Sunday, April 18, 2021

8. Compassionate Conversations Are Critical

Yesterday I wrote about the ways hurt people hurt people and my intention to be part of changing this perpetual cycle of pain.  I want to live in a democracy that prioritizes human rights, maintains social justice, corrects systemic errors, repairs historical travesties, and creates communities where love, family, and friendship, can flourish.  I don’t think any of this is possible if we can’t have reasonable, rational, and compassionate conversations with people who think differently and carry divergent values.     

Social media allows us a historically unprecedented opportunity to share ideas, exchange opinions and engage in riveting debates. Unfortunately, it also allows anyone with a Wi-Fi connection to express stigma, spew hatred, and claim unscientific and unfounded opinions as “facts.” How does one cope productively with irrational and vitriolic aggression? And when given an opportunity, how do we open people’s minds?

Most people are not taught the skills to partake in these types of respectful conversations and discussions. I learned a lot of these tools from my father, who became a political figure in Culver City when I was four-years-old, and remained at the center of civic debates for the next sixteen years. During that time, I watched him field attacks, navigate irrational aggression, and delicately handle irate voters who claimed that his efforts to protect public safety was impinging on their civil rights (sound familiar?). Case in point:  He was the “lone vote” in banning the sales of fireworks for many years, and I remember him getting a lot of angry phone calls for that.  But ultimately caution and safety won out, showing that people are capable of prioritizing human lives over righteousness when given an opportunity.  I never saw my father shame anyone in this process, he actively engaged them in compassionate conversation instead.
I have used many similar methods for engaging with doctors and healthcare professionals when I’ve taught and about PrEP and U=U over this past decade.  I’ve continued to practice the lesson that no one opens their minds or hearts or changes their behavior when they feel shamed or attacked.  But how do you engage people who hold medical and scientific views that oppose facts and rationality?  I’d like to propose some methods I’ve practiced on the front lines with a (mostly) fictional opponent named "Larry": 

Method #1:  Find some agreement in what the other person says: Find a kernel of truth in something your opponent expresses in order to demonstrate respect and understanding.
Larry:  Everyone should just use condoms.
Damon: For some people, condoms are a very effective and satisfying way of preventing HIV. Others who take PrEP continue to use condoms and appreciate the peace of mind that the combination gives them. At the same time, condom usage is not a preferable nor realistic option for many people.  Just like birth control, PrEP is an umbrella term that describes a "toolkit" of biomedical options to prevent HIV transmission.  

Method #2:  Use “I” statements: Preface opinions with “I” statements, “I think,” or “In my opinion.” 
Larry: It’s stupid and reckless to use a pill to prevent HIV.
Damon: I have found people who use to PrEP to be intelligent, resourceful, and quite methodical in their planning. I think using PrEP requires one to make a series of complicated decisions - from speaking to their doctors, to navigating insurance, to deciding how (or if) to come out and discuss their usage to their communities. In my opnion, these conundrums require a level of cognitive reasoning. For me, taking PrEP was well thought out, and was the most responsible and loving choice I could make for myself and for my sexual partners. 
 Method #3:  Find common ground: Build a rapport and connection with someone before tearing apart their argument. 
Larry: Using Truvada for PrEP is going to result in a proliferation of new STI infections.
Damon: I share your concerns about STI infections. I have similar concerns, myself. However, people using Truvada for PrEP are better linked to STI treatment and prevention by the virtue of the fact that they are typically being screened by their doctor three to four times a year. Most HIV negative people not on PrEP, and not using condoms, don’t go for STI testing until after they’ve developed symptoms, and by then have likely spread it to others. By getting screened and tested consistently, people on PrEP are less likely to transmit STIs.

Method #4: Use humor: When appropriate, find something humorous or ironic to say, but that is not sarcastic or demeaning to your opponent. 
Larry: You must have rocks in your head.
Damon: Oh Larry, I don’t take Truvada for the rocks in my head.

Method #5: Call out bullshit when necessary: When someone starts making claims that seem to come from outer space, call them on it without labeling or shaming. 
Larry: Half the people using Truvada for PrEP have already become HIV positive and then were resistant to Truvada.
Damon: There is simply no evidence or data to support this claim.

Method #6:  Demonstrate flexibility: You can be a powerful force for changing others when you show you are willing to change yourself.
Larry: Your message about PrEP and STIs is misleading.  You can’t deny the evidence that proves STIs have increased since PrEP was approved in 2012.
Damon:  On face value what you are saying is accurate.  Where we don’t have clear evidence is discerning correlation and causation.  People on PrEP may have higher rates of STIs because they are having more sex and getting tested more often.  There are about a dozen other variables that may be contributing as well (smart phones, new CDC testing protocols, more accessible services through Obamacare…).   Either way, I share your concern about higher rates of STIs in this community, and similarly want to find helpful strategies to bring those numbers down and help my community be healthy. 

Method #7: Demonstrate empathy: Showing that your concerns are similar to their own can disarm an opponent and open them up to more of a discussion and less of a debate. 
Larry: I don’t like people putting poisonous drugs in their body.
Damon: I hear that you’re concerned that people might get hurt themselves.  That can be scary.  I feel the same. 
Method  #8: Demonstrate authentic emotion when called for: You can demonstrate integrity by sharing an authentic emotional reaction without attacking your opponent.
Larry: All you PrEP Whores deserve to get liver damage.  
Damon: It genuinely saddens me that you would feel this way.

By using these strategies, you will increase the possibility of your opponent listening to your point of view, hearing your opinion and possibly changing their mind. It is no guarantee that the other person is going to radically shift their perception right away, but in the past nine years I've been doing this I have seen these kinds of conversations create possibility for change and growth.  Even when there is not mutual common ground or agreement on what constitutes a "fact," we still have the option to practice respect and compassion.  When we treat one another with appreciation and respect, instead of stigma and condemnation, we open the possibility for all kinds of learning, creating, and connecting.  I'm not sure this democracy is going to survive without them.  

 Damon L. Jacobs is a Licensed Marriage and Family Therapist helping individuals and couples enjoy life with peace, purpose, and pleasure. His books "Absolutely Should-less" and "Rational Relating" help people experience connection with joy, serenity, and meaning. His work has been featured on CNN Health, The New York Times, MSNBC, USA Today and more. He can be reached at or 347-227-7707

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