This page has 2 core elements. First we will look at dealing with difficult people. Second, we will consider strategies for dealing with difficult situations.

By the end of this page you will be able to:

• Identify some strategies to deal with difficult people
• Understand why thinking about vulnerability may be important when considering how we relate to others or how others relate to us
• Reflect on students’ experiences of difficult situations,  apply  them to your own context and consider solutions.

Difficult people

Dealing with other people is perhaps one the most difficult and stressful situations you will have to deal with in your workplace and personal life. How you decide or experience someone as ‘difficult’ is different for everyone; but it tends to result in a negative emotional response of some kind and/or a conflict situation. This is not good in any workplace or situation, but it is double trouble when teamwork and communication is critical to the delivery of your service.

Have a look at this Ted Talk by Jay Johnson which introduces the idea of a model of behavioural intelligence to address difficult behaviour in the workplace.  He suggests 4 quadrants to help you think about behaviours and apply them to reviewing how you think about the ‘difficult person’. These are my summaries of his ideas so if you want to use them cite Clouston (2019) suggests that Johnson’s (2018) 4 quandrants…….or similar.

1. Explain existing behaviours:

   • Usually we make assumptions and label behaviours e.g. difficult; stubborn; aggressive.
   • In someone we know we may see this kind of behaviour more positively because we know the person and can contextualise it. So with the person you do not know so well, ask the question why did they behaved that way? Ask yourself what pushes them to behave that way? This might help you to understand what is motivating them to be ‘difficult’ in that moment.

2. Predict future behaviour

   • When you understand why others are behaving in the way they are you can begin to PREDICT how they might behave in future. This helps to address your uncertainty and fear about them; as such anxiety and /or stress is reduced. In essence this is helping you to feel more in control of the situation rather than feeling they (the difficult person) is controlling it…and you.

3. Influence other people’s behaviours

   • To influence behaviour be positive in your responses: use ‘we’ when talking to them so it becomes a ‘shared’ problem; so it’s not “I am having difficulty talking to you!” But rather…”I feel we have are having some difficulties understanding one another…” This approach is not so blame focused, defensive or aggressive toward the other and allows them to respond from a safe place rather than feeling threatened.
   • Give them positive feedback; this will help you to build influence and rapport.

4. Change your own behaviour

   • When you are dealing with a ‘difficult’ person remember that each of us has the potential to be perceived as ‘difficult’ by someone else……Reflect on this point and think about the implications of that. It is VERY easy to forget that behaviour is about reactions and personal perceptions, biases, fears and concerns. These influence how we interact with others; who we feel connections with and who we do not.
   • When responding to the ‘difficult’ person in-situ or when reflecting on them outside of the situation take a deep breath and try and be calm when thinking, reacting. or responding. This will help you be objective and considered in your response. Look at these breathing and mindfulness techniques here on Professor Clouston’s website to help prepare yourself. This is about managing your own stress response and helps you to feel calmer and more in control of the situation.
   • Separate the behaviour from the person; we are not always the assumptions and beliefs that others label us with; we can be so much more (adapted from Jay Johnson online here.)

Why are people ‘difficult’? Why are you sometimes ‘difficult’

There are many reasons for difficult behaviours and these can be as varied as the people themselves but my thoughts (so cite Clouston TJ 2019 this page and URL) revolve around the idea of vulnerability and fear. Listen to Brene Brown’s now famous Ted Talk on vulnerability and consider her ideas in the context of behaviour and interactions in relationships both in the work and non-work context. For me (so cite Clouston TJ 2019, this page and URL), Brown’s ideas on vulnerability, openness and connection really resonate in terms of how we might behave toward others in our interactions with them. I would suggest that any archetypical ‘difficult’ behaviours eg the bully, the ‘know it all’, the narcissist, the  passive-aggressive, the gossip, the challenger or the sniper all have the potential to be behaving this way because they fear feeling vulnerable or open to criticism or being seen as inadequate; in essence they are putting up barriers and are  protecting themselves against vulnerability. It is not your place to help them see that, or make them embrace their fears and accept their vulnerability….That is their personal journey. But what if you could explore your own fears and vulnerabilities and could come to recognise and adjust the strategies you may have adopted to protect yourself? Would this help you respond more positively to the ‘difficult’ person or persons? Just a thought and one worth really considering. This does not mean I am suggesting difficult people will still not hurt you, frighten you or bully you but you might be able to gain some ground and step away or raise concerns with dignity and professionalism.

Difficult situations

Students working in healthcare often meet situations that are personally challenging, emotive and difficult. We did focus groups with final year healthcare students. Some of the very common examples of difficult situations they identified included:

• being unable to help someone
• being required to do something that they did not agree with
• working with people with challenging behaviour
• witnessing unprofessional behaviour
• feeling that they were being unfairly judged or treated unfairly.

Developing the tools to manage these situations effectively is part of being a healthcare professional. There are a vast array of specific training programmes that include different methods and tools which are promoted as useful in specific situations. However, we felt it would be interesting to share some of the strategies that the final year students identified in the focus groups as useful in meeting and managing difficult situations in professional contexts.

1. Stepping back

This was a common approach. Stepping back referred to regaining  perspective on the situation.

• This often involved revisiting a person’s values to recognise where the tension arose from;
• recognising what a person can control and what they cannot control
• considering whether they were taking on a problem that was actually theirs or whether it was not. Professionalism requires we assume responsibility and accountability but that does not make every problem one’s own.

2. Asking for help

This occurred at two levels:

• Recognising that a specific situation resulted in a strong emotional response because an individual felt overwhelmed by a series of stressful events. In these situations it was not the specific situation that a person felt they needed help with. Often this was about asking their personal tutor, GP or student support for help. Students realized that reticence to do this was NOT effective and that they should seek support or advice.
• The second level was specific to managing the situation. This often involved talking with their practice educator, peers, lecturers that visit the area or their personal tutors. Involving the university was seen as a big step; however people who had involved academic staff reported that it was a positive experience. It is important to feel confident in speaking out and remember there is support to enable you to do so meaning that you can escalate concerns.

3. Knowing that it is OK

This referred to the fact that healthcare is a stressful place to work and situations often are difficult and challenging. Research literature consistently highlights that healthcare programmes are stressful and this is hardly surprising considering that students are preparing to work with patients who may be facing life changing events in an environment that may not be optimally resourced.

• Realising that  it is difficult, that a novice is unlikely to respond as a senior practitioner would and that ‘you are here to learn’ was often described as an important moment in being able to recognise that being overly self critical was not helpful.

4. Raising concerns

The issue of raising concerns when the behaviour of colleagues or organizational cultures were  deemed as unprofessional was a huge challenge for students. Fear and vulnerability were at the basis of this and the sense of being newly qualified or a new staff member all played a part in how students/new practitioners felt they could respond; this is about power politics and the impact of and acculturation to the accepted cultures of the workplace. The fact is that there are now professional standards that mean you HAVE to raise concerns if you want to maintain your professional registration. So what can you do? Take a look at this role play by final year occupational therapy students and read your own professional standards about raising concerns to put this technique into your own professional context. How would you raise concerns about a colleague in this situation? Can you apply the principles to a personal situation you may have experienced?

Thank you for working through this material; we hope you have enjoyed it.