Don't ask Why
During class, my counseling professor (a lovely and brilliant individual) encouraged us to avoid asking the “Why Question.” For example, don’t say
Why did you do yell back?
or
Why didn’t you tell your husband about that?
My professor’s reasoning was simple and appropriate. Why often comes across as blaming or judgemental. It often conveys a (not so subtle) tone of Well, that was stupid. But, his advice felt limiting. I have used why to undersand how things happen. I’m interested in engineering. What was the antecedent, the event, and the outcome? What is the story of how this happened. The event is usually only the denouement. It’s what lies before that gives rise to the outcome and hence, the fallout. So, that one piece of advice has itched me for years. Here I am, still scratching it.
He was absolutely correct. Often, when we asak the why question, counseling sessions often come to a halt. It sounds categorically critical when the why blaming tone is used.
Alternatively, we could ask, What were you thinking when you did that? This response can also sound blaming or critical.
I thought a lot about this; maybe too much.
Our quarry as counselors is the thinking process: what was going on when you did this? What lay before, during, and after you did x? It is here that we learn about the experience of the person we’re helping. But, we aren’t (or shouldn’t be) blaming.
The focus isn’t on the use of the word why or what. It’s possible to ask both questions so we highlight the thinking (and hurting) processes.
I think the question Why is important, just as it is, and completely without judgement.
Often when patients were relating their hard experiences prior to coming to the hospital, I would ask why in the following way.
You said that you drove off after your argument, and in anger you pulled off the road into the bridge abutment. I’m going to ask a question. It might sound judgemental. But, I swear to you I don’t feel judgemental at all. In fact, I hurt for your pain and I’d like to understand more about why this particular experience hit you so hard? You said you’d been through similar situations before. This one seemed to hit you especially hard. Can you tell me more?
Moving to a personal level, I think we often say to ourselves, why did I do that? How could I have been so stupid?
As in counseling sessions, this kind of question stops the really important work, the potential of growth and understanding. We don’t need the Blaming Why. We absolutely need the Inquisitive Why. Though insight is not enough to create change, it can certainly provide a stepstool from which we can see possible actions.
Be kinder to yourself. Use the Inquisitive Why. Not the other one. In many ways, my professor was right. Thanks, Dr. Ken!
Addendum for those in corporate settings: When something goes wrong in hospitals, they have critical incident reviews. Perhaps this process began with physician meetings called Morbidity and Mortality Reviews: what went wrong and how could care have been improved?
These critical incident reviews began to take place in hospitals, engineering, and other settings. Some came to call them event post-mortems. For those involved, these committees were often painful, psychologically traumatic, and - sometimes - life-altering. All too often, there was a search for the person to blame.
For a great example of a critical incident where one person was cited as the person to blame, check out the RaDonda Vaught case. She was determined as the person to blame. This case was a perfect example of the failure to use what has been called the blameless post-mortem. While Vaught should certainly have suffered professional and, arguably, legal penalties, murder seems excessive in the extreme. But, the biggest failures, in my opinion, were systemic. There were problems with the Vanderbilt pharmacy system and with the approach of the administration, amongst others. The point here is that the process used was blame-focused not learning-focused. It’s hard to know what people lerned from the approach used by Vnderbilt and the Knoxville DA. Vaught reported her own medical error. What will nurses learn from the event? Don’t report your errors or you’ll go to jail? Don’t report your errors because the fill-in-the-blank System will hang you out to dry?
When I worked in my hospital, the President was very careful to emphasize the importance of reporting and that critical incident reviews be focused on the funcioning of the System, not on personal failures (unless there was some history or evidence of intentionally harmful conduct). She had seen first-hand the failure to report patient harms in blame-based Systems.
We can only learn from events if we feel we can safely report incidents, fully review them, and use them to change. Whenever we look for blame, we lose valuable information for meaningful change. Start by owning the truth.