12. Non-verbal communication
CHAPTER OBJECTIVES
• Explain and give examples of non-verbal communication
• Discuss the significance of non-verbal communication
• Examine the benefits of non-verbal communication
• List and explain the results of non-verbal communication
• Recognise and synthesise the components of non-verbal communication.
Non-verbal communication is, as the name implies, communication without words. It encompasses the environment, manner and style of communicating and the internal values of the person communicating (Holli et al 2003). Non-verbal communication includes the behaviours that accompany words (Burgoon & Hoobler 2002). Crystal (2007) states that even though non-verbal messages carry meaning, they are less flexible and adaptable than verbal modes of expression. While this may be true, non-verbal cues significantly influence the meaning of a sent message and as such are often more important than the spoken words (Egan 2007).
Body language is the general name given to non-verbal cues. Body language includes gesture, facial expression, posture, eye contact, gait and clothing. However, some elements of our speech are also non-verbal. The technical name for non-verbal characteristics of the voice is suprasegmentals. There are two types of suprasegmentals: prosodic and paralinguistic. The prosodic features of the voice include volume, pitch and rate of speech, which combine to create the unique ‘rhythm’ of a language. The paralinguistic features (also called paralanguage) of the voice use other vocal effects to convey meaning; they include emphasis (see Ch 1), timely pauses and tone, as well as laughing, whining, moaning and other non-verbal sounds (Crystal 1997). Suprasegmental vocal characteristics along with body language can change meaning, and thus are worthy of recognition and examination when considering non-verbal communication.
The significance of non-verbal communication
Researchers have investigated the significance of non-verbal cues in communicating meaning. Mehrabian (1981) suggests that the words only carry 7–10% of the meaning of a message. The suprasegmentals of a message carry 38% of the meaning and body language delivers 55% of the meaning. While such statistical reduction of messages is interesting, it does not change the reality that health professionals must use both verbal and non-verbal forms of communication consciously and with care, regardless of the relative significance of either in delivering the meaning.
The benefits of non-verbal communication
Burgoon & Hoobler (2002) indicate that skill in interpreting and using non-verbal behaviour increases the attraction, popularity and psychosocial wellbeing of an individual. However, they also state that the ability to use non-verbal behaviours increases the likelihood of manipulating others. Thus, individuals who are skilful in using non-verbal communication can be influential in assisting and supporting as well as deceiving others.
The effects of non-verbal communication
Non-verbal behaviour regulates or adjusts verbal communication (Egan 2007). It can
• Substantiate or reiterate the meaning of the words (e.g. yelling Yeah! at a football game is often reiterated by throwing arms up in the air or jumping up and down)
• Contradict or complicate the meaning of the words (e.g. stating I am OK with a faltering voice and quivering lip may indicate the opposite meaning to the words)
• Reinforce or accentuate the meaning of the words (e.g. saying No thanks along with specific non-verbal gestures and body positions, such as covering a cup with a hand, makes the message very clear)
• Influence the response of the ‘other’ regardless of words (e.g. avoiding eye contact may indicate a desire to evade interaction, or holding up a hand may indicate a need to stop an interaction).
ACTIVITY
Non-verbal communication can achieve positive and negative results.
List the positive and negative results of the non-verbal behaviours listed above. Consider the results from the perspectives of both parties – the sender and the receiver.
The components of non-verbal communication
Environment
The environment communicates clearly the level of interest in, and care for, the ‘other’ (Brill & Levine 2005; see Ch 8). Seating arrangements in a cosy room that promote appropriate levels of connection communicate careful attention to the needs of those using the room. Health professionals who focus, rather than being distracted by responding to every other event in the service, deliver specific messages that develop trust and positive outcomes.
Body language
DISCUSSION
• Discuss the different meanings of standing while waving both arms frantically above the head. When have you done this or seen others do it?
• How does context assist the interpretation of body language?
The physical appearance of a health professional communicates particular messages. Conscious consideration of those messages assists the health professional to communicate equality and acceptance.
Facial expression
Facial expressions can be powerful additions to words and generally express emotions. Facial expressions can also convey messages without the use of words (Purtilo & Haddad 2002). Some individuals have expressive faces while others rarely use their face to express their emotions. Some comedians are excellent examples of people who, when performing, rarely use facial expressions to communicate their emotions (i.e. the classic ‘deadpan’ delivery). Individuals with expressive faces must take care when communicating with others not to demonstrate emotions they regret. Health professionals should consciously use and control facial expressions to express respect, empathy and attention.
REFLECTION
• Do you use your face to express your emotions regularly?
• How successfully do you express your emotions with your face?
GROUP ACTIVITY
• Each member of the group chooses an emotion (e.g. happy, sad, embarrassed, tired, angry, frustrated, disgusted, anxious, confused, peaceful, lonely, bored, sleepy, interested). Do not tell anyone in the group your chosen emotion.
• Each person uses their face to express their chosen emotion.
• The other group members write down the name of the person and the emotion they are expressing on a piece of paper.
• When everyone has expressed their emotion, check the interpretations of the emotion. How many were incorrect? How could you vary your facial expression to more accurately express the emotion? How many variations of the same emotion were there?
• What are the implications for a health professional if different people assume different emotions from similar facial expressions?
Eye contact
Eye contact in some cultures signals interest and attention, while avoiding eye contact can indicate the opposite (i.e. disinterest). Eye contact can regulate turn-taking in an interaction and indicate the nature of the relationship between the people communicating. Using eye contact can assist the health professional to assess the feelings or functioning of the ‘other’ while communicating.
There are cultural variations in the use of eye contact. Some Aboriginal and Torres Strait Islander Peoples may communicate discomfort or pain by turning their heads to avoid any possibility of eye contact. Some cultures have different rules or beliefs about eye contact relating to gender, age and status.
ACTIVITY
• In pairs, look each other in the eye. How long can you continue this until you feel uncomfortable? Continue beyond the point of discomfort. What was the result?
• Discuss the variations in comfort with eye contact. What does this mean for a health professional?
Gesture
Gestures vary from individual to individual and convey attitudes, feelings and ideas. They do not necessarily require words. Gestures can use the entire upper limb or one finger; using an arm to wave or a finger to wave conveys very different meanings. Folded arms can communicate lack of openness or unhappiness, a tapping foot along with folded arms communicates impatience, and looking at a watch while tapping a foot with folded arms has a different meaning again (i.e. anger). In these cases the action clearly communicates the meaning without words.
Understanding subtle as well as obvious gestures is essential for effective communication (Purtilo & Haddad 2002). When working with people from different cultures it is appropriate for a health professional to state the conventions of gesture in their own culture and ask for the convention in the culture of the person seeking assistance. For example, the health professional might say When we do this it means this; what does it mean to you? Asking such a question of the person will assist understanding and build rapport.
ACTIVITY
Think of five common gestures (e.g. waving). Do they have the same meaning every time they are used? If not, what changes the meaning?
If gestures can change meaning within a single culture due to context, it is inappropriate to assume that the gestures of one culture have the same meaning in another culture. Specifically asking about the meaning of particular gestures in the relevant culture is often conducive to the development of the therapeutic relationship.
Space
The use of space or proximity while interacting is important because it communicates interest (Mohan et al 2004) and, in some cultures, the nature of the relationship. In some South Pacific cultures, the authority figure must always be at a higher level than others. Generally, however, it is important to attempt to communicate on the same level with people seeking assistance. That is, if they are sitting it is beneficial to attempt to sit as well.
REFLECTIVE ACTIVITY
• Converse in pairs while one person is sitting and the other standing. Then swap positions.
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