Crafting Transformational Feedback Series, Part 1: The Role of Self-Reflection

10 min read with practical, structured advice included

By Aaron Tabacco, PhD, RN

“The only reason we don't open our hearts and minds to other people is that they trigger confusion in us that we don't feel brave enough or sane enough to deal with. To the degree that we look clearly and compassionately at ourselves, we feel confident and fearless about looking into someone else's eyes.” - Pema Chodron

Many years ago, I changed careers for the first time. At thirty-years-old and with small children at home, working while going to school was paramount. As I attended my local community college taking pre-requisite courses for nursing, I decided to become trained as a phlebotomist so that I could get a job that was relevant to my future work and also had better hourly pay. In short order, I completed my courses and clinical work and was hired on at my busy, local hospital. Of course, I was a novice in the skill and the role so my first several weeks on the job were challenging. 

One of the biggest challenges was just wanting to be good at the task. The better my skill level, the more likely I was to prevent pain and harm with what was an inherently uncomfortable procedure. Not to mention I’d come from a career where I was highly competent at my role, and my novice state was causing me feelings of distress. 

But I had a breakthrough about a month into my work. I was called one morning to obtain some blood specimens from someone considered by the staff to be “difficult” for a number of reasons. A former IV drug user, this person’s veins had all but disappeared from years of needle use. Additionally, her frequent health problems and exposure to the same staff led to a certain disenchantment across the board. “Good luck”, came the chiding remarks of my colleagues as I went to her hospital room. I felt overwhelmed by my feelings. I couldn’t get out of my own brain. It seemed that the best way through this all was to be as fast and efficient as possible. I donned my clinical “emotional armor” and eventually knocked on her door. 

Greeting her with kindness and warmth was genuine and easy. It’s just one-part my own nature and one-part authentic curiosity. I reminded myself that while everyone seemed to say this patient was going to be a certain way with me, the truth is, I had never met her. So I set aside my biases and went in. 

She was withdrawn; sullen. I explained the reason for my visit at which she held out her right arm to me and rolled her eyes. “Good luck. No one ever gets anything. They just poke me over and over and leave. I don’t know why they do this. It’s a waste of time and just hurts. Of course, people like me don’t feel pain anyway, do we? Us junkies.”

I was struck by her words and even more so by the emotion behind them. It seemed to me that behind her “attitude” was profound suffering. This realization only added a new element to my stress about helping her: the altruistic desire to be a source of healing - to be different than the others she’d experienced. To “see” her for who she really was and show her that I accepted her. After all, it was her journey and not mine. I had plenty of my own life lessons and sources of suffering. But hers was hers and mine was mine. My suffering might give me a window of some emotional insight to hers, but ultimately, her difficulties were not mine to live. I could be with her but I didn’t have to suffer for her. 

At that moment, I realized something that should have been obvious, but was really just more profound. Yes, I would have to put a needle into her body, triggering pain and a host of images that flashed back to a traumatic past life of hers. But, it would not hurt me. I guess in some strange way, I’d been feeling like every needle puncture I performed had some kind of potential to cause me pain or trigger my own memories of it. The realization that her life journey was the same as the needle procedure really hit home. It doesn’t hurt me. 

I’ve told this story often over the years to my first semester nursing students. Not as a way to instruct them to be callous and to turn away from the pain of others.  But rather, to help them learn the freedom that comes from the realization that no matter what they are doing in therapeutic service to others, “it is not about you.” What I learned from my moments of reflection-in-action that day many years ago, was that I had been making my interactions inadvertently about my needs: my fears, my worries, my insecurities. Through deep reflection about myself, I was able to set aside those needs, be much more fully present with those I served, and free myself to make actual skillful progress in my work as my attention and focus on the people and task became my primary intention.

The very first lesson in this six-week series is dedicated to this most important foundation for being able to craft and deliver Transformational Feedback. It’s not about you. It is not about your journey. It is not about your success or your failure. It is not about your own struggles and it is not a means to the outcome of you feeling better in your life or situation. It is, however, about setting yourself aside in the service of others; others who need your insight and understanding about the work in order to have the best opportunity you can give them for growth in the workplace. It is my belief after thirty years in the workplace, that this is the most ethical, humane, and even financially responsible approach as humans working together.

So, how do you do that? How do you set yourself aside in such a way as to be present and meet the needs of those you are serving by taking this first step of reflection? Here is some of the best advice I can give on the kind of reflective questions to ask yourself before taking the actions of feedback:

1. How soon can I give this feedback?I advocate for the giving of feedback as close to the situation of observation as possible. Start first by committing to minimizing the time from the identification of the need for some kind of “corrective” feedback to the time of its creation and delivery. Ask yourself, “what are my feelings when I think about calling this person for a meeting in 24 hours?” Scan your body and locate discomforts relating to these thoughts. Does your stomach feel as though it is dropping or in knots? Does your heartrate shoot up? Do you feel excited and invigorated? If you find yourself experiencing relatively strong emotions of any kind, it will be very important to lean in deeper. In terms of timeline, the two biggest issues here that result in problems down the road are the likelihood of delaying the giving of feedback in a timely way, or of jumping too soon, giving feedback that is fueled by your own emotions, dissatisfactions, experiences, or agenda.
2. Why do I feel the way I do about this person and situation? The answers could be incredibly varied, but the until you know how you feel about this person and the feedback they need to be given, you will not be able to set yourself aside. If you recognize that the intended recipient of feedback is one you resent, have been injured or are angered by, it makes sense that you may have a difficult time with objectivity, and you will need to figure out how to set your own emotions aside. If you find that you are feeling sadly, fearfully, or pityingly, you may have a difficult time with clarity and specificity. And of course, if you find yourself realizing that you feel the way you do because you feel “powerful” engaging in this feedback task, then you definitely need to check your ego at the door. I’d suggest a good dose of Cy Wakeman’s work.
3. What is my frame for this person and situation?I believe that three frames provide the strongest footings for the process of crafting feedback that has the power to transform. First is the frame of wonder or curiosity. Are you considering this person and the performance of their work from a place of knowing or uncertainty? Self-reflection will help you identify where you stand. If you feel you know everything you think you need to know, the feedback will likely be imprecise or even completely ill-informed. As a nurse, I learned that the surest way for things to go wrong with a critically ill person was to assume I knew what was going on and put an intervention in place based on that supposition. I am sure that as you read this, you can think of several times in your life where you or another were totally misunderstood because of the assumptions of others. I will be addressing some specific strategies for this in the weeks ahead. But for now, the important reflective work is to be found in looking inward and noticing if you are asking questions about the person and the situation, or if you are making statements. Curiosity, obviously, sounds like uncertainty. And that is an optimal place from which to work. Second, is the frame of learning. What happens to my thinking in the context of this person and feedback, if I step back and frame this person as a learner? Framing things from the perspective of learning inherently makes us question. Do they have the right knowledge or skill? Are there barriers that are getting in the way of the learning? Is the support adequate? What are my own experiences with learning, especially at times where I was failing at something?When we look inward at ourselves and others as learners, we open the door for compassion and grace to enter the room. If feedback were considered a practice of learning rather than a process of documentation driven by worries about poor performance, it would take on new characteristics and meaning. These characteristics would tend to be naturally more objective, compassionate, clear, and concise. Seeing the feedback recipient as a learner also leads naturally to the third frame: Assuming good will. Assuming good will is much easier to do if you have done the reflective work to set aside your own feelings and experiences related to the person and situation. By asking, "What assumptions have I made about intention?" and then listing those out, you will begin to see where your thoughts and feelings have projected a certain negative quality into the mix. For some reason, human beings are fantastic at assuming that everything causing distress or dysfunction in a situation is some kind of direct, intentional practice. “He’s just such a self-centered, arrogant snob - he doesn’t listen to anyone's needs but his”, or “she clearly doesn’t want to see me succeed which is why she always gives my team our data requests at the last minute”, are good examples of the kinds of assumptions that someone we are working with is just out to get us in one way or another. Assuming goodwill from the beginning combats these problems by reinforcing the need for wonder and curiosity about things, while helping us to look more critically at the thoughts and emotions of our own pre-feedback encounters.
4. What is my own history receiving and giving feedback? This final reflective question is incredibly helpful to you as it will help you uncover a number of potentially hidden thoughts and feelings that can either get in the way of crafting transformational feedback, or effectively facilitate it. No matter who it is we need to address with feedback, our own past experiences are likely some of the greatest determinants of how we will craft the experience for others. Reflect on past experiences to see if you can uncover your own wisdom for practice. Can you remember a time where you had a terrible experience? How did it feel and what made it so uncomfortable and ineffective? How about a time where the feedback was useful and effective as well as comfortable and kind? How is my past similar and different than the present situation? Are there ways I you can re-create that positive experience in this current situation as the giver of feedback and eliminate those negative ones? How do my past experiences result in my own emotions about it all, and how am I going to set all that aside? 

Self-reflection is the beginning of wise, effective, compassionate practice in the crafting of Transformational Feedback. In order to offer our full presence, most objective and accurate communications, and assist those we serve, we must first find ourselves in the situation in order to set ourselves aside. To do that, we look inward and ask meaningful questions. But these questions are only a beginning. Next week, I am going to focus on how we can work with what we discover through our intentional practice of reflection prior to crafting and giving feedback. Our reflections will help us identify a number of thoughts and feelings that we can tackle to shift our focus from ourselves to our colleagues with more objectivity and clarity. Stay tuned for Part 2: Differentiating Between Observations, Interpretations, & Judgments!

Looking for EXPERT advice on going deeper into reflection and setting yourself aside? I recommend the following books and authors:

Start Where You Are: A Guide to Compassionate Living by Pema Ch?dr?n

NO EGO: How Leaders Can Cut the Cost of Workplace Drama, End Entitlement and Drive Big Results by Cy Wakeman

The Art of Communicating by Thich Nhat Hanh