I can’t tell you how unprepared I was for a patient I met recently. Last week, I evaluated a patient was dealing with neck pain. From a strictly musculoskeletal perspective, treating this patient’s neck pain seemed straightforward. But from a holistic perspective, it was far from straightforward.

During the evaluation, the patient started to talk about her complicated relationship with her husband and children, as well as her complicated views on pain and the healthcare system.

So much to unpack here.

How often have you found yourself talking to someone when they start to unload their emotions on you? When unprepared (and let’s face it, we’re rarely prepared), these situations can lead the listener to feel speechless, which in turn makes the person speaking feel unheard. A very awkward situation to be in.

What if I told you that there’s a way to respond that allows that person to feel heard? In the book Never Split the Difference, Chris Voss explains the concept of labeling: a way of validating someone’s emotion by acknowledging it. Think of it as calling out someone’s emotion and giving it a name to show that you identify with how they feel.

When Labeling is Most Useful

One of the best situations to use this tool is when the other party is tense. As it turns out, exposing negative thoughts and bringing them to light makes them seem less frightening. When someone has heightened emotions, stress hormones and neurochemicals disrupt their ability to properly evaluate and respond to their situations. Instead, a part of the brain called the amygdala tends to take over and generate fear as a reaction to any perceived threat.

However, the faster we can interrupt the amygdala’s reaction, the faster we can clear the road of perceived obstacles and generate feelings of safety, well-being, and trust. Labeling allows you to expose someone else’s emotions and show that you understand them.

How to Use Labeling to Your Advantage

As obvious as it sounds, the first step involves detecting the other person’s emotional state. However, our intuition may be guiding us astray. While our intuition tells us to pay attention to every aspect of our interaction – their facial expressions, their body language, their use of words, and their tone of voice – there is evidence that solely paying attention to someone’s tone of voice provides the most accurate representation of their emotion.

My take on this? Pay attention to all of it: their facial expressions, body language, words, and tone. Take all of it as it is: information. No reaction, no judgement. 

More importantly, pay attention to any changes in any of these aspects people undergo when they respond to external events. Use those changes as a guide for your labeling. Did they roll their eyes when you asked them how often they exercise? Maybe they don’t have a positive attitude toward it. Did they answer with a wavering tone? Perhaps they’re unsure or even anxious about things.

Once you’ve got a good handle on their emotion, label it out loud. I prefer to label emotions with statements that start with “it sounds like,” “it seems like,” or “it looks like,” which creates a neutral statement of understanding and calls them to respond. And more often than not, their response allows you to navigate your way safely out of any negative aspect of your conversation. 

But… What if I’m Wrong?

No one’s perfect. I don’t expect you to accurately label everyone’s emotions every single time. But what makes labeling great is that if you’re wrong, they will likely correct you and tell you how they truly feel. Either way, it’s a win-win: you more fully understand who you’re talking to and they feel heard.

The Last Step is CRUCIAL

What is the most important step in this process? Silence. The beauty of labels is that they invite the other party to reveal themselves. They feel encouraged to let their guard down and open up. So, give them time to respond because their response will reveal more than you expect.

As with all assessment and communication tools, using calibrated questions requires practice. At first, it’ll feel awkward. But soon you’ll find that you will get valuable information about your patient that will help guide your treatment plan and help create a therapeutic alliance to successfully rehabilitate your patient.

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