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What are your cues? Affirming balance via awareness and relationship management

Insight Article - September 22, 2021

Leadership Development

Culture & Engagement

Susan Childs FACMPE
Emotional intelligence (E.I. or E.Q.) is the uniqueness within each of us and the nuances that comprise our demeanor and instinctive behaviors.

This means being fully cognizant of our actions and responses. For leaders, E.I. allows us to be in touch with and understand what is going on in our offices and the dynamics of our organization’s culture. This understanding of our environment rewards us with the knowledge of how best to approach and engage staff in impactful and positive ways.

It teaches practices how to maintain a compassionate rapport and rhythm with patients beyond the practice walls.

E.I. has two primary competencies (personal and social), as well as four core skills that pair up: self-awareness and self-management and social awareness and relationship management. This is how you manage your behavior and navigate those fun and social complexities, making decisions that achieve the most constructive results. The goal with E.I. is always to produce positive results. It is where your heart and mind meet and impacts everything you do and say.

Recognizing our strengths and weaknesses and fine-tuning empathy skills adds to our awareness of verbal and nonverbal signs and cues with coworkers on every level.

Personal competence is composed of self-awareness and self-management skills, helping you to become aware of your emotions by better perceiving your actions and words throughout exchanges with others.

Self-awareness is the ability to tap into your instincts and work with internal impressions to help you make decisions in an open-minded manner. It also helps you maintain an even keel as you recognize and react to cues that may trigger you. Whatever your demeanor, there is no right or wrong; it is simply the way you are.

This insight helps us maintain composure, gain confidence and communicate in an assured style.

Physical connections

When I waited tables during college, I could spot a good tipper as soon as that person walked in the door. I have no idea how and I could not do that today. Similarly, E.I. can grow as you become in tune with your environment.

The communication between the emotional and rational part of your brain is embodied by E.I. The pathway for E.I. originates in your spinal cord and travels through the limbic system (the emotional part of your brain) before arriving in the front of your brain. Thus, there is always an emotional reaction before rationalization kicks in.

Remember too that the deeper you feel about something the more it remains front and center in your thoughts. Consider a time when you’ve been in love or so angry that it was difficult to think of anything else.

One of the most important tips that helps me regain composure is to respond, not react. We are used to dealing with issues and chaos, but by taking time to think, we can come up with a calming solution that works best for all.

 In healthcare, uncertain times can help us bond and become stronger and more resilient. It also helps heal tense relationships.

 Unspoken cues should also be considered. One’s body language reveals a lot. For example, as you introduce a new policy or protocol, do staff offer confirming nods or avoid eye contact, suggesting they don’t quite understand? 

Ask these questions regarding cues:
  • Q: “What are some words, actions, kinds of people, emotions or events that press your buttons?”
  • Q: “In considering a specific event, ask yourself what occurred, how you reacted, and what you might do differently now.”

Cues and overload

Being overloaded is an occupational hazard. Many of us love our jobs, but sometimes it’s hard to say no and other times we may just have too much work. How we manage it is the important part.

There are also cues we need to recognize. One of my cues is that I begin to lose things when I am known for being organized.

An important aspect of E.I. is delegating appropriately to make sure future leaders have the tools they need to succeed.

This is true of your role as well, keeping in mind that you can only do so much. This is where clear communication and E.I. can work with your supervisors too!

Body language and mirroring

We’ve all heard the saying “Go to where they are,” meaning perceiving someone’s world as they do, connecting on a level where there is comfort and trust.

The next time you are engrossed in conversation be aware of your and others’ posture and tones. Do you notice that when one person speaks quietly the other person tends to as well? I find myself doing this with accents, depending upon where I am and with whom I am speaking without even noticing it.

Make no mistake, there are times when mirroring can benefit you greatly. The most common scenarios could be during an interview, networking or to improve rapport with someone. It often connects people and is unconsciously positively received.

Also, consider the negotiation of a new contract. A 2008 study in the Journal of Experimental Social Psychology found that “62 students were assigned to negotiate with other students. Those who mirrored others’ posture and speech reached a settlement 67% of the time, while those who didn’t reached a settlement only 12.5% of the time.”1

This carries over to discussing an uncomfortable situation with a staff member, patient or physician. Mirroring may make some feel more reassured, which can result in more agreements. Start with eye contact, then move to verbal reflection. If you would like to better connect, try repeating the last three or four words of the person you are speaking with.

Research has shown that shared behaviors extend past mirroring. A 2016 study, cowritten by Uri Hasson, PhD, associate professor of psychology and neuroscience at Princeton University, found that those engaged in mutual mirroring are “dynamically coupled.” The brains of the speaker and the listener showed evidence that they reacted and adapted to signals from each other. Hasson likened the phenomena to wireless connectivity: “The brain’s mirroring capacity is the basis for this interplay of signals and reactions, and nonverbal cues enhance it.”2

Even in our personal lives we may find ourselves mirroring without realizing it. I find myself doing this with my husband, especially during an important conversation.

One point to always remember is that every expression should be authentic and honest. This can easily be overdone and can result in negative mirroring in which you enunciate a person’s negative body position, posture or demeanor.

Tips to build trust:

  • If you do not already have a connection, physically stand and present 100% of yourself to represent the whole you rather than just the half that is seen from behind a desk.
  • Enter every conversation knowing that listening to the other person and their priorities are now your priorities.
  • Tilt your head, reflect focus and nod when appropriate. The key is not doing anything so much it makes a person wonder why you’re doing it!
  • Look at their posture, listen to their tone, and observe other not so obvious factors. For example, match their volume level and cadence in conversation.
If you’re not comfortable with active mirroring, let the connection occur naturally. The fact that you are considering this shows that you are focused on others and their thoughts. This reflects honest sincerity, which always shows.

While you are reading others’ behavior, also observe subtle nuances, such as when someone rubs their chin, plays with or pulls their hair, or taps their fingers. These gentle actions reveal a lot if you pay attention, such as how comfortable the person really is. Negotiators often will look for these features. They can be a clear indicator as to when someone is nervous or appears totally in control.

Consider someone who might play with their collar as they felt a loss in control. This is when you want to make someone feel more comfortable and body mirroring can come in to play. Each person should leave feeling confident and encouraged.

As you begin to do this you will notice it becomes a very beneficial habit. Interestingly, some salespeople will tell you that is a “tell” and these unconscious behaviors often clinch the sale.

Combining E.I. and body language can result in very favorable interactions and solutions. Clear communication with a positive resolution is always the goal with emotional intelligence.

Relationship management

Relationship management is the ability to use awareness of your and others’ emotions to successfully manage interactions. For example, having a difficult conversation with a particularly challenging staff member or physician.

This is also the perfect opportunity to inspire others and connect with peers. Begin by focusing on being as diplomatic as possible, especially as challenging situations occur. Focusing on the issue helps diffuse what could possibly be a volatile situation.

Keeping certain points in mind help us turn anger into positive energy. Speak half as often as you listen as it is essential to acknowledge and respect others’ opinions. Authenticity and honesty are always the best way to go. By connecting emotions and thoughts to create a complete experience, your genuine concern will show.

Think of E.I. not just as being sensitive, but as having complete awareness of your feelings as well as those around you. For example, what is the best approach when speaking with an unsettled patient, one who is throwing a fit at the front desk or screaming at your billing manager. How would you handle that?

What about a staff member who did not receive the raise or promotion they believe they deserve? Have you had a discussion with that individual to explain why they didn’t receive it? Using E.I. allows you to approach the situation with empathy and balance.

Leaders place themselves in others’ positions and focus on supportive conversation. Consider how many negative reactions you can forgo and promote positive morale and awareness throughout the organization. That’s E.I.

Questions to ask yourself — and maybe others — that can help convey your organization’s culture:
  • Q: Have you ever entered a room and sense that something has just gone on that you wish you were more aware of?
  • Q: What are the top four reasons a candidate would want to work for your practice or facility?
In healthcare, there is always something to address, such as a new system not working, staff coverage mix-ups, or a provider wanting to know why it takes so long to get a patient to the back.

Healthy communication can easily be squelched by criticism and blame. Although we need to hold people accountable, consider being respectful and allowing individuals to accept ownership when things don’t go the way we may have originally envisioned. We all make mistakes and want to reduce barriers that can inhibit our success — and our staff members can tell us a lot!

Connections are based on quality time, not the amount of time you spend with someone. Clear communication benefits everyone when conveyed with compassion. For many reasons, it is important to let your staff get to know you authentically, including your style and leadership priorities.

In leading with E.I., leaders can successfully relate to each employee that they are expected to do their job independently, while receiving 100% support. This reflects personal accountability while positioning each staff member to succeed.

Utilizing your E.I. is easier than you might think, it’s instinctive! It provides great rewards and helps you affirm the balance of your personal awareness as well as relationships with others.


  1. Maddux WW, Mullen E, Galinsky A. “Chameleons Bake Bigger Pies and Take Bigger Pieces: Strategic Behavioral Mimicry Facilitates Negotiation Outcomes.” Journal of Experimental Social Psychology, Elsevier, 2008, 44 (2), 461. doi:10.1016/j.jesp.2007.02.003.
  2. Hasson U, Frith CD. “Mirroring and beyond: coupled dynamics as a generalized framework for modelling social interactions.” Philosophical Transactions of the Royal Society B, 371: 20150366.20150366.

About the Author

Susan Childs
Susan Childs FACMPE
President Evolution Healthcare Consulting

Susan Childs, FACMPE, can be reached at


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