The principles of Non-Violent Communication

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Compassionate Relationships and Health Care

Do you wonder how you can communicate with someone who is raising his voice? Do you wonder what is going on for someone who is swearing at you? Do you wonder how you can create peace and harmony between you and this person.

Marshall Rosenberg, the founder of Nonviolent Communication states, that everything that we say or do is to meet a need. He states that for thousands of years we have been taught a language that alienates us from others rather than helping us to connect with others in a compassionate, non-judgmental way. Every time we blame, judge, label, or diagnose someone, we disconnect ourselves from others. Instead we can choose to empathize with others by guessing their feelings and needs. This can invoke compassion in our selves and others.

Marshall Rosenberg presents a four-part communication process that is simple, powerful and effective. The four components are: observation, feelings, needs and requests. Instead of judging, we focus on facts or observations about what has been said or done. What can a camera see? Instead of thoughts, we look at what feelings we are experiencing in the moment. We empower ourselves by making requests of ourselves and others to increase the possibility of getting our needs met.

For example, when someone is raising his voice, we have 4 choices.

The following examples will alienate us from ourself and the other.

These following will help us to connect with the other and ourself.

In order to feel more empowered, we can make a request of the other.

When you have compassion for yourself, you are better able to connect with the other. When you have compassion for the other, the individual may be inclined to change his behavior to contribute to your well-being.

How is Marshall Rosenberg's communication process helpful in health care settings? We can teach clients to become conscious of their feelings and needs and help them to get their needs met or help them to come to peace about needs not met. Working as a psychiatric nurse, I have had many positive outcomes by empathizing with my clients. Nonviolent Communication can help in various ways in the health care settings. For example:

1. Least Restraint Policy.

We can prevent people from getting into restraints, as hospitals are moving towards least restraint policies. For example, a nurse in the United States working in forensics, Donna Reimer, RN, PMHN-BC, a certified traumologist and her team, was able to reduce the number of clients going into seclusion and restraints by over 90% in 3 years by training staff with less restrictive interventions that included training in NVC. Clients also were taught non-violent communication. In 2009, Donna Riemer was recognized for her accomplishments in the field of forensic nursing by The International Association of Forensic Nurses (IAFN). She has written an article called, “Creating Sanctuary: Reducing Violence in a Maximum Security Forensic Psychiatric Hospital,”

On the Edge - Spring 2009.

Another nurse trainer of Nonviolent Communication in the United States, Melanie Sears, had told me that when she worked with certain patients, they stayed out of restraints because they did not have to act out in order to get their needs met. As soon as she left the unit for her dinner break these patients would be placed in restraints by other staff who did not understand how to listen behind the patient's words to the feelings and needs being expressed. Staff not trained in NVC were not able to verbally deescalate a patient before the patient expressed his/her needs in ways that were problematic. The patient was judged as violent or inappropriate and the procedure for dealing with that was to put him/her in restraints. Nurses did not consider their own behavior and the words they used toward patients to be contributing factors in stimulating the violence that occurred on the unit.

Humanizing Health Care with Nonviolent Communication: A Guide To Revitalizing The Health Care Industry In America by Melanie Sears (2006),

Choose Your Words: Harnessing the Power of Compassionate Communication to Heal and Connect (for Professionals) by Melanie Sears 2009 (

A patient once asked me to put him into restraints. We talked about what needs would be met by him going into restraints. He acknowledged his needs to be heard and understood and I told him my needs which were to have a peaceful working relationship and to contribute to his well-being. He did not go into restraints when he was working with me, but did go into them on other days.

2. Connection with clients.

When clients feel they have been understood and heard, they feel happy and you enjoy a peaceful, working relationship with them. A client was brought back from the airport to the hospital because he was planning on going to Italy to race cars. However, he had no experience in racing cars. I connected with him by asking, “Are you feeling sad because you would like to able to pursue your dream of racing cars?” Whenever I came to work, he would smile at me and I sensed that he was happy to see me.

3. Non-compliance with medications.

Sometimes, patients do not want to take medications and by empathizing with them, they are more likely to take them. A patient said to me, “Why do I have to take this medication,” and I said, “I want to contribute to your well-being; I want to see you getting better.” After hearing this, she took the medications.

4. Decrease the use of medications for anxiety.

A patient told me that he felt paranoid, and I asked him, ”are you feeling scared and needing to feel safe?” and he said, “yes.” Then we talked some more and I understood his need to be seen for who he was; that he would not harm anyone when he went out. Earlier in the day, he had read in the newspaper that an innocent boy was killed by a black male while being outside. He feared that being black himself, people would stereotype him as someone who would harm others. He felt relieved to be understood. When I asked if he would like medications for his anxiety he said, “No, Miss. The talking helped.”

These are some examples of how empathizing with clients can help us to meet their needs and our needs. Nonviolent Communication is a powerful communication process that can help us to contribute to our well-being and that of others. The beauty of this process is that not only is it useful when working with clients, but it also improves our relationships with ourselves and with people at work and at home. We begin to enjoy our relationships more.

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Holding on to anger is like grasping a hot coal with the intent of throwing it at someone else; you are the one who gets burned.



The most basic of all human needs is the need to understand and be understood. The best way to understand people is to listen to them.

Ralph Nichols