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05 Nov 2025

Your Employees Aren’t Difficult. Their Nervous Systems Are Protecting Them.

By Admin • 05 Nov 2025

I was three months into my mediation practice when a healthcare manager called and asked if she could ask me a few questions: “Let me begin with, how do you get people to actually hear difficult things without falling apart?” About an hour later, it was clear she needed support. She’d just had what she called “the performance review from hell” — an hour-long conversation where a talented nurse became defensive, then tearful, then completely shut down. Despite the manager’s best intentions and careful preparation, the relationship was now damaged, and nothing had actually changed. “I just don’t know what I did. I knew it would be a difficult conversation, but how do I have it and make it productive?

That conversation changed how I think about both mediation and management.

Because here’s what I’ve realized after 20 years studying communication, working as a patient advocate, and now practicing as a mediator: Performance reviews fail for the same reason mediations fail — because we’re asking people to engage in high-stakes dialogue when their nervous systems have moved into threat response.

The skills that help resolve conflicts are the exact same skills that make performance feedback effective. Yet most managers are never taught them.

The Moment I Saw the Pattern

A few weeks after that conversation with the healthcare manager, I was mediating a faculty grievance. A department chair needed to address performance concerns with a tenured professor. Sound familiar? It was a performance review, just called something else.

I watched the same dynamic I’d heard about from the healthcare manager: The chair tried to be constructive. She had specific examples. She used careful language. But the moment she mentioned areas for improvement, the professor’s entire body language changed. His breathing became shallow. His responses became defensive. Within minutes, he was rigidly repeating “I disagree with your assessment” to everything she said.

I recognized what was happening — I’d written about it in my piece on recognizing nervous system dysregulation. His amygdala had hijacked his prefrontal cortex. He was no longer able to think flexibly, take a perspective, or engage in collaborative problem-solving. He was in survival mode.

But here’s what struck me: This wasn’t a mediation problem. This was exactly what the healthcare manager had described happening in performance reviews. Different context, identical dynamic.

That’s when it hit me: Whether you call it mediation, performance review, difficult conversation, or feedback session, you’re trying to facilitate the same neurologically challenging interaction. Someone needs to hear something difficult about themselves or their behavior, and their brain will interpret it as a threat.

The conversation succeeds or fails based on whether the facilitator—manager or mediator — can create conditions where that person’s nervous system feels safe enough actually to hear what needs to be said.

What I Learned From Watching Performance Reviews Fail

After that realization, I started paying attention differently. Managers would consult with me about upcoming difficult conversations. I’d hear their stories about performance reviews gone wrong. And I kept seeing the same patterns I see in failed mediations.

The manager who kept pushing despite the signs. One academic department chair told me she’d noticed her faculty member getting increasingly tense during a review, but she kept going because she “wanted to get through everything on her list.” By the end, the faculty member was agreeing to everything while meaning nothing. She’d shut down completely, and the chair had missed it until it was too late.

I’ve done the same thing in mediations. Pushed forward with my agenda while missing that someone had already left the building emotionally.

The manager backed off at the first sign of emotion. A nurse manager described how she’d started addressing chronic lateness. Still, when the employee’s eyes filled with tears, she immediately softened her message, leaving the employee unsure whether anything needed to change at all.

I’ve watched mediators do this too — retreat from necessary confrontation because they can’t tolerate the other person’s distress.

The manager who tried to cover everything at once. A hospital administrator told me she’d compiled six months of observations across 12 areas for improvement. She presented it all in one sitting, proud of her thoroughness. The employee left the meeting, gave two weeks’ notice, and never returned.

In mediation, I’ve learned the hard way that overwhelming people with information guarantees they’ll retain nothing. But it took watching managers make the same mistake to understand how destructive comprehensive feedback dumps are entirely.

The Healthcare Manager Who Taught Me Everything

Remember the healthcare manager I mentioned in the beginning? We stayed in touch. She started asking me to help her prepare for difficult conversations with her team. And together, we started experimenting with applying mediation principles to performance reviews.

One situation stands out. She had a nurse — let’s call her Sarah — whose documentation had become problematic. Not egregiously bad, but inconsistent enough to create risk. Previous attempts at addressing it had gone nowhere. Sarah would get defensive, insist her documentation was fine, and the conversation would end in a stalemate.

The manager called me before the next attempt. “Walk me through how you’d handle this as a mediator,” she asked.

So I did. I taught her what I’d learned about building psychological safety, recognizing cognitive load, inviting collaboration, distinguishing between impact and intent, fostering forward focus, and establishing ongoing dialogue. Concepts I was already using in mediation but hadn’t yet formalized into the framework I now call the BRIDGE Feedback Method.

She went into that conversation very differently from how she’d approached previous ones. Instead of leading with the problem, she built safety first: “Sarah, I know documentation reviews can feel like criticism of your nursing, which is not my intent at all. Your patient care is excellent. This is specifically about one aspect of documentation that I want to help you with.”

Instead of presenting twelve concerns, she focused on one issue with two clear examples.

Instead of telling Sarah what to do, she asked: “What makes documentation challenging for you? What would help?”

Instead of dwelling on past problems, she spent 80% of the conversation on how to make it better going forward.

The entire conversation took 15 minutes. Sarah left with clarity instead of defensiveness. Two weeks later, the documentation had noticeably improved.

The manager called me, stunned. “That’s the conversation I’ve been trying to have for six months. What did I do differently?”

“You treated it like mediation,” I told her. “You facilitated a difficult conversation instead of delivering a judgment.”

What My 20 Years in Communication Taught Me About Threat Response

Long before I became a mediator, I was teaching interpersonal communication and conflict at the university level. I watched students role-play difficult conversations. I observed faculty meetings devolve into dysfunction. I studied what happened when people tried to address problems with each other.

But it was my work as a patient advocate that really opened my eyes to how threat response hijacks communication.

I’ve sat with families trying to make impossible medical decisions while terrified and overwhelmed. I’ve watched brilliant, capable people suddenly unable to remember basic information because their stress response had disrupted their hippocampus. I’ve seen how pushing harder when someone is shutting down makes everything worse, not better.

I learned that families couldn’t make good decisions when they didn’t feel safe. The most important thing I could do was help people regulate their nervous systems before we tried to solve problems. That creating psychological safety wasn’t a weakness — it was a prerequisite for clear thinking.

When I became a mediator, I brought all of this with me. And I started recognizing the same patterns in mediation rooms that I’d seen in hospital rooms, faculty meetings, and difficult conversations everywhere.

Performance reviews trigger the same neurobiological response as conflict mediation because they ARE the same conversation: someone needs to hear something difficult about themselves, and their brain will interpret that as a threat.

Let me show you what that looks like neurologically, because understanding this changed everything for me.

When someone perceives a threat — and performance reviews are definitely perceived as threatening — their brain triggers a cascade of responses designed to ensure survival. The amygdala activates. Stress hormones flood the system. The prefrontal cortex, responsible for reasoning and perspective-taking, goes offline.

Research by neuroscientist David Rock shows that social threats activate the same neural pathways as physical threats. Your employee isn’t being difficult when they become defensive. Their brain has literally interpreted your feedback as danger.

In this state:

Memory becomes unreliable (explaining the “I don’t remember” responses)
Thinking becomes rigid and binary (explaining the “this is completely unfair” defensiveness)
Communication becomes defensive or shuts down (explaining the tears or silence)
Creative problem-solving becomes impossible (explaining why they can’t see solutions)

The first time I really understood this was during that faculty grievance mediation. The professor who kept saying “I disagree with your assessment” wasn’t being stubborn. His nervous system had moved into protection mode, and all he could do was defend.

Once I saw it, I couldn’t unsee it. It’s happening in every difficult conversation — in mediation, in performance reviews, in family healthcare discussions, in conflict everywhere.

Building the BRIDGE: How I Integrated What I’d Learned

After working with that healthcare manager on Sarah’s documentation conversation, other managers started reaching out. Could I help them prepare for a difficult performance conversation? Could I observe their review and give feedback? Could I teach their team these skills?

I found myself explaining the same principles over and over — the ones I’d developed through mediation but that clearly applied to any difficult conversation. Eventually, I thought this would make a good episode for my podcast, Communication Compass, and formalized them into what I now call the BRIDGE Feedback Method.

Each component emerged from decades of research and from conversations I had in mediation rooms, in hospital settings during my patient advocacy work, in university faculty meetings, and now in the performance reviews.

Let me walk you through each piece, not as abstract theory, but as lessons learned from real conversations.

B — Build Psychological Safety First (The Lesson From My First Mediation Failure)

In my third week of mediation practice, I made a rookie mistake. I was so focused on being efficient that I spent 30 seconds opening before diving into the conflict. Within five minutes, one party was completely shut down.

My supervisor pulled me aside afterward: “You can’t skip the foundation. If people don’t feel safe, nothing else matters.”

She was right. In mediation, I never jump straight into conflict anymore. I spend significant time creating conditions where both parties feel safe enough to be vulnerable and honest.

Yet when I started working with managers, I noticed they were making the exact mistake I’d made: They’d do a 30-second check-in (“How are you?”) and then dive straight into evaluation. The employee’s nervous system would immediately go on high alert.

What this looks like in performance reviews:

I taught that healthcare manager to start differently: “Sarah, I know documentation reviews can feel like criticism of your nursing, which is not my intent at all. Your patient care is excellent. This is specifically about one aspect of documentation that I want to help you with.”

This isn’t the feedback sandwich. It’s creating neurobiological conditions where feedback can actually be received. It’s explicitly stating positive intent, acknowledging the difficulty, and establishing that you’re there to support rather than judge.

When I do this in mediation, I can watch people’s shoulders drop slightly. Their breathing becomes fuller. They make eye contact. Those small shifts signal that their nervous system is moving toward safety rather than toward threat.

Managers tell me they see the same thing when they build safety first: “She actually looked at me instead of staring at the table,” or “He asked a clarifying question instead of just defending himself.”

R — Recognize Cognitive Load (The Faculty Meeting That Taught Me This)

I learned about cognitive load the hard way during a particularly contentious faculty meeting early in my teaching career. A colleague was trying to address 12 different curricular issues in a single discussion. I watched as the faculty — brilliant people, all of them — glazed over. By issue number four, no one was tracking anymore.

Later, I learned about John Sweller’s research showing that working memory can handle about seven items, and under stress, that drops to 3–4. The faculty meeting had been doomed from the start. Our colleague had exceeded everyone’s cognitive capacity within the first ten minutes.

I see managers make this exact mistake in performance reviews. They’ve compiled six months of observations covering a dozen areas for improvement. They present it all in one sitting, proud of their thoroughness.

The employee’s brain shuts down. They walk away having absorbed almost nothing, and the manager feels frustrated that “they just don’t get it.”

What this looks like in performance reviews:

After watching that healthcare manager’s success with Sarah, I formalized what I now call the 3–2–1 Rule: Maximum 3 key developmental areas, illustrated with 2 specific examples each, leading to 1 concrete next step.

One hospital administrator I worked with pushed back: “But I have so much feedback to give. How can I only address three things?”

“You can’t address everything effectively,” I told her. “You can address three things that might actually change, or twelve things that definitely won’t.”

She tried it. Focused on three areas in one conversation, scheduled follow-ups for others. Three months later: “Two of the three things have dramatically improved. With the old approach, nothing ever changed.”

I — Invite Collaboration

Here’s what I’ve learned from mediation: People support what they help create. When someone participates in identifying the problem and developing the solution, their buy-in and commitment increase dramatically.

Research by Sheila Heen and Douglas Stone shows people are 40% more likely to change behavior when they’re involved in the problem-solving process.

Most performance reviews are monologues: “Here’s what I’ve observed. Here’s what you need to change. Here’s the plan.” The employee sits passively, feeling like something is being done to them rather than with them.

What this looks like in performance reviews:

Ask more than you tell: “I’ve noticed some challenges with X. What’s your perspective on this? What do you think might be contributing?”

Invite their analysis: “When this happens, what do you think the impact is on the team?”

Co-create solutions: “What would help you in this area? What support do you need? What would success look like from your perspective?”

This isn’t avoiding accountability. It’s engaging the person’s prefrontal cortex — their thinking brain — rather than keeping them in reactive threat response.

D — Distinguish Impact from Intent

In mediation, I see this constantly: Person A attributes Person B’s behavior to malicious intent when it was actually just a mistake or misunderstanding. This attribution error escalates conflict unnecessarily.

Performance reviews often make the same mistake. Managers attribute performance issues to character flaws (“You’re careless” or “You don’t take this seriously”) when the actual causes might be systemic, situational, or skill-based.

What this looks like in performance reviews:

Separate observable behavior from assumed motivation: “When the report was submitted three days late, it created challenges for the team’s timeline” rather than “You obviously don’t care about deadlines.”

Ask about intent: “Help me understand what was happening from your side. What were you trying to accomplish?”

Focus on impact and future behavior: “Whether it was intentional or not, here’s the impact. Let’s talk about how to prevent this going forward.”

This approach reduces defensiveness dramatically. People can hear feedback about impact much more easily than accusations about their character.

G — Generate Forward Focus

In mediation, I learned that dwelling on past problems keeps people stuck. Solution-focused conversations activate different neural pathways — ones associated with creativity and possibility rather than threat and defense.

Research shows that spending 20% of time on problem identification and 80% on solution development creates better outcomes than the reverse.

Yet most performance reviews are problem-focused: “Here’s what you did wrong, here’s another thing you did wrong, here’s one more thing…” The employee leaves feeling criticized and demoralized, with little clarity about the path forward.

What this looks like in performance reviews:

Acknowledge the issue briefly, then pivot: “So we’ve identified that project management has been challenging. Now let’s focus our energy on how to develop that skill.”

Ask forward-focused questions: “Six months from now, if this has completely improved, what would you be doing differently?”

Create specific development plans with clear next steps, not just vague directives to “do better.”

End the conversation focused on growth and possibility, not on problems and deficiencies.

E — Establish Ongoing Dialogue

Here’s what research on learning and behavior change shows: One-time conversations have minimal lasting impact. Distributed practice — ongoing conversations over time — is significantly more effective.

Yet organizations often treat performance reviews as annual events. Managers deliver comprehensive feedback once a year, then wonder why nothing changes.

In mediation, we understand that difficult conversations are processes, not events. Resolution happens through ongoing dialogue, not single sessions.

What this looks like in performance reviews:

Transform annual reviews into quarterly or monthly check-ins. Brief, focused conversations are more effective than annual marathons.

Follow up on development plans: “Two weeks ago we discussed X. How’s that going? What support do you need?”

Make feedback continuous rather than saved up: When you see something in the moment, address it in the moment (or very soon after). Don’t stockpile observations for annual reviews.

Create accountability through regular touchpoints, not through one high-stakes conversation per year.

Why This Matters More Than Ever

Organizations are facing unprecedented challenges: remote work, burnout, diversity and inclusion efforts, rapid change. All of these require difficult conversations — about performance, about behavior, about expectations, about growth.

Leaders who can navigate these conversations effectively have a massive advantage. Those who can’t watch talent walk out the door or, worse, stay and slowly disengage.

The managers who excel at this aren’t necessarily the ones with the best technical skills or the most charisma. They’re the ones who understand how human nervous systems work under stress, who can recognize when someone has moved into threat response, and who know how to create conditions where productive dialogue becomes possible.

These are mediation skills. They’re also essential leadership skills.

The Integration That Changes Everything

As I’ve shared in my work on trauma-informed mediation and recognizing nervous system dysregulation, the most effective facilitators — whether in mediation or management — are those who work with human biology rather than against it.

Performance reviews feel like mediation because they ARE like mediation: two people trying to have a difficult conversation with high emotional stakes, power dynamics at play, and nervous systems on high alert. The conversation succeeds or fails based on whether the facilitator (manager) can create conditions where both parties’ nervous systems feel safe enough to engage.

When managers learn what mediators know about psychological safety, cognitive load, nervous system regulation, and collaborative dialogue, everything changes. Performance reviews become conversations employees prepare for rather than dread. Feedback becomes something people can actually hear and act on. Development becomes a shared journey rather than a judgment handed down.

And managers stop dreading performance review season.

The Bigger Picture

I believe we’re at a turning point in how organizations think about difficult conversations. The old model — annual reviews, comprehensive feedback dumps, “tough love” management — is failing. People are burned out, disengaged, and leaving organizations that don’t know how to have developmentally-focused conversations without triggering threat responses.

The organizations that will thrive are those that train their leaders in the skills that mediators have been developing for decades: reading nervous system states, creating psychological safety, structuring dialogue for maximum receptivity, and treating difficult conversations as processes rather than events.

This isn’t soft skills. It’s neuroscience. It’s communication research. It’s what we actually know about how human beings process challenging information and commit to meaningful change.

Your performance reviews don’t have to feel like mediation in the worst sense — adversarial, defensive, stuck. They can feel like mediation in the best sense — collaborative, productive, and focused on finding solutions that work for everyone.

It starts with understanding what mediators know: that the quality of the conversation depends less on the content you deliver and more on the neurobiological conditions you create for that content to be received.

Are your performance conversations feeling more like conflict than collaboration? What’s your biggest challenge in delivering feedback that actually improves performance? Share in the comments — I’d love to hear from managers navigating these conversations.

About the Author

Malynnda Stewart is a certified conflict mediator through the Michigan Supreme Court, board-certified patient advocate, and health communication expert with 20 years of experience teaching interpersonal and conflict communication. She specializes in trauma-informed facilitative mediation and trains leaders on navigating difficult conversations across contexts — from performance reviews to family healthcare decisions to organizational conflict. Her work integrates neuroscience, communication research, and practical experience to help people have the conversations that matter most. Creator of the BRIDGE Feedback Method for effective, difficult conversations. Connect with Malynnda on LinkedIn or visit Compassionate Navigation to book a free consult.