Having difficult conversations
If you think back to a particularly difficult day, what was it about the day that made it difficult? A disappointment or setback, perhaps? Not being able to meet the demands being asked of you? Negative feedback or criticism? Things being done in an inefficient or ineffective way? Feeling that you are on your own? Frustrated that your view has not been heard or understood?
Studies show that the main source of contentment in humans comes from the quality of our relationships with those around us. They can bring headaches and heartache, but also much joy and inspiration. Those who age most successfully have positive connections with friends, family, and the community. The landmark Harvard Study of Adult Development —sometimes referred to as the 85-year study—tracked hundreds of lives to ask what predicts happiness and good health over time. The results were not money, status, nor any physical markers. The single biggest predictors of both health and longevity were relationships and social connection.
We are, as humans, more often than not, operating in a group. As soon as we are, group processes come into play. Our ability to navigate relationships in a group has a huge impact on our health and well-being. People with deeper connections to family, friends, and community live longer, report less pain, cope better with stress, and maintain sharper minds well into later life.
The way each of us connects with those around us depends on our genetics, personality and early experiences, our attachment patterns set up while we were babies and infants, our family and educational experiences, and our role models—whether family members, teachers, coaches, or mentors. They are also influenced by the culture of the family, workplace, or society we live and work in. These personality traits and life experiences, past and present, influence why individuals respond very differently to the same group. What makes for a successful group? Another landmark study, Experiences in Groups, published by the Tavistock in 1961, had an unexpected finding. Wilfred Bion and John Rickman concluded, “The group must have the capacity to face discontent and the means to cope with it.”
Curiously, while we may have an idea of a “happy” family or “happy” workplace as being a light space filled with fun and friendship, what Bion and Rickman are saying is that the most successful and robust groups are those that can tolerate conflict and find ways to overcome or resolve differences. The happiest and most successful children are not those who come from families that avoid conflict, but from those that do have conflicts—conflicts that are (more or less) resolved. This teaches children not to fear having different opinions or encountering others with differing viewpoints. Ultimately, they develop the recognition that even heated discussions, with a to-and-fro of ideas and viewpoints, may lead to new ways of seeing or doing things, leaving everyone in a better place. It is a template for engaging with the diversity and complexity of the real world, and these children are better equipped to face it.
Unresolved “toxic” conflict—the type that festers, intimidates, paralyzes, and silences—is not healthy. Not surprisingly, children from households with unresolved conflict fare the worst, even worse than those from families where conflicts are avoided completely.
So how does this help us as adults navigating our homes, workplaces, and society at large? Perhaps one thing we can do is develop our skills at engaging in difficult conversations. Dr John Launer, a family doctor (GP), systemically trained therapist, friend, and mentor, has written on “conversations inviting change.”
https://www.conversationsinvitingchange.com/
At work, when faced with a “sticky issue,” I think about what conversation is needed to make it less sticky: what conversation, when, with whom, where, and why? These questions help avoid “unhelpful” conversations—gossip, rumors, rants—which may have limited usefulness in small doses with a trusted friend or colleague. Far more valuable are “helpful conversations,” undertaken genuinely to find positive ways forward with those who can help achieve a task—whether providing the best care for patients and families, meeting departmental or organizational performance indicators, or supporting colleagues to perform at their best.
Engaging in potentially “helpful” conversations sometimes requires having difficult ones, as it involves raising concerns or expressing views that may conflict with others. Naming the elephant in the room, breaking bad news, or identifying shortcomings exposes you to criticism or other strong emotions. It requires boldness and bravery, as well as caution and care. Talking things through with a “trusted advisor”—a wise friend, family member, senior colleague, or executive coach—can help. In my 20 years as a hospital doctor, with rich clinical and managerial experience, I still enter certain conversations with trepidation. I have learned—painfully—that sometimes it is better to bide your time. Not everything has to be “fixed” immediately! But in the long term, brushing things under the carpet is not the answer. As James Baldwin wrote, “Not everything that is faced can be changed, but nothing can be changed until it is faced.”
About the Author
Dr Nadia Taysir Dabbagh is a UK-trained consultant child and adolescent psychiatrist, working in the UAE since 2011. She helped establish specialist child psychiatry services at Rashid Hospital and, as Programme Leader, secured approval for Dubai’s first Mental Health Strategy in 2017. Currently Chief of Division for Paediatric Mental Health at Dubai Health, she led the award-winning project ‘One Day is Too Long: transforming access to Autism care in Dubai’, recognized by the Shaikh Hamdan bin Rashid Al Maktoum Foundation for Healthcare Innovation (2025).
Dr Dabbagh studied medicine at Guy’s and St Thomas’ Hospitals and UCL, with psychiatry training at the Royal Free Hospitals and child psychiatry at the Tavistock Clinic. She became RCPsych Member in 2005 and Fellow in 2022. She helped develop Palestine’s first Child and Adolescent Mental Health Strategy and has published two books and multiple peer-reviewed articles. Her work emphasizes the importance of mental health, conflict resolution, and child protection in a globally connected world.
