How to Prepare for Scary and Important Conversations

A few years ago, one of my eyes started getting a bit blurry. Reassured by an optician, I sat with it for another few months, until a growing knowing that something was wrong took me to the hospital eye clinic.

Sitting in a consulting room, waiting for a doctor, I was completely unconcerned. I didn’t realise it then, but I was operating under the assumption that health problems were for other people. The doctor came in and cured me of that notion - the lens in my right eye was dislocating.

Just so you know, it’s not supposed to do that.

They asked me if I’d experienced a trauma to my eye. No, I said. Strange, they said. A consultant will see you in a few months.

Naturally, I went home and turned to Doctor Google. Dr G confirmed that my eye lens should not be dislocating by itself (er… no shit). Dr G introduced me to a world of genetic disorders that can cause eye lenses to spontaneously make a break for freedom, and as I read lists of symptoms, I recognised seemingly unconnected health issues I’d had in my childhood. Scoliosis - check. Crowded jaw - check. Hypermobility - check. Terrible eyesight - check. Dr G told me perhaps, maybe, I had something called Marfan Syndrome.

A few months later, I saw my Consultant. Actually, I saw a Fellow first. Lots of complicated measurements and images were taken, my eyes thoroughly examined, and it was agreed that my right lens was buggered but the left was ok. Then the Consultant came in. He looked through the ophthalmoscope at my left eye, banged hard on the table a few times (technology is a wonderful thing 🤣), and pronounced that my left lens was also dislocating.

To (mis)quote Oscar Wilde, to lose one eye lens may be regarded as a misfortune; to lose both looks like a genetic abnormality.

Since then, I’ve had many conversations with various health professionals about genetics. Some say I almost certainly have Marfans. Some say I don’t. Some say I might have something like it. Some say I might never know what I have. (Apparently, genetics is quite complicated. Who knew? 🤣)

Why does it matter to me? Because genetic abnormalities that cause eye dislocation can also cause life-threatening heart problems, among other things, and can be passed on to your children.

That May, a geneticist took a blood sample and told me I’d hear back in a year (yes, you read that right). He told me that, while I might get a clear diagnosis, it’s more likely I’d get a Variant of Uncertain Significance (I dunno - after spending half of the year blind and having three eye surgeries, it felt pretty significant to me…), meaning I’d have an abnormality that doesn’t fit neatly under any named syndrome. I might even discover other, completely unconnected genetic issues, which would be… good to know about? Bad to know about? Is ignorance bliss? Or is knowledge power?

On the day I received my genetic test results, I had a 30-minute appointment to absorb and understand what they meant. It was my one chance to ask questions - at a moment when I needed to be mentally sharp while emotionally stressed.

This is a tall order. Research shows that when you’re stressed, your cognitive function declines. You find it harder to pay attention, respond well, think flexibly, remember, and plan.

So how can you resource yourself for scary and important conversations?

Whether it’s an appointment about your (or a loved one’s) health, a job interview, a potentially negative performance appraisal, a disciplinary meeting, a serious conversation with your child’s headteacher, an ominous “we need to talk” from your partner, friend, family member or co-parent, or even a court appearance - there are things you can do to prepare and show up as your best self.

Luckily (sort of 🤣), I’ve had plenty of practice preparing for scary and important interactions, and I’ve tried lots of things. Here’s what’s worked for me.

Set some time aside to prepare

This seems obvious, but how often do you actually do it?

I’m not talking about all the time you spend worrying about the interaction (I know you’re all over that 🤣). I’m talking about setting aside some uninterrupted time, with paper and pen, to make a proper plan.

Ask yourself: “How do I want to show up for this interaction?”

Here was my list for my genetics appointment:

• Calm (this is something I can plan for - see below)

• Open - listening
  When I’m nervous, I have a tendency to babble. This was my reminder to listen first, stay open, and absorb what was being said rather than letting my brain bound off like a dog chasing a squirrel.

• With agency
  I can feel powerless in interactions with medics. This was my reminder that I do have agency - that we are two human beings in a room, on equal footing, having a conversation.

• In partnership
  I believe health works best as a partnership between medic and patient. The more we work together, the better the outcome.

Write down what you want to get out of the interaction

What’s your goal?

Even if the interaction has been set up by someone else, and even if it feels like they hold all the cards, you still have agency. Take it. Your interaction will feel and go better if you stand in your power.

What questions do you want to ask? Write them down. Do not rely on your memory - stress impairs it.

One question that’s almost always useful at the end is:
What next? What are the next steps?

Think through how the interaction will occur - and make a plan

Sort out the logistics: when, where, how long it will last, and what you need with you. Taking care of the details helps you feel prepared and calm (and you’ll need all the help you can get with that).

Plan how you’re going to spend the rest of the day

How will you occupy yourself before the interaction?

I’m usually a big advocate of sitting with your feelings rather than distracting yourself - and I still recommend doing that in the days beforehand. But on the day itself, I find keeping myself gently busy beforehand helps me feel calmer when the moment arrives.

What about afterwards? As far as possible, give yourself space to process whatever happens. You don’t want to bounce straight from a difficult conversation into an important client meeting.

I heartily recommend getting outside for a walk, preferably in nature. And because I’m British, obviously there needs to be a cup of tea 🫖

Write down how you’ll calm your nervous system beforehand

This will literally change how well-resourced your brain is during the interaction.

Here was my plan:

• Take care of my basic needs - eat beforehand, drink water, go to the toilet, make sure I’m warm

• Sit down at my desk 15 minutes before the appointment

• Log on to the video call system

• Review my plan - how I want to show up, my goal, and my questions

• Do some stomping and shaking to ground myself and release nervous energy

• Relax my shoulders (if they’re up round your ears, your body assumes you’re in danger)

• Relax my face and jaw, yawn, and gently massage my jaw
  (When I do breathwork with clients, I’m always amazed at how instantly relaxing the jaw deepens the breath.)

• Do slow, deep diaphragmatic breathing until the call starts
  When we’re stressed, we breathe into our chest and stay in fight-or-flight. Breathing into the diaphragm signals safety. Put one hand on your belly and one on your chest, and breathe into both. Let the exhale go - not forcing it, not controlling it. Just letting go. Delicious.

Tell at least one supportive person

It can be tempting to handle these things alone. We can feel small, protective, frozen. We can struggle to ask for and receive support (er… guilty 🤣).

Take it from someone who knows: it’s always better to have support. The people who love you want to be there for you - just as you want to be there for them.

Think how cross you’d be if your best friend went through something like this without telling you. Don’t be that person.

Do you have any strategies for preparing for scary and important conversations? Drop me a line, I’d genuinely love to hear them.

With love,

Mia x