NON-VERBAL COMMUNICATION

We give and receive powerful non-verbal messages about each other. When we say we have “an intuition” or “a feeling about someone” we have usually been reading non-verbal cues. If words and body language are incongruent it is the latter that is believed. (“He said the operation was a success, but I didn’t believe him.”) Body language is very difficult to control or alter. Some is autonomic and outside conscious control (skin flushes, pupil size).

«  Body language must be interpreted in context. It is clusters of signals that convey information. There are significant cultural variations in how body language is interpreted.

Eye contact should ideally occur for 60% to 70% of the time during a conversation (less can seem evasive, more can seem hostile or flirtatious depending on other signals). Poor eye contact may be due to shyness or awkwardness, but tends to suggest dishonesty or coldness. Looking only at the eyes and forehead (instead of the whole face) can convey coldness. Even brief eye contact with a smile can be supportive behavior in a crisis. (see Support)

Facial expression is very important. Many expressions are universal. For example, the eyebrow is raised for a greeting, or the furrowed brow and tightened muscles around the eyes suggest sadness or tension. (In primates, this latter facial expression often precedes a loud scream.) No other animal has as many superficial facial muscles as man, and we recognize each other not by smell but by facial characteristics. We can detect the most minute changes in facial expression and we are sensitive to their meaning. We become skillful at facial displays, but most people cannot sustain them for long. (Notice how hospitalized patients relax their facial muscles a few seconds after the doctor has visited them and left their bedside.)

Posture conveys attitudes. Sitting down with someone is a powerful message. (“On the level” means honesty.) We tend to turn our body towards what interests us. This can give away our true feelings. When standing we point our feet towards what interests us. We cross our arms or legs when we feel defensive, or want to distance ourselves from someone. Leaning back on a chair can make us appear aggressive or domineering. When two people are in agreement they often mirror each other’s posture and unconsciously take up the same position as each other. The distance we stay from others conveys a message. Entering a person’s intimate zone (about 12 inches) is often allowed for doctors and nurses in the right context, but can sometimes signal either flirtation or aggression (depending on other cues and on culture). Richard Asher observed that the distance a person sits from the back of a chair often correlates with anxiety levels.

Gestures and mannerisms can easily be misinterpreted. Looking over the top of eyeglasses tilts the chin down which tends to convey disapproval. Fidgeting with the hands may be a habit, but tends to convey irritation or frustration. A palm-downwards handshake signals a dominant attitude, a palm-upwards handshake signals willingness to give control to the other person. Hand-to-face gestures are mostly displaced hand over mouth gestures (seen often in lying children) and often indicate that the person is having negative thoughts.

The spoken word has music as well as content. Tone of voice, volume, variation, emphasis, sighs, laughter, pauses — all convey messages. Not discussing a topic can be a powerful communication. Even sad words ("You have got a serious illness which is going to shorten your life") can be spoken in a depressing, pessimistic way or a kind and supportive way.

Touch is a very powerful form of non-verbal communication. This is emphasized by a psychological experiment in which the feelings of subjects towards a librarian (in fact an actress) were significantly affected by whether or not she touched their hand (very briefly) as she returned their library card. (see Touch)

Smell affects communication (and is the basis of the perfume industry). A foul smelling wound or discharge reduces communication and can be socially isolating.

Non-verbal signs of anxiety, awkwardness or anger include:

• Looking away

• Eye closing (for longer than one second)

• Side glance with furrowed brow

• Chin down

• Displacement gestures (picking at clothes)

• Hand-to-face gestures

• Fingers in the mouth

• Neck rubbing

• Clenched fists

• Tight grip (on objects or self)

When talking to patients ask yourself “What is my body communicating?” Feelings affect body language, and body language affects feelings. Consciously practicing good body language habits may produce positive feelings. (see Talking with Patients)

Awareness of non-verbal communication is not new. The following passage was written over 3,000 years ago: “If you have been foolish, exalting yourself, or if you have been devising evil, put your hand on your mouth.” (Proverbs 30; verse 32)

The author and publisher have taken precautions to ensure that the information in this book is error-free. However, readers must be guided by their own personal and professional standards of good practice in evaluating and applying recommendations made herein. The contents of this book represent the views and experience of the author, and not necessarily those of the publisher.