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How a person speaks says as much, if not more, than what they say. Nonverbal cues, such as facial expression, posture and tone of voice are part of all interpersonal relatedness. Nonverbal cues not only express emotion, but also regulate the body physiology, emotions and behaviors between individuals. The homeostatic regulatory mechanisms and affective exchanges between mother and infant proceed nonverbally. Neuroscience data now indicates these same nonverbal mechanisms occur between adults to facilitate attachment, regulate affect and physiology and to provide a sense of being understood. The impact of nonverbal cues is mediated by circuits involving limbic structures in the brain which activate nonverbal cues along with changes in hormone levels, neurotransmitters and the autonomic nervous system. Clinical vignettes are used to illustrate how nonverbal cues function in the analytic treatment setting to shape both transference and countertransference phenomena. Since nonverbal mechanisms can be activated without conscious awareness, neither patient nor analysand may be directly aware of their impact. Analysts must pay attention to their own feelings, behaviors and body sensations as indirect indicators of the affective state and meanings of the patient.
Regina Pally, M.D. is a psychiatrist in private practice in Los Angeles and a clinical professor of psychiatry at UCLA.
The advent of language is a very mixed blessing [Stern, 1985, p. 177].