By Alan Koenigsberg, M.D.

Last time I wrote about listening, a way we learn about what others think, believe and can teach us. The old saw about having two ears and one mouth because we need to listen twice as much as we talk may be a valid one.

However, speaking articulately and clearly is not a natural process for many of us. Every day I hear people muttering, holding their hands in front of their mouths, not speaking loud enough, saying “like,” “you know,” “umm” and so on. They apologize for their opinions. They avoid taking a clear stand on something that is important.

We have slowly become a group of people who hem and haw, prevaricate, mumble and avoid being forthright, more often than not because we haven’t taken the time to think through what we want to say. We don’t want to appear rude or too aggressive.

We don’t have a clear understanding of our own beliefs, convictions, ideologies or even what flavor ice cream we want. Choosing a place to go to dinner — “I’m fine with whatever…” can indeed be fine, or an attempt to not figure out what we actually want.

I have been working with patients for decades, so I learned early on how crucial it is to be clear with my patients. Sometimes, our medical vocabulary can be more of an obstacle to understanding than helpful. I have learned how to explain complex concepts in ordinary words. It may take time, but it’s worth it.

I have learned how to convey being reasonably confident in my ability to diagnose and provide appropriate treatment, so that my patients develop trust in my skills. If I were to hem and haw, mutter, say “This medication is kinda good, you know, maybe it will help you,” that doesn’t usually go over too well.

One needn’t be a physician with patients in order to benefit from clear speech. How many spousal frustrations develop because of less than ideal listening skills, combined with lack of confidence in asking for something?

What I am suggesting is that we all take time to think through what we believe in, why, what we want, from the trivial, such as ice cream flavors, to the more meaningful, such as what we want our of our relationships.

I am not suggesting arrogance, nor bullying. I am suggesting clarity.

Let’s work to avoid building up to the point, softening our wants and desires. Let’s be confident in asking for what we want.

While asking for what we want can be a stretch, many people also have serious difficulty in saying “No.”

Knowing when and how to say no is also a learned skill. Far too many people agree to something, and then regret agreeing. We don’t need to explain why we are declining an invitation. It can be to a party, a date or to volunteer on a board. A polite, “Thank you for thinking of me, but no thank you” is a perfectly sufficient reply.

Take time to examine your beliefs, what you want, what you don’t want; and learn to clearly express those interests. Ask clearly for what you want to the people who are most likely to be able to provide what you need.

Avoid apologizing, building up to the point and waffling. Just ask.

When asked a question, do consider the person asking and what their motivations are. If it is appropriate to answer, be direct and clear.

If they don’t like the answer, you have learned something and that may change how you answer them in the future. 

One of the most valuable lessons I learned a long time ago is that when people learn who I really am, what I believe in and what I want, it helps clarify whom I can be friends with. Many people are uncomfortable with some of my beliefs, and some are fine with them. By being reasonably open and honest, people learn to trust me, knowing I am being truthful.

Go forth and speak with conviction!

Alan Koenigsberg, M.D., is a practicing psychiatrist and clinical professor of psychiatry at UTSW Medical School in Dallas.

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