Some thoughts about a conversation

A friend asked me why I had bothered to engage at length on social media with a self-identified ‘vaccine skeptic’ who had posted his vigorous opposition to any vaccine mandates, supporting his position with demonstrably incorrect information and references to poorly done (and even retracted) studies. My friend felt that my efforts were destined to fail and therefore pointless. When I asked what he meant by failure, he said “You’ll never convince someone like that they are wrong.”

He was half right, of course: there was no chance that my posts would change the poster’s ‘vaccine skeptic’ beliefs.  My friend was only half right, however, because my engagement in this conversation was far from pointless.

My definition of a conversation is any exchange of words (written or spoken) between two or more individuals. When teaching family medicine residents about the nature and potential impacts of conversation, I found PACTS to be a useful acronym for Purpose, Audience, Content, Tone, and Success. I will discuss these five aspects individually, but they are not separate or distinct, and overlap and interact/impact each other, often in complex ways.


Purpose:  What the participants in the conversation want to achieve.

If the purpose of a conversation is defined unilaterally by one participant, it is a monologue, not a dialogue or conversation. If different participants have different purposes, it is likely to result in dueling monologues rather than constructive conversation. (Aaron Sorkin is often held up as an expert author of dialogues, but his most popular’ dialogues’ in West Wing are really dueling monologues,)

Before engaging in conversation, it is useful to ask oneself: what do I want to accomplish? does it matter? is it worth it? Sometimes the answer to one or more of these questions is nothing/no, in which case common sense suggests moving on without engaging. It’s also useful to ask oneself what the other participant(s) want to accomplish, and then to ask oneself how do I know? Am I guessing or did I ask?

Conversations may have one or more of the following (incomplete) list of purposes:

    •    Social ritual.
    •    Signaling something.
    •    Factual information transfer.
    •    Negotiation.
    •    Cooperation or collaboration on a task.
    •    Selling or convincing (winning).
    •    Directions.
    •    Marking social status.

For some of these, listening is crucial, but that is the subject for another day. (Note: people sometimes talk so they don’t have to listen. This can be incompatible with a good conversation.)


Audience: With whom one is conversing.

The following factors can have an impact on how a conversation proceeds and the impact(s) it has:

    •    Is the audience one person or a group. Is the audience present or is the conversation happening remotely (postal mail, phone, email, social media)? Is there a non-engaged or non-participating audience in addition to the engaged participant(s)? (If there are no engaged participants, it is a speech, not a conversation.)
    •    If the audience is a group, is it homogenous or heterogenous? 
    •    Is the audience participating (or observing) voluntarily or not?
    •    What is your relationship to members of the audience? What relationships exist within the audience? 
    •    Is the conversation occurring in realtime, is it asynchronous,  will there later be a different audience?


Content: What the conversation is about.

First are some semantic issues. Do the parties agree on the topic? Are the participants using the same definitions for words or phrases? Are the parties using words or phrases that have different emotional impacts or metamessages among different participants? Do the participants agree on what information sources are reliable and valid?

Second, is the conversation about verifiable factual material or subjective topics like opinions and beliefs?


Tone: How the conversation is conducted.

    •    Are the parties being respectful and empathetic?
    •    Are the parties being disrespectful or hostile?
    •    Do the parties check on this?
    •    Is there asymmetry in knowledge, vocabulary, experience, status.
    •    Have the participants discussed or agreed on ground rules for the conversation?


Success: Whether the conversation had a positive outcome.

I consider a conversation successful if the participants feel that they were respected and heard, and that they benefitted in some way from the conversation. The commonest benefits are learning something new or understanding something in a new way. I find it doesn’t hurt to ask if the other person(s) felt respected and heard, and if not, what I could have done better.

Circling back to the question of why I bothered to respond to that particular social media post:. My purpose was to ensure that others following the thread (or reading it later) would have access to accurate and verifiable information,  Secondarily, I didn’t want the vaccine skeptic to think his perspective was beyond challenge. Finally, I wanted to model a more general audience a constructive way to behave in the context of inappropriate behavior or inaccurate information.

I was not trying to convince the vaccine skeptic that he was wrong.  In fact, I didn’t really consider him to be part of my audience. If I had wanted to change his mind (or even get him to consider that here might be an alternative perspective worth considering) I would have:

  • Moved the conversation out of a public arena.
  • Asked him if he was willing to have a respectful conversation to help me understand how he had come to a perspective that was different from mine.
  • Focused on understanding his perspective so well that I could state it in a way that he liked.
  • Only then would I have asked if he was curious about how I had come to my different perspective.