Standing vs. Sitting: The Compassion Angle

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In my post yesterday, I talked about seating arrangements, and the notion that men –although not necessarily women — at the head of the table are seen as leaders. Cindy asked about standing vs. sitting and power dynamics. My hunch, is that standing is taken as a sign of power, and I bet there is some research out on the question. Indeed, given the struggles that women have to be recognized as leaders, especially in mixed-gender groups, I would suggest both going to the head of the table AND standing if you want to run the show.

But power is different than compassion. I just ran into an interesting study suggesting that oncology (i.e., cancer) doctors who sit rather than stand are seen as more compassionate, and that is what patients much prefer them to do during consultations. To generalize beyond these data, it strikes me that anytime that it is an emotionally sensitive meeting (rather than one where efficiency is the main goal), sitting down is good idea.

Here is the reference:

F.Strasser, J.Palmer, J.Willey, L.Shen, K.Shin, D.Sivesind, E.Beale, E.Bruera. "Impact of Physician Sitting Versus Standing During Inpatient Oncology
Consultations: Patients' Preference and Perception of Compassion and
Duration. A Randomized Controlled Trial. Journal of Pain and Symptom Management, Volume 29, Issue 5, Pages 489-497,2005.

Here is the abstract:

The purpose of this study was to determine the impact of
physician sitting versus standing on the patient's preference of physician
communication style, and perception of compassion and consult duration.
Sixty-nine patients were randomized to watch one of two videos in which the
physician was standing and then sitting (video A) or sitting and then standing
(video B) during an inpatient consultation. Both video sequences lasted 9.5
minutes. Thirty-five patients (51%) blindly preferred the sitting physician, 16
(23%) preferred the standing, and 18 (26%) had no preference. Patients
perceived that their preferred physician was more compassionate and spent more
time with the patient when compared with the other physician. There was a
strong period effect favoring the second sequence within the video. The
patients blinded choice of preference (P =0.003),
perception of compassion (P =0.0016),
and other attributes favored the second sequence seen in the video. The
significant period effect suggests that patients prefer the second option
presented, notwithstanding a stated preference for a sitting posture (55/68,
81%). Physicians should ask patients for their preference regarding physician sitting
or standing as a way to enhance communication.

Comments

12 responses to “Standing vs. Sitting: The Compassion Angle”

March 16, 2009

speddoc

I am curious about your thoughts about assholes in public education. I work with parents whose children are in special education. They are typically intimidated, confused, and bewildered in planning meetings. The educational “experts” around the table don’t intend to be assholes, but I’m pretty sure we seem that way to too many parents.

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March 16, 2009

speddoc

I am curious about your thoughts about assholes in public education. I work with parents whose children are in special education. They are typically intimidated, confused, and bewildered in planning meetings. The educational “experts” around the table don’t intend to be assholes, but I’m pretty sure we seem that way to too many parents.

Reply
March 17, 2009

kare anderson

On standing vs. sitting here’s an added element: when one is standing, facing someone sitting, the close you stand, the sharper the angle, the more imposing (read aggressive) you seem to the person sitting – not a compassionate stance, so to speak.
However, a diminutive person (especially a woman or non-white individual) may choose to stand close to an aggressive and/or hostile person when that person is sitting down and assume a genial pose and tone. In so doing she or he is able to move towards equalizing power in the situation without acting harshly. in short, to get the other person to back off.
Also, when people face each other (as women tend to do more than men) it is an inadvertent “face-off.” Even standing (or sitting) at a slight angle from another person makes that person feel more at ease and often warmer towards you.

Reply
March 17, 2009

kare anderson

On standing vs. sitting here’s an added element: when one is standing, facing someone sitting, the close you stand, the sharper the angle, the more imposing (read aggressive) you seem to the person sitting – not a compassionate stance, so to speak.
However, a diminutive person (especially a woman or non-white individual) may choose to stand close to an aggressive and/or hostile person when that person is sitting down and assume a genial pose and tone. In so doing she or he is able to move towards equalizing power in the situation without acting harshly. in short, to get the other person to back off.
Also, when people face each other (as women tend to do more than men) it is an inadvertent “face-off.” Even standing (or sitting) at a slight angle from another person makes that person feel more at ease and often warmer towards you.

Reply
March 17, 2009

Wally Bock

Kare is right, as she usually is. Let me add something for which I have no scientific data.
Most of the time, it seems that people stand when they want to take control. But one manager I knew removed all chairs from his office except his own whenever he had a strong disciplinary message to convey. When the person, who by this time had been counseled and warned several times about behavior/performance, entered for a supervisory conversation, he or she would find that the only choice was to stand, while the boss remained seating.
I need to point out that this was an exceptional behavior chosen for exceptional circumstances and not his routine way of dealing with people who worked for him.

Reply
March 17, 2009

Wally Bock

Kare is right, as she usually is. Let me add something for which I have no scientific data.
Most of the time, it seems that people stand when they want to take control. But one manager I knew removed all chairs from his office except his own whenever he had a strong disciplinary message to convey. When the person, who by this time had been counseled and warned several times about behavior/performance, entered for a supervisory conversation, he or she would find that the only choice was to stand, while the boss remained seating.
I need to point out that this was an exceptional behavior chosen for exceptional circumstances and not his routine way of dealing with people who worked for him.

Reply
March 17, 2009

Murthy

Fascinating observation! I suspect this a very complex relationship with a lot of learned and cultural behaviors mixed in. For example, in many Asian cultures, leaders expert staff to bow their heads, whereas in American culture it would seem like the staff lacked confidence.
I think standing/sitting could be similar. For example, I remember a friend saying that corporate presentations in Japan are given in large rooms where the execs sit in chairs that are elevated from the main floor – and the presenter stands in a pit below everyone. Vertical height in this case is a symbol of power. However, in America, this is exactly the configuration that most universities use between professors and students in class, and clearly the same connotation is not there.
Another example of double meanings: whether someone looks you in the eye while talking or not. One school of thought would suggest that a person lacks confidence when they don’t look you in the eye. But I had a boss once who used that technique powerfully to disarm someone attacking them – but not looking, he would give off this sense that he wasn’t accepting/reacting to the attack.
So perhaps the meaning of sitting/standing/bowing/etc is more of a learned behavior and one that is dependent on the situation vs. an innate and generalizable one.

Reply
March 17, 2009

Murthy

Fascinating observation! I suspect this a very complex relationship with a lot of learned and cultural behaviors mixed in. For example, in many Asian cultures, leaders expert staff to bow their heads, whereas in American culture it would seem like the staff lacked confidence.
I think standing/sitting could be similar. For example, I remember a friend saying that corporate presentations in Japan are given in large rooms where the execs sit in chairs that are elevated from the main floor – and the presenter stands in a pit below everyone. Vertical height in this case is a symbol of power. However, in America, this is exactly the configuration that most universities use between professors and students in class, and clearly the same connotation is not there.
Another example of double meanings: whether someone looks you in the eye while talking or not. One school of thought would suggest that a person lacks confidence when they don’t look you in the eye. But I had a boss once who used that technique powerfully to disarm someone attacking them – but not looking, he would give off this sense that he wasn’t accepting/reacting to the attack.
So perhaps the meaning of sitting/standing/bowing/etc is more of a learned behavior and one that is dependent on the situation vs. an innate and generalizable one.

Reply
March 18, 2009

Rosalind Joffe aka cicoach.com

Interestingly enough I just blogged – http://bit.ly/li3ki- about Judge Reggie Lindsey, Fed MA judge. An African American and in a wheelchair since 1988 when paralyzed from cancer, he died last week. Judge Lindsey said he learned more about the world looking at the ground from a seated position than from anything else in his life. 6’4″, he had tremendous personal and professional power while seated.

Reply
March 18, 2009

Rosalind Joffe aka cicoach.com

Interestingly enough I just blogged – http://bit.ly/li3ki- about Judge Reggie Lindsey, Fed MA judge. An African American and in a wheelchair since 1988 when paralyzed from cancer, he died last week. Judge Lindsey said he learned more about the world looking at the ground from a seated position than from anything else in his life. 6’4″, he had tremendous personal and professional power while seated.

Reply
March 23, 2009

Robin Koval @ ThePowerOfSmall

What an interesting post! It’s so amazing how such small gestures can make such a strong impression. Reminds me of a post I read a while back from the Harvard Business Review Blog: http://blogs.harvardbusiness.org/hbreditors/2009/01/small_changes_make_big_differe.html

Reply
March 23, 2009

Robin Koval @ ThePowerOfSmall

What an interesting post! It’s so amazing how such small gestures can make such a strong impression. Reminds me of a post I read a while back from the Harvard Business Review Blog: http://blogs.harvardbusiness.org/hbreditors/2009/01/small_changes_make_big_differe.html

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