Essay: Listening During a Pandemic

 

“No Guarantees,” from the Quarantine Series, by Walker T. Roman


In the time of COVID, has listening changed?

It seems to me that it must have, if only because it has become so crucial. We are stuck together in small groups, many of us—couples, small families, those in multi-family quarantine bubbles. Or we have been sequestering alone. Friendships that buffer primary relationships have been pushed into the background. Misunderstandings that might come and go in life as it once was now accumulate, become fixed, loom large, and lead to disappointment and resentment.

So much is at stake. We’re grieving, some of us. Jobs are at risk, and savings. Education is on hold. Childcare is complicated. And then there’s the illness, which is to say, debility and, finally, life or death.

Imagine an impasse in a marriage. We are approaching the surge in COVID cases. A woman in her thirties wants to get pregnant. Before, she had been overwhelmed by work, but now she is home — and getting older. The time is right.

Her husband has had diabetes from childhood and would be vulnerable if infected. He cannot believe what his wife is saying. If she gets pregnant, she will need prenatal checkups, sonograms, and blood tests. What will she bring home? She will be putting his life at risk. When she goes to a hospital to deliver, will the baby become infected?

She thinks he’s catastrophizing. The medical system knows how to handle patients. The crisis will not last forever.

When they try to resolve the disagreement, quickly the discussion turns to character. You’re fussy. You’re selfish. You’re uncaring,

I am proposing a problem with no answer. But in milder form, we confront parallel conflicts daily. How often should we go to the market? If a family member leaves home for work, can he or she come home? We feel unsafe, or we believe that the risks have been exaggerated.

The expert guidance we receive is never sufficient. Our judgments often seem to reflect our personality. Because we’re frightened or we feel hemmed in, we have a limited tolerance for disagreement.

I’ve spent most of my career listening or writing about listening. I am a psychiatrist. For forty years, most afternoons, I saw patients in a practice built around psychotherapy. I spent mornings writing books and essays that have clinical care at their core. Most years, I taught psychotherapy as well, which is to say that I taught listening.

In psychiatry, listening is a complex art. If I had to say what is central, and what is hardest to convey, it is awareness that people are different — different from us, and different from each other.

In the standard training for contact tracers — preparing them to speak with those who test positive for the virus and those to whom they may have spread it — the protocol instructs interviewers not to say, I know how you feel. People can take offense at that claim. Often it means, I know what I would feel in that situation, which is altogether different.

The difficulty may arise from disparities in social class or circumstance. Imagine a single mother living in poverty, in cramped quarters, say, with a history of neglect and abuse — add whatever burdens you choose — hearing someone who sounds well-spoken say that she understands. The well-intentioned claim will sound condescending — and mistaken.

But people of similar backgrounds can assume too much as well.

Psychologists have addressed this problem for as long as their discipline has existed. In 1899, the philosopher William James — he taught the first psychology course in the United States — wrote an essay titled “On a Certain Blindness in Human Beings.” The gist is that we are peculiarly bad at judging what other people feel and what they value.

James gives the example of Pierre, the hero of Tolstoy’s War and Peace. The richest man in Russia, Pierre is happiest after being taken prisoner by Napoleon’s army and made to suffer from cold and hunger. We know what Pierre feels and values only if we ask him and are open to hearing the unexpected.

We can be blind even with people we are close to. That was my observation when I did couple therapy. Husbands and wives arrived burdened by fixed and partly false beliefs about one another.

In the 1990s, my mentor, the Harvard psychiatrist Leston Havens, took the problem that William James noted and reframed it: “We all stare forth from an individually shaped and genetically different nervous system onto a world seen from this time and place by no one else.” And then the question is, how do we gain insight into another person’s parallel world?

Havens would try, metaphorically, to sit beside a patient and look outward. Instead of asking patients how they felt, he might say something tentative, as in their voice — in hopes of being corrected. Each effort was a test of his own understanding. Often, he used short exclamations: Frustrating! The patient could say, No, that wasn’t what was hard for me.

I am mentioning one technique from among many. And of course, the tentative statement serves a purpose only if we are prepared to listen, uncritically and unselfconsciously, to the response.

Still, can we borrow this tool from psychotherapy, radical curiosity? I mean, borrow it for occasional use — now and then, when we feel up to it.

When Pierre describes his capture, we say, How difficult! He demurs: Actually, no…

In the case of our young couple, what would curiosity look or sound like?

The husband may say, How badly you want a baby!

He must take care not to sound superior or dismissive. He must signal openness to a discussion of her upset.

The wife may complain that he has ignored her needs. If he can, he may stay to hear how he has hurt her.

I should have said that about curiosity. It can make us self aware. It can stir up conflict and put us in the line of fire.

Thinking of the wife, she may begin: I’ve scared you.

Or else: How hard it is to live with illness!

Again, the trick is to mean it — not to sound strange.

If she seems to be listening with a fresh ear, then, with luck, he may reassess her past attitude. A limitation he’s complained of, his wife’s obliviousness to the burdens that diabetes imposes, has also been strength. It’s because she is optimistic that she was able to marry him. Will he then be less alarmed to discover that this crisis does not oppress her as it does him?

  1. You can imagine any number of conversations — depending, perhaps, on your own advance assumptions. How hard they are to avoid or get beyond!

I will not attempt to manufacture an ending. We face problems for which there is no privileged vantage point, no best answer. All the more reason then, to think about how we want to arrive at decisions. A result achieved through awareness and consideration may serve us better than the same choice made after endless fighting and finally the assertion of power.

This is not to deny the pleasure — or inevitability — of occasional spats. But the core fact of life under COVID is uncertainty. When consequences of our actions are unclear, it seems all the more sensible to work at becoming attuned to one another’s experience. That process begins with reminding ourselves that our own perspective is limited and that the wonderful thing about other people is that they are not just like us.

 

Peter D. Kramer, a psychiatrist, is a longtime seasonal resident sheltering in Chilmark. His books include Listening to Prozac, Should You Leave?, and Ordinarily Well.

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