What Your Doctor Doesn’t Tell You & How to Unlock Your True Voice

Summary

Podcast Summary: Something You Should Know Episode: What Your Doctor Doesn’t Tell You & How to Unlock Your True Voice
Host: Mike Carruthers | OmniCast Media
Release Date: April 3, 2025

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Introduction

In this enlightening episode of Something You Should Know, host Mike Carruthers delves into two crucial topics that impact our daily lives: the often-overlooked aspects of medical diagnoses and the art of effective communication. Through insightful conversations with top experts in their respective fields, Mike uncovers valuable information and practical advice aimed at enhancing both personal health and interpersonal interactions.

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Part 1: What Your Doctor Doesn’t Tell You

Guest: Dr. Suzanne O'Sullivan
Timestamp: [00:30] - [27:59]

Overview: Dr. Suzanne O'Sullivan, a renowned consultant neurologist and author of The Age of Diagnosis: How Our Obsession with Medical Labels is Making Us Sicker, challenges the conventional wisdom that early medical diagnosis is invariably beneficial. She presents compelling evidence that overdiagnosis can lead to unnecessary treatments and increased anxiety among patients.

Key Discussions:

1. Overdiagnosis in Healthcare:

   • Definition & Implications: Dr. O'Sullivan explains that overdiagnosis occurs when medical tests identify abnormalities that wouldn't have caused harm if left undetected.
   • Cancer Screening: She highlights that while early detection of cancers like breast or prostate can save lives, many detected early-stage cancers never progress to life-threatening stages. This leads to unnecessary treatments that carry their own risks.
     • Quote: “Only certain cancer cells grow to become malignant, life-threatening cancers. If you catch lots and lots of early cancer cells and treat them all as if they are potentially going to be life-threatening in the future, you'll be treating a lot of those people unnecessarily.” ([08:46])

2. Heart Disease and Risk Factors:

   • Dr. O'Sullivan draws parallels to heart disease, where redefining risk factors like hypertension and prediabetes has expanded the pool of individuals deemed at risk. This broadening can result in over-treatment without significantly impacting overall mortality rates.
     • Quote: “If you adjust the parameters of blood pressure to identify more people as hypertensive...you can identify huge numbers of people as being potentially hypertensive and potentially at risk of heart disease or stroke. But actually, of those huge number of people, you will be over treating maybe 80% of them who are never at risk.” ([12:13])

3. The Role of Medical Technology:

   • The advancement of medical technology has enabled the detection of numerous anomalies in healthy bodies, many of which may never pose a health threat. Dr. O'Sullivan emphasizes the need for medical professionals to contextualize these findings within the broader clinical picture.
     • Quote: “We have all these new types of technology that allow us to look inside the healthy body in a way that we never have before, and we're detecting things that were always there that we didn't know were there.” ([09:06])

4. Psychological Impact on Patients:

   • Receiving a diagnosis, even a benign one, can cause significant anxiety. Dr. O'Sullivan suggests that rebranding certain detected anomalies with less alarming terminology could alleviate unnecessary fear.
     • Quote: “Perhaps to solve the problem of fear, we should give these screened abnormal cells a name that is less frightening than cancer.” ([23:21])

5. Clinical Art vs. Test Reliance:

   • She advocates for a balanced approach where clinical judgment and patient history are prioritized over an overreliance on scans and blood tests. This approach can prevent the pitfalls of overdiagnosis while ensuring genuine health concerns are addressed.
     • Quote: “Medicine and diagnosis is still a clinical art. Tests need to be put into a clinical perspective.” ([19:42])

Conclusion: Dr. O'Sullivan's insights shed light on the complexities of modern medical diagnostics. While technology has undeniably advanced our ability to detect diseases early, it also necessitates a more nuanced approach to prevent overdiagnosis and the consequent psychological and physical burdens on patients.

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Part 2: How to Unlock Your True Voice

Guest: Michael Chad Hepner
Timestamp: [31:27] - [50:42]

Overview: Michael Chad Hepner, a top communications coach and author of Don't Say How to Communicate Effectively to Live a Better Life, explores the intricacies of effective verbal communication. He provides practical strategies to enhance one's speaking abilities, aiming to make interactions more engaging and impactful.

Key Discussions:

1. Perception vs. Reality in Communication Skills:

   • Hepner observes that individuals often misjudge their own communication abilities, either underestimating or overestimating their skills.
     • Quote: “Most of the folks who think they're terrible communicators, they're not actually as bad as they think.” ([31:45])

2. Common Communication Pitfalls:

   • Contraction Under Stress: In high-stakes situations, people tend to contract their bodies, leading to reduced expressiveness and increased use of filler words like "um" and "ah."
     • Quote: “They don't look like more professional or more dignified or as though they're conveying more gravitas. No, they just look like a more limited version of themselves.” ([33:53])

3. Preparation Techniques:

   • Out Loud Drafting: Instead of writing scripts, Hepner recommends practicing speaking aloud to align preparation with actual speaking dynamics.
     • Quote: “Stand up, walk around the room and ask yourself some big open-ended prompt to get your ideas flowing.” ([35:26])

4. Overcoming Filler Words:

   • Hepner introduces exercises like "Finger Walking" and "Silent Storytelling" to build muscle memory for more deliberate and expressive speech, thereby reducing reliance on fillers.
     • Quote: “This activates something fancy called embodied cognition, which is simply thinking or learning with your body, and it forces you to actually fixate on choosing words.” ([37:27])
     • Quote: “Silent Storytelling... allows your communication instrument to become much more expressive.” ([43:16])

5. The Five Ps of Vocal Variety:

   • Pace, Pitch, Pause, Power, Placement: These elements are crucial for maintaining vocal interest and effectively conveying messages.
     • Quote: “Pace is speed, pitch is high and low. Pause is silence. Power is volume, loud and soft. And then placement is where the sound is placed in the body.” ([45:00])

6. Practical Exercises:

   • Hepner demonstrates techniques to reinforce these principles, emphasizing that effective communication is a learnable skill akin to athletic training.
     • Quote: “This stuff can be learned. This is not a fixed mindset thing.” ([41:54])

Conclusion: Michael Chad Hepner provides actionable advice for anyone looking to improve their communication skills. By addressing both the psychological and physical aspects of speaking, Hepner empowers listeners to unlock their true voice, making their interactions more effective and engaging.

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Notable Quotes with Timestamps

• Dr. Suzanne O'Sullivan:

  • “[08:46] Only certain cancer cells grow to become malignant, life-threatening cancers. If you catch lots and lots of early cancer cells and treat them all as if they are potentially going to be life-threatening in the future, you'll be treating a lot of those people unnecessarily.”
  • “[12:13] If you adjust the parameters of blood pressure to identify more people as hypertensive...you can identify huge numbers of people as being potentially hypertensive and potentially at risk of heart disease or stroke. But actually, of those huge number of people, you will be over treating maybe 80% of them who are never at risk.”
  • “[19:42] Medicine and diagnosis is still a clinical art. Tests need to be put into a clinical perspective.”

• Michael Chad Hepner:

  • “[31:45] Most of the folks who think they're terrible communicators, they're not actually as bad as they think.”
  • “[33:53] They don't look like more professional or more dignified or as though they're conveying more gravitas. No, they just look like a more limited version of themselves.”
  • “[37:27] This activates something fancy called embodied cognition, which is simply thinking or learning with your body, and it forces you to actually fixate on choosing words.”
  • “[45:00] Pace is speed, pitch is high and low. Pause is silence. Power is volume, loud and soft. And then placement is where the sound is placed in the body.”

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Final Thoughts

This episode of Something You Should Know offers a blend of critical health insights and practical communication strategies. Dr. Suzanne O'Sullivan's examination of overdiagnosis urges listeners to approach medical information with a discerning eye, while Michael Chad Hepner's communication techniques provide tools for personal and professional growth. Together, these discussions empower listeners to make informed decisions about their health and enhance their interpersonal interactions.

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For more detailed discussions and resources mentioned in this episode, be sure to visit the show notes and explore the recommended books by Dr. Suzanne O'Sullivan and Michael Chad Hepner.

Transcript

[Mike Carruthers]

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[Dr. Suzanne O'Sullivan]

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[Mike Carruthers]

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[Dr. Suzanne O'Sullivan]

Very often time is a better answer to medical problems than bunches of scans and loads of blood tests. You can be over diagnosed very, very easily if a doctor sends you for a scan every time you go and see them.

[Mike Carruthers]

Also, which buttons on a blazer are you supposed to button or leave unbuttoned? And a top communications coach helps you improve your verbal skills and looks at just how good or bad a verbal communicator you are.

[Michael Chad Hepner]

Most of the folks who think they're terrible communicators, they're not actually as bad as they. And on the flip side that people are like, ah, I communicate all day long. I'm great at this. Very often they're not nearly as good as they think.

[Mike Carruthers]

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[Michael Chad Hepner]

World'S top experts and practical advice you can use in your life today.

[Mike Carruthers]

Something you Should Know with Mike Carruthers. What do you think happens to the items you buy online or in the store? What happens to those items when you return them? For whatever reason? Probably not what you think. Hi and welcome to this episode of Something youg Should Know. If you've been shopping online for any length of time, you know that most online sellers make it pretty easy to return items that you don't want. They even pay for the return shipping sometimes. And you might think those items are just repackaged and resold to someone else. And that does happen sometimes. To be sure, Amazon, Target and Walmart resell a portion of return products themselves. Amazon has Amazon Warehouse, a marketplace for used and refurbished products. Similarly, Walmart lists refurbished electronics on its website and sometimes resells return products in its store's clearance section. But in many cases, the math just doesn't make sense to repackage and relist those items. So a lot of those items are sent to liquidation warehouses, which then resell those items to smaller retailers to resell to other consumers. But what surprised me is that a lot of stuff just gets thrown out and ends up in a landfill. There are some interesting reasons for that. For example, the product might be discontinued. The store doesn't even sell that product anymore. Or it isn't cost effective to repackage and resell it to anyone. One estimate is that 25% or more of returned items get tossed out and end up in a landfill. And stuff like inexpensive clothes and returned underwear all fall in that category. And that is something you should know. There is an assumption, I think, when it comes to your health care that if something seems wrong, you should have it looked at so you can get a diagnosis. Because early diagnosis of an illness is a good thing. It allows you to treat something early. And just generally getting an early diagnosis is always better. Well, maybe. But there is another side to that coin, as you're about to hear from Dr. Suzanne O'Sullivan. She is a consultant neurologist and clinical neurophysiologist and author of three previous books. She has a new one out called the Age of Diagnosis. How our obsession with medical labels is making us sicker. Hey doctor, welcome to something you should know.

[Dr. Suzanne O'Sullivan]

Thanks for having me.

[Mike Carruthers]

So I think it's widely believed it's conventional wisdom that early diagnosis is a good thing. So explain this alternate view you have.

[Dr. Suzanne O'Sullivan]

Yeah, so I think that there's some fairly sort of, there's some received wisdom which is that earlier diagnosis are always for the better. If you catch a diagnosis early, you'll promote long term health. You know that the more health conditions you recognize, the more treatment you give, the more you promote long term health of the population. And those assumptions, they make a huge amount of sense. One can understand why we think that way. However, when we look at the statistics of diagnosis, we see something that suggests those assumptions may actually be quite problematic. So for several decades now, we've really been focused on diagnosing lots of things at earlier stages. So for example, we have screening programs for cancer that detect very early cancers. We have screening programs for learning problems that are detecting milder forms of problems like autism and adhd. Now, if the assumption that early diagnosis and recognizing mild conditions was to our benefit was correct, we should be seeing the downstream effects of all that improved diagnosis. We should be seeing fewer late stage cancers, fewer deaths from cancer. We should see children with better mental health going into adulthood, better able to progress through life. But we are actually seeing the opposite of all of those things. We are diagnosing lots of conditions earlier. So we've got lots of people becoming patients earlier than they would have before. And we have just as many people with late stage problems.

[Mike Carruthers]

So I'm surprised to hear you say that because my perception is, and I'm certainly no doctor, but my perception is that there are fewer deaths from cancer, that we are catching cancer earlier and that that has proven to be a good thing, that people are not dying and they are getting their cancer cured.

[Dr. Suzanne O'Sullivan]

No, if you look at people who have been diagnosed with early cancers on screening, you will see fewer deaths from cancers in those groups. But if you look at the overall mortality from cancer, we have a gradually increasing amount of cancer diagnosis with late stage cancer also. And the reason that happens is because if you diagnose lots of people with early cancer cells, what people don't realize is that not every abnormal cell that looks cancerous will actually grow and cause long term health problems. Only certain cancer cells grow to become malignant, life threatening cancers. If you catch lots and lots of early cancer cells and treat them all as if they are potentially going to be life threatening in the future, you'll be treating a lot of those people unnecessarily. But if you look at the survival rates for cancer in those people, they'll look because a lot of those people didn't need to be treated in the long run, they'll be very healthy. They'll attribute that to their cancer treatment, not knowing that the treatment was never necessary.

[Mike Carruthers]

Well, you know, I have heard that or something like that before that, you know, if you looked at any of us with a, you know, a microscope, we all have cancer in us somewhere, probably, or something that looks like cancer, but it doesn't mean that we necessarily need to treat it. But why don't we need to treat it?

[Dr. Suzanne O'Sullivan]

Yeah. So what I always say to people is, you know, you have to remember that a lot of the technology we have now to look inside the healthy body has only been available to us for a couple of decades. You know, the MRI scan came into regular use in the 1990s, but the really good MRI scanners have only been around for a couple of decades now. So we did not know for a very, very long time what the inside of the healthy body looked like. You know, we were not able to genetically test, you know, mass numbers of people until the last 10 years. So what we have is a sort of. We've got all these new types of technology that allow us look inside the healthy body in a way that we never have before, and we're detecting things that were always there that we didn't know were there. So, for example, if you look at autism studies of people, you will often find that they have small abnormal cells that didn't progress. There was a study in Detroit of men, and they found that 45% of men in their 50s had prostate cancer at the time of death. Their deaths were for things other than prostate cancer, and that those. Those numbers were substantially higher as men got older. So huge numbers of men have early cancer cells that never cause them in their prostate, that never cause them health problems. We didn't know about them because we didn't have the means to look for them. So now that we're finding them, we're kind of acting on the assumption that all of them will progress because we simply don' the knowledge base yet to know what factors make cancer cells grow in some people, but they don't grow in other people. How do you tell a serious cell that will progress from one that doesn't? So these cells have always been there. And the difference now is we have the technology and the ability to see them.

[Mike Carruthers]

So I get that. That's really interesting. And I've heard, too, that there are many men, as they age, get prostate cancer and that many men die with it, but far fewer men die of it. That it's just there because you live long enough, you're going to get it.

[Dr. Suzanne O'Sullivan]

Precisely. And you know, a lot of countries don't do prostate screening because of the problems of over diagnosis of prostate cancer. So some estimates would be that if you screen a thousand men for prostate cancer, you won't save any lives, but you will over treat 10 to 20 men for prostate cancer who didn't need treatment because these abnormal cells in the prostate are so common. The difficulty is that if a man presents for screening of his prostate and abnormal cells are found, how is he to react to that? Because it's very frightening to learn that you have abnormal cells. And there are watchful waiting programs that suggest we don't have to overreact when this sort of thing is found. But that can be very hard to do on an individual level if you don't know ahead of time that these things exist.

[Mike Carruthers]

So I get what you're saying about cancer, but what about something like heart disease where it's reversible in many cases? So it would seem the earlier you catch it, the less reversing you have to do. So why not catch it early?

[Dr. Suzanne O'Sullivan]

So a lot of focus at the moment with regard to something like heart disease is on identifying the risk factors that might put you at higher risk of heart disease going down the line. So, for example, something like diabetes or something like hypertension, over the years, there's no point at which a blood sugar suddenly turns into diabetes. There's no right point. At some point, too much glucose on your blood means you're diabetic, but no one can say what that exact point is. And similarly, what is normal blood pressure? Is it 140 over 80? Is it 130 over 80? Nobody knows. So what has been happening over the years in order to reduce the risk of something like heart disease or strokes down the line, committees of specialists have been gradually changing the parameters required to be diagnosed with something like pre diabetes or hypertension, with the idea that if you address these issues, you'll prevent heart disease at a later date. Now, this runs into the same difficulties as the early cancer diagnosis. If you adjust the parameters of blood pressure to, to identify more people as hypertensive, as happened not that very long ago, you can identify huge numbers of people as being potentially hypertensive and potentially at risk of heart disease or stroke. But actually, of those huge number of people, you will certainly be helping a percentage of them, maybe 20% of them will genuinely be at risk of stroke. But you are inevitably going to be over treating maybe 80% of them who are never at risk because they didn't have other high risk factors. And similarly, if you identify lots of people with pre diabetes, only a percentage of those people would actually develop diabetes if you didn't identify them. So you've always got this health economics going on where you're saying I identify 100 people, 10 of them might benefit, but 90 of them will probably not benefit from this intervention. And the assumption all the time is that the intervention doesn't do any harm. So that's okay, you've saved 10 people and the other 90 people have just been gotten some good advice in health monitoring. But of course it's not as simple as that. Health monitoring in itself has problems.

[Mike Carruthers]

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[Dr. Suzanne O'Sullivan]

Well, I mean with regard to sort of if somebody notices a symptom and goes to their doctor, we do. You know, I'm certainly not advocating that they don't do that. The distinction I'm making is between us as a scientific and medical community seeking out patients who are asymptomatic. So I'm talking about asymptomatic cancers and asymptomatic hypertension and asymptomatic prediabetes. If we work really hard to try and find loads of asymptomatic people at risk of problems, we over diagnose. But obviously symptomatic disease is a completely different thing that does need to be taken more seriously. However, when it comes to things that come to a doctor and how one should approach that, very often their time is a better answer to medical problems than bunches of scans and loads of blood tests. Medicine and diagnosis is still a clinical art. Tests need to be put into a clinical perspective. You will get a better and more reliable diagnosis from a good doctor who takes time listening to you and examining you than you will from a scan. Because again, the problem is that scans and blood tests, they pick up irregularities all the time. You can be over diagnosed very, very easily if a doctor sends you for a scan every time you go and see them.

[Mike Carruthers]

What about something like pancreatic cancer, which is, you know, asymptomatic for a long time and then it's too late. And so wouldn't it have been nice if we had been able to find this earlier? But that seems to be impossible or close to impossible.

[Dr. Suzanne O'Sullivan]

I mean, obviously, you know, finding progressive cancer early is the aim, but the difficulty is that our science isn't very good at doing it yet. So I'm not suggesting this won't be a wonderful strategy in the future. But unfortunately, there are some cancers, and pancreatic cancer would be one of those that spreads very quickly and therefore screening problems don't work very well for those. So for example, ovarian cancer spreads very quickly, so you don't have a screening program for that because by the time it's found, it's often already spread. And that can be a difficulty. So other cancers spread very slowly or grow or don't grow at all. And that's where overdi so under diagnosis occurs in some cancers because they're hard to detect, or they spread very quickly. Over diagnosis occurs in other cancers because some don't grow at all. So there's absolutely no doubt that the logic that we should try and find them early is the correct one. But the point is we're not very good at doing that yet. We just have not mastered that yet.

[Mike Carruthers]

Well, you just used the term progressive cancer. The only way you can tell if something is progressing is to look at it at least two points in time. You can't look at something once and say it's progressing. You don't know.

[Dr. Suzanne O'Sullivan]

Well, that's precisely the point of how one could perhaps think about how one deals differently with this issue of screened cancers. So again, I'm talking a cancer that presents with symptoms is completely different. But let's say a cancer found on screening, you can actually consider a watchful waiting program for those cancers. So a lot of abnormal breast cancer Cells and a lot of abnormal prostate cancer cells don't necessarily progress to be life threatening. And what you can do in those situations is do exactly what you're suggesting, which is monitor them with scans over time to look to see is this one that's progressing or is it staying the same at the moment? Because the word cancer is such a frightening one, you know, we feel a bit compelled into action. People need to know that, you know, these cancer cancers are not all equal. A screen cancer is not exactly the same as a symptomatic cancer. And you do have time to think. But to be able to have time to think, you need to understand that these cancers don't all grow. And you also need to have a good doctor by your side supporting you while you have serial testing to see whether you are one of the lucky ones who has just cells that aren't going to grow if you're, or if you're one of the unlucky ones.

[Mike Carruthers]

But you just use that, you know, the word frightening. But when I hear, if I were to hear that I have cancer cells, if I have early stage cancer, and I think it's just human nature, I don't, I don't want that. I want you to get rid of that. You're the doctor, get rid of my early stage cancer. So it doesn't, it's an emotional knee jerk reaction, but it's certainly understandable.

[Dr. Suzanne O'Sullivan]

I guarantee you, Mike, I would be exactly the same. You know, if I, you know, I do have cancer screening because in the UK it's, it's recommended on a regular basis. I have the standard screening and if something is found, even with the knowledge that I have now, I would be just as frightened as anybody else and I would also feel compelled to act. And I think probably one of the issues there is we're calling all of these things cancers, but that's not necessarily representative of what is being found. So what some people would argue is that we should name, give these kind of abnormal cells found on screening a different name to cancer. Because the minute we kind of hear, oh, it's a cancer, well, you just want it out and you'll be subjecting yourself to treatment which could be harmful in itself. So, you know, to solve that problem of fear, because fear compels us into doing things that aren't necessarily the best thing for us. And perhaps to solve the problem of fear, we should give these screened abnormal cells a name that is less frightening than cancer.

[Mike Carruthers]

You would almost think, I mean, you could imagine one course of action might be If a doctor knows that, this isn't something to worry about yet, to stay quiet. But you can't do that as a doctor. You can't not tell people they have cancer.

[Dr. Suzanne O'Sullivan]

No, obviously you can't withhold those kind of findings. Although, you know, I don't want to frighten your listeners in any way, but, you know, doctors to a certain degree withhold things all the time, you know, because it's quite unusual. Not things of the magnitude of cancer, I should add, but, you know, it's quite unusual. If you see a patient and you do a bunch of blood tests and a couple of scans and a chest X ray and a few things, you, you know, the likelihood that every one of those tests is going to come back saying giving a 100% clean bill of health is actually quite unusual because every single blood test is open to a range of different results, and scans constantly show little white spots and cysts and things. You know, they are just incredibly common. And it's a doctor's job all the time to decide what is important and what is unimportant. You know, we could frighten the living daylights out of our patients if we kind of made a big deal of everything abnormal we found on tests. Medicine is an art. Diagnosis is an art. So a doctor is constantly sort of weighing up little irregularities that they found on tests against their patient's story and deciding whether those irregularities are worth a mention or not. But of course, screen cancer, well, that's a whole nother story. But it is part of the art of medicine to decide what is important and what isn't. And there is an argument for some tests, not cancer per se, but some tests that, you know, not everything needs to be passed on to the patient if it's judged to be likely to cause them more anxiety instead of putting their minds at ease.

[Mike Carruthers]

What about other medical conditions? It seems people go to the doctor for a lot of things that might just go away by themselves. I mean, muscle pain, for example. I mean, sometimes it really can be very painful. But it does seem like it eventually goes away and that it didn't need medical intervention. But if you go to the doctor, you want medical intervention?

[Dr. Suzanne O'Sullivan]

Yeah, I mean, you know, there's surprisingly few real emergency situation unless you're working in a big trauma center where you're constantly seeing road traffic accidents, et cetera. You know, a lot of medicine isn't an emergency situation. And a lot of time a better diagnosis is made and the patient is better treated. If you take a little bit of time to think most problems are not rapidly progressive and usually, you know, a patient working in concert with the doctor, with the doctor has a few meetings so that you can kind of really get a sense of the story and that you can kind of understand the person you're speaking to. That's how you make an an accurate diagnosis. Feeling a need to label things immediately to satisfy the patient isn't necessarily the best type of medicine. And very often things disappear. And you know, I'm sure you already know this, but you know, doctors don't have the answer to everything. We don't know what causes every ache and pain. We don't know why people go through various transient symptoms once we've ruled out through the history and examination anything serious. Often the safest strategy is just a series of meetings and time to think.

[Mike Carruthers]

This is a part of medicine that I don't think people think much about, that sometimes having too much information is a problem. And a lot of this we're just not that good at yet. I've been speaking with Dr. Suzanne O'Sullivan. She is a neurologist and author of the book the Age of How Our Obsession with Medical Labels is Making Us Sicker. And there's a link to her book at Amazon in The show notes Dr. O'Sullivan. Thank you for explaining all this, making it much clearer. Every business owner knows there's your business and then there's the business behind the business, the guts of it that make everything run smoothly. And for so many businesses, the business behind the business is Shopify. Shopify is home of the number one checkout on the planet and the not so secret secret with shop pay that boosts conversions up to 50% meaning far fewer carts going abandoned and way more sales going to you. I know plenty of people with small businesses and even home based businesses that use Shopify. But also big brands use Shopify like Mattel Magic Spoon, Death Wish Coffee. In order to grow your business, your commerce platform better be ready to sell wherever your customers are scrolling or strolling on the web, in your store, in their feed and everywhere in between. Businesses that sell more sell on Shopify. It's no accident that Shopify is the number one checkout system. Upgrade your business and get the same checkout Thrive Cosmetics and Heinz and so many other businesses use Sign up for your $1 per month trial period at shopify.com all lowercase go to shopify.com sysk to upgrade your selling today. Shopify.com sysk.

[Michael Chad Hepner]

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[Mike Carruthers]

It's hard to imagine a day going by when you don't talk to someone. I mean, that's what we humans do. We talk. Most of us talk all day long. And you probably don't think a whole lot about how you speak. Are you being effective in how and what you say? Do other people enjoy speaking with you? All these things are important because others are certainly making judgments about you based on how you speak. Here, with some great advice on how to speak for maximum effectiveness, is Michael Chad Hepner. He's coached presidential candidates, prominent CEOs and Ivy League deans on their communication skills. He's author of a book called don't say how to Communicate Effectively to Live a Better Life. Hi, Michael. Welcome to something you should know.

[Michael Chad Hepner]

Thank you. It's great to be here.

[Mike Carruthers]

So I'm curious, since you talk to people about this all the time, do you think most people think of themselves as pretty good communicators, that they speak well? Or do most people, or do a lot of people think I'm not very good at this. This is a real problem.

[Michael Chad Hepner]

My funny answer to your question is that I think for both groups, their perception is not equal to reality. And what I mean by that is most of the folks who think they're terrible communicators, they're not actually as bad as they think. They have some sort of tape playing in their head about how bad they are in this situation. They can't tell stories, they can't tell jokes, and usually they're being too hard on themselves. And on the flip side, that people are like, ah, I communicate all day long. I'm great at this. You know, I've been talking to groups my whole life. Very often they're not nearly as good as they think.

[Mike Carruthers]

And so what is the biggest problem, either the real problem or the perceived problem in the way people communicate?

[Michael Chad Hepner]

The thing I see the most commonly, and I'll give it one big title, but then I'll show you how it manifests in a bunch of behaviors, is that people contract when they're in these higher stakes kind of communication situations. And I mean that technically they close their mouth more, they Use their face in an expressive way less. They restrain their hand gestures, they collapse their posture, they breathe in a more limited way. They use less vocal variety, they use less dynamic enunciation, all of those things. The problem with this is that what ends up happening is they don't look like more professional or more dignified or as though they're conveying more gravitas. No, they just look like a more limited version of themselves. Bored by their topic, perhaps. And the assumption they make that I should be more serious or I should be more professional shoots them in the foot pretty badly. That then manifests into a whole bunch of things. More monotone voice, faster rate of speech, more stumbles, more ums and uhs and filler. But you can all. You can trace a lot of that back to that first initial adjustment of contracting.

[Mike Carruthers]

And is that nerves is what causes that?

[Michael Chad Hepner]

Well, for some people, yeah, for sure. I mean, I'll give you. You can think of the three evolutionary threat responses of fight, flight, or freeze. When you're giving a big presentation or you're at a networking event or whatever the thing might be. You can't fight anybody. There's no one to fight. You can't flight, you can't leave the room. So what do you do? Well, you freeze a little bit. But speaking is moving. To speak is to move. We breathe in, our diaphragm moves down, our rib cage expands and moves out. And then we allow the air to flow over our vocal cords. Our mouth moves in this tremendously dynamic, dynamic way to enunciate words. Speaking is moving. So if those nerves and those anxieties manifest in freezing, what you're doing is, yes, contracting yourself quite dramatically. Other people contract for different reasons. They might, as I suggested earlier, think it's more professional or dignified or something like this. And most of the time, in my experience, anyway, it's just wrong.

[Mike Carruthers]

Knowing this, what is it that people should be looking to do? When people present, have their big presentation that's coming up, are they preparing right. And then just failing in the moment? Or would better preparation or different preparation have prevented the falling apart in the presentation?

[Michael Chad Hepner]

Yeah, you ask a really important question. Oftentimes they do prepare badly and it shoots them in the foot. And I'll give you the primary culprit. Most people think of preparation as writing. So they type a bunch of stuff or they write out all their comments, but they're doing an activity that is completely different from what they're actually going to do in the moment, which is speaking. So one of the first Missteps people make is this writing first approach. And what I often coach people to do is something I call out loud drafting. And it is exactly like it sounds. As opposed to grabbing the laptop or a pad of paper to begin. No, stand up, walk around the room and ask yourself some big open ended prompt to get your ideas flowing. Something simple like if my audience were to walk away with one thing from this today, what would I want that to be? And then answer the question. Well, the first answer is going to be bad. Fine, do it again. Second answer, a bit better, Third time you answer the same question, I promise you, you will already have come up with something that you can begin to work with. Not only that, but it will sound more like how people actually use language in speaking. You will have come up with it with a muscle memory experience of relaxation and release as opposed to effort and tenseness. And you will already have started to loosely memorize what you want to say. And it's almost instant. So once you've done that a few times, then sure, grab a pad of paper or grab your laptop at that point and jot a few notes. But begin the process by doing the thing you're eventually going to have to do anyway, which is speaking. So that's on the preparation side of things. But then when it actually comes to delivering your communication message, whatever it is, there's some pitfalls there too. You want me to get into it?

[Mike Carruthers]

Yeah.

[Michael Chad Hepner]

So people try to correct problems, not just ineffective ways, but counterproductive ways. And I'll give you an example. If people know about themselves that they speak way too quickly, either they know this or people always tell them this. Oftentimes the advice they get is wrong in three terrible ways. The first is it's negative. The second is it's general. And the third is it's mental. So the first it's negative. What does that sound like? Don't talk too fast. Okay, well now all I'm trafficking in is thought suppression. I hear a don't. All I can do is fixate on the don't. So it's negative. Doesn't work. It's the don't think about a pink elephant trick number two. Then it's going to get general. So what do they typically hear next? Just slow down. But that's so general. How does one actually do that? And in fact, if you get advice, I would challenge folks to this idea. If you get advice that begins with the word just, there's a pretty good chance you can throw it out. Just slow down in each word. Between the words, between the sections. How would I even do that? And then the third thing they get is a mental adjustment for what is a physical activity. So the third thing they hear is remember to breathe or remember to pause. But you're being given a mental instruction for what is a physical activity. Speaking. And we would never give an athlete a bunch of mental instructions for how to perform better. Speaking essentially is a sport. So we have to dramatically rethink how we try to help people improve at the sport of speaking.

[Mike Carruthers]

And so how do you do that?

[Michael Chad Hepner]

By using kinesthetic tools to change bad habits and build good ones. So let's take the speaking too quickly example, as opposed to all that garbage of, you know, negative, general and mental instead. And I'll demonstrate this now you can probably even hear it in my voice if I go far enough with it. This is an exercise called finger walking. And the way it works is the following. I walk my fingers across a desk or a table and I choose every single word that comes out of my mouth. If I don't know what word to say next, I pause the walking forward of my fingers until I have figured out which word I want to share. And I will often tell clients that if they fail in this drill, it's not a mental failure. It's not even a failure in the mouth, it's a failure in the fingers. They need to be more specific, placing each and every single finger step on the desk or table, essentially walking their ideas across the table. Now, what this does is it activates something fancy called embodied cognition, which is simply thinking or learning with your body, and it forces you to actually fixate on choosing words. So what does it do? Well, automatically it slows you down, but it also gets to a thing that you and I were talking about earlier, which is it makes your language a lot more precise because as opposed to don't say what you're thinking about is which words should I actually choose? So that's one example. I actually did that, but a bigger version with one of the co anchors on Good Morning America. I made her walk on a balance beam, which is the more fully realized version of this exercise in which you actually use a balance beam and walk your feet just like I described walking your fingers.

[Mike Carruthers]

One of the things people seemingly struggle with when it comes to speaking, and one of the things that listening to you that you demonstrate is your voice is clear as a bell. You don't, um. And, ah, you say what you came to say and you say it well, right off the top of your head. Is that something that you learn or is that something that experience gives you?

[Michael Chad Hepner]

I would say both. You just said, do you. Do you learn it or does experience give you? I actually think those two things can work in a very virtuous cycle. So, yes, one can train to get better in these things. By the way, we have. I mean, as a species, we have done this many, many times. We've been whole cultures that are dedicated to rhetoric and elocution and things like that. So yes, you can train for these things. And in fact, if I could give listeners one big aha moment, it is that this stuff can be learned. This is not a fixed mindset thing. I'm a bad joke teller, I'm a bad presenter, I'm a bad networker. No, it's stuff you can train at, just like an athlete. But to your second point, yeah, experience is crucial. And the more that you give yourself opportunities to speak in situations that matter, the better. But the gift about speaking that I think so many people miss is that we do it all day long. This is not like I want to get better at coding, so I have to carve out time of my day to work on my coding. You could get better at speaking. Ordering a cup of coffee, talking to a operator on a customer service phone call. There are endless opportunities to practice this stuff throughout our days.

[Mike Carruthers]

Well, but there are different kinds of speaking. In my experience, I can sit here and talk and I'm not the least bit nervous. I'm not the least bit self conscious. One of the reasons is I know I could do it over again if we had to and edit it or whatever. But this is very easy for me. But if there were 20 people in this room watching me, that's a different story. Speaking in public is a different kind of speaking than sitting here talking into a microphone where there's nobody else listening. Even though ultimately thousands and thousands of people will hear this. That doesn't play into my concern at all.

[Michael Chad Hepner]

Which is all the more reason that people should treat speaking like a sport. Because what you have to rely on in those moments of tremendous nerves is the muscle memory that you have built. So let me make this very specific. Let's say that, you know, when you get nervous, you tend to speak in a more monotone voice. I'm not saying that about you. Okay? But let's. The mythical you out there, someone, you get nervous and you start speaking in a more monotone voice. By the way, monotone, we think of that solely as pertaining to pitch, meaning high and low. But monotone just Means more uniform. So if you know about yourself when you get nervous, that you speak more quickly, you never take any pauses, and your rate of speech is uniform with very little variation that is monotone. So if you know this about yourself, then it's important to train the ability to use what I call the five Ps of vocal variety. And those five Ps are pace, pitch, pause, power and placement. Pace is speed, pitch is high and low. I just said that one before. Pause is silence. Power is volume, loud and soft. And then placement is where the sound is placed in the body. So more of a nasal sound, more of a front of mouth, mid mouth, back of mouth, more of a chest voice. Where is the sound placed in the body? We use these five Ps fluidly, fluently, to get our ideas across to each other. Now, if you're this person and you get nervous, and you know that I get much more monotone when I'm nervous, it's very important to build the muscle memory of even when you're nervous, being able to use those 5Ps to communicate how you want to to how do you do it? The best exercise for this that I have developed is called silent storytelling. And it works just like the name of the drill. Sounds. You practice speaking, but you don't get to use the benefit of sound. So imagine you're lip syncing, okay? Or you're on a television and someone has muted you. You're going to speak just like you would. You're going to mouth the words, move your hands because they have a story to tell too. Allow your face to be as expressive as possible to try to communic what you're saying. Even though your listener has no sound, they have to be able to perceive what you're saying just by watching you. Well, what happens when you do this? Your communication instrument becomes much more expressive. And then once you've done this a little bit, put sound back into the equation, allow sound back, and all of a sudden you will hear your voice is filled with those five P's of vocal variety. You practice that just a little bit, and it builds muscle memory. And you can rely on muscle memory even when you're nervous.

[Mike Carruthers]

Since it's the title of your book, let's talk about. And ah. And those things which do get in the way for a lot of people. And I don't even know if people really know how much they do it. I hear it a lot when I, you know, listen back to interviews, I hear a lot. Um, ah. And you know, more frequently than I Think the people who said them know, think that they said them.

[Michael Chad Hepner]

I'm sure of that. I'm sure your perception is right about that.

[Mike Carruthers]

And why do we do that?

[Michael Chad Hepner]

There's a lot of fascinating research about this, and we should be very nuanced because it's not as though I am the police or ums are sins. In fact, humans use alms for some interesting reasons, some that are pretty valid. As an example, if you really want to get your voice into a conversation, but you have not yet figured out what it is precisely you want to say, but darn it, you want to claim that conversational moment. People sometimes use ums just to get their voice started and into a conversation. They sometimes similarly use them to demonstrate to somebody, I'm not done talking yet, so don't interrupt me, because I'm still going to keep making sound. By the way, these strategies don't always work. Okay, but I'm simply saying that there are some reasons that people use ums. So I don't consider myself the UM police because I'm not on a mission to eradicate ums. What I am on a mission to do, however, is help people become aware of how useless a lot of the sounds that they allow to come out of their mouth are and how much more they do it when they're not at their best.

[Mike Carruthers]

But for people who know they say and ah a lot and and would like to not do that, it's hard to know how. Like, how do you stop it? How do you stop saying um and ah?

[Michael Chad Hepner]

And I'll give you a fun example. If magically, everyone listening, I could just click a button and put you all on mute and then say, you have to speak for the next 60 seconds. But you have to speak so expressively with your mouth, your face, and your hands that someone could actually understand what you're saying. Even without sound, you would very likely not say any ums. Why? In order to mouth the words sufficiently that someone could read your lips, think of the amount of concentration you have to dedicate to choosing your words, because you're going to have to mouth them so expressively that someone could read your lips. Well, when you do that, you've unlocked your brain to do what it's really good at, which is make real time decisions between one word and another. But you've deeply, deeply enhanced your brain's concentration on that crucial activity of choosing words. And so therefore, the ums go away as a byproduct of you actively trying to choose your words, as opposed to just opening your mouth and letting a bunch of words tumble out.

[Mike Carruthers]

Well, what's great about this is I think it makes people think about a topic that most people I don't believe think about all that much. And yet it's so important how you speak to people every day. And you've given some really good advice. Michael Chad Hepner has been my guest. He is author of the book don't say how to Communicate Effectively to Live a Better Life. There's a link to his book in the show notes. Michael, I appreciate you coming on.

[Michael Chad Hepner]

It's my pleasure, Mike. I enjoyed that a lot.

[Mike Carruthers]

Every man's suit, coat, blazer or sport coat has buttons on it. But which ones do you button and when? Well, according to Esquire magazine, the one button jacket. Well, that's pretty easy. It should be buttoned while you're standing and unbuttoned when you sit down. The two button jacket, well, the top button is all you need. The two button jacket should never have both buttons fastened. On a three button jacket, the rule is simple. Sometimes, always, and never. It means you should sometimes fasten the top button if you feel like it, always fasten the middle button, but never fasten the bottom button. On the double breasted jacket, fasten every button except the bottom button. Even though there is some leeway there, English royalty have been known to fasten every button when they feel like it. And with a double breasted blazer, you can keep it buttoned when you sit down. And that is something you should know if you enjoyed what you heard in today's episode. My guess is you know someone else who would probably enjoy it as well. So please share this episode with someone you know. I'm Mike Carruthers. Thanks for listening today to something you should know.

[Amy Nicholson]

I'm Amy Nicholson, the film critic for the LA Times.

[Michael Chad Hepner]

And I'm Paul Scheer, an actor, writer and director. You might know me from the League, Veep, or my non eligible for Academy Award role in Twisters.

[Amy Nicholson]

We love movies and we come at them from different perspectives.

[Michael Chad Hepner]

Yeah, like Amy thinks that Joe Pesci was miscast in Goodfellas and I don't.

[Dr. Suzanne O'Sullivan]

He's too old.

[Amy Nicholson]

Let's not forget that Paul thinks that Dune 2 is overrated.

[Mike Carruthers]

It is.

[Amy Nicholson]

Anyway, despite this, we come together to host Unspooled, a podcast where we talk.

[Michael Chad Hepner]

About good movies, critical hits, fan favorites, must sees, and in case you missed.

[Amy Nicholson]

Ems, we're talking the Home Alone From.

[Michael Chad Hepner]

Grease to the Dark Knight.

[Amy Nicholson]

We've done deep dives on popcorn flicks. We've talked about why Independence Day deserves a second look.

[Michael Chad Hepner]

And we talk about horror movies, some that you've never even heard of, like Ganja and Hess.

[Amy Nicholson]

So if you love movies like we do, come along on our cinematic adventure.

[Michael Chad Hepner]

Listen to unspooled wherever you get your podcasts and don't forget to hit the follow button.

[Amy Nicholson]

Have you ever heard about the 19th century French actress with so many lovers that they formed a lovers union? Or what about the aboriginal Australian bandit who faked going into labor just to escape the police? Which she did escape from them. It was a great plan. How about the French queen who murdered her rival with poison gloves? I'm Anne Foster, host of the feminist women's history comedy podcast Vulgar History. Every week I share the saga of a woman from history whose story you probably didn't already know and you will never forget after you hear it. Sometimes we reexamine well known people like Cleopatra or Pocahontas, sharing the truth behind their legends. Sometimes we look at the scandalous women you'll never find in a history textbook. Listen to Vulgar History wherever you get podcasts. And if you're curious, the people I was talking about before the Australian woman is named Marianne Bug and the French actress was named Rochelle. No last name, just Rochelle. And the queen who poisoned her rival is Catherine de Medici. I have episodes about all of them.