On Monday, I attended a meeting of lawyers, doctors, community workers, government officials, people from umbrella organizations for service/support providers.  This group meets monthly to discuss and agree shared lobbying priorities in relation to mental health provisions in Illinois.  Not surprisingly, a dominant topic was the public spending cuts – very different healthcare systems between the UK and US, but we are grappling with similar issues/challenges.  Yet, what is on my mind now are the people dynamics I witnessed during this two-hour meeting. The meeting ended on a sour note, with a very long and tense exchange between a few people out of the approximately forty people in attendance. The group covered less than half of the agenda. Rather than thinking about healthcare policy, I reflect on the meeting and I am compelled to consider what makes for a constructive, time-well spent meeting?

I found out about this meeting the night before, from one of the participants whom I was scheduled to meet for the first time that day.  I came in and sat down – anticipating I would simply be an observer.  For a two hour meeting, they had eleven items on the agenda. We got through four. I later learned this happens regularly.  Reminder: keep agendas realistic, doing a few items well rather than a lot of items poorly or not at all. It is much more inspiring and motivating to go to meetings where you can experience the satisfaction of delivering on the purpose of the meeting.

The first agenda item was about whether or not to hold a public rally around spending cuts, and in particular closure of facilities. The Chair asked if anyone would volunteer to be the lead organizer. No one came forward initially, though as the discussion continued covering topics such as who might speak at it, the person next to me quietly (though within earshot of the Chair) offered himself up. The next key question was if people would go back to their organizations and use their networks to ensure attendance – a rally needs people. This question was put out to the group and ignored. People continued to talk about possible speakers and the need for a theme, and then went off in another direction on a different subject. After about twenty minutes, the Chair asked: ‘We’ve moved onto the second agenda item, but have we finished on the rally?”

I was so frustrated by the disarray I raised my hand in a request to speak. I observed what I had heard: The person next to me is willing to be lead organizer but a critical issue is getting people to the event. I suggested that they take a show of hands to see how many people were willing to commit to going back to their orgs to rally people if someone agreed to take a lead on organizing. This was done, and a date set for the Rally. Reminder: be clear on what decisions need to be made in a meeting and get decisive answers as needed. Know what must be/is best decided at the meeting and what can be decided outside.

On the next subject, a participant – via speaker phone (a great arrangement, where the speakers/microphones were built into the ceiling and the sound is extraordinary) spoke at length about critical aspects of the issue of facility closures, including the importance of having a concrete plan for patient care in the event of closures. The Chair responded by saying, I think we all agree with you.  The speaker had been responding to a formal motion for the group to send a letter to legislators (later extended to also include a briefing for the media).  For me, the exchange lacked constructive engagement. What would I have liked to see? I wanted an explanation of exactly what the Chair believed everyone was agreeing with, further to that one woman’s extensive comments – that is, in a few sentences, he could have summarized the speaker’s key points so she and others would be clear as to what he meant by saying ‘We agree’ – in order to gauge for themselves if he was fairly reflecting the group’s overall views. I also wanted a decision on how what the speaker said would impact on the motion made to write a letter – for example, did they need to change the initially proposed content of the letter, given they agreed with her comments?

It is really important to me that in meetings people feel heard and comments (particularly if they are well thought out and detailed) are not left hanging – you know, with ‘Thank you, that’s interesting or well said….next…’ In fact, I was agitated enough that I ventured – again – to speak up. I took the opportunity to repeat what I thought were the key points of what the speaker had said and asked how it impacts on the letter to legislators the group proposed to write. Reminder: it benefits a meeting to check that we are hearing each other correctly and to distill any concrete/practical implications of what we’ve heard.  

Discussion continued over the content of the letter and a media briefing (notably, with a couple of people newly beginning their sentences with ‘What I’m hearing is…’) and they agreed broad outlines. The meeting then moved slowly along with the agenda. However, it ended up being dominated in the last fifteen to twenty minutes by a back and forth exchange primarily between a small number of people, one of whom became visibly and increasingly frustrated. It got to the point where I felt I was watching someone throw a quiet tantrum; for example, when someone in a very tense voice responds with a question to ‘Fine. Do whatever you want.’ – which means, ‘Not-fine, you aren’t listening to me, you don’t care about what I’m saying, and I’m really angry.’  After later learning more about the substance to the exchange, it seems that the person who was frustrated has over the years been at odds with the others involved in the exchange – including the Chair  – which might explain why he did little to mediate the exchange and also, the extent of her frustration and anger. 

The exchange was tied to a formal motion that had been put forward to the group, though I lost track of how it all related. At one point, the woman who was frustrated kept talking at length and I wanted to know what her request was – what she was asking of the group and in particular in relation to the motion at hand. It struck me that it seemed like different people were saying their observations, and perhaps even disagreeing with each other – but little effort was being made by anyone to draw conclusions for the group on what it meant for their advocacy positioning.

When we are working on sensitive issues which we are passionate about, we can get wrapped up in our own words and in our desire/need to be seen and heard. We can also – when sparring with familiar colleagues – stop listening. We assume we already know what they are saying. After the meeting, I had the opportunity to talk to the woman who was very frustrated. I started to see that the layers to what she was saying did not come out clearly during the meeting and that some of the issues she raised went beyond the parameters of the discussion they were having at that moment.  I also got the sense she hadn’t been really listening to what people were saying in response to her comments. In fact, I sensed that in some aspects of the matter, they were not totally in disagreement.

What I did not get during the meeting was a sense that people had seen and connected with the different layers of the discussion. In fact, at some points, I think people were talking at cross-purposes because of the lack of clarity about the range of specific issues being packed into a rushed and emotionally fraught conversation. What’s more, underlying the discussion seemed to be very important differences in fundamental beliefs and assumptions – despite the fact that the people in the room were part of an advocacy alliance.

I tend to believe that when someone is repeating themselves in a meeting – as it seemed was happening, though perhaps it was also a matter of raising slightly different, but related issues – it is because they are not feeling heard. A useful response in such an instance is for someone to play back what they think is being said and why it is important to the discussion. Reminder: when people start doing the ‘I’m fine’ or ‘Whatever, I’m talking too much’ statements, it is usually a sign that they could do with some active listening. 

Actively listening not only is a tool to engage with people in a way that they feel understood and heard, but also can be used to re-frame points to help clarify content for others and it can be a bridge to managing the dialogue. That is, for example, if an exchange needs to be cut short and continued elsewhere, another participant or Chair can join up active listening with a re-routing which people are comfortable with, because they feel they’ve been heard and understood.  Reminder: People talk to be heard. If they are not sensing they are being heard, they’ll either try to keep talking or express frustration in some shape or form, often bringing a constraining energy into the room. Also, active listening can be a bridge to making connections – connections that help join up what is being said to the wider discussion in ways that assist people to consider (a) concrete ideas for action to be taken or agreements to be made and (b) identify significant points of contention that impact on consensus-building and group action.

What struck me most about this meeting is that one issue – the proposed closing of a particular facility – seems to be a recurring debate/battle with policymakers, perhaps taking place every few years. It made me wonder what this alliance could do to break the cycle. Specifically, as I type now, I’m wondering if part of their strategy should be to reform their habits of engagement. I suspect, for example, that different – perhaps more creative – policy and advocacy approaches would be generated if they had more connective and expansive ways of communicating with each other.

But I would say that, wouldn’t I?