Listening to Understand: A Core Leadership Skill : Journal of Public Health Management and Practice

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The Management Moment

Listening to Understand: A Core Leadership Skill

Baker, Edward L. MD, MPH, MSc; Dunne-Moses, Abigail MEd; Calarco, Allan J. MEd; Gilkey, Roderick PhD

Editor(s): Baker, Edward L. MD, MPH, MSc, Column Editor

Author Information
Journal of Public Health Management and Practice: September/October 2019 - Volume 25 - Issue 5 - p 508-510
doi: 10.1097/PHH.0000000000001051
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As noted in prior Management Moment columns, research on public health leadership practice has identified the ability to “really listen” as a critical success factor.1 This factor is particularly important in the early phases of entering a new position where rapid learning is needed. As one gains more experience and the span of control increases, listening becomes key to understanding how to face the most daunting of challenges. In this column, we will share a few best practices for leaders with respect to the practice of “listening to understand” based on research from the Center for Creative Leadership2 and the work of Edgar Schein,3 a widely respected leadership thought leader.

Preconditions for Effective Listening

In view of the many distractions and the pace of work life, being able to focus on what is being said in any conversation represents a major challenge. Thus, active listening (in the face of 24/7 electronic access) presents the listener with the imperative of making and taking time to really listen. Thus, a basic precondition for effective listening is to provide full attention to whoever is speaking. Obviously putting aside distraction sources (eg, cell phones) and making eye contact are the basic first steps in establishing the conditions for effective listening. Furthermore, the listener must set aside premature judgments regarding what is being said. In doing so, the listener must mentally surface and suspend assumptions that may obstruct one's ability to listen deeply. As noted by Edgar Schein,3 the effective listener must also cultivate a mental posture ofgenuine curiosity.

In one of the first essays ever written about listening, Sigmund Freud described what he terms, “even hovering attention.” He described the process as managing one's attention and focus by neither underfocusing (being distracted) nor hyperfocusing (focusing on the wrong details or missing the meaning behind the words).

Components of Effective Listening

Three core components of effective listening may be helpful to consider:

  1. Listening for content: The first step toward actually deepening the listening process is to listen for the content of what is actually being said. In this way, one can act like a voice recorder tracking key words or phrases. Here you are focusing on what is actually said, not on what you are imagining was said or what you would have preferred was said. This component requires focused attention and practice. Listening for content should call not only on the literal auditory-processing ability to hear what is said but also on intuitive capacity to hear what is not said. Sometimes those messages are conveyed indirectly and can be observed in a moment of “somatic leakage,” where the speaker communicates through nonverbal channels.
  2. Listening for meaning and intent: A second aspect of deep listening is to listen for meaning and intent. In this aspect of deep listening, one is attempting to discern the underlying meaning of what is being said and the intention of the speaker. The intent could include simply informing the listener, attempting to influence the listener, or to enhance and deepen a relationship. This component requires not only focused attention but also the ability to step back and attempt to discern the underlying purpose of what is being said. Listening for meaning while listening for content is a skill that is acquired through careful attention and repeated practice.
  3. Listening for feelings and values: Feeling introduces affect into the skill mix. The affect is where the emotions and the power live. Being able to understand at the affective level enables a leader to know what to say and how to influence. It is what helps a leader connect to stakeholders. In this regard, one can infer much from the choice of words, tone, body language, and other aspects of the experience of effective listening as a way to better appreciate the underlying values of the speaker. This aspect of listening is reminiscent of the detective in the classic murder mystery The Big Easy commenting on interviewing a witness saying, “It's not what he says that so important. It's what you hear that counts.”

Benefits of Effective Listening

The most important benefits of effective listening are relationship building and the enhancement of trust. Effective listening can result in challenging one's own assumptions and thereby becoming more knowledgeable and even wiser. In the words of Stephen Covey: “Seek first to understand and then to be understood.”4 Understanding is the beginning of wisdom, and wisdom gives the leadership edge.

One of the key lessons learned by senior leaders who work across cultural and national boundaries is that “listening is the one skill that is universally effective at building trust and respect across boundaries” (Herve' Coyco, President Michelin SCA, Emeritus—oral communication, 2018). In an increasingly global world of diverse populations, good listening skills are a critical competency for leaders.

Impact of Poor Listening

In contrast, poor listening may contribute to a range of negative reactions that have real consequences such as “He is not listening to me because he already has his mind made up.” The impression may be (which is often true) that only people with certain attributes are really listened to. As a result, a poor listener may be viewed as being arrogant, critical, and not paying attention to what is really going on under the surface. Poor listening may result in a misunderstanding (due to failure to properly listen for content), the listener being branded as lacking savvy (due to a failure to listen for meaning), or distrust (due to a failure to listen for feeling and values).

Obstacles to Effective Listening

One obstacle to effective listening is the emphasis on telling in contrast to asking.3 In our culture, which is driven by a need to relate to what has just happened and what one wants to see happen, the dominant mode of conversation is telling, not asking. Perhaps, the biggest obstacle to effective listening is compulsive internal dialogue and discomfort with silence. Asking (rather than telling) builds the curiosity needed to be an effective listener and helps overcome these obstacles.

Overcoming Obstacles to Effective Listening

Research from the Center for Creative Leadership has identified certain approaches to overcoming obstacles to effective listening that can be put into practice:

  1. Understand one's natural conversational style: Each person has a variety of conversational styles that range from telling to asking (see Figure). A telling style is often needed in short-term problem-solving situations while an asking style may be more desirable in long-term situations characterized by a need to challenge one's assumptions and patterns of thinking.
  2. Listen for specific words or phrases: As noted in our description of “listening for content,” one can listen for specific words or phrases that particularly capture the meaning of what is being said. Then, one can repeat back those exact words or phrases and ask, “Am I hearing you correctly?”
  3. Listen for imbedded questions: Often one may hear another say, “I'm wondering about something.” When hearing this opening for inquiry, one can further explore this line of inquiry.
  4. Maintain a posture of active inquiry and learning: This can be achieved by avoiding common tendencies such as advocating for a position, problem-solving behaviors, and giving advice. One can also state what you have learned from the conversation.
  5. Maintain an awareness of one's own presence in the conversation: To be able to listen effectively, one must be able to develop the capacity to monitor the quality of one's own presence on real time. This awareness includes an awareness of nonverbal cues such as eye contact, posture, tone, and facial expressions that impact the degree to which the other feels really listened to.
  6. Deepen the level of listening: One can attempt to deepen the level of listening with a few probing questions such as “Why are you thinking this way?” or “What leads you to conclude that...?”

Understanding Conversational Styles—Telling Versus Asking

Tips for Effective Listening

  1. Be attentive: Lean forward and give nonverbal affirmation (eg, a nod or a smile) while maintaining comfortable eye contact. Above all, be present!
  2. Clarify: At some point, ask, “Am I clear about what you are saying?” or “Can you repeat what you said? I'm not sure I am following you.”
  3. Paraphrase: Using words or phrases that have been heard, one can paraphrase what was heard to signal an attempt to better understand. This step involves an analysis of the content and intent of what was said.
  4. Reflect: In an attempt to step back and better understand what has been said and underlying dynamics and assumptions, one can reflect openly what he or she understands and his or her feelings about what has been said.
  5. Summarize: As a way of demonstrating that one has been listening for content, meaning, and feelings of the person speaking, one can attempt to summarize one's understanding of what was said and then follow the summary with a question such as “Am I understanding you?”


Effective listening is central to leadership practice and, when practiced consistently, can enhance relationships and improve organizational performance. The behaviors and tips listed here are offered as tools for use by leaders at all stages of their development. Effective listening is a core leadership skill that can be improved by practicing these critical behaviors over a working lifetime.


1. Halverson PK, Castrucci BC, Moffatt S, Hancock SE, Boedigheimer SF, Baker EL. State health officials—defining success and identifying critical success factors. J Public Health Manag Pract. 2017;23(2):192–194.
2. Center for Creative Leadership. Better Conversations Everyday. Greensboro, NC: Center for Creative Leadership; 2018. Accessed on April 4, 2019.
3. Schein Edgar H. Humble Inquiry: The Gentle Art of Asking Instead of Telling. San Francisco, CA: Berrett-Koehler Publishers; 2013.
4. Covey Stephen R. The 7 Habits of Highly Effective People: Restoring the Character Ethic. Rev ed. New York, NY: Free Press; 2004.
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