Sarah, the head nurse at the Pine Valley Medical Center in northwestern Washington, stands frozen as doctors discuss the treatment of an elderly patient. Years of experience have taught Sarah two things: One, the patient probably needed an immediate and large dose of antibiotics, and two, even though the doctors were dis- cussing a treatment that didn’t involve antibiotics, Sarah would keep her mouth shut.

Years earlier, fresh out of college, Sarah had cheerful- ly disagreed with the three doctors she had been assist- ing. They stopped dead in their tracks and looked at her as if she were a cockroach on a wedding cake. In one poignant moment that was forever burned into her psy- che, the rules had been made clear to Sarah: Don’t dis- agree with a physician — ever. Now, nearly two decades and hundreds of confirming incidents later, she stands by wondering: Will the doctors do what I believe they should do, or will they come to the same conclusion too late? She doesn’t wonder if she should speak up. Sarah’s expectations weren’t met, and in response she has resorted to silence.

Staring into the face of a possible disaster, some peo- ple are caught in agonizing silence. Rather than speak directly and frankly about the problem at hand, they drop hints, change the subject, or actually withdraw from the interaction altogether. Fear drives them to vari-  ous forms of silence and their point of view is never heard — except maybe as gossip or rumor.

Others break away from their tortured inaction only to slip into violence. Frightened at the thought of not being heard, they try to force their ideas on others. They cut people off, overstate arguments, attack ideas, employ harsh debate tactics, and eventually resort to insults and threats. Fear drives them to do violence to the discus- sion and their ideas are often resisted.

We all face crucial confrontations. We set clear expec-  tations, but the other person doesn’t live up to them — we feel disappointed. Lawyers call these incidents breaches of contract. What do you do when someone disappoints you? You could choose violence, or you could opt for another choice, like Sarah, and choose silence. But there is a method that falls somewhere between the polar worlds of fight and flight. Mastering crucial confrontations allows you to deal with failed promises, disappointments and other performance gaps.

Unless you step up to and master crucial confrontations, nothing will get better. It will be a skill set, not a policy, that will enable you to solve pressing problems.

If you can’t effectively confront violated expectations, you eventually experience massive personal, social and organizational consequences. If you can’t deal with performance gaps, you’ll either fight or take flight. Productivity will run at half of what it should.

If you learn how to hold people accountable in a way that solves problems without causing new ones, you can look forward to significant and lasting change.

When you confront, you hold someone accountable, face to face. When confrontations are handled correctly, both parties are candid, open, honest and respectful. As a result, problems are resolved and relationships benefit. Crucial confrontation skills offer the best chance to suc- ceed — no matter the topic, person or circumstance.

Learn how to hold crucial confrontations and you’ll never have to walk away from another conflict again.