Navigating difficult conversations with ease – by creating psychological safety

This post was originally published on October 4 2019. It is being republished  as a 2019 popular post, over the holiday season.

This article discusses a really important skill that healthcare managers need – to be truly successful in getting the best from their team, and creating a high performance culture.

We are looking at how we approach handling issues and challenges in the team. How we get them interacting well and being productive. How we give feedback for optimal performance and how we handle sensitive issues.

What are the issues that you would like to fix with your team?

Are there some difficult conversations that you need to have? Some conflicts to resolve, performance issues to address?

The life of a healthcare manager is loaded with team challenges such as this; it’s fairly common in the stressful world of healthcare.

Too often I have seen team issues cause ongoing stress and dysfunction, yet with no action taken. There are various reasons for the issues not being addressed. Often the avoidance comes down to uncertainty about how best to discuss challenges with the staff involved. This is especially true if it is a sensitive matter, or the individual is emotive.

I’ve also seen the issues handled, yet with not great results. Where an often well intentioned manager will give feedback or instructions and the people on the end of this communication react emotionally – be that becoming sad, angry, or defensive. It’s in some cases because the manager has not delivered the information in a way that allows people to process it openly and non-emotionally. They might use words or phrases that upset, or miss showing the support or empathy that someone might need. Unfortunately, when strong emotions are triggered, it’s rare that the situation resolves quickly and constructively.

There are processes and planners to help have these discussions. These help us think about HOW we have difficult conversations. Yet before we dive in there, it might be worth checking out a very important concept first. A concept that makes sure the HOW is done well, and that the message is more likely to be received. And acted on. This concept is one a lot of people are talking about at the moment – psychological safety.

Today we will explore what this actually is, why it’s important, and how it impacts a team’s culture. (Disclaimer* I am not a psychologist and refer to this concept from an employee development perspective).

It starts with the brain.

The first thing to explore is the brain. What is the brain ultimately designed to do? It’s designed to keep us safe. It does this by scanning the environment constantly for things that could help or harm us. Much of this scanning, we are not even aware of – what could be called ‘non conscious’. The brain is amazing!

When scanning the environment, the brain can determine within a 5th of a second whether something in that environment is a threat. If it determines that a threat does exist, then it is able to signal the body to start a cascade of events that ultimately leads to what most people know as fight or flight – when the body instinctively prepares to defend itself or run away. One additional mode that’s not as often talked about is freeze – where the body stops motion to avoid detection or interaction.

Now this super fast detection of threat has been useful throughout human evolution – enabling us to run from wild animals and fight battles in self defence. The problem we have in the modern world, and in interacting at work, is that many things are considered a threat by the brain, triggering these instinctive responses, when maybe more logical thought might be required.

Because we respond via instinctive processes to generate fast actions, our logical brain is not always involved. Yet the instinct to fight, flee or freeze may not actually be what’s required when the threat is not life threatening. The threat might be a new team member – until we know people, our brains are wary and consider them a threat until proven otherwise. It might be a change to processes – change is considered a threat because we have to use brain energy to think more about what we are doing – we can’t rely on the autopilot, energy-conserving of habits and routine. The threat might be uncertainty or insecurity that comes with change. It might be when people feel that they don’t have a choice.

All of these things can be challenging to deal with, yet they are generally not life threateningly serious. However, if we react on instinct to these things, this is when we see behaviour that might not be in proportion to the real threat. So someone gets angry and is negative about the change, resisting and arguing against it. They feel aggrieved, stressed and worried. They act out and catastrophise.

When our emotional brain centres take the lead, it takes resources away from our thinking, decision-making and logical brain. It can take control. So then we don’t have the resources to hear information, process messages and act rationally.

As managers, this is an issue if we want to deal with team or individual challenges or give someone feedback. Because they may respond emotionally if they feel under threat. And that will never lead to successful change or new behaviours.

If, on the other hand, we as managers can create an environment where people o not feel under threat when having difficult conversations, then we provide the space for logical, less emotional thinking.

When they give their brain a chance to think logically, they might not see the situation as being so bad, they might not get overwhelmed and angry. If they gave their logical brain centres a chance to kick in, then maybe the emotion could reduce and they could find solutions, overcome challenges and change negative perspectives into positives.

So while the ’emotional brain’ is working to keep us safe in life and the workplace, we need to find ways to bring our logical thinking parts of the brain into play. And help our teams do the same.

Logical thinking can reduce threat levels.

Because really, if we think logically we can realise that a new team member might be a future friend, or a team asset.

That change is not always all bad and can indeed be a good thing.

And that uncertainty is normally temporary and we may have a chance to influence outcomes.

That the feedback we are receiving might be hard to hear, yet is designed to help us improve.

How can managers help?

So how do we as managers help our team members to respond less emotionally and more logically to the challenges they face, and also to help us create an environment in which we can deal with issues and give feedback, no matter how challenging – in a way that minimises the threat that others feel?

We focus on creating an environment geared toward psychological safety. I would describe this as a state in which threat is minimised by creating an environment in which difficult subjects can be raised without triggering a disruptive emotional response; where challenges and grievances can be aired in a constructive, vs destructive fashion; where someone can be given the space to hear and process information to allow for positive action.

Creating psychological safety is important because it enables us to more effectively have change initiatives acted on, to give feedback that is heard and actioned, and to enable the best environment for positive team interactions and collaboration.

Team culture impacts…

Psychological safety can be a positive force for team culture. Where it exists, team members can be honest without fear of judgement or retribution, and they learn to communicate more effectively. It essentially means that we communicate in a way that minimises any threat response, and maximises positive action.

A big part of creating psychological safety comes down to our communication. In human interactions, there are a few things that can trigger a threat response beyond physical danger. Things like uncertainty and change, lack of choice, a sense of unfair, lack of trust, impacts on esteem and other factors including life circumstances causing vulnerability.

So when we communicate as managers, we need to find a way to give brains what they seek.

They seek Choice, Assurance, Respect and Empathy.


Humans love choice. So when we deliver challenging information or feedback, or introduce a compulsory change, we need to be able to provide a sense of choice for others. Even if a situation means something MUST be changed, for example, there still is the opportunity of choice and we need to point this out or explore this with our teams. To help reduce the negative emotion that can be associated with change, and to allow logical thinking and ownership of the change.


People want to feel that there is some certainty or plan for the future. They want to feel supported and that resources will be available to them if needed. We need to help them see that there is a plan, or that we are there for them. With situations of change, Help them understand exactly what is changing, and what is not changing. In giving challenging feedback help them see what the clear facts are, rather than be overwhelmed by unclear and general messages. Assurance comes largely from clear and precise communication.


We demonstrate our team can trust us by being honest. Being honest demonstrates the respect we have for our team members. So we give honest feedback in a way that is non judgmental and using language that aims to help, not threaten others. Respect in this instance also means that we value someone’s strengths, efforts and experience.


We aim to see another’s perspective, to put ourselves in their shoes so that we hear them when they express concern, we understand them when they discuss challenges, and we support them when they are looking for opportunities. Rather than make snap judgements about people and why they do something or how they interact, we will have a better mindset for discussions if we try to remember that there may be other ways of looking at a situation.

An important point to note here is that empathy does not mean we avoid discussing someone’s behaviour or performance – it just means that we show kindness and understanding in how we discuss it.


If we address all of these elements in our communications, we make discussing challenging situations that much easier.

Do you make it safe to have difficult conversations or to interact effectively in your team? Are you encouraging a culture of treating people with empathy and respect?

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