This article describes the three perceptual positions and how providers can step into a robust Observer position to advance problem-solving, improve outcomes, and prevent compassion fatigue (better known as burnout).

The three main perceptual positions are Self, Other and Observer.

  • To experience the Self position, ask yourself, “What do I think, what are my feelings, my ideas and my observations?”
  • To consider an issue from the Other position, imagine stepping into someone else’s shoes, taking on that person’s feelings, perceptions and world view.
  • To experience the Observer position, step out of your Self position and see the situation from a distance. In short, an Observer’s primary function is to witness in a neutral way.

What is the purpose of being in the Observer position? What good does it do?

It is time to step into the Observer position when you think to yourself, “I need to step back,” “I need more breathing space,” or “I need to look at this with fresh eyes.”

The Observer position allows you to:

Think creatively because you see things “as is.” By stepping outside of yourself, you view situations objectively, gaining new perspectives and possibilities.

Manage powerful feelings. Feelings can become overwhelming, leading to negative judgments about yourself and patients. So especially with difficult patients, the Observer position is important to utilize. As you gain some distance, you better engage your cognitive skills, and can take a more neutral—and less critical—stance to improve understanding. Also, effective utilization of the Observer position is an antidote to burnout in which providers re-experience the stressful feelings of their patients.

Improve. By stepping back and witnessing what you’re doing, you make appropriate adjustments. Without the usual attachments to self, you can more easily shift and change.

Advance problem-solving and systemic thinking. The Observer position’s view is broad allowing you see and better understand your relationship to the larger system you operate in. It also allows you to consider how changes you make will affect the system.

How can I step into this role? How can I tell if I am really acting as an Observer?

Overall, the Observer’s internal voice is curious and questioning. You could call it a “Mr. Spock” angle. You’ll know you are in the Observer position when:

  1. You see yourself interacting with someone else. This creates an Observer position, since you can’t be yourself and an observer at same time.
  2. You experience curiosity and neutral questioning. If you find yourself commenting negatively and judging you have left the Observer position. In the Observer role, you want to report the news, stick to “just the facts” rather than inject your feelings and editorialize.
  3. Your physiology reflects the role. For example, your breathing is calm and your muscles relaxed. You might even tilt your head as you think about things. If you find yourself clenching your fists, you’ve reverted to the Self position.

In summary, The Observer position engages a provider’s best thinking particularly with difficult patients and in times of stress. The Observer position also provides a place to improve and rejuvenate so providers relate even better to their patients.

The research is clear: patient success is linked to the quality of the relationship between provider and patient. Knowing how and when to step into and balance each of these perceptual positions is fundamental to creating a positive therapeutic alliance.

Watch for more on Perceptual Positions in upcoming newsletters.