16 Apr I Broke Up With a Boy… Using SPIKES
…and it was the best break up I’ve ever had.
I’ve grown up on a steady entertainment diet of Taylor Swift, teen rom-coms and Disney. Dramatic confessions of feelings are all I’ve ever known. My relationships have always been filled with soaring heights or the deepest of lows. From mountain sunrises to crying in car parks, I am a living, breathing tumblr quote. However, to clarify, I am not an emotionally unstable person. I just go big or go home. Mostly, I go big. If you filmed my love-life it would be a be up there with La La Land or The Fault in Our Stars. Okay, maybe not quite, but in the interest of drama…
I suppose my attraction toward melodramatic relationships is, or was, really just a manifestation of immaturity. As I’ve aged, I have realised that roller coasters are best left to theme parks instead of emotions. Although thrilling, they bring more pain than fulfilment. The crashing, burning, breakup that is followed by shredding his letters and ringing at 4am a month later is, to put it mildly, unhealthy.
If my medical degree thus far has taught me anything, it is that emotional regulation is imperative. Keeping emotions in check allows better clinical reasoning, greater focus and more effective communication. It allows me to interact with people in a way that maximises the productivity of an encounter and minimises the messiness. It maximises the responding part of communication and minimises the reacting part. In the last few years, these communication skills I’ve learnt in medicine, have seeped into every day life. I don’t just mean that they have saved me in painfully slow conversations with people I went to high school with and run into at a party, but they have made me more attentive in conversation, more genuinely empathetic and more self-aware.
I’d been seeing a boy for a few months before I realised that I didn’t see it working. I liked him, I didn’t want to hurt him, nor did I want to ghost him and leave him confused. This is a terrible position to be in- knowing that your actions, your words, are going to hurt someone but having to tell them anyway. It’s a hard conversation to have and, arguably, there is no right way to have it. I’d been processing for days, trying to think of the right words to say as to make a hard blow hit softer. I’d had enough drama in my life, I wasn’t looking to create more.
Unfortunately, we’d definitely never had a comm skills session about how to break up with boys- SPIKES was all I had. In true comm skills style, I knew that the words I said were only part of the task. Breaking bad news goes beyond just words. It requires responding to emotions, validating them and creating clarity. Although I don’t mean to reduce a breakup to a clinical encounter, the similarities are indisputable. Both are complex interactions where improperly executed empathy can create miscommunications or unrealistic expectations. Fear of putting someone in distress leads to dodging the conversation altogether and creates its own complicated tangle of issues. Poor communication makes messy things messier. I didn’t need more mess.
S is for ‘set up’, I thought. This was a quiet room, face-to-face, no distraction conversation. This was not an improv, “see what comes out of my mouth in the moment” conversation. This was a think and feel and know what I want before I enter the room conversation. But regardless of how sure you are, entering that room to have that conversation is nerve-wracking.
P is for Perception and I needed to understand his. “Before I tell you what I’ve been thinking, tell me where you’re at with us,” I said. Talley and O’Connor would be proud. But then comes the hard part, now I had to tell him I was done. No matter how sure you are about what you want, it’s not easy to let go of someone nor is it easy to see the consequence of your words manifest as they were about to. Warning shot loaded, I collected myself. Honestly, non-technically and without excessive bluntness is how I’d been taught to break bad news, so that’s what I did.
I was met with tears and confusion. The words “I don’t understand” came over and over. Sitting in tears yourself, it’s hard to do the E part of SPIKES, but I tried my hardest. I verbalised the confusion, addressing the shock-factor of a breakup and allowed room for that to be extrapolated. Confusion breeds anger and anger breeds resentment so we worked through the confusion. In OSCE’s this takes 8 minutes, with ex-boyfriends this takes 2 hours and we’ve still only spelt ‘SPIKE’.
‘S’ is harder with exes than patients, I’ve discovered. How do you create a strategy for your personal life? Apparently, you talk for another hour and conclude that maybe in another life you would be a good couple but, in this one, you’ll only ever be Facebook friends.
A sigh, a hug, a squeeze of the hand,
There was no, “I’ll always love you”. No final hook-up that leaves you feeling confused next week. There was no shredding of letters or poorly constructed, blubbering, upset voicemail. There was only one watch of the 51st Dates in bed with too much ice-cream and there were absolutely no hard feelings.
Sometimes medicine hijacks your life but sometimes it teaches you life skills. I can’t say I ever want to break up with someone again, but if I have to, I’ll do it with SPIKES.