Parenting is hardly all sunshine and rainbows. And neither is the world we all live in. Which is why, stressful as it may be, it’s important to talk to kids about difficult topics in age-appropriate ways—and probably earlier than you think.
To help wade through the discomfort of addressing everything from death to climate change to sex, we turned to Emily Barth Isler, the author of AfterMath, a middle grade novel about navigating grief; one that Amy Schumer has called “a gift to the culture.”
While the parents in AfterMath shy away from these conversations, Isler, a mom of two, takes a different approach, drawing influence from the famous Fred Rogers quote: “When I was a boy and I would see scary things in the news, my mother would say to me, ‘Look for the helpers. You will always find people who are helping.’”
Here, she walks us through tackling some of the tougher conversations with a similar approach: Find ways to draw kids in, activate their empathy, and encourage them to get involved.
Emily Barth Isler: “Let’s be clear, I hate that this article is so necessary, but I do appreciate that it features really clear, age-specific ways to start conversations with kids about school shootings. As someone who wrote a book that deals with this topic, I often hear from people who think it’s inappropriate to talk about these things with kids. But let’s be clear:
What’s inappropriate for kids is gun violence—gun violence in schools, churches, synagogues, grocery stores—all places they deserve to feel safe. When I wrote AfterMath, I hoped that it would soon be shelved in the Historical Fiction section of the library; I’m devastated that it continues to land squarely in current events. And will, until lawmakers do what’s necessary to make the violence stop.”
Emily Barth Isler : “The first step towards getting comfortable talking to kids about hard things is to get comfortable with those things yourself. Historically, American culture has often favored the “let’s pretend that’s not a thing” mentality when it comes to death and other tough stuff. I’d like to present another angle.
What if we dive in? What if we get vulnerable and honest with ourselves, and find a way to make some peace with things like the inevitability of death? I love how artists confront mortality, and the genius TV writer/creator Mike Schur does such a great job of doing so in the most hilarious, moving, brilliant way with his show, The Good Place.”
Emily Barth Isler : “Kids have excellent bullsh*t detectors. They tend to know when we’re lying—or even just withholding truth—and it can damage their trust in us. I’m not saying that you have to include all the details you would give a 30 year old when talking to a 10 year old, but if honesty is the foundation, you’re in good shape.
I appreciate this article because it gives parents very clear step-by-step instructions to get through the tough parts, it helps to be able to lean on that structure.”
Emily Barth Isler : “The survivors of tragedies do not owe us their stories or wisdom. But sometimes, something horrible will bring our attention to a bright light in the world, someone who is knowledgeable, compassionate, and brilliant. Nelba Marquez-Greene, my favorite Twitter follow, is one of these lights. She is such a vulnerable, honest voice, and I—an adult!—have found so much comfort in her faith and resilience.
She’s a therapist, but also lost her daughter, Ana Grace, in the Sandy Hook school shooting in 2012, so I find that she’s able to give multiple perspectives on life, death, and grief. Her TEDx talk has advice directed at teachers and teachers-in-training, but I think it translates very well to parents, too.”
Emily Barth Isler lives in Los Angeles, California, with her husband and their two kids. A former child actress, she performed all over the world in theatre, film, and TV. In addition to books, Emily writes about sustainable, eco-friendly beauty and skincare, and has also written web sitcoms, parenting columns, and personal essays. She has a B.A. in Film Studies from Wesleyan University, and really, really loves television. Her debut novel, AfterMath, is out now; learn more at emilybarthisler.com.
At this point, it’s not novel to point out that we’re socialized from childhood to prize monogamous relationships above all else. It’s an idea deeply embedded in our culture, from books to films to music. But we seldom pause to consider the real extent to which this is baked into the very fabric of our society.
It’s not just a cultural thing: it’s why one-bed flats are usually designed to accommodate two, with rent prices intended to be divided in half. It’s why seats on buses and trains come in pairs. It’s why packs of food so often ‘serve two’. It’s why gyms and Spotify offer discounted memberships for couples.
There are numerous material benefits to monogamy, such as the Married Couple’s Allowance, the option to take out a joint mortgage on a house, or the fact landlords are more likely to choose couples as tenants. As author and psychotherapist Sasha Roseneil writes in the Guardian, compulsory monogamy “operates through laws and policies that assume and privilege coupledom, with myriad economic impacts in terms of access to welfare benefits, pensions, inheritance and housing.”
Aaron, 21, has experienced this firsthand. “I used to live with my girlfriend, but we split up and she moved out which has made paying bills really stressful and hard for me,” he says, noting “food and subscriptions like Netflix and Spotify” as particularly costly expenses. “The cost of living crisis has made this even more difficult – especially with food shopping.”
Essentially, society isn’t built for single people, and as a result it’s expensive to be single. Research backs this up: according to Ocean Finance, the UK’s singles spend on average £630 more per month than their coupled counterparts. On top of this, a 2019 report from the Office for National Statistics (ONS) found that people living alone are more likely to be renting and feel less financially secure than childless couples.
The cost of being single has now been compounded by rising inflation and the ongoing cost of living crisis. Of course, the current crisis is impacting everyone – regardless of whether they’re in a relationship or not – and it’s unquestionably hitting the poor the hardest. But as an estimated 35 per cent of the UK’s population are single, this is an issue which affects millions of people.
24-year-old Sophie is in a similar situation to Aaron. She lists “rent, food, and bills” as the main costs she struggles to cover. “If you’re single you get a council tax discount, but it’s really not a lot at all. My council tax is still over £100 a month,” she says. “But the one thing that’s impacted me the most is my rent went up by quite a lot in April. It went up by over £100.”
She adds that she has to fork out nearly £400 a month to pay her building’s service charge. “Whether it’s one person in a flat or four people, you still have to pay the same service charge for building maintenance and stuff like that,” she says. “And I’m just one person.” According to Ocean Finance, housing is the most expensive outgoing for single people, with a single person paying an average of £674 a month on rent while a person in a couple pays £433.
“I have a full-time job and spend most of my free time doing freelance work just to make up the money,” Sophie adds.
The current cost of living crisis is even forcing some people to stay in relationships they’re unhappy in. “I’ve been with my partner for around two years and lived with him for just over a year. It’s been fairly up and down, as we realised around a year ago that it’s more platonic. We’re not really any more than friends, and that’s mutual,” Holly*, 26, tells me.
At present, Holly is living in a two-bed flat with her partner and a mutual friend of theirs. “I recently moved to a new job that has halved my previous salary, and it means that if he leaves the room I share with him then I can no longer afford the room,” she says. “The extra costs would be terrible. Bristol is incredibly expensive and my salary isn’t up to scratch. Splitting up would mean splitting everything in half would no longer be an option.”
“The couple norm continues to exert a strong and far from benign influence on people’s lives” – Sasha Roseneil
In her Guardian article, Roseneil stresses that “the couple norm continues to exert a strong and far from benign influence on people’s lives.” This much is clear from Aaron, Sophie, and Holly’s testimonies: evidently, despite the progress made by feminist and LGBTQ+ movements in recent years, we’re still penalised by society for living outside the couple norm.
Still – it’s worth noting that despite the financial benefits of being in a couple, Holly admits that it’s not worth the emotional strain when your relationship is on its last legs. “I’ve realised this isn’t healthy for either of us. It’s quite clear it’s getting to the end of the relationship,” she says. “I spoke to him about it last night, so the process of moving out is likely just around the corner.”
However, this doesn’t negate the fact that being single is still a financial burden. Although Holly is keen to move on from her relationship, she’s still not sure how she’s going to afford to pay her rent. Obviously, monogamous couples are not a social ill in and of themselves. But the ways in which compulsory monogamy is perpetuated in society evidently are a problem, and a problem which is being exacerbated by the ongoing cost of living crisis.
Unfortunately, regulating rents or increasing taxes are actions beyond the power of most individuals – but that doesn’t mean we can’t challenge compulsory monogamy in our everyday lives. There’s so much to be gained by shelving the concept of ‘soulmates’ and nurturing other types of connection in our lives – whether you’re in a relationship or not. Ultimately, it’s only by chipping away at the status quo can we hope for a future where we’re all financially stable and independent.
It’s called “other-oriented perfectionism,” and it can have a negative effect on children. Here’s why it happens.
Joliene Trujillo-Fuenning, who lives in Denver, Colorado with her two kids, ages 3 and 22 months, has some pretty clear perfectionist tendencies. If she sends an email with a typo in it, she says, “It will drive me nuts for a solid week or two.” After her husband cleans the bathroom, she has to fight the urge to criticize. (Sometimes she’ll just clean it again.)
And when it comes to her 3-year-old’s education, Trujillo-Fuenning says, “I have been very much struggling with the fact that she doesn’t want to write letters,” and finds herself thinking, “You are supposed to be at this point by three and a half or four, and if you don’t do it, you’re never going to.”
What Trujillo-Fuenning struggles with is something called other-oriented perfectionism. (You may have seen a shorter piece I wrote about the phenomenon for the Atlantic back in July.) Other-oriented perfectionism bears similarity to self-oriented perfectionism, when a person puts tremendous pressure on themselves to be perfect and then self-flagellates when they can’t be.
It’s also a little bit like socially prescribed perfectionism, where one internalizes the need to be perfect thanks to perceived pressure from others. The big difference is that with other-oriented perfectionism, unrealistic expectations are directed at, well, others.
When a parent sets exacting standards for their child and assumes a critical attitude, it can change how they parent (to their child’s detriment) and leave the parent bitter, resentful, and sometimes even wishing they’d never had children. That’s particularly problematic in light of new research suggesting that both parental expectations and parental criticism have been on the rise.
The impulse behind child-oriented perfectionism comes mostly from early life experiences and societal forces outside individuals’ control, but understanding — and interventions — can help thwart it, improving the wellbeing of both parent and child.
Natalie Dattilo, Ph.D., a psychologist at Brigham & Women’s Hospital and instructor of psychiatry at Harvard Medical School, has a patient roster made up mostly of young doctors, some of whom are the targets of other-oriented perfectionists who are “looking around and wondering why everybody [they] work with is incompetent.” For a supervisor like that, she said, “There is going to be an over-reliance on control, especially wanting to control how people do things.”
The other-oriented perfectionist seems self-assured. They always know the best way to do things and everything would be splendid if only others weren’t so flawed.
“On the surface it looks like grandiosity,” said Thomas Curran, Ph.D., an assistant professor of psychology at London School of Economics and Political Science, “but at root, it’s really a profound insecurity about place in the world and whether you’re worth something.” The other-oriented perfectionist’s judgment, he said, is actually just “my way of projecting the things that I dislike in myself onto other people.”
People become other-oriented perfectionists in a variety of ways discussed in the book “Perfectionism: A Relational Approach to Conceptualization, Assessment, and Treatment.” Oftentimes a cocktail of other types of perfectionism is to blame. Trujillo-Fuenning worries about her daughter’s progress because she wants the best for her, but there’s something more than that.
“I had a friend who pointed out that her language, her enunciation, her knowledge is pretty advanced for her age,” she explained, “And immediately, I had this sense of like, ‘Ha!’ It had nothing to do with me! Yet you still have a part of your brain that’s like, ‘She speaks well. That means I did my job right.
If she reads early, I did my job right.'” The pressure Trujillo-Fuenning feels to be perfect requires being — and being perceived as — a perfect parent. “How you’re doing as a parent is a reflection of who you are,” she said, “There’s no separation there in my head.”
In a paper published in 2020, Konrad Piotrowski, Ph.D., an assistant professor of psychology at SWPS University in Poland, reported that both mothers and fathers there “tend to accept to a greater extent the mistakes and ‘imperfection’ of their children than those of their partner.” But sometimes they don’t.
John Lockner’s experience supports that idea. He was a stay-at-home dad for years and told me, “I kind of still am,” since he works part-time and spends the rest of it with his two teenage sons. “It’s definitely a struggle not to be on them all the time,” he said, but he knows that’s more about him than them. “I never wanted to be a manager, because I know I would expect my employees to do their best, and it would be very hard for me when they don’t,” he told me.
As one of just a handful of dads involved at their old school, Lockner said, “I felt this pressure to be better, and because of that my kids needed to be better.” With up-to-the-minute access to their assignments and grades through an online portal, he’d issue reminders on the drive to school: “You have to be sure to check on that and make sure it was turned in” or “You’re going to ask for that extra credit, right?” And he’d grill them on test results as soon as they got into the car at pickup.
But now, he said, “I’m kind of working on myself, to let some of that go.” What seems to be the key determinant is which relationship—the romantic one or the parental one—is more strongly associated with the parent’s self-esteem. Those who hang their identity on their parental role, like Trujillo-Fuenning, are more likely to experience child-oriented perfectionism than those who do not, Piotrowski theorized.
The impact of other-oriented perfectionism on children
That’s likely a good thing for his kids. Curran, the British perfectionism researcher, looked at a questionnaire that’s been given to cohorts of young people for decades. He and his team found that current college students perceive that their parents were more expectant than past generations — which is problematic, because studies (old and new) tie a caregiver having performance-oriented goals to controlling, critical parenting.
Though the research is murky, because different forms of perfectionism both overlap and function in distinct ways, children of parents who are perfectionists likely have higher odds of developing psychological distress, including anxiety and depression. Even when the impact falls short of clinical classification, children whose parents expect them to be perfect often grow up in homes characterized by conflict and tension. “It’s going to be a pressure cooker,” Curran told me.
The end result is often another generation of perfectionists. A 2017 study of 159 father-daughter dyads found a tie between “controlling fathers who demand perfection” and perfectionist daughters. And Curran’s own research has found that as parents’ expectations and criticism have increased, so too have rates of adolescent perfectionism.
We make jokes about perfectionism. (Did you hear the one about the perfectionist who walked into a bar? Apparently, it wasn’t set high enough.) But it’s a truly stressful way to live, Dr. Dattilo said, “Always striving to prove that you are capable, to prove that you are worthy, prove that you are successful based on other people’s evaluations.”
It should come as no surprise then, that there are, in Curran’s words, “huge, uncharacteristically strong correlations” between perfectionism and psychological distress, including anxiety, depression, suicidal ideation, and anorexia.
“The data’s never that clean,” he told me. Gayani DeSilva knows what it feels like to be one of those data points. “My parents really did put a lot of pressure on me as a kid to be perfect,” recalled the child and adolescent psychiatrist who practices in Southern California. “I had to have straight As, couldn’t have an A-minus.”
When she carried a D in Calculus at one point, “I was so afraid that I actually thought that my parents were going to kill me.” Now looking back with a therapist’s eye, she said, “I couldn’t imagine them actually physically harming me, I just knew that I was gonna die.”
She internalized their exacting standards, “There was just no room for anything other than what they expected.” And when she couldn’t meet them, she said, “I faced all this guilt, like, ‘Why couldn’t I do it?'”
Josh McKivigan, a behavioral health therapist based in Pittsburgh, Pennsylvania, sees an impact at both ends of the economic spectrum. For kids of highly educated, well-off parents, he said, “You’d see them well put together, amazing grades, but behind the scenes, they’re barely holding it together. The only type of school they feel is acceptable is an Ivy League. They say things like, ‘I couldn’t imagine going to UCLA.'”
McKivigan also works with a refugee population. With these kids, he sees pressure to make something of a parent’s dangerous immigration journey. They end up saying, “I gotta make this right. I can’t let them down,” McKivigan told me.
But some kids don’t develop perfectionism of their own, instead responding to a parent’s pressure by rejecting their goals. After all, if someone is impossible to please, why bother trying?Nicole Coomber, Ph.D., an assistant dean at the University of Maryland’s Robert H. Smith School of Business, said research on motivation explains why.
“Autonomy is an important piece of this where you have to actually buy into whatever the goal is,” she notes. Requiring that a child practice piano for hours each day when they’d rather be playing soccer “can really backfire,” she added. Kids can end up feeling like their parent’s project or product — and push back by quitting. No matter how much bravado accompanies that move, there’s often also a sense of having let themselves and their parents down.
DeSilva failed her first year of medical school, she said, “because I just didn’t know how to ask for help.” After a car accident, she quit residency and then spent two years in therapy: “Once I was able to admit, ‘I’m not perfect,’ I was successful at pretty much everything I wanted to do, and I didn’t have to be anxious about it. I knew I could do it, whereas before, when I had to be perfect, I was really insecure.”
After she worked through her perfectionism, she said, “I was trying for my own standard, my own goals, my own desires, instead of somebody else’s standard for me.”
Other-oriented perfectionism is bad for parents too, but they can change
Child-oriented perfectionist tendencies aren’t just bad for kids. Trujillo-Fuenning started to feel burned out by her high standards in the parenting realm. The cumulative effect of a thousand little maximizations, like “trying to make sure they were eating the right things every meal,” became overwhelming and depleting. “To be honest, that’s part of why I went back to work,” she told me.
In his 2020 study, Piotrowski found that parents who target their children with other-oriented perfectionism tend to display higher levels of stress, dissatisfaction with parenthood, and feeling so burdened by the parental role that they regret parenthood entirely. He explained, “For mothers characterized by increased other-oriented perfectionism, family life is probably associated with many frustrations and stress, hence the focus on alternative visions of themselves that seem to be better than [being] a parent.”
When she starts trying to work on literacy again, Trujillo-Fuenning said, “I have to pull back and remind myself, if she’s fighting you, just let it go.” The same thing goes for micromanaging her kids’ appearance. “I’m catching my own insecurities of like, ‘You don’t look well put together. People are going to look at you and think I’m not taking care of you.'” But to avoid acting on those impulses requires “a constant mental check,” she told me.
Every now and then Lockner’s wife would say, “You’re being too hard on them. You are expecting too much.” But that doesn’t seem to be what made him change. His sons are at an all-boys school now, and, Lockner said, “Being around other groups of dads made a difference. Listening to how they act, and how their kids are, made me think, ‘Maybe I can ease up a little. My kids really are pretty good.'”
This sort of shift is what Curran sees happening in society as a whole—only in reverse.Other-oriented perfectionist parents aren’t the only ones ratcheting up expectations and pressure. Some parents don’t want to push, Curran said, “but they feel like they have to in this world where elite college is harder to access, where you basically have an economy where the middle class is downwardly mobile with increasing costs of living and stagnated income, and you’ve got chronic and increasing inequality.”
And the pressure can be even more intense for parents like Eric L. Heard, author of “Reflections of an Anxious African American Dad.” He described feeling “the need for immediate feedback” from his son’s teachers: “I always held a fear that I would not address some problem and he would head down a well-worn road of destruction” for Black men, he wrote. “My mind was haunted by the crippling thought of how I would be judged …. I would wear a permanent brand … a large white D for being a deadbeat dad who couldn’t save his son.”
If you’re a parent ruminating on the odds stacked against your child, it is rational to drive them to work harder, achieve more, and be better. Other parents react the same way, the result of which is a frenzied, fearful “rug rat race.” Once that starts to kick in, Curran said, “it’s really hard to stop, at a societal level. It creates an echo chamber where everybody’s engaging in unhealthy behaviors and no one wins.”
He doesn’t just mean that we all lose when we succumb to perfectionism. It also just plain doesn’t work. “Everybody’s engaging in this frantic upward comparison, and no one gains an advantage,” he said. “We just move the average of what’s expected further and further. It’s looking bad.”
But individuals can push back against a trend of overwhelmed young people and parents who, like the old Lockner, feel no choice but to be “the bad guy.” Now that he’s backed off, he said, “It’s easier on me. It’s easier on them.” They do more for themselves, and “they seem more willing to do stuff if I’m not on them all the time.” Truth be told, he likes himself more now.
Therapists can help their clients get there. Dr. Dattilo would tell an other-oriented perfectionist they need to believe it when someone says, “I’m doing the best I can.” Parents can interrogate their perfectionism in psychotherapy: Why is having a perfect child so important to me? Where did this need come from? And cognitive-behavioral therapists push people to fact-check their anxiety: What level of pressure is really necessary to prepare your child to live a good life? Is parental pressure truly the most effective way to forestall your fears? What will happen if you just back off?
When it came to parenting her son, DeSilva, the perfectionist-turned-psychiatrist, said she made a conscious decision. “I was going to raise him to have his own ideas and his own set of standards and really, for me to learn about and help him develop his strengths. And also, to really be comfortable with his weaknesses and vulnerabilities.” That puts her at odds with her own parents. When it comes to her son’s homework, they think, “It’s your job.
You have to make sure his homework is done,” she said. His grandparents even tell her to fix it for him “so it’s correct.” Instead, she explained to her son the consequences of not doing homework, or not doing it well, and let him decide. “He didn’t like it that his teacher was upset with him. So the next time he did his homework, he did it as best he could.”
Tying it all together
Yet individual parents can’t reverse course alone. Putting aside economic inequality for a minute, Curran said, “I think if the pressures of things like standardized testing — for young people to perform perfectly in school at such a young age — could be recalibrated downwards” it would take pressure off parents too. He called online grade portals “even scarier.”
If kids were just allowed to learn, to be, without all the tracking, assessing, and ranking, maybe more parents would feel like they can afford to break — and encourage their kids to break — the link between one’s accomplishments and one’s worth.
A couple of years ago, I started to talk to strangers. That’s not to say I hadn’t talked to strangers before that, because I had. I’m the son and brother of highly social small-business owners, and I’m a journalist, so talking to strangers has been both a way of life and a livelihood for me. And yet, a few years ago I noticed I wasn’t doing it much anymore — if at all. Between balancing a demanding job and a really demanding small child, I was often tired, distracted, and overscheduled. The prospect of striking up conversations with random strangers in coffee shops, or bars, or on the bus started to feel daunting. Eventually, I just stopped doing it.
This was a coping strategy, of course. I was overwhelmed, so something had to go. And talking to strangers can, as it turns out, be taxing. Psychologists have found that just making small talk with a stranger can be cognitively demanding, tiring, and even stressful. That makes sense. You don’t know the person, you don’t know where the conversation is going, so you must pay closer attention than you would if you were talking to someone you know well. But psychologists have found that talking to a stranger actually boosts your mental performance — for that same reason: It’s a workout. I was saving myself a bit of effort, but I also noticed that my life was becoming less interesting, less surprising, maybe even a little lonely.
After my epiphany, I got to wondering: Why don’t we talk to strangers more, what happens when we do, and how can we get better at it? It turns out, many researchers are asking the same questions. I started flying around the world to meet them: psychologists, evolutionary scientists, historians, urban planners, entrepreneurs, sociologists, and — you guessed it — a ton of fascinating strangers I met along the way. They all taught me that talking to strangers can not only be fun but also enhance our sense of well-being, make us smarter, expand our social and professional networks, and even help us overcome some of our most intractable social problems. (I detail this all in my new book, The Power of Strangers: The Benefits of Connecting in a Suspicious World.)
And as I researched the book, I kept coming back to the implications talking to strangers could have for entrepreneurs. Because I come from a family of small-business owners — and for a while served as executive editor at this magazine — I have seen firsthand how beneficial it is for businesspeople to hone those social skills. I have also spoken to a lot of college professors who lament that their students struggle to make the sorts of serendipitous social connections that will serve them so well once they start their careers. And, like all of us, I’m coming out of a year spent in relative quarantine. I’m rusty on these skills and need to get used to the sorts of fun, fruitful, and, yes, sometimes difficult freewheeling social interactions we were deprived of for more than a year.
All of which is to say, I decided that I needed to become an expert at talking to strangers. How? I signed up for a class unlike anything I’d ever taken before and bought a plane ticket to London.
Our journey begins on a bright day in a small classroom at Regent’s University. I’m sitting on a chair, limp with jet lag, clutching my third cup of coffee. There are four other people there, too. They appear to be functioning at a higher level than I am, thankfully. We have come to this classroom to learn how to talk to strangers.
Our teacher is an energetic 20-something named Georgie Nightingall. She’s the founder of Trigger Conversations, an acclaimed London-based “human connection organization” that hosts social events and immersive workshops aimed at helping people have meaningful interactions with strangers. Since she founded it in 2016, Nightingall has done more than 100 events and many training sessions — with strangers, companies, communities, universities, and conferences, both in London and around the world.
Nightingall has learned that, for a lot of people, the hardest thing about talking to strangers is initiating the conversation: approaching someone, making them feel safe, and quickly conveying the idea that you don’t have an agenda, that you’re just being friendly or curious. She found that older people are much more likely to initiate a conversation, for instance, whereas younger people require a little more assurance. But she also found that in all her own attempts to speak to strangers, the vast majority of those interactions were substantial, and many went great.
She came to believe, too — and this is important — that making a practice of talking to strangers could offer more than a jolt of good feeling for an individual. There was joy in it, profundity, real communion. If practiced widely enough, she believed it could help repair a fracturing society. “We’re not just talking about a few individualized things,” she says. “We’re talking about a different way to live.”
Nightingall stands before our class, bright, engaging, and articulate, and walks us through what to expect over the coming days. She wants to take us “from unconscious incompetence to conscious incompetence, and from conscious competence to unconscious competence,” she says. In other words, we are currently bad at this and we’re unaware of why or how. We will learn what we are lacking. We will improve on it. And we will, hopefully, become so proficient that it will become second nature to us.
Our first lesson is small talk. A lot of people hate small talk, which is understandable, because a lot of small talk is deadly boring. Nightingall concedes the point. Yes, she says, small talk can be dull. But that’s because most people don’t understand what it’s for. It’s not the conversation. It’s the opener for a better conversation. It’s a way to get comfortable with one another and cast around for something you want to talk about. That, she says, is why it’s important to be aware of your response when someone asks something like “What do you do?” You are failing to understand what that question is really asking, which is this: “What should you and I talk about?”
Nightingall came to this insight via a couple of sources. She had done improve comedy in the past, and in improve, you start a sketch with something familiar to everyone in the audience — something relevant, timely, or present in the room — to bind the room together. Only then can you really take the audience on a ride. That’s small talk. But Nightingall has also followed the work of social anthropologist Kate Fox, who has studied, for instance, the seemingly inexhaustible English desire to discuss weather. While some critics have pointed to this affinity as evidence of a listless and unimaginative people, Fox argued that weather wasn’t the point. Instead, it is a means of social bonding, a greeting ritual. “English weather-speak is a form of code, evolved to help us overcome our natural reserve and actually talk to each other,” Fox writes. The content is not the point — familiarity, connection, and reassurance are. Once those are in place, a real conversation can happen.
When you recognize that small talk is just a door to a better conversation, Nightingall says, then it can be useful, because it’s structured in a way that naturally leads you toward common ground. We have all experienced how these conversations, if given the time, can move in ever-tightening circles until you both zero in on something you have in common and want to talk about. With that in place, you can wander, get a little personal, go deeper. But it’s probably on you to take it there, Nightingall says. “Everyone is interesting, but it’s not up to them to show you — it’s up to you to discover it.”
The best way to discover that interesting stuff, Nightingall says, is by “breaking the script.” That means using the techniques of small talk, but resisting the temptation to go on autopilot. For example, you go into a store and say, “How are you doing?” and the clerk says, “Fine; how are you?” and the conversation contains no information and goes nowhere. That’s a script. We use scripts to make interactions more efficient, particularly in busy, dense, fast-moving places like big cities. But in doing so, we deny ourselves the chance at a better experience and maybe a new contact, and we wall ourselves off from all the benefits that can come from talking to strangers.
So how do you break those scripts? With specificity and surprise, Nightingall says. For example, when someone says, “How are you?” she doesn’t say, “Fine.” Instead, she says, “I’d say I’m a 7.5 out of 10.” She briefly explains why she’s a 7.5, asks them how they’re doing, and then just waits. This is when mirroring kicks in; it’s a phenomenon where people naturally follow the lead of their conversational partners. If you say something generic, they will say something generic. If you say something specific, they are likely to as well. Thus, because Nightingall gave a number, her partner is likely to give a number themselves. If they say they’re a 6, Nightingall will ask, “What’ll it take to get you to an 8?” This specificity creates a light atmosphere and makes it harder for the other person to maintain the belief that you’re of a lesser mind, because it instantly demonstrates complexity, feeling, and humor: humanity, in other words. “Straightaway, they’re like, ‘Oh, you’re a human,’ ” Nightingall says. “You have that bond, and then, naturally, things open up.”
Here are other ways Nightingall suggests breaking a script. When a shop clerk asks, “Can I help you?” you can reply, “Can I help you?” Or instead of asking people at a party what they do, ask them what they’d like to do more of, or what they don’t do. Or instead of asking someone how their day went, ask, “Has your day lived up to your expectations?” All these things require a certain measure of confidence to pull off, Nightingall says. But they work. And when they do, they will reveal a little nugget of what it’s like to be that person. That is meaningful, because that nugget is indicative of what is beneath the surface. “How you do anything is how you do everything,” Nightingall says. That nugget tells you where to go next in the conversation.
Once you’ve established a little connection, what do you do? I normally start asking questions. Which makes sense: I’m showing an interest in the other person, and I demonstrate my interest by indulging my curiosity. But one paradox about talking to a stranger, Nightingall explains, is that while curiosity is indispensable, a barrage of questions out of the gate can feel like prying, or an interview. They don’t quite know where you’re coming from yet, and they don’t know if you have some kind of agenda. Even one personal question asked too early can create an uncomfortable dynamic because you’re asking something of someone. You’re making a demand.
Nightingall suggests that statements, not questions, can be a better way to open a conversation. A question compels an answer, whereas a statement leaves it up to the other person to decide whether they want to talk. It’s not a demand; it’s an offer. You notice something about your shared surroundings, offer an observation, and leave it to the other party to respond. If they do, you respond with another statement that builds on what they said.
These observations should ideally not be moronic — “I noticed that the sun came up today!” — but they can be simple. Like weather talk in England, the point is to indicate a shared experience. Nightingall has found that proximity helps, too. If you are at a museum, walking right up to someone looking at a painting and blurting out “What do you think?” is very different from making an observation about a painting after standing next to them for 30 seconds looking at it. That’s because you have been in their proximity. They have adjusted to your being there, and you have demonstrated a measure of self-control. Then you can speak. It feels less like an invasion.
One day in class, my fellow students and I pair off to practice our technique. I’m partnered with “Paula,” who tells me that one of her favorite things is making a cup of good coffee for herself on the weekends and just sitting alone. I try to remember Nightingall’s advice about opening with statements, not questions, but now we’re in a groove — so I dig in. After four questions, Paula is talking about how resentful she is at having to work for other people. I’m obviously quite pleased with myself as I trot back to Nightingall with this pheasant in my mouth. But she is less impressed. She delicately explains that while “it’s clear you’re a person who asks questions for a living,” everything about my body language suggested I was looking for something to pounce on. I asked questions too quickly, she said. I was leaning forward. This wasn’t a conversation; it was an interview. Possibly an interrogation.
Nightingall suggested asking simpler and more open-ended questions. Instead of saying, “Do you think this was because you were a control freak?” just echo, or say, “Why do you think that is?” That is the opposite of what I usually do, but it’s what I must learn to do. In a good conversation, you must relinquish control. Your job is to help your partner arrive at their own conclusion and surprise you, not to ferret out whatever it is, slap a bow on it, and go, Next! There’s a powerful lesson there: If you’re interested only in things you know you’re interested in, you will never be surprised. You’ll never learn anything new, or gain a fresh perspective, or make a new friend or contact. The key to talking to strangers, it turns out, is letting go, letting them lead. Then the world opens itself to you.
Why don’t we talk to strangers? The answer I heard, over and over again from experts, is simply that we don’t talk to strangers. In many places, for many reasons, it has become a social norm, and social norms are really powerful. That is why Nightingall uses what she calls a foolproof method to not just violate the norm — but to openly acknowledge that you are violating the norm.
She asks us to imagine riding mass transit — which, as we know, is the last place anyone ever talks to a stranger. There is someone who strikes us as interesting. We can’t turn to that person and say, “Why do I find you so interesting?” because if you said something like that to a stranger on the subway, they’re going to assume this is the initiation of a chain of events that will ultimately conclude with their becoming crude homemade taxidermy. So Nightingall suggests something called a pre-frame. It’s an idea based in the field of neurolinguistic programming, which coaches people to “reframe” the possible negative thoughts of others — in essence redefining their expectations for the interaction to come. Ordinarily, we might be wary if a stranger just starts talking to us. We don’t know who they are, or what they want, or whether they’re right in the head. What a pre-frame does is reassure them that you know all this.
To do it, you acknowledge out of the gate that this is a violation of a social norm. You say something like “Look, I know we’re not supposed to talk to people on the subway, but…” This demonstrates that you’re in full possession of your faculties. You’re not erratic, disturbed, or otherwise off in some way. It helps alleviate wariness and opens the possibility of a connection. Once that is established, Nightingall says, you follow the pre-frame with your statement — “I really like your sunglasses,” for instance. Then you follow that with a justification: “I just lost mine and I’ve been looking for a new pair.” The justification eases the person’s suspicion that you have some kind of agenda and allows you to talk a little more openly.
That’s when questions become more important, Nightingall says. Questions serve a multitude of functions, which is why, as I learned in my exercise with Paula, they can be so complicated. Yes, questions help you obtain information. And yes, on a deeper level, they help your conversational partner clarify the point they are trying to make. But they also help us emotionally bond with other people. In a series of studies in 2017, psychologist Karen Huang and her colleagues discovered that “people who ask more questions, particularly follow-up questions, are better liked by their conversation partners.” Those who ask more questions, the authors found, are perceived as higher in responsiveness — which is defined as “listening, understanding, validation, and care.” In other words, people like us because we are interested in them.
And yet, the researchers noted, people tend not to ask a lot of questions. Why? Several reasons. “First,” Huang writes, “people may not think to ask questions at all…because people are egocentric — focused on expressing their own thoughts, feelings, and beliefs with little or no interest in hearing what another person has to say. Or they may be so distracted by other aspects of the conversation that they do not realize that asking a question is an option.” Even if a question does pop into someone’s head, they may not ask it, because they worry it’ll land badly and be “perceived as rude, inappropriate, intrusive, or incompetent.” In these cases, people will probably just talk about themselves, which studies show they do twice as often as they talk about other matters — which, ironically, makes people like them less. (Good work, everybody.)
But what’s a good question to ask? Nightingall has us complete an exercise in which we are given banal statements — the sort commonly offered in small talk—and tasked with coming up with good questions. For instance, one student says she ran along the Thames yesterday. There is almost nothing in the world less interesting to me than running, and usually I’d take this as my cue to begin plotting my escape. But, working from the idea that small talk is the means, not the end, the class brainstorms good questions to ask that might lead to something more personal or interesting: “Do you run every day?” “Is that a passion for you?” “What would you do if you couldn’t run every day?” I suggest, “What are you running from?” which is meant as a joke, but the class seems to go for it.
Then we move on to the flip side of question-asking: It is listening. When people do start talking, you must listen, make eye contact, and generally show you’re engaged. We know this, of course. But we are not always good at showing it. Two effective techniques to signal engagement are paraphrasing what people have just said — “It seems like you’re saying…” — and echoing — which is simply occasionally repeating things your partner just said—both of which are commonly used by therapists and hostage negotiators to foster connection and build trust. For instance, if they say, “I guess at that point I was frustrated,” you say, “You were frustrated.” This seems deeply weird and unnatural, and feels awkward to do, and if you overdo it, your partner is going to think something’s wrong with you. But I am here to attest that, done well, it is extremely effective. It’s like a magic trick. Researchers have concluded as much. According to the French psychologists Nicolas Guéguen and Angélique Martin, “Research has shown that mimicry…leads to greater liking of the mimicker” and helps create rapport during a social interaction.
Nightingall breaks down listening into three levels. There is listening for things you know about. That’s the most superficial level. That’s when someone says something about baseball and you jump on it and start talking about baseball. Then there is listening for information — you show curiosity about someone but your questions are about collecting factual data. That’s also more about you and your interests. And then there’s the deepest level of listening: listening for experiences, feelings, motivations, and values. That kind of listening is more than simply hearing, or self-affirmation. It’s paying attention and endeavoring to understand. It is demonstrated with eye contact, echoing, and paraphrasing, and it can be deepened by asking clarifying questions — Why? How? Who? — that help the person get to the heart of the matter.
In other words, at this level of listening, you are not simply listening for something you want to talk about, or offering advice, or trying to think of something smart to say in response. It’s not about your agenda. It is a level of engagement that is about helping your partner get to what they really want to talk about, and you going along for the ride. You still want to talk about yourself a bit, Nightingall says — to give a little, and not leave the person feeling like you’ve just rummaged around in the bureau of their personal life and made off with a watch. But you want most of the focus to be on them. It is, again, a form of hospitality. You are hosting someone. You are surrendering a measure of control. You are giving them space. You are taking a risk. That risk opens you to the potential rewards of talking to a stranger.
During lunch and after class, I try out some of these techniques around London. I ask a 20-something bartender at a pub if the day has met her expectations, and she confesses with very little prompting that yes, it has. She’s about to quit her day job. She feels she’s been sold a bill of goods about the merits of a straight corporate career, and she’s going to empty her savings and travel the world. She hasn’t told anyone this yet, she says. But she will soon.
At lunch at a Lebanese takeout restaurant, I ask the owner what menu items he’s most proud of — because that’s what I want. He starts taking bits of this and that and dropping them into my bag. I tell him I grew up in a white neighborhood, and when I was a kid, a Lebanese family moved in behind us and used to hand us plates over the fence of what was at that time very exotic food. Since then, Lebanese food has always been among my favorites. Curiously, when I eat it, I think about home. This, as Nightingall instructed, was me opening up the conversation with a statement, not a question. The owner tells me that in Lebanon, that kind of hospitality is a big deal; people always make a lot of food for visitors. While he talks, he keeps dropping more food into my bag. When he’s done, the bag weighs about five pounds and he charges me for maybe a third of it.
At the end of the final day of class, Nightingall tells us that practice will be everything. Some encounters will go poorly, she says, and some will be great, but in time, we will get more comfortable with doing this as we internalize the techniques we have learned. We will be able to get a little bolder or more playful. Our confidence, tone, and body language will alleviate people’s wariness at the flagrant violation of a social norm of long standing.
Indeed, Nightingall is something of a wizard at this. She once started a conversation with a man on the tube just by pointing at his hat, smiling, and saying, simply, “Hat.” She will randomly high-five people in the street, she says. She smiles at people going the opposite direction down an escalator just to see if they’ll smile back. She doesn’t order an Americano; she orders “the best Americano in the world.” And people respond. During a break one day, I walked into the campus Starbucks to get more coffee. Nightingall was already in there, talking animatedly with a barista she’d never met before. When she and I walked out, she told me he gave her the coffee on the house.
Nightingall’s free coffee, my Lebanese meal — these were not coincidences. As I learned repeatedly while testing techniques of talking to strangers, I’d often be rewarded with free food. There are, of course, far more fruitful, meaningful, and valuable reasons to talk to strangers. But the food stuck with me. Then I realized why: When you start a good conversation with a stranger, it’s like you’re giving them an uncommon gift. And more often than not, they want to give you something in return.
In these times of post-pandemic financial uncertainty, additional return on investment for medical providers is more welcome than ever. Patient financing — which for the purposes of this article means partnering with an external lender to provide service and procedure payments — can produce not just steady income for a practice, but help ensure that patients won’t have to put off procedures or, worse yet, abandon them altogether.
For example, Toronto Plastic Surgeons provides this facility to its patients through Medicard Patient Financing. There are also veterinary financing services for pets available through Medicard Patient Financing. What are some reasons practitioners might have employed in deciding upon this option?
No More Delays
There are, unfortunately, economic disparities when it comes to accessing healthcare services. Too often, the high-income and privileged have more access to healthcare resources than the medium- and low-income populations. Patient financing can help in reducing this imbalance, because the simple and daunting truth is that many medical problems don’t come announced, and it’s often impossible to plan for their associated expenses. With financing, patients don’t need to wait to get their accounts in order before opting for procedures — the result is, ideally, prompt and less stressful treatment.
Since clients can often better manage their expenses via patient financing, they tend to be more satisfied on the whole. In part this is because they are not stressed and burdened with sudden financial decisions associated with urgent medical procedures. Better yet, they are more likely to stay loyal to a practice if they don’t have to worry as much. Compared to other practices that don’t offer this option, they are more likely to choose the former, which can mean increased business through word of mouth.
Reduced Collection Costs
When you partner with a patient financer, you receive payments on time. It also means that your team won’t spend needless hours and energy trying to collect payments.
Steady Cash Flow and Less Bad Debt
In setting up a conventional payment plan for a patient, your team is taking the responsibility of keeping tabs on payments and collecting them on time. It’s essentially extending a loan to a patient, typically without any interest. However, expenses like bills, payroll and lease/rent go on as usual. This can lead to money tied up in accounts receivable, which will easily and quickly impact a budget. But when you opt for association with a patient financing company, the latter bears the cost of collections, including giving you the option of getting payment upfront.
Association with a financing company with its own marketing arm can help promote a business — making your clinic stand out in comparison to competitors.
Which to Choose?
When it comes to financing models, three predominate. In the first, Self-Funding, you as the healthcare provider are responsible for receivables. From creating a payment schedule to collecting funds to following up with the patient, your team carries out all the tasks. In the Recourse Lending model, you work with a patient financier/lender, which will approve a patient’s loan after the business/practice passes qualifying criteria.
If the patient doesn’t pay, the lending/financing company will recover the losses from you. Among the drawbacks here is that the practice will have to bear the losses and lender’s fees. Lastly, there is the Non-Recourse Lending model. Similar to the second, you work with a lending company. Key differences are that it is the patient who has to pass the underwriting criteria (if the lender doesn’t approve the patient, no funding is provided by them), and that losses are borne by the lender. One disadvantage of this method is that the lenders charge interest from patients; when rates are high, patients might not be interested. Also, patients with a weak credit history might be rejected during the underwriting evaluation.
By : Chris Porteous / Entrepreneur Leadership Network Contributor – High Performance Growth Marketer
Publicly funded healthcare is a form of health care financing designed to meet the cost of all or most healthcare needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population contributing to the fund or receiving benefits from it.
The fund may be a not-for-profit trust that pays out for healthcare according to common rules established by the members or by some other democratic form. In some countries, the fund is controlled directly by the government or by an agency of the government for the benefit of the entire population. That distinguishes it from other forms of private medical insurance, the rights of access to which are subject to contractual obligations between an insured person (or their sponsor) and an insurance company, which seeks to make a profit by managing the flow of funds between funders and providers of health care services.
When taxation is the primary means of financing health care and sometimes with compulsory insurance, all eligible people receive the same level of cover regardless of their financial circumstances or risk factors.
Most developed countries have partially or fully publicly funded health systems. Most western industrial countries have a system of social insurance based on the principle of social solidarity that covers eligible people from bearing the direct burden of most health care expenditure, funded by taxation during their working life.
Among countries with significant public funding of healthcare there are many different approaches to the funding and provision of medical services. Systems may be funded from general government revenues (as in Canada, United Kingdom, Brazil and India) or through a government social security system (as in Australia, France, Belgium, Japan and Germany) with a separate budget and hypothecated taxes or contributions.
The proportion of the cost of care covered also differs: in Canada, all hospital care is paid for by the government, while in Japan, patients must pay 10 to 30% of the cost of a hospital stay. Services provided by public systems vary. For example, the Belgian government pays the bulk of the fees for dental and eye care, while the Australian government covers eye care but not dental care.
Publicly funded medicine may be administered and provided by the government, as in the Nordic countries, Portugal, Spain, and Italy; in some systems, though, medicine is publicly funded but most hospital providers are private entities, as in Canada. The organization providing public health insurance is not necessarily a public administration, and its budget may be isolated from the main state budget. Some systems do not provide universal healthcare or restrict coverage to public health facilities. Some countries, such as Germany, have multiple public insurance organizations linked by a common legal framework. Some, such as the Netherlands and Switzerland, allow private for-profit insurers to participate.
Woolhandler S, Himmelstein DU (August 1999). “When money is the mission—the high costs of investor-owned care”. N. Engl. J. Med. 341 (6): 444–6. doi:10.1056/NEJM199908053410611. PMID10432332.
Be Honest and Concrete: Tips for Talking to Kids About Death Cory TurnerAnya Kamenetz NPR
