As a doctor, it’s not just breaking bad news to patients that’s difficult. Sometimes patients come in convinced of something that’s just not true. Recently, Dr. Berk counseled a patient in his thirties named Carlos who had endured years of unremitting headaches.

“I’ve been suffering from migraines since I was a teenager,” Carlos explained. “I’ve been to a lot of doctors for it, but I was hoping you could give me one of the latest treatments.”

Dr. Berk took his time examining all of Carlos’s previous brain scans. Then he noticed something interesting. He turned back to Carlos. “What are your symptoms?”

“I get headaches. I can’t stand for long periods of time. I have to lie down a lot.”

Dr. Berk nodded. “I saw very subtle signs of a spinal fluid leak on your scans, and the symptoms you describe also point to that diagnosis. We need to do a lumbar test to be sure.”

The patient frowned. “No, no, no. I’ve been to dozens of doctors, and they all agree I have migraines. No one else has said anything about a spinal fluid leak.”

“You have a lot of the symptoms of it. I think we’d be irresponsible not to test for it.”

“Just give me a new migraine treatment. That’s what I came here for.”

“I can give you a new migraine treatment if you want,” Dr. Berk said gently, “but it won’t be helpful if you do have a spinal fluid leak. Your headaches have been going on for so long. Isn’t it worth trying a new approach?”

Reluctantly, the patient agreed. He went for the lumbar test and it showed what Dr. Berk had suspected all along: the patient had a spinal fluid leak. Now that he had a proper diagnosis, he could finally get the treatment he needed.

Principal / Student

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the principal of Valley Torah, a girl’s high school in Los Angeles, Doctor Yali Rosenberg starts every difficult conversation with a short, quiet tefillah: Hashem, give me the right words to help this girl.

“The words I choose can make or break a child,” Dr. Rosenberg explains. “So I always ask myself, ‘How can I be warm and caring, but still keep my expectations high, and hold my students accountable?’ ”

Dr. Rosenberg works hard to develop a relationship with every student, so if there’s a need for a difficult conversation, there’s already a relationship. “I try to make my office a warm and inviting place. I keep chocolate on my desk and have an open-door policy for students. I have a monthly ‘Oneg in the Office,’ where students come by for cholent on Fridays. I want to create a warm atmosphere so that if a student comes to my office for a more serious reason, the student knows I’m not here to punish her, but to help her be successful and reach her potential.”

What happens when a girl is sent to the principal’s office? “While it’s always a serious discussion, I try to make sure it’s never a scary or intimidating one,” says Dr. Rosenberg. She recently called Aviva^* into her office, and after a little small talk, she got down to the point. “I notice you’ve been having some trouble lately. I see you’ve had three dress code infractions, you cut class twice, and your grades are slipping due to missing tests and assignments. Can you tell me what’s going on?”

Aviva played with her hands, looking down at the floor as she spoke. “I don’t know. I guess I was just having trouble focusing in class and I’ve been feeling overwhelmed by all the work. At some point, I just kind of gave up trying.”

“I hear that. Can we brainstorm some ideas to help you feel less overwhelmed?”

Aviva nodded.

Dr. Rosenberg shared some techniques for time management that have worked for other students, such as exercising when she gets home to clear her head after a long day, or setting a time limit on her phone so she doesn’t get lost on it for hours. By the end of their talk, Aviva was feeling much better because she had a plan for how she could succeed.

Occasionally, Dr. Rosenberg meets with a student who’s unhappy with a school policy. “At Valley Torah, every student is allowed the same number of absences and if they go over that, they lose one-third of a letter grade. The point of the policy is to give our students a measure of responsibility, similar to an employee’s allotted days off. They get to choose how to use their time. Once a student came into my office and complained, “My grade was lowered from an A- to a B+ just because I went on a family trip. It’s not like I was cutting class. My parents wanted me to be there.”

“I looked through her attendance record. ‘It’s true that the trip used up some of the absences but there were a bunch of others. Was every one of those unavoidable? Were some of those because you felt you needed a day off? No one is upset with you. This is a judgment-free policy, but actions have consequences.’

“My conversations around consequences are always warm and empathetic,” Dr. Rosenberg explains. “The most important thing is to be fair. Teenagers have a strong sense of justice, and if they feel rules are enforced unevenly, that makes them feel very upset.”

The most painful conversations for Dr. Rosenberg are with parents of applicants who weren’t accepted into Valley Torah. “A girl’s mother will call me in tears and say, ‘My daughter is wonderful. She tries so hard, she’s kind, she’s smart, she has great middos.’ It may all be true, but sometimes we can’t accept a student because it’s not the right fit, or we can’t support the student, or we just don’t have the space. The school has limited spots per grade and unfortunately there aren’t many girls’ high schools in the area with our particular hashkafah. Sometimes I’ll have to tell the mother, ‘I know your child is wonderful, but we simply don’t have the resources to support her.’ ”

Even when Dr. Rosenberg doesn’t accept an applicant, she still has a conversation with any parent who wants one. “These parents are in a lot of pain, and I feel that I owe them the courtesy of a conversation. We can’t accept every student, but I do not make those decisions lightly. It’s dinei nefashos. I know the weight these choices carry.”

*All students in this section are composite sketches and not based on any specific student.

Expert / Client

“Clients hire us to tell them the truth, but sometimes they don’t actually want to hear it,” says Barbara Tuckel, a focus group moderator and communications coach with a PhD in Rhetoric and Speech Communication. Until 2018, she was president of InVision, where she interviewed children and adults for Fortune 100 companies and small start-ups. “As a qualitative researcher, I test everything with consumers, from new products to advertising campaigns. It’s a key part of my job to tell companies exactly what consumers think and feel about the product or campaign under study.”

Dr. Tuckel remembers the hardest incident in her career, which happened over 20 years ago. “I was just a few years into the company, and I was hired to test an advertising campaign for a beverage company.” The beverage company had hired an outside marketing team to create a national ad campaign. Dr. Tuckel’s job was to run a focus group to see how it tested with consumers before the beverage company went out and spent hundreds of thousands of dollars on advertisements.

“The consumers didn’t understand the product at all,” Dr. Tuckel recalls. “This was a drink, a cold beverage like ice tea that people drink in summer, but it showed a snow-covered mountain in the background. The print ad said the drink was ‘smoothly sweet,’ and ‘exotic,’ and the focus group said they didn’t know what to expect the beverage to taste like. It didn’t connect to consumers in the slightest.”

Dr. Tuckel was flown to a meeting to present her findings. She met with executives from the beverage company, as well as creatives from the outside marketing company that had created the ads. “I stood up and explained to them that the consumers didn’t understand it, the vocabulary was too hard, the imagery was confusing. As I spoke, I could see the creatives from the marketing company getting angrier and angrier. One of the creatives even threw a pencil in my direction!”

After that, there was a terrible silence before the marketing team began arguing with her. “Maybe you didn’t present it correctly to the focus group?” one creative asked.

“We don’t agree with your findings at all,” remarked another.

Dr. Tuckel was completely taken off guard. She froze for a moment as the marketers attacked her.

The head of the beverage company took her aside and said, “This is exactly what we’re paying you to do. We need you to tell the bad news objectively. If you can’t handle it, you have no place being in this business.”

After that incident, Dr. Tuckel used her training in rhetoric and communications to develop a method to tell over bad news. “First, I review the objectives of the research to make sure we’re all on the same page. I explain the results of the focus group testing in impersonal language. I won’t say, ‘I don’t think consumers are interested in this,” I say, ‘We may hypothesize that consumers are less interested in this than they might be.’ I provide examples by quoting specifically from the focus groups. I purposefully use impersonal language because I want my listeners to focus on the message, not on me as the messenger. You can argue with a person, but you can’t argue with data in the same way.”

Dr. Tuckel believes that preparation is key. “I always prepare myself to answer the tough questions. I ask myself, ‘Who is going to be in the room? Who is going to be upset by what I have to say? What are they going to ask me?’ Before my presentation, I create an outline and decide what critical message I’m going to leave my listeners with.”

Recently, a snack company asked Dr. Tuckel to test a microwavable cookie with soft chocolate chips. They thought it would be a blockbuster, but the majority of consumers in Dr. Tuckel’s test group didn’t see themselves buying this product.

“I was prepared for anger,” Dr. Tuckel recalls with a laugh, “and they were very angry.”

After she explained her findings, the cookie-developers fought back. “Wasn’t the cookie delicious?” they asked.

“Yes, the consumers agreed the cookie was delicious, but they didn’t see themselves taking the extra time it takes to microwave a cookie,” she replied.

“But it only takes thirty seconds to microwave!”

“The research suggests that consumers are always looking for ways to save time,” Dr. Tuckel replied, looking down at her notes. “As one consumer in our focus group stated, ‘When my children want a cookie, they want it now, and I don’t want to spend an extra thirty seconds microwaving it!’ ”

“What if we make the packaging easier to open?” they asked.

“Maybe.” Dr. Tuckel nodded. “We’d have to bring it to consumers and test it.”

Finally, the cookie developers accepted that they’d have to do more work in research and development before launching the cookie.

“It’s easier to stand your ground,” says Dr. Tuckel, “if you follow two rules: Keep it impersonal and always refer back to the research.”

Shadchan / Single

Tanya, a shadchan in Long Island, recently had an excruciating phone call to make. “I set up a couple and they went out seven times. The girl, Nechama, thought it was going well. After the sixth date, she told me she thought they would be planning a l’chayim soon. After the seventh date, the boy called me and said that there was nothing wrong with Nechama — they got along great — but he just couldn’t picture himself marrying her. He didn’t feel there was any point dragging it out any longer and he asked me to call it off.

“My heart broke for her,” Tanya recalls. “I girded myself for what I knew was going to be a painful discussion. In these situations, I believe there’s no point beating around the bush, giving someone false hope. I called her and got straight to the point: ‘Nechama, Abe decided to call it off. He just wasn’t feeling the spark.’ ”

Nechama shrieked like a wounded animal and dropped the phone.

“I knew she was going to be heartbroken,” Tanya said, “but even so, I was surprised by how extreme her reaction was. My husband asked me if I was sorry I had been so blunt, but I think it’s like ripping off a Band-Aid. It doesn’t help to do it slowly. Afterward, I always check in to make sure the girl or boy is doing okay. I called Nechama back later and said, ‘I’m so sorry. I know you’re disappointed. Your bashert is still out there waiting for you, and I want to set you up again whenever you’re ready.’”

Nechama had a lot of questions. She wanted to know exactly what he had said. She wanted to know why he couldn’t picture himself marrying her. She wanted to know why he had said certain things that made her think he’d be proposing soon.

“I told Nechama that it just wasn’t the right fit — when it was meant to be, it would work. I was calm and matter-of-fact. I know that when I’m speaking to someone who’s upset, I have to stay collected and in control of my emotions.”

Recently, Tanya had a different type of tough  conversation with a young man named Yaakov. “I never met him in person,” Tanya explains, “but on his résumé, he looked like a huge catch. He had a great job working for a tech firm, he looked handsome in his photos, and he made time for learning every day. I couldn’t figure out why all the girls were saying no to him after a date or two. Then I spoke to one of the girls who had turned him down after the first date, and she told me that he came to the date in sneakers, with pants that needed to be hemmed, nails that should have been cut before the date, and a wrinkly yarmulke. I called up some of the other girls who had refused him, and they all said the same thing. I found out that his appearance was the reason more than one girl had ended things. I never would have realized it because he looked fine in his photo. It was clear that he needed to work on his grooming.”

Tanya called Yaakov on the phone and told him exactly what the girls had said. “I didn’t mince words. I told him in a kind but direct way that if he wanted to get married, there was a list of things he was going to have to fix.”

Yaakov didn’t want to hear it at first. He told her that she was just setting him up with materialistic, superficial girls.

“Maybe I can find a girl to overlook your grooming habits, but then I don’t think you’ll be happy with her,” she replied. He got the hint, and came to the next date properly groomed.

“I wasn’t the one who made his shidduch, but after he got married, he said that if it wasn’t for me, he never would have found his kallah. And that’s the truth. I guarantee you his kallah wouldn’t have married him if he had gone out looking the way he had gone out with some of those other girls.”

Tanya admits that not everyone appreciates her very honest, blunt approach. “Once a gentleman in his late fifties approached me at a singles event. He told me that he was looking to marry a woman in her twenties. I said, ‘If you’re serious about getting married, you’ll have to adjust your expectations.’ He was irate and told me, ‘Hashem makes matches, not you,’ and walked away. I’ve had more than one client drop me because they didn’t like my honesty. But I think it’s important to be real and authentic. If you want a shadchan who sugarcoats things, we’re not going to be a good fit. But if you want the truth, I’ll be the best shadchan you ever had.”

Editor / Writer

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the editor in chief of Menucha Publishers, Esther Heller receives thousands of manuscripts from aspiring writers. “Rejecting manuscripts is the hardest part of my job,” she shares, “and unfortunately, the majority need to be rejected. Writers put their heart and soul into their writing and it’s hard to crush and disappoint them.”

Most of the writers get a form letter stating nicely that the manuscript, “doesn’t fit with our publishing plans,” but sometimes Mrs. Heller is so touched by what she’s read that she feels compelled to write the author a personal note.

“Occasionally, an author sends us a manuscript about a harrowing challenge they went through, and to reject it feels hurtful, as if it might add to the suffering they’ve been through. Unfortunately, sometimes we just can’t publish it because it’s too long, or too short, or doesn’t have the right structure, or we’ve already written about this topic. It has nothing to do with the person, and it’s not in any way meant to invalidate what they went through. In those cases, I’ll write the author a personal letter.”

It’s not unusual for Mrs. Heller to receive handwritten manuscripts from writers as young as nine, ten, and eleven. “It’s often poetry or another topic we don’t cover. But if I see they have budding talent, I try to write them an encouraging letter.”

Sometimes, a manuscript is amazing, but just isn’t a good fit for a frum publication. “There was one middle grade novel that I would have loved to publish. It was about two Jewish orphans in World War II, and it was so beautiful and moving, but it was centered on a friendship between a boy and girl, and although it was completely innocent, it just wouldn’t work for a frum publication.”

In that case, Heller wrote the author a letter telling her what a wonderful author she was, and directed her to a non-frum publisher. “It was an outstanding children’s book,” Heller admits. “This was difficult for me because I would have loved to publish it.”

Over the years, Mrs. Heller has changed her approach to rejection letters. “I used to write a letter explaining my decision. ‘I really enjoyed reading it, but….’ What ended up happening, though, was that most writers would start arguing with me, trying to convince me that their manuscript really did have whatever I thought was lacking. If I wrote, ‘We enjoyed your manuscript, but we feel the content is too scary for children,’ the author would write back, ‘I read it to my kids and they weren’t scared at all.’ If I wrote, ‘I really enjoyed your book, but we’ve covered this topic before,’ they would write back, ‘But not in the way my book does.’ I found that these emails only dragged it out longer. Now I keep my emails brief and business-like. I would like to be nicer and more personal, but it only gives authors false hope.”

When it comes to delivering disappointing news, Mrs. Heller has one distinct advantage: “All my difficult conversations happen over email,” she says. “This allows me to think about what to write and revise it to make it even more sensitive. I think it helps the recipient, too. It’s upsetting to have your work rejected, even if it’s for reasons that have nothing to do with the quality of the writing. With email, the writer’s privacy is protected while they take in the rejection.”

“BIFF” YOUR WAY TO CONFLICT RESOLUTION

Some conversations are challenging, but not because the topic is difficult; rather, it’s because the person you’re speaking with is hostile, highly defensive, or just prone to conflict. Even when you’re discussing simple logistics, they derail the conversation with demeaning comments or personal attacks.

When you encounter someone who’s itching to start a fight, it’s helpful to know how to formulate a BIFF response. Bill Eddy, a lawyer, social worker, and mediator, designed the method to help people de-escalate conflict and keep their cool.

Brief: Keep your response short (think three to five sentences). If you rattle on, it gives the other person more material to criticize. Ignore any personal attacks and be as succinct as possible.

Informative: Stick to the facts. Focus on the accurate statement you want to make and not the inaccurate statements made by the other person. Avoid threats, sarcasm, anger, or any high emotion. Starting a sentence with something like, “For your information,” helps set the tone. The goal is to appeal to the person’s problem-solving left brain.

Friendly: You don’t need to be overly friendly — just be relaxed and refuse to get pulled into an argument. Sentences like, “Thanks for responding,” or “Thanks for the information,” are easy ways to create a friendly vibe.

Firm: In a nonthreatening way, clarify or reinforce your stance on the issue. If follow-up is needed, boil it down to a “yes or no” question. And don’t make comments that keep the conversation going.

If, for example, your pushy sister says:

“I can’t believe you asked Mommy to babysit your kids this Motzaei Shabbos so you and Shmuli could go to a musical Havdalah. Why are you always so selfish? Mommy and Tatty are going to be exhausted the next day when they’re supposed to go to my Dovid’s Chumash play. You never think of anyone but yourself.”

You breathe deeply and reply:

“I wasn’t aware that Dovid’s Chumash play was on Sunday [Informative, you’re simply stating facts].

The tickets to the musical Havdalah are nonrefundable so we’re going to go unless Mommy lets us know otherwise [Firm, but not threatening].

Mazel tov on Dovid’s Chumash play [Friendly].”

Notice it’s also Brief at just three lines.

(Originally featured in Family First, Issue 903)