• Stephen Harden

Stop Disruptive Staff from Wrecking Your Culture



With 3 Amazing Tools from the Former Chief FBI Hostage Negotiator



Disruptive physicians and staff have a knack for causing havoc with your patient safety or quality initiatives.


Their angry outbursts, demeaning behaviors, and caustic comments can derail the culture of high performance you are trying to create.


Most leaders become overwhelmed by the voices in their own head when dealing with difficult staff. Leaders and staff need proven communication tools to prevent being overwhelmed by the emotional conflict with these difficult people.


The best way to learn these communication tools is to take some lessons from the former Chief FBI Hostage Negotiator, Chris Voss, and his book, “Never Split the Difference.”  The FBI’s negotiation team’s tactics must work, because failure often means death for the hostage and the hostage taker. Their proven tactics are based on Nobel Prize-winning “behavioral economics” and neuroscience documenting how the human mind actually works. Mr. Voss described his system of handling disruptive personalities as one “that had successfully resolved almost every kidnapping we applied it to."


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1. Mirroring


It’s almost laughably simple - a “mirror” is when you repeat the last three words (or the critical one to three words) of what someone has just said. For example, a disruptive person my angrily exclaim, “this happens to me all the time and I am sick of it!” To mirror, you would respond, “All the time?”


Of the entirety of the FBI’s hostage negotiation skill set, negotiators believe that mirroring is the closest one that gets to a Jedi mind trick. It’s simple, and yet uncannily effective (when you try you’ll see what they mean). The reason it works is that it is based on a neuro-behavior that humans (and other animals) display in which we copy each other to comfort each other. It can be done with speech patterns, body language, vocabulary, tempo, and tone of voice. We fear what’s different and are drawn to what’s similar.


Lots of research has proven its effectiveness. One study showed the average tip of the waiters who mirrored the words of those they served was 70 percent more than of those waiters who used positive reinforcement.


Research has proven the effectiveness of Mirroring


After mirroring the last three words (or the critical one to three words) of what someone has just said, it is critical to use “Silence.” Don’t say anything else. Wait, at least four seconds, to let the mirror work its magic on your counterpart.


2. Labeling


Labeling is a way of validating someone’s emotion by acknowledging it. Give someone’s emotion a name and you show you identify with how that person feels. It is a timesaving emotional hack. You spot the disruptive person’s feelings, turn them into words, and then very calmly and respectfully repeat their emotions back to them by saying something like, “It seems as if this causes you a lot of anger.”


If you are worried about “poking the bear,” keep in mind the words of Mr. Voss, “Early on in my hostage negotiation career, I learned how important it was to go directly at negative dynamics in a fearless but deferential manner." Neuroscience is on your side.


"Go directly at negative dynamics"

Exposing negative thoughts to daylight—“It looks like you are frustrated and don’t want to wait to re-do the count”—lessens the effective of negative emotions. Neuroscience reveals that when you label the emotion, brain activity moves to the areas of the mind that govern rational thinking. In other words, labeling an emotion—applying rational words to a fear—disrupts its raw intensity. The research shows that the best way to deal with negativity is to observe it, without reaction and without judgment. Then consciously label each negative feeling.


When you label, you must use words like “It seems like . . . It sounds like . . . or, It looks like . . .” “It sounds like . . .” and not “I’m hearing that . . .” That’s because the word “I” gets people’s guard up. When you say “I,” it says you’re more interested in yourself than the other person, and it makes you take personal responsibility and negates the cognitive effect of labeling.


3. Open-Ended Question


The calibrated open-ended question takes the aggression out of a confrontational statement or close-ended request that might otherwise anger the disruptive team member. What makes these questions work is that they are subject to interpretation by the person with whom you are dealing.

These questions offer no target for attack like statements do. They avoid causing conflict by telling the difficult person what the problem is.

A calibrated, open-ended question always begins with, “How.” The most common version of the question is...

“How am I supposed to do that?”

Now, let’s tie all three tactics together with an example.


During a surgical procedure, the count is incorrect. The surgeon is obviously in a hurry and angry that a recount must be done. During his outburst, he heatedly says that he is going to close the incision anyway, and not wait on a successful recount.  The circulator has already made an assertive, stop-the-line statement. The surgeon has ignored the stop-the-line statement. He loudly insists he is going ahead with closing the incision because he is sure nothing has been left in the body.


Circulator: (Labeling) “It seems as if a recount causes you a lot of anger.” Silence for 4 seconds.


Surgeon:  “I am angry. I don’t know why you can’t get this right the first time. This happens to me all the time!”


Circulator: (Mirroring) “All the time?” Silence.


Surgeon: “Well not every time, but way too much. I’m tired of always waiting on you to get the count right. Let’s go ahead and close and you guys do the count afterwards.”


Circulator: (Open-ended question.) “How are we supposed to that?” Silence. Surgeon: “I know what the policy says, but I’m tired of waiting. Let’s close.”


Circulator: (Mirroring) “Close despite the policy?” Silence.


Surgeon: “Well, no. Okay. Let’s get a correct count before we close.”



These three communication tactics will calm the voices in your head, and get you over the fear of conflict with disruptive physicians and staff. They give you the tools to navigate it with empathy and preserve your culture of safety. If you’re going to have a great culture and create a high performing organization—you’re going to have to do just that.


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