It’s no secret veterinarians are plagued by poor mental health, and that communication, as in talking to our fellow humans, is one of the major reasons. One study suggests it is actually the number one reason for professional dissatisfaction in vets.1 If you have been in practice for at least five minutes, you have been complained about, unfairly represented, verbally abused, and been called “greedy.” That makes about as much sense as saying diabetic cats are losing weight because they eat too much–but hey, most of the public isn’t all that scientifically literate. It gets to you–heck, it gets to me, because it gets to everybody. Here we are, buried under colossal debt, juggling impossible schedules, and battling Dr. Google, and then John Q. pet owner comes along and blames us for not doing more to save his $7,000 French bulldog puppy he left in the car in August … because “all you care about is money.” This stuff hurts. It really can eat away at your little animal-loving soul, and unfortunately, it might be getting worse. Two factors—the rise in anxiety levels in the general population,2 and the increasing emotional salience of pets in people’s lives3—mean veterinarians are going to increasingly bear the brunt of people’s disappointment. Unfortunately, mean words are part of some clients’ behavioral repertoire, and their nastiness can creep into our minds like an L3 larva and take up semi-permanent residence. However, interestingly, there is a kind of modern technology that can prevent much, if not all, of the harm resulting from these interactions. It’s called nonviolent communication (NVC). The NVC people should probably rebrand to something much sexier. SuperTalk™ might work, or maybe Imperma-Comms™, but that’s not the point. It doesn’t matter what this thing is called because it works. This simple way of thinking has the power to completely transform toxic relationships. Now, it is beyond the scope of a humble veterinary cartoonist to explain the entire philosophy of NVC in a single column. However, I’m convinced the more you use this “technology,” the more your professional enjoyment will increase—and the more your clients will appreciate and trust you. Obviously, all of this is good for the animals. The birth of NVC The backstory is that in the 1980s, psychologist Marshall Rosenberg essentially said most human language involves some sort of coercion, mostly subconscious. In other words, we are kind of mean to each other, like kids arguing on a kickball field. Nasty name-calling is our go-to response when upset. Rosenberg invented a communication system based on the concept of nonviolence. He claimed that no matter the size or intensity of the conflict (up to and including horrific physical violence), NVC could resolve it in fewer than 20 minutes if both parties agreed to use it. Even if only one party practices it, it can still be remarkably effective. Which is great, because you are the oath-bound grownup in the exam room, and it is unlikely Karen J. McBad-Yelp-Review is aware of this remarkable system. The basic premise is that we all have needs and feelings, and when our needs are not met, we get grumpy and act like jerks. However, the simple recognition that everyone has valid needs and that grownups should and can try to meet their own needs (which includes politely asking for help) means that, in theory, everyone can meet their needs without hurting each other. On the one hand, this sounds like rainbow-infused unicorn excrement. On the other hand, it is a rule recognizable in any kindergarten: use your words and ask for help. Fulfilling needs in the practice Here’s an example: if you present a reasonable dental estimate to the owner of a 12-year-old Chihuahua, and they laugh you off like you are a used-car salesman, they are using violent communication. Whether they are aware of it or not, they are trying to hurt your feelings. However, underneath that unsavory behavior is probably their own unmet need: vis-à-vis not enough dough. Now, you and I both know, you’re not recommending these treatments to fund your luxury yacht in the Bahamas. You are doing it because you are a highly trained professional who wants to help Little Miss Chomper. If your feelings get hurt and you start to believe this client does not trust you, it is easy to have a negative emotional experience. But NVC can neutralize personal insults. When I’m talking to an angry client, and they say something terrible, I might take this as disrespectful and get upset. But when I recognize that my unmet need in this instance is for respect, I suddenly realize I don’t need it to get it from them. I can practice self-respect instead. My other need in these situations is to figure out how to treat their animals, which is how I make a living. I did not wake up that morning needing people to be nice to me. I showed up at work to help animals. Their owners are necessary because I need their consent and cooperation to perform those treatments, but fighting their toxic behavior with more of my own is like infecting yourself with tapeworms to get rid of Giardia. It’s just going to lead to more crap. There’s really something genuinely beautiful here. When I tell myself I’m not a “greedy,” “incompetent,” “stupid,” and “horrible” person, their insults fall flat. Self-respect. Suddenly, I’m immune to attack, and there’s no need to be defensive. I still want to help their animal, so I still listen to what they are saying because 10 percent of the nasty verbiage might contain clinically relevant information. I wait until they are done and repeat back their concerns, to make sure I have them correct, without any judgment whatsoever in my tone. This has an absolutely remarkable effect on people; their rage fizzles and then sputters out. I take their “violent” words and let them drop harmlessly to the ground. Most of the time–seriously–this will get you an apology and a willingness to work together. It’s gorgeous, like getting a snarling cat to curl up on your lap. The hard part is getting over that hill of personal insult. The easy part is finding out what the angry client wants. They want their pet to be okay. Whether they are unrealistic medical perceptions, unattainable costs, or something else, this is usually their goal. Sometimes, it’s more complicated, like with interpersonal family struggles or the guilt of wanting to be free of caregiver burden, but those are not usually that hard to diagnose either. Just listen to them. Then decide on how you can help. This does require some careful interpretation. You do not want to make them feel attacked (or embarrassed, or blamed). It requires patience and politeness (“I'm afraid I cannot write off the entire bill and have the staff bow to you and kiss your boots, sir...”) and some level of professional competence (“Unfortunately, I don't think an ALT of 17,000 is related to the groomer’s shampoo, ma’am...”). We teach our kids to be polite, so why not aim for excellence ourselves? Unlocking the empath in you NVC is about catching just a bit of empathy for that person, which is really what’s driving their behavior. It might be a childish tantrum, but kids throw tantrums to get something they want. You can either: give them what they want and resent them for it; get angry and fight them, which makes everything worse; or stay calm and listen. After understanding them, cooperation can take place. In the case of the chuckling Chihuahua owner, their unmet need is for a magical resolution to their micro-dog’s dental disease and their poorly balanced checkbook. Since you did not create either of those problems, you should not—in a perfect world—feel responsible for their scoff. You obviously can’t change reality, but you can hear someone’s concerns and then keep working with them on attainable solutions. Reminding myself that I’m doing my best, that I’m here because I care about animals, that I’m still that little kid who wanted to help them, allows me to show up when things go terribly wrong. Sometimes, that might mean a case of critical polytrauma. Other times, it might mean enduring a tirade from someone who’s genuinely concerned about their pet but act like an intoxicated psychopath. Now, which would I rather deal with? I don’t want a patient’s femur shattered by a truck, but I also don’t want to suffer the slings and arrows of verbal abuse. The difference is, I can’t suddenly become triple boarded in ERCC, orthopedic surgery, and anesthesia. But I can develop a different way of thinking. So, I highly encourage you to consider nonviolent communication—not just as a feel-good idea, but as an actual tool to immunize yourself against abusive language, and, ultimately, to extend your ability to care for pets whose owners might otherwise sabotage that care with their own childish behavior. It’s evidence-based, too; a large scoping review found it to be effective in human healthcare, leading to better outcomes for everyone involved.4 Remarkably, all it takes is a different way of thinking to keep client moods at bay. Greg Bishop, DVM, is a small animal veterinarian and a part-time veterinary technology instructor in Portland, Ore. Dr. Bishop also creates the monthly cartoon series, “The Lighter Side.” The author’s opinions do not necessarily reflect those of Veterinary Practice News. References Stetina BU, Krouzecky C. Reviewing a decade of change for veterinarians: past, present and gaps in researching stress, coping and mental health risks. Animals. 2022 Nov 18;12(22):3199. Terlizzi EP, Zablotsky B. Symptoms of anxiety and depression among adults: United States, 2019 and 2022. Fox R, Gee NR. Changing conceptions of care: Humanization of the companion animal–human relationship. Society & animals. 2016 Mar 17;24(2):107-28. Adriani PA, Hino P, Taminato M, Okuno MF, Santos OV, Fernandes H. Non-violent communication as a technology in interpersonal relationships in health work: a scoping review. BMC health services research. 2024 Mar 6;24(1):289.
