What We Can’t See in Conversation

Communication

Oct 7

Reading, perspective-taking, and shared understanding

We tend to talk about communication and relational skills in one of two ways.

At one extreme is the notion that they can’t really be taught. You are either naturally good with people, or you aren’t. Maybe it’s part of your personality, or something you acquired through childhood experiences and relationships.

At the other extreme is the idea that communication can be distilled down to a series of do’s and don’ts that leaders, physicians, and other healthcare professionals can learn and implement: say this, don’t say that, ask the open-ended question, make eye contact.

I don’t think either explanation quite gets there.

Somewhere underneath effective communication is another skill: perspective-taking, the ability to build a picture of what might be happening in another person’s mind.

We use cues like words, tone, facial expression, body language, context, and what we already know about someone to piece together what they may be thinking and feeling. I say may be because, of course, we never have complete access to someone else’s mind.

To complicate things further, that person doesn’t have complete access to their own mind either. Our thoughts and emotions are dynamic. Sometimes we know exactly why something bothers us. Sometimes the explanation comes later. Sometimes the thought is only half-formed and never makes it into words.

And yet two people still have to communicate across that gap.

What fiction lets us see

If shared understanding requires some ability to imagine another person’s interior world, how do we get better at it?

One practice I’ve been thinking about lately is reading fiction.

In healthcare, there is an established field called narrative medicine. Rita Charon described “narrative competence” as the ability to acknowledge, absorb, interpret, and act on the stories and plights of others. Close reading and reflective writing are among the practices used to develop it. [1]

The evidence is interesting, although I don’t think we should overstate it. A 2024 meta-analysis of 70 experiments found a small overall cognitive benefit from reading fiction. Among the outcomes studied, significant experimental effects emerged for empathy and mentalizing, roughly our ability to infer or reason about other people’s mental states. [2] A systematic review of narrative medicine programs also reported gains in empathy, relationship-building, and perspective-taking/reflection, while noting substantial variation in the programs and how their outcomes were measured. [3]

Leadership scholarship has also explored storytelling, particularly how leaders use stories to communicate values and move people toward collective action. Public narrative is one example. [4] What seems less developed is the other direction: using close reading and reflective writing specifically to practice understanding perspectives beyond our own.

None of this means reading a novel alone magically makes someone a better communicator.

But fiction does something special here.

It gives us access to something we almost never get in real life: another person’s mind. Yes, it’s fictional. But until we’re all walking around with mind-reading technology (please, no!), it may be one of the closest ways we have to witnessing what another person is thinking and feeling from the inside.

A character can say:

“I’m fine.”

Meanwhile, we may have spent the previous four pages inside that character’s humiliation, anger, fear, jealousy, grief, ambivalence, or all of them at once.

We know that I’m fine tells us very little about what is actually happening inside them.

In ordinary life, we usually work in the opposite direction. We see someone’s behavior and hear what they say, and then we try to infer what might be happening underneath.

Fiction temporarily reverses that. We are given access to their inner world and then watch what the character says and does from the outside.

We get to witness the distance between what someone experiences, what they understand about it, what they choose to say, and what another person hears.

That distance exists in real conversations all the time. We just don’t usually get the footnotes.

Perspective-taking gives us a hypothesis, not an answer.

A patient tells me they understand their follow-up plan. A team member says they’re comfortable with a decision. A colleague responds to feedback with, “Okay.”

Maybe they mean exactly what they said.

Or maybe not.

Perspective-taking and curiosity

If one important part of effective communication is perspective-taking, another is remembering that our read of another person is still an interpretation.

The other person is operating with information, assumptions, experiences, and meanings that may be quite different from our own. Ideally, our hypotheses make us more curious, not more certain.

When it matters, we can ask and clarify. We can compare what we thought we understood with what the other person actually meant, notice what doesn’t fit our first interpretation, and revise. Often, we have to do that more than once.

Clarifying has limits, of course. People may be uncertain themselves, or unable or unwilling to put everything into words.

Perspective-taking also doesn’t require agreement. I can understand how someone arrived at a position without sharing it. If I can’t reasonably imagine what the situation looks like from their point of view—and remain open to being wrong—my ability to communicate with them is limited.

That matters in an exam room, in feedback conversations, in conflict, and when people are trying to lead through change.

Reading another mind, writing our own

While reading is a key part of narrative medicine, writing is the other half of the practice.

Even with people we know well, we don’t narrate our entire inner world. Some thoughts are uncomfortable, contradictory, fleeting, or still half-formed.

Writing slows that reflective process down enough for us to examine it.

When we try to put something into words, we have to ask: Is that actually what I mean?

And if someone else is going to read it: Will they understand it the way I intend?

We choose a word, read it back, realize it isn’t quite right, and try another. Sometimes an argument that felt perfectly clear inside our own head looks much less convincing once it is on the page.

We are observing our own thinking while also trying to imagine how it will appear from outside of us.

Reading asks us to practice inhabiting another mind.

Writing asks us to examine and translate our own.

We need both kinds of practice for the much messier work of communicating with actual people.

The truth is, we will never have direct access to another person’s mind, and we certainly don’t have complete access to our own. Perfect understanding may be impossible.

But that still leaves a lot of room to practice.

We don’t have to accept either extreme: that effective communication is something you are simply born with, or that it can be boiled down to a series of scripts and behaviors.

We can read. We can write. We can pay attention to the stories we tell ourselves about what someone else may be thinking. We can shift perspective, notice where our assumptions begin, and get curious enough to ask what we may be missing.

That willingness to keep checking our assumptions may be what gets us closest to the shared understanding we were trying to reach in the first place.