[Linda]

Every day, I see how important good communication skills are. Cancer survivors need to reach out to family and friends, to doctors and other health care workers, employers and yes, insurance people, in order to get the best help they can. I work with cancer survivors and other members of the cancer survivors' health care team, like the doctors and nurses. We know that these people can feel overwhelmed and unable to communicate, so we try to ask them questions, like "Do you understand your medical condition?" Do you need special counseling?" "How is your family doing?" And, "Do you have any concerns about your job or insurance coverage?"

[Narrator]

But, there may be things that are important to you that no one thinks to ask about. You may want the health care team to know about your wishes related to your family. You may not feel comfortable with the way members of the team explain things to you. Or, you may need to tell the team if you have religious beliefs or customs that you need them to respect. Don't forget, it's the job of the health care team to help you and make you feel comfortable.

[Linda]

Sure, good communication can be a problem for most of us at any time. But, when cancer enters the picture, things can get much tougher. All of a sudden, all sorts of thoughts and questions go racing through your mind. It's hard to know what to say or ask first. Some people may find it hard to talk to doctors who seem to know so much, use big medical words, and often do not have much time to talk. On the other hand, some survivors don't want to worry a family member. Or, they may expect a family member to know what to say or do without having to be told.

[Linda]

Good communication means letting someone know clearly what you are thinking and feeling -- and finding out what the other person is thinking and feeling, too. To me, it's like a friendly game of catch. One person throws the ball so that the other person can catch it without too much trouble. Then, the second person throws it back. The purpose is to keep the ball -- the communication -- going. Nobody is expecting you to be a star. All you have to do is learn -- and use -- some basic communication skills.

[Narrator]

So, how can you make sure you are communicating effectively? In this section, we will review five basic skills that can improve your understanding of what other people are trying to say to you, and improve how well you communicate with them. Then, we'll hear these skills in action.

[Narrator]

The first skill is BEING ASSERTIVE -- saying what you need to say in ways that make it clear to others that what you have to say is important.

[Narrator]

The second skill is USING "I" MESSAGES. This means making statements with the word "I" in them, such as "I think" or "I feel", rather than making statements like "you should".

[Narrator]

The third communication skill is ACTIVE LISTENING. With this skill you listen to someone carefully, show them you are listening, and then CHECK THE MESSAGE with them to make sure that what you heard is what they actually meant.

[Narrator]

The fourth communication skill is MATCHING WHAT YOU SAY IN WORDS WITH WHAT YOU "SAY" WITHOUT WORDS. If your facial expressions or actions send a different message from your words, like smiling when you tell someone you are in pain, people may be confused and not actually realize how uncomfortable you are.

[Narrator]

The fifth communication skill is EXPRESSING YOUR FEELINGS. This means letting others know how you feel, as well as what you think.

[Narrator]

Keep in mind, good communication does not mean perfect communication. It does mean that two or more people use their skills to help each other get the story told and be understood clearly.

[Narrator]

Like the friendly game of catch Linda talked about, good communication means that one person tries to aim the message as directly as possible toward the receiver. In turn, the receiver is willing to move a little or stretch a bit if necessary to catch the message before returning it. Sometimes, one person with far better communication skills than the other has to stretch quite a bit to keep it going. And, the "ball" may be dropped now and then, but it can always be picked up and thrown again.

[Narrator]

Now, let's take a closer look at each of these five communications skills. First, what do we mean when we say BE ASSERTIVE.

[Linda]

BEING ASSERTIVE means showing that you believe that what you say is really important. When it comes to your health, there is no such thing as a silly question. I appreciate it when a cancer survivor says, "I really want to be involved in my treatment decisions" or "I didn't quite get that -- please say it again so I can understand better", because it makes my job easier.

[Narrator]

The second skill, using "I" MESSAGES.

[Linda]

Most of the issues I discuss with cancer survivors are very hard to talk about... issues so personal and important. Most people are just not used to talking about those things. The quicker you can learn to communicate clearly and directly, the better off you will be. For example, when someone starts sentences by saying "I feel" or "I think," it is very helpful to me -- I can better understand what that person is trying to tell me.

[Narrator]

The third communication skill, called ACTIVE LISTENING, involves making sure that the other person knows that you are listening carefully to what he or she said followed by a CHECK to be sure that what you heard is really what that person meant to say.

[Linda]

I use active listening everyday. As I listen to a cancer survivor, I nod, while looking directly at the person when they speak, and then repeat back what I think the person has just said. For example, I check my active listening by saying, "So, what I hear you saying is that..." then I tell the person what I heard, and ask, "Is that right?" It's easy to misunderstand when somebody else is speaking and easy to think that a listener understands you when he or she may actually have a different thought in mind than what you intended. That's why checking the message is so important.

[Narrator]

The fourth skill we need to talk about is MATCHING YOUR WORDS WITH YOUR NON-VERBAL COMMUNICATION.

[Linda]

When I listen to cancer survivors, or anybody else for that matter, I notice many ways in which they communicate without words, by facial expressions, hand gestures, posture, or other "body language." When I speak, I want to make sure my "body language" matches my words. If it doesn't, the listener won't know which message to believe. As a listener, I want to pay attention to the other persons' non-verbal communication as well as to the words. Have you ever seen someone in a conversation say something like, "That's interesting" while yawning and slumping back in their seat? You don't really know what that person is trying to say.

[Narrator]

The fifth communication skill is EXPRESSING YOUR FEELINGS, as well as your thoughts.

[Linda]

It's healthy to be aware of what you're feeling and to share that with people who can help you. I recently heard a woman cancer survivor say, "I feel angry. It just isn't fair that I got cancer when I was eating right and not smoking." Then she said, "I'm so scared, I don't know what to do." Even though I couldn't change what has happened, I can understand how this woman is feeling at this time and how it will impact her care. I can listen and offer her support for the feelings she has just expressed.

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