Bikur Cholim: Conversation Essentials

Techniques to help facilitate communication when making a visit or talking with the person on the phone.

Bikur Cholim is an investment of time and includes attention, patience, perceptive listening, sincere concern, openness, and communication skills.

Open-ended questions

  • Use questions that elicit an in-depth response, one that cannot be answered with “yes” or “no.”
  • Use “How” and “What” instead of “Do,” “Did,” and “Were.” Closed questions include “Are you feeling upset right now?” and “Do you like to read?”, while open questions include “How do you feel right now?” and “What are some activities that you enjoy doing?”
  • Open ended questions are good conversation starters. Ask things like “What was it like growing up in the 1930s (or other date)?,” “How is your family doing?,” and “What do you think about [topic]?”
  • Help the person expand. Encourage them with statements like “Tell me more…”, “Tell me about it…” and “You seem upset…”
  • Ask questions to better understand, like “I’m not sure I really know what you mean when you say…,” and “Let’s go over that one more time.”
  • Redirect the conversation with statements like “Thank you for your concern, but I’d really like to hear about…,” “You mentioned before that…,” and “Let’s go back to…”
  • Review past and present efforts at problem solving by asking “Have you talked with anyone about this?,” “What do you usually do when…?,” “What have you done about this so far?,” and “What choices do you feel you might have?”

Seven ways of asking “How are you?”

Simply asking “How are you?” may not convey your authentic personal interest and invite an honest, expressive response. Some people who are suffering have criticized this common question because it doesn’t seem to acknowledge the very different course their life has taken—and can encourage automatic expected answers such as “I’m OK” or “Fine, thanks,” which may not be a sincere reply or convey the whole story. Below are some suggested alternatives.

  • How are you doing with all of this?
  • How are your spirits?
  • How are you hanging in?
  • What do you need the most, right now?
  • What’s helping you get through this?
  • What’s been on your mind as you try to cope with all of this?
  • What are some of the obstacles to your managing/coping?

Avoid double-questions

Asking more than one question at a time makes it difficult for the person to answer one or both of them.

  • “How are you feeling? Pretty bad, huh?”
  • “How are things going at home and with your family?”
  • In holding a conversation, ask one question and then wait for the answer.

Avoid “Why” questions

At times, “why” questions are used as a way to convey judgment and can be misunderstood. Asking “Why?” makes a person feel as though you are attacking his or her ideas. Questions can be easily rephrased to avoid any misunderstandings, for example:

  • “Why are you late?” vs. “What caused your delay?”
  • “Why did you quit your job?” vs. “How is it that you decided to quit your job?”

Avoid these types of responses

  • “Oh, don’t worry. Everything will turn out all right.”
  • “Oh, yes, I know exactly how you feel. As a matter of fact, let me tell you about what happened to me once…”
  • “What a mistake. You must really regret what you did.”
  • “Well, if I were you…”

Active listening

Show that you have heard what the person said by summarizing briefly the meaning of what was said and checking by asking if you understood his or her feelings correctly. When you listen, just listen – do not plan your reply while waiting for your turn to talk. Wait until the person talking finishes, so you can gather all the information before responding. Make a restatement or paraphrase. Reflect the feeling or emotion behind what you think was said.

For example:

  • Statement: “No one really cares about me.” / Visitor: “You feel that no one especially is looking out for you?”
  • Statement: “I just couldn’t tell her because we were never alone. All those other people are always around.” / Visitor: “You’d like to get her alone long enough to tell her.”

Some Final Tips:

  • Do not give advice: Help others to see their strengths, recognize their resources and alternatives, and let them come to their own conclusions.
  • Keep an open mind: Be aware of your own values, beliefs, and prejudices, and remember that you are participating in another person’s world, not judging it.
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