Bad News Bearer

My mother's longtime partner, Al, died this past May. It wasn't unexpected — he was 98 years old, and had had a stroke a month earlier that left him paralyzed on one side. My mother visited him every day in the hospital for the two weeks before his family moved him to an assisted living facility, and although she was beginning to show early signs of dementia, she knew his condition was dire.

Late on the afternoon of Memorial Day, his family texted my brother and me to say that Al had passed. I called my brother and suggested that I tell our mother the next day, when I could be with her. Instead he opted to tell her himself that evening, by phone.

His decision got me wondering: What is the kindest, most compassionate way to deliver difficult news to the people we care about? Is it better to be present, or can we convey our compassion and respect for other people's losses from a distance, if necessary?

I recalled a friend's story about being on an important business trip when her sister called to inform her, against their mother's wishes, that their beloved grandmother had died. My friend was devastated by the news, and as a result, her trip was a disaster. This made me think about the power we yield, as bad news bearers, over the people to whom we are delivering the news.

According to a study conducted by the National Institute of Aging, over 90% of the physicians interviewed said that the ability to deliver bad news competently and with compassion was important to their practice, but only 40% felt that they actually possessed the skill.

If physicians feel underprepared to deliver bad news, what does that mean for the rest of us? I decided to do some research and to speak with a few experts about best practices when it comes to bearing bad news. What I discovered is that there are a number of factors to consider before, during and after we dive into potentially difficult conversations.

The key, says Hannah Mayderry, a licensed mental health counselor in Jacksonville, Florida, is maintaining a balance of empathy and honesty, along with a genuine concern for the recipient's feelings. Let's unpack what this might look like.  

You'd be hard pressed to find anyone who likes to deliver bad news. Giving people bad news can make us look bad (consider the phrase "don't kill the messenger"), even if and when we are not responsible for it. There is also the possibility that we'll be forced to witness, and possibly deal with, some uncomfortable emotional responses.

For these reasons, it's good to take our own emotional inventory before we go to deliver bad news. Am I feeling relatively calm and centered? Do I have enough distance from the bad news — i.e. can I recognize that it doesn't affect me directly, or impact me as strongly, as it does the person to whom I am delivering it? If we are directly impacted by the bad news as well, or feeling highly emotional, it can be a good idea to bring in another person for support — a friend, a therapist, a social worker, etc.

It can also be beneficial to have a plan of attack. Knowing what you are going to say beforehand, thinking though possible questions that might come up and rehearsing can help you stay calm and focused and, most importantly, keep you in the best emotional space to be of support to the other person.

There's a reason we ask if people are sitting down before we relay momentous news. The resulting emotions can be overwhelming, and we want the environment to be as supportive as our words. To that end, consider the recipient's surroundings. Wherever the conversation takes place, it should be as quiet and as private as possible. Avoid having difficult conversations over a meal, or in a crowded, noisy room with distractions.

While it may not be possible to get the person alone, you can assess whether they are in a comfortable, secure environment, and if not, find the next best thing. Difficult news is hard enough to hear without having to fight off distractions, interruptions and commotion. 

"Don't give too much information at once as this can be overwhelming," advises Dr. Howard Hong, board-certified psychiatrist at New Waters Recovery in North Carolina. Instead, he says, bad news bearers should pace the speed at which they deliver the information, and pause often to gauge the reactions of the recipient. Are they terribly upset? Would a touch of your hand, a hug or some water provide welcome relief? We don't have to go into every detail if we feel it would only be more upsetting. Share what the recipient can take in and save the insignificant — or very upsetting — details for when they are able to hear them.

"Give the information clearly," says Kelly Whitaker, a certified communication coach in Los Angeles, and prioritize the most relevant information. "What is the most important piece for them to understand? Try to avoid over-explaining, as that risks complicating the situation or making it difficult to understand."

"An honest and direct approach can foster trust and deepen the bond between people," says Mayderry. "Forthrightness shows respect for the recipient's resilience and capacity to handle challenging situations."  

The idea is not to be so blunt as to be inconsiderate of the recipient's feelings. But conveying that you trust the recipient can handle what you are telling them can boost their confidence and their sense that they can, indeed, handle this latest development.

"Once the news has been delivered, stop speaking and give space for the other person to process and ask questions," says Whitaker. It's ok to ask questions of your own as well, as the conversation unfolds.

"Do you have any questions for me? Is there anything more you would like to know about what happened?" are examples of what we might ask as we go along.

"What do you need most from me? How can I best help you going forward? Is there anyone else you'd like me to call, or that you would like to hear from (or talk to)?"

"What are you feeling?" is another question we might ask. While we might be able to intuit some of how they feel from their body language, it never hurts to let the other person put a name to their own emotions and experiences. It's all a process of allowing them to take control of a situation that might otherwise feel out of their control.

Remember, as the bearer of bad news, no one expects you to have all the answers or to be so unemotional as to be robotic. It's okay to admit you are uncomfortable early on.

"A possible script could be: 'I have something important to share with you, and it's not easy for me to say. However, I believe it's crucial that you know...' Then share the news directly. This isn't to elicit sympathy for yourself, but rather to express recognition of the seriousness of the situation," says Mayderry. Do keep your focus on the message, however, and not yourself, so as not to draw attention or support away from the recipient.

Delivering bad news can feel overwhelming, says Whitaker, because we don't want to let people we love down, or cause pain.

"That said, honesty is compassion, and being the bearer of hard news also comes with the opportunity to set the tone and provide comfort, support and perspective during a challenging time."

There's no perfect way to relay bad news. It's a bit like improv, whereby you follow the lead of the recipient. Don't try to manipulate or control the other person's emotions, and do let them express whatever they are feeling, even if it's uncomfortable for you.

Hope is life-sustaining. It's very hard to go on without it. Even the worse news can include a note of hope. For my mother, the loss of her longtime partner meant a loss of independence and a move to an assisted living facility at 93 years of age. But my brother and I were careful to remind her often of the fact that she is not alone, and that we would see her at regular, frequent intervals, which we do. What rays of hope can you extend to your recipient of bad news?

Uncomfortable as it may be to admit, there is unspoken power in delivering bad news. It elevates the teller to a position of authority and importance, and in some cases, can even feel like a shortcut to intimacy. We are in control of where and how we deliver the news, and are, at least for the amount of time we are relaying the news, privy to the recipient's emotional state, which may be quite fragile.

For this reason, it is important to remember that our job as the bearer of bad news is to be as clear and compassionate as possible, and to support the recipient fully and without grabs for gratitude, recognition, status or credit. 

There is an art to delivering bad news in a way that supports and grounds the individual receiving it. Ask yourself a few simple questions up front, and you will shepherd the recipient of the news into their new reality with the kindness and compassion they need and deserve.

These questions can include:

• Where is the best time and place to deliver this news?

• Who is the best person to deliver it?

• Should someone else the recipient trusts be present also?

• What is the crux of the information, and how can I deliver it succinctly and clearly?

• How is the recipient likely to respond? How can I prepare myself for strong emotions?

• How can I leave the recipient with a sense of hope?

If you go into the situation with an eye toward doing what's best for the other person, you are more likely to leave them with the sense that they can cope, and with the hope they need in order to do so.

Dana Shavin’s essays and articles have appeared in Garden and Gun, Oxford American, The Sun, Fourth Genre, Today.com, Appalachian Review, Longridge Review, Psychology Today, Parade,Bark, The Writer, AARP’s The Ethel, and Travel+Leisure.com. She is an award-winning humor columnist for the Chattanooga Times Free Press, and the author of a memoir, The Body Tourist (Little Feather Books, 2014)and Finding the World: Thoughts on Life, Love, Home and Dogs, a collection of her most popular columns spanning twenty years. You can find more at Danashavin.com, and follow her on Facebook at Dana Shavin Writes. 

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