviews,

workplace observations, and survey data from more than 1,700 nurses, physicians, clinical staff,

and administrators, identified seven different crucial conversations that are often avoided and
correlate strongly with medical errors, patient safety, quality of care, staff commitment,

employee satisfaction, discretionary effort, and turnover “(Maxfield et al., 2005). The Silence

Kills study suggests most reasons why health-care professionals avoid difficult conversations

including people’s lack of ability to have a difficult conversation, low confidence that it will do

any good to have the conversation, fear of retaliation, lack of time, and a belief that it is not part

of their job. Results of the “Silence Kills” study, put into perspective “more Americans die each

year from medical errors than from motor vehicle accidents, breast cancer,or HIV/AIDS.” (King,

Christine)

Comparing healthcare professional results with a setting outside of health care, the

classroom setting, Abrams (2006) notes that “people avoid difficult conversations because of the

desire to be pleasing to others including both the avoidance of appearing mean as well as

wanting to be liked and respected by others; maintaining safety in terms of both emotional

comfort (avoiding any potential emotional pain or discomfort) and job security (fearing the

attempt could jeopardize one’s employment); an organizational culture where people do not face

things head-on; power/control differentials where one person may not feel they have the

authority or position to undertake the conversation, or feels the other person has power, which

makes them hesitant; priorities, such as a lack of time due to other pressing concerns; or a

personal identity based on one or more characteristics that leaves one feeling that they would not

be taken seriously.”

Study concluded the two main barriers to having difficult conversations are the fear of the

other person’s response and emotional discomfort. The study also showed that the more difficult

a conversation was, the more likely it was to be avoided. Conversations were seen as difficult

when they are about a person having to make a change. The degree of difficulty depended on
what the conversation was about, the least difficult being about clinical skills and the most

difficult about needing a change in behavior and/or attitude with a student or staff member who

“lacks insight.”

“We live in a culture based on avoidance and blame.” According to Elaine Montilla,

founder of 5xminority.com and Assistant Vice President and CIO for Information Technology at

The Graduate Center, CUNY, “The top reasons we tend to avoid conflict is because we want to

feel “safe” and make sure we are liked and supported by others. Avoiding hard conversations

leads us to swallow our feelings, which is unhealthy. Resentments we fail to address turn into

blame or anger, or they manifest in different ways, like a stress-related illness.” Faced with a

difficult conversation containing controversial topics many people focus on whether or not they

will be “liked” after speaking their mind. Their fear of not being liked or supported by others

overshadows the subject matter of the conversation.

Despite known health benefits of spiritual care and high patient interest in discussing

spirituality with their physicians, the frequency of spiritual discussions in medical consultation is

low. The top five reasons being (1) confusing spirituality with religion; (2) peer pressure; (3)

personal spirituality; (4) institutional factors; (5) historical factors. Underlying confusion

regarding the differences between religion and spirituality, and the current suspicion with which

religion is regarded in medicine needs to be addressed so discussion of spirituality in a medical

consultation is a possibility. Historical opposition to a biopsychosocial-spiritual model of the

human being is problematic.

 Communication is the cornerstone of good multidisciplinary medical care, and the impact

of conversations about diagnosis, treatment, and prognosis is indisputable. Healthcare providers

must be able to have difficult conversations that accurately describe diagnostic procedures,

treatment goals, and the benefits and/or risks involved.

Most of us weren’t taught in school or at home how to deal with conflict effectively or in

a productive way, so we aren’t well-equipped In a literature review published in The Ochsner

Journal by Joel D. Marcus, PsyD, Director of Psychosocial Oncology and Palliative Care

Services at Ochsner Cancer Institute in New Orleans, LA about the importance of

communication in delivering bad news. Communication training is lacking. Consequently, many

clinicians may have difficulties with, or in the worst-case scenario, avoid delivering bad news

and discussing end-of-life treatment. Clinicians also struggle with how to have the last

conversation with a patient.

“The consensus about difficult conversations as part of our professional lives, being most

people would prefer to avoid such conflict at work. Unfortunately, difficult conversations in the

workplace happen more often than they should. There is a fundamental reason for this, the “Inner

Voices.” A conversation between two people has four voices. Two of them being what each

person speaks, the other two being what each person thinks.
 Figure 1. Spoken & Unspoken

Stone et al. (2010) illustrates this with an example. He shows two stick images of a

supervisor and subordinate. The speaking bubble of the supervisor says, “How is the project

going?” while his internal voice bubble says, “Why can’t you pick up and work faster?” At the

same time, the subordinate’s speaking voice bubble says, “It is going fine” while all the while his

internal voice bubble is saying, “You never help me on this. You are no good manager!” Now, as

both individuals hide their real inner voices and speak out only the superficial voices, over a

period of time, these inner voices will start to surface in almost every conversation of theirs and
suddenly one day they will find themselves in the middle of a difficult conversation that

escalates to a point of heated arguments.

Additional instances, terminating a position, resolving conflict between employees, or

giving a poor employee review. All are unpleasant conversations to have but necessary none the

less. Is it confrontation? conflict? Or lack of concern that prompt us to put off having difficult

conversations? Realizing my own stalling efforts are perceived as procrastination, pushed me to

find answers into why we avoid having difficult conversations. Conflicts are known to be the

most difficult of all conversations at the workplace. People are known to go to any lengths to

avoid conflict or the person. In fact, conflict resolution is one of the most researched

interpersonal skills in the corporate world.

Being averse to confrontation is largely considered a negative trait. A person displays a

non-confrontational attitude, they’re thought of as fearful of reproach, underconfident about

expressing their views, and afraid to burn bridges with others. However, according to leadership

expert and author Lisa McLeod, t’s quite the opposite, “People that address conflict head on and

possess good confrontation skills are considered paramount to being in leadership.”

No one is exempt from difficult conversations, they are a necessary evil, nor are they

limited to our own personal issues. A common reaction to unwanted impending confrontation is

wanting to avoid conflict or discord, but they’re an essential part of life, and something we need

to become more comfortable with. As to why we avoid having difficult conversations, the

research is hard to dispute, it is fear. No matter what form it presents itself, at the center is an

undeniable measure of fear.

Works Cited

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Connection and disconnection in the mind.” Psychology Today, September 7, 2021
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why-we-avoid-difficult-conversations

Batja Mesquita, Lisa Feldman Barrett, Emotion: Current Opinion in Psychology,Volume 17,
2017, Pages iv-vi, ISSN 2352-250X, https://doi.org/10.1016/j.copsyc.2017.07.030.
(https://www.sciencedirect.com/science/article/pii/S2352250X17302208)

Best, Megan, et al. “Why Do We Find It so Hard to Discuss Spirituality? A Qualitative

Exploration of Attitudinal Barriers.” Journal of Clinical Medicine,vol. 5, no. 9, Sept.
2016. EBSCOhost, doi:10.3390/jcm5090077.

Garfinkle, Joel, How to Have Difficult Conversations When You Don’t Like Conflict, Harvard
Business Review, May 24, 2017

Keating, DavidM., et al. “Family Communication Patterns and Difficult Family Conversations.”
Journal of Applied Communication Research, vol. 41, no. 2, May 2013, pp. 160–180.
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Levine, Emma E., et al. “Difficult Conversations: Navigating the Tension between Honesty and
Benevolence.” Current Opinion in Psychology, vol. 31, Feb. 2020, pp. 38–43.
EBSCOhost, doi:10.1016/j.copsyc. 2019.07.034.

Marcus, Joel D, and Frank E Mott. “Difficult conversations: from diagnosis to death.” The
Ochsner journal vol. 14,4 (2014): 712-7.

Miller, Joshua, et al. “TALKING WHEN TALKING IS TOUGH: TAKING ON

CONVERSATIONS ABOUT RACE, SEXUAL ORIENTATION, GENDER, CLASS
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Montilla, Elaine, “Difficult Conversations, Why We Should Stop Avoiding Them”, 5XMinority,
February 9, 2020
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“‘Silence Kills.’” Nursing, vol. 35, no. 4, Apr. 2005, p. 33. EBSCOhost,
doi:10.1097/00152193-200504000-00027

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