Desktop SubscribePointing your Whys.


There are whole range of business, self improvement and leadership books written about the word why, there are TED talks about how the word fuels purpose, and there is even a business tool called the 5 whys that advocates the persistent use of this word (usually 5 times) until the a root cause of a problem is found.

I’m a doctor, in the past I used to use the word why in my consultations to find out causes of problems, to find out reasons, to find out specifics and to help me diagnose common conditions, however I’m now increasingly aware of how the word if used wrongly in a coaching, counselling, or medical consultation can demotivate a patient and put them further into their problem state, and this is why at least in a counselling or therapeutic setting we need to learn how to point the word why in a positive direction, and with this in mind allow me to explain a little more.

Let’s imagine that you’re feeling really depressed, if I was to ask you ‘why are you feeling depressed’ you will automatically start to think of all of the reasons that you feel so bad and also start to feel all of the negative emotions that go with it.

By using the word why directed towards a problem you demotivate a person by reminding them of all of the problems and reasons they are feeling so bad.

Too many times as doctors when looking for signs and symptoms to make a diagnosis we can leave the patient feeling trapped in their problem, inadvertently we can concentrate a patient’s attention on their problem state and often we we can even make their condition worse.

Lets use the example of depression, and instead of using asking them ‘why they are depressed’ I believe when exploring their problem we could ask instead ‘what’ is making them feel that way, and ‘how’ are they feeling like that.

With a ‘what’ we can still get more specific, but more importantly this word can lead elsewhere, for example we can use this ‘what’ to lead onto other ‘whats’ we could ask ‘what else’ could they do if they felt like that, or what would they do if they were feeling better.

Alternatively with a ‘how’ instead of a ‘why’ when we are asking about a problem we are also implying that there’s a process and a ‘how’ behind their problem, and with this we can create a question, we can create choice and give the person once stuck in their problem a degree of control over their situation, and we could ask them ‘how are they feeling so depressed’, ‘how else they could they feel or ‘how could they feel better. 

Instead of using why when looking at problems, I use why when directing a patient towards a solution or a positive goal, and in this way I am using why to give purpose and momentum towards a solution.

I would bet that there are few doctors out there that routinely ask a patient ‘why do you want to feel better?’ not surprisingly when I do this I often get pauses and puzzled looks because someone dwelling in a problem too long spends a lot of time thinking about why they feel so bad as opposed to all of the reasons why they should want to get better. 

So point your ‘why’ in the right direction, point it towards solutions, point it towards something that gives purpose and, there is power in the word why, the word why can give the patient meaning and a reason to get better, we just need to use it to push a patient in the right direction and not towards their problem.


Start with Why – Simon Sinek.

TPS / Six Sigma 5 Why Root Cause Analysis.