How to Have Difficult Conversations with Dr. Nicholas Crimarco

Faith: Welcome to Health Matters. Your weekly dose of health and wellness from NewYork-Presbyterian. I’m Faith Salie.

The holiday season is often filled with big gatherings, which offers the potential for meaningful conversations with loved ones — as well as disagreements.

This week, Dr. Nicholas Crimarco, a psychologist with NewYork-Presbyterian and Columbia, shares thoughtful, practical strategies on how to approach differing opinions and challenging conversations. He provided some do’s and don’ts, as well as what you can say to help make a conversation more effective.

Faith: Dr. Nick Crimarco, you are here not a moment too soon. Thank you so much for joining us.

Dr. Nicholas Crimarco: Oh, you’re welcome. Thank you for having me.

Faith: We’re here to talk with you today about having difficult conversations, which may especially occur around the holiday season, when you’re with family whom you might not see during other times of the year. Sometimes we may not have the same opinions or certain topics might come up. So I’d love to get your advice on how to navigate that. I would guess it’s one of the most fundamental skills any of us can learn, not just in this situation, but in general.

Dr. Nicholas Crimarco: It’s an important skill and a relevant one because we’re having a lot of difficult conversations.

Having difficult conversations is necessary. We’re either avoiding them, which leads to a lot of dissatisfaction in our relationships, or we are trying to have them, but it’s not going the way that we had hoped, which is also negatively affecting our relationships. So I think it’s critical that we’re able to have difficult conversations and do so in a way in which people feel like they can be heard, that we feel like we can come to a mutual understanding on something, even if we disagree.

Faith: Can you share some tips that can help set a positive tone for initiating one of these conversations?

Dr. Nicholas Crimarco: What’s important to start with is being mindful about what your goal is. Because a lot of times what happens is we go into these conversations from an emotional place and we haven’t taken the time to reflect on what it is we’re trying to accomplish with them. And when that happens, it’s really easy to get distracted or go down a path that you didn’t intend in that conversation.

So really being mindful of those goals. You might have a goal of – right now I really need to get into this conversation to talk about something that’s affecting our relationship. And then I need that person to change – that would be one goal.

Another goal might be someone’s asking me to do something that I’m not comfortable with, and I need to be able to say no to that. Another one could be, I want to have a conversation about something we disagree with, although the goal of this conversation isn’t necessarily for me to change their opinion, but rather for them to hear what I have to say.

I think it’s just really helpful that whatever that goal is, you know what it is going in and you’ve thought about it and you try to stick to that goal during that conversation.

Faith: How can you express your goal or your intentions in a way that doesn’t make the other person feel defensive from the start?

Dr. Nicholas Crimarco: So I would lean into validation. This key concept of communicating that from the start that another person’s thoughts and feelings are justified and understandable even if we disagree. So if we’re going into a conversation and I know this is going to be something where there could be some defensiveness, I’m going to lead with what we agree on first.

So I’m going to say, here are the facts and here’s what we agree on, and here’s what makes sense to me about what you’re thinking, or what you’ve been saying, or what you’ve been feeling. And using that keyword “and” instead of “but,” I will then say what I’m thinking. I feel like that kind of takes the other person off the defensive.

Faith: In the context of the upcoming holidays and potential for family gatherings, what is your advice in navigating these dinner table conversations with close family and loved ones we care about?

Dr. Nicholas Crimarco: So what I would say is, go into that holiday ahead of time anticipating. Because you’ve had holidays before so you likely can predict the patterns. And have a plan. Cope ahead.

Visualize how it’s gonna go. And visualize what you want your response to be. And then for advice on what that response would be, I would say if you would like to steer a conversation away from a particular topic, you have a plan on how to do that. And it might sound something like, I know this is like a really important topic that everybody really wants to talk about – and I think it would be great if we “blank.” Like, have a plan for what you want to talk about. You can be proactive. And if you anticipate what those things are going to be, you can guide the conversation.

It may sound something like, you know, we’ve got all the time in the world to talk about politics, and I totally understand it’s an important conversation. And I’m really interested in how your vacation went. So it doesn’t say, like, you can’t do it. It’s just a, validate, guide that conversation.

We have that power to do that.

Faith: And if you do choose to engage, what is the best way to do so peacefully and, and really listen to someone whose opinion might be very different than your own?

Dr. Nicholas Crimarco: If I’ve identified that, through experience, that a person is not going to be persuaded to your point of view, then I just lean right into the validate and the active listening. And I just don’t need to share my opinion. Like, what’s the point of sharing that opinion? If I want that person to know my opinion, and it’s in line with my values, I can share it. Otherwise, I can just say, yeah, I understand you’re frustrated about what’s been going on in the world right now. I hear you on that, or, you know, ask them questions. If something doesn’t make sense to you, ask them why, right? Ask them why they think that way.

Faith: You really do get to own your opinion without giving it away. And when you say,” thank you so much for sharing your thoughts with me.” That’s a great closer. Everybody walks away from that feeling good, right?

Dr. Nicholas Crimarco: Absolutely. As long as, and this is what takes practice, you convey that in an authentic way.

Faith: Right.

Dr. Nicholas Crimarco: So if they really felt like you were listening and really cared about their perspective, even if you disagreed and were curious about why they think the way they do, when you say, thank you for sharing those thoughts with me, they’re going to believe you.

Faith: Yep.

Dr. Nicholas Crimarco: And even at the end, if you still haven’t changed your perspective, they will appreciate that you actually took the time to consider it.

Faith: Yeah.

Dr. Nicholas Crimarco: Because that’s what people really want. They want to be heard.

Faith: You mentioned active listening skills before. What do we look like when we’re actively listening?

Dr. Nicholas Crimarco: Body language, right? So if our arms are crossed, that might be conveyed as closed off. That doesn’t necessarily mean that you are. So what I would encourage is, if you’re feeling closed off, then take a look at what you’re doing with your body. And say, like, what am I doing with my body that conveys that feeling? Because if we’re feeling it, there’s a chance we’re conveying it.

So what am I doing? Am I turning away? Am I, like, about to open my mouth to speak even though they’re not done? That’s you saying, “I’m having this urge to speak.” That’s not listening.

So usually listening, though, would look like I’m not moving a lot. I mean, maybe I’m nodding my head, but generally speaking, I’m faced towards them.

Making eye contact, or if, even if I’m not making eye contact, if I’m looking away, I’m nodding. They’re seeing that I’m thinking about what they’re saying, and then I’m looking up to them when I’m, like, ready to reflect.

Faith: And you gotta have your devices away.

Dr. Nicholas Crimarco: Correct.

Faith: There’s no side glance at your phone to see how long you’ve been talking or if someone texted you.

Dr. Nicholas Crimarco: Because that, again, wouldn’t be in the spirit of curiosity or active listening. We gotta minimize distractions in those conversations.

So another thing to remember is sometimes once our eyes are open to certain skills and we start practicing them, it gets frustrating to us if other people aren’t using them. And we do have to remember that we can’t control other people. We can only control ourselves. And another good thing about using these skills is it gives us pride in ourselves for how we handle difficult conversations. It doesn’t necessarily guarantee that other people will do the same, but it does increase the chance that they will.

Faith: If we put together kind of a list of do’s and don’ts in a conversation, what would they be for, for an effective conversation in which both folks feel heard?

Dr. Nicholas Crimarco: Excellent question. Definitely be gentle in your communication, which is a skill that takes practice because when our emotions kick in, we’re going to want to talk over people. We’re going to want to be forceful in our opinions. So being gentle. We’re still stating our opinions. We’re just doing it in a calm, respectful way that even if someone else’s emotions are increasing, we’re trying to keep ours steady. “I’m hearing what you’re saying is this, and I understand that,” or “that makes sense to me.” Finding that first. Being interested in what they have to say and trying really hard to save what you want to say until they finished their point, and like really wait, pause, you don’t have to respond right away.

Reflect on what they’ve said, incorporate it into what you’re about to say, and if it changes what you’re about to say, you’re now able to change that before you speak. And have an easygoing manner with it. Sometimes even using humor, as long as it’s not, like, at the other person’s expense. But just to kind of communicate, we can keep this lighthearted while we’re having this discussion.

Faith: I do find in my personal life I actually check in with my body when I’m flooded with emotions, whether it’s pain or defensiveness or anger, and literally make myself take a deep breath while I’m listening. That is always a good reset.

Dr. Nicholas Crimarco: And that is a key mindfulness skill – to check in with ourselves, especially when we start to feel emotions. And I do it all the time. It’s sort of like my cue to be like, let’s take a moment, pause, take a breath, observe what’s going on for me emotionally.

Faith: Yeah.

Dr. Nicholas Crimarco: Observe what I’m thinking before I respond. Remember that you don’t have to respond right away. These pauses at first may feel awkward. However, once you practice it, you realize that it is helpful and that the other person can perceive that as you being thoughtful about what they’re saying.

Faith: Yeah. The other person experiences it as you’re trying to understand them.

So this is a really crucial question, which is, how do you determine if it’s even worth engaging with someone? Because sometimes, maybe some difficult conversations aren’t going to be worth having.

Dr. Nicholas Crimarco: I would go back to values, this concept of what’s important to me on an aspirational level? That can be a guide.

So if this is a conversation that’s going to be difficult and it doesn’t really align with my values for what I want for myself or my relationship, it’s not necessarily worth having because I don’t need to have a difficult conversation just for the sake of having it. Though, if it’s a difficult conversation that is important for the relationship, then it aligns with your values and it is worth having.

I think though of times when someone comes to you and says, and initiates a conversation. And they may be doing so in a manner that isn’t thoughtful or intentional. Sometimes we just start a conversation and it becomes difficult. You can ask yourself, is this the time and the place for this conversation? It might be yes, so I’m not saying don’t talk politics on the holidays. What I am saying though is be mindful about it and if you know, hey, this is one where we don’t agree, and also I know that it gets heated, this might not be the time for it.

The next question would be, so then what would you do? How would you navigate if you didn’t want to have that conversation?

Faith: Yeah.

Dr. Nicholas Crimarco: I’d go back to that validation and active listening. I would say, yeah, I understand. Like, it makes a lot of sense what you’re saying – and – I think we can pick that conversation up at a different time. Like I think right now may not be the best time for it, but you led with that validation. So it’s not like you dismissed them.

I know it is a cliche term, but “agree to disagree” is a valuable skill. Because if the person senses that you’re saying agree to disagree, but I’m right and you’re wrong, it doesn’t really convey what I’m trying to say, which is, again, I understand that you feel that way and I respect your difference of opinion and I don’t think less of you for having it and I don’t agree with you.

We’re not going to come to a resolution on this one, but that we still can have positive feelings towards one another without agreeing. That’s the spirit of what “agree to disagree” would mean.

Faith: Yeah. Dr. Nick Cramarco, this conversation about difficult conversations has been fascinating and I really appreciate your being here.

Dr. Nicholas Crimarco: Thank you for having me. I really appreciate it.

Faith: Our many thanks to Dr. Nick Crimarco.

I’m Faith Salie.

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