A Primary Role For Nonverbal


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  • How a person speaks says as much, if not more, than what they say. In fact there are some aspects of experience, such as feelings of attachment, empathy and the subtleties of emotion, which are better expressed nonverbally than verbally. Psychoanalytic technique traditionally relies on verbal exchange and gives privileged status to language. However, since words alone never quite capture lived experience, more attention needs to be given to nonverbal aspects of communication. P 1
  • A Primary Role For Nonverbal

    1. 1. A Primary Role for Nonverbal Communication in Psychoanalysis Regina Pally, M.D. How we communicate body to body and biology to biology
    2. 2. Types of NVC <ul><li>Body movement </li></ul><ul><li>Facial expression </li></ul><ul><li>Gesture </li></ul><ul><li>Tone of voice </li></ul><ul><li>Vocal “calls” </li></ul><ul><li>Visceral changes </li></ul><ul><li>Posture & Gait </li></ul><ul><li>Smell </li></ul><ul><li>Touch </li></ul><ul><li>Apparel </li></ul>
    3. 3. Verbal vs. Nonverbal <ul><li>Conscious </li></ul><ul><li>Voluntary </li></ul><ul><li>Left hemisphere </li></ul><ul><li>Past, present, future </li></ul><ul><li>Feelings more at a distance </li></ul><ul><li>Always learned </li></ul><ul><li>Cs and Non-Cs </li></ul><ul><li>Vol./involuntary </li></ul><ul><li>Right hemisphere </li></ul><ul><li>Only in the present </li></ul><ul><li>Feelings are more immediate </li></ul><ul><li>May be unlearned </li></ul>
    4. 4. <ul><li>A non-verbal realm of interpersonal exchange exists…. body to body, biology to biology </li></ul>The body speaks
    5. 5. The body listens <ul><li>The anaylst’s involuntary, innate, nonverbal responses provide additional sources to understanding the meaning of the patient's material. </li></ul>
    6. 6. &quot;Language is inadequate to the task of communicating internal states.” Stern Language causes a rupture between what one says and how one feels
    7. 7. Darwin understood emotional expression <ul><li>similar in man and animals </li></ul><ul><li>activity of nervous system </li></ul><ul><li>can be non-conscious </li></ul><ul><li>has survival value </li></ul><ul><li>often unlearned </li></ul>
    8. 8. Functions of NVC <ul><li>Communicate : emotion, state, intention </li></ul><ul><li>Trigger : response in others </li></ul><ul><li>Regulate : other’s emotion/physiology </li></ul><ul><li>Organize social relatedness </li></ul><ul><li>Share mental states </li></ul><ul><li>Organize spoken conversation </li></ul>
    9. 9. trigger/release non-verbal behaviors in others <ul><li>Trigger </li></ul><ul><li>Threat display </li></ul><ul><li>Mating display (male) </li></ul><ul><li>Released behavior </li></ul><ul><li>Submission </li></ul><ul><li>“ Presentation” display (female) </li></ul>
    10. 10. Regulate Social Interaction <ul><li>Smiling </li></ul><ul><ul><li>invites ‘face to face’ engagement </li></ul></ul><ul><ul><li>controls aggression in others </li></ul></ul><ul><li>Direct eye contact : </li></ul><ul><ul><li>creates threat </li></ul></ul><ul><ul><li>activates aggression </li></ul></ul>
    11. 11. Regulate Affect & Physiology <ul><li>Lowered head of “shame” </li></ul><ul><ul><li>initiates ‘repair response’ </li></ul></ul><ul><li>Infant distress cry </li></ul><ul><ul><li>Activates nurturance, ‘care-taker’ response </li></ul></ul>
    12. 12. Animal “alarm calls” <ul><li>Basis of human calls: grunt, shout </li></ul><ul><li>Not semantic: not symbolic </li></ul><ul><li>Function to regulate behavior in others in the ‘here and now’ </li></ul><ul><li>Vervet ‘lion call’….run up a tree </li></ul><ul><li>Vervet ‘eagle call’….run in the bushes </li></ul>
    13. 13. Alexithymia <ul><li>Lack verbal expression of emotion </li></ul><ul><li>Lack nonverbal expression of emotion </li></ul><ul><li>But ANS still indicates emotional arousal </li></ul><ul><li>Because of lack NVC, they don’t elicit empathy in others </li></ul>
    14. 14. Crying and Grief Reaction <ul><li>Crying (even in adults): elicits responses in others to alleviate the person’s distress </li></ul><ul><li>Grief reactions (even without crying): activates social relatedness between the mourner and others </li></ul>
    15. 15. Infant-Caretaker: earliest NVC <ul><li>Smell- infant can find the breast in the dark </li></ul><ul><li>Touch- increases feeding and weight gain </li></ul><ul><li>Babyish appearance- promotes the “nurturant response” in caretakers </li></ul>
    16. 16. Protoconversation: 2months <ul><li>infant focuses on face and voice of mother </li></ul><ul><li>responds in “listen and reply” manner </li></ul><ul><li>Voice, gesture, body enters “back and forth” exchange with mother </li></ul>
    17. 17. Mirroring/Expectancy: 3-9mos <ul><ul><li>0- 6 mos: caretaker responds with same modality (vocalization, face, gesture) </li></ul></ul><ul><ul><li>3-4 mos: express emotion </li></ul></ul><ul><ul><li>8-9 mos: caretaker uses multi-modal response, attachment is cemented </li></ul></ul><ul><ul><li>Distress: if “expectancy” fails to occur </li></ul></ul>
    18. 18. Matching of NVC: “adult-adult” <ul><li>Affiliation </li></ul><ul><li>Sense of warmth </li></ul><ul><li>Feeling of friendship </li></ul>
    19. 19. Empathy and Theory of Mind <ul><li>Empathy : requires “theory of mind” development </li></ul><ul><li>Theory of Mind : others have mental states which differ from one’s own </li></ul><ul><li>Shared point of view/pointing (9 mos): early step in development of “theory of mind” </li></ul>
    20. 20. NVC regulates infant exploratory behavior <ul><li>Social referencing : infant checks caretaker’s response to exploration </li></ul><ul><li>Shame response : abrupt interruption of exploratory behavior </li></ul><ul><li>Construction of childhood narratives : what is OK to say and what is not </li></ul>
    21. 21. A special system for detecting “Social Signals” <ul><li>Amygdala, anterior temporal lobe, OFC </li></ul><ul><li>Special cells for detecting social cues </li></ul><ul><li>Ex: direct eye contact, arched eyebrows, open mouth </li></ul><ul><li>Signal feelings and intentions </li></ul><ul><li>Angry, hungry, lonely, fight, mate, play </li></ul>
    22. 22. Facial expression and ANS <ul><li>Facial expression linked ANS </li></ul><ul><li>6 basic emotions (anger, fear, sadness, disgust, happiness, surprise) </li></ul>
    23. 23. Emotion and Reason <ul><li>Body changes: integral to all emotion </li></ul><ul><li>Body changes of emotion: play an important role in reason and adaptive problem solving </li></ul>
    24. 24. Brain Circuit: NVC AMYGDALA CORTEX THALAMUS HYPOTHALAMUS BRAIN STEM <ul><li>Autonomic Nervous System </li></ul><ul><li>Sympathetic: Fight or Flight </li></ul><ul><li>Parasympathetic: Rest and Digest </li></ul><ul><li>Motor System </li></ul><ul><li>Posture </li></ul><ul><li>Head Position </li></ul><ul><li>Gesture </li></ul><ul><li>Facial expression </li></ul><ul><li>Endocrine System </li></ul><ul><li>Oxytocin </li></ul><ul><li>Vasopressin </li></ul><ul><li>HPA-cortisol </li></ul>Visual inputs Facial expression: sadness OFC
    25. 25. Autonomic Nervous System <ul><li>Sympathetic </li></ul><ul><li>Dilate pupil </li></ul><ul><li>Inhibit salivation </li></ul><ul><li>Increase heart rate </li></ul><ul><li>Increase respiration </li></ul><ul><li>Inhibit digestion </li></ul><ul><li>Parasympathetic </li></ul><ul><li>Constrict pupil </li></ul><ul><li>Stimulate salivation </li></ul><ul><li>Decrease heart rate </li></ul><ul><li>Decrease respiration </li></ul><ul><li>Stimulate digestion </li></ul>
    26. 26. Separation & loss of regulation <ul><li>Cry of distress </li></ul><ul><li>Decreased activity & exploratory behavior </li></ul><ul><li>Ignore food and non-nutritive sucking </li></ul><ul><li>Decreased temperature, heart rate </li></ul><ul><li>Increased cortisol </li></ul><ul><li>Neurotransmitters: GABA, endorphins, 5-HT </li></ul>
    27. 27. Grief Reaction <ul><li>Even adults regulate one another </li></ul><ul><li>Adult grief reaction parallels infant separation </li></ul><ul><li>Initial “protest phase”: acute grief </li></ul><ul><li>Followed by “despair phase”: dysregulation, sleep, eating, activity, CV status, immune response </li></ul>
    28. 28. Reunion Response <ul><li>Each species has unique reunion response </li></ul><ul><li>Reunion behaviors increase endogenous opiates </li></ul><ul><li>Reunion is “rewarding” and “addictive” </li></ul>
    29. 29. Stress hormones and NVC <ul><li>Stress stimulates catecholamines (NE) </li></ul><ul><li>Continued stress stimulates cortisol </li></ul><ul><li>PTSD: increased NE, but ‘blunted’ cortisol response </li></ul><ul><li>‘ blunted’ cortisol may be associated with decreased RH/LH integration </li></ul>
    30. 30. Take Home Lesson <ul><li>People are designed by nature to communicate nonverbally at all times </li></ul><ul><li>The analysts non-verbal response guides the verbal one </li></ul><ul><li>We will soon have the “non-talking” as well as the “talking cure” </li></ul>
    31. 31. “Right Brain-Left Brain” <ul><li>Normally function in integrated fashion </li></ul><ul><li>Right hemisphere: non-verbal aspects of emotion and communication </li></ul><ul><li>Left hemisphere: spoken language, functions as ‘interpeter’ of RH emotion </li></ul>