By Adam Widdison, author of The Expert Clinician, and Andrea Mead, patient advocate and blogger on Emotional Intelligence
In this series of blogs on The Art of the Conversation, we have explored why words matter, the art of asking questions and the importance of listening. Together, these are essential information-gathering skills.
But a patient can tell you exactly what is wrong without telling you how they feel.
Understanding the patient as a person goes beyond gathering facts. People are driven by emotions as well as by rational thought. Listening beyond the words spoken and trying to understand what it must be like to be in their position connects us with those emotions and can transform the HCP-patient relationship.
In this blog, we explore emotional intelligence: the awareness that helps us recognise emotions, respond appropriately, and show patients that we understand and care.
Emotional intelligence begins with self-awareness and self-control
Healthcare can be stressful. Patients may be anxious, frustrated, frightened or angry, and their emotions can sometimes trigger ours.
Their emotions are theirs, but how we respond to them is our responsibility.
Being aware of our own emotions, strengths and weaknesses, and able to manage our instincts, reactions and biases, helps us remain professional and build better relationships.
Don’t let a patient’s distress become your emotional fallout. Ask yourself:
“What am I feeling right now?”
Consider what has triggered that feeling. If necessary, give yourself time to reset your mental and emotional compass. Sometimes even simple, familiar tasks can help restore mental order.
Staying calm does not mean becoming detached. It means being self-aware enough to stay present with the patient.
One person: many conversations
A warm welcome, an open posture and good eye contact set the scene for a meaningful conversation. Short, open questions, asked sincerely and with time for the patient to answer, help the patient talk.
Conversational intelligence means knowing when to speak and when to listen, what to say and when, and which questions to ask and how to ask them. It keeps the conversation relevant and appropriate, sometimes factual and serious, sometimes light-hearted and friendly, or sympathetic and understanding, while remaining professional.
But while listening, think beyond what is said.
Listen beyond the words
Every consultation contains more than the spoken conversation.
Patients are also having an internal conversation: thinking about what has been said, what might happen next, and what it all means to them. These thoughts are influenced by past experiences, beliefs, hopes, fears and expectations.
Emotions such as surprise, anger, fear, anxiety, sadness, grief, uncertainty and helplessness may be revealed through word choice, pauses and silences, facial expressions, posture and other non-verbal cues.
Sometimes what is left unsaid is as important as what is said.
We need emotional intelligence to recognise these signals and respond appropriately.
Allowing patients to share their emotions makes the consultation personal, bringing life, understanding and empathy to what might otherwise be a sterile checklist.
Often, what matters lies beneath the surface.
Recognising emotions is the first step towards responding to them.
Be emotion-aware.
Some anxiety or sadness is to be expected when people are unwell. It would be unusual for every patient to arrive calm and content. However, for some, emotions can significantly affect wellbeing, rational thinking and decision-making.
Obvious emotions are often easy to recognise. When they are openly expressed, professionals need empathy. When emotions are concealed, emotional intelligence and experience matter even more.
Time, understanding and experience help us recognise what may be happening beneath the surface.
A patient may appear calm and matter-of-fact while feeling frightened underneath. Low mood, negative feelings, or a stoic, resolute attitude may mask underlying grief or fear.
Sometimes, patients cope by referring to their illness or care as if it were an abstract idea, speaking in the third person and acting as if it doesn’t directly affect them, creating emotional distance from something too difficult to confront.
Grief and fear are normal responses to serious illness. Hearing that you have a life-limiting or life-changing diagnosis, such as cancer, or learning that your cancer has returned, can be overwhelming. Fear of the unknown can be equally powerful.
Some patients express anger: “Why me?”
Others suppress it and show frustration or resentment. They may snap at others, become sarcastic, or appear suspicious and sceptical rather than being openly angry.
Healthcare itself can be taxing, even for patient people. Long waits, bureaucracy, repetitive tasks, complexity and dealing with multiple parties can all contribute to frustration. Not every patient complains. Some remain polite while growing increasingly frustrated. Others express their feelings through sarcasm, scepticism or disbelief.
Emotions are not always negative. Positive news can evoke intense relief or joy. When an outcome exceeds expectations or defies the odds, it can bring a profound sense of triumph.
The important point is to notice the emotion and understand what it might mean to that individual.
Help patients come to terms with their emotions
Patients are more likely to discuss deep-seated emotions when they trust the HCP. This requires a good working relationship.
Pace the conversation. Give the patient time to think and time to talk.
Avoid rushing into technical explanations. Risks, statistics, and clinical detail matter, but introducing them too early can divert attention from what the patient is feeling.
The words and phrases we use, along with pauses and non-verbal cues, can convey far more than literal information.
Silence can be a great revealer.
Allow the patient time to speak without interruption. Resist the temptation to fill every silence.
Listen not only to the patient but also to your own thoughts and feelings.
What does your instinct tell you?
Do you sense something is amiss?
How would you feel in their shoes?
Use active listening skills and sensitive questions to translate concern into awareness.
“Is there anything else you would like to discuss?”
Show empathy by acknowledging what you observe and giving the patient permission to express their feelings.
“It’s natural to be upset.”
“That must have been difficult.”
Sometimes it may be appropriate to say:
“If you want to talk about how this feels, that’s fine. I’m here to listen.”
Or,
“I can see this is really weighing on you. Take your time—I’m listening.”
Validating an emotion reassures the patient that it is safe to talk about it.
“I can see this is worrying you. Would you like to talk about it?”
Reflecting both content and emotion shows you listened accurately and gives the patient the chance to correct you. This can build trust and reduce misunderstandings.
“The long wait must have been very difficult. How did it make you feel?”
If a family member or carer is present, invite them into the conversation where appropriate and with the patient’s consent.
The opportunity to talk about emotions safely and without judgement with a caring and understanding HCP can be therapeutic in itself.
An illustrative moment
A middle-aged man returns to his GP with severe knee pain from osteoarthritis, despite taking painkillers. He has recently consulted a surgeon but remains unsure about whether to undergo surgery.
The GP opens with:
“I can see this is incredibly difficult for you. Could you tell me how it is affecting you?”
This acknowledges the patient’s distress before immediately focusing on the clinical details. It also opens the door to understanding how the pain affects his life.
The patient replies:
“I can’t go shopping with my wife or play with my grandchildren. I don’t have a life at the moment.”
Talking about the impact of the pain raises his awareness of what he is experiencing and opens the door to discussing his emotions.
The GP responds:
“It’s clear you are missing out on a lot. On the other hand, the thought of having an operation can be frightening. Would you like to talk about it?”
The patient is now given permission to talk openly about his fears without fear of judgement. Only then can the conversation move towards understanding and managing those concerns.
Take-home message
Emotions are always present in clinical encounters and shape how patients experience their illness and care.
Emotions matter to the patient and should therefore matter to us.
Emotional intelligence begins with the HCP’s self-awareness and calm, then extends to noticing what lies beneath the spoken words—silences, body language, shifts in tone, third-person distancing and subtle cues of fear, grief or frustration.
By giving patients a safe space and explicit permission to express those feelings, through paced listening and simple validating statements, the HCP can transform a transactional consultation into a relationship that patients experience as understanding and human.
When emotions are recognised and respected, care quality and patient trust can improve.
Emotional intelligence can change the consultation and, importantly, how a patient feels about their care.
If you want to read more about understanding emotions and emotional intelligence, read Andrea’s series of blogs: https://living-with-autoimmune.com/2026/09/05/the-power-of-silence/
In the next post, I will explore the art of sharing information with the patient.
I’d love to hear your thoughts:
Is there really time to talk about emotions in a busy clinic?
Do emotions get in the way of the facts—or help us understand them?
We explore these ideas further in The Expert Clinician: Bridging the Clinical Divide. If you’re interested in developing a more adaptive, patient-centred approach, you can read more here:
The Expert Clinician 
Thoughts? Join the conversation…..