A Primary Role for Nonverbal Communication in Psychoanalysis

Regina Pally, M.D.

How we communicate body to body and biology to biology

Types of NVC Body movement Facial expression Gesture Tone of voice Vocal “calls” Visceral changes Posture & Gait

Smell Touch Apparel

Verbal vs. Nonverbal Conscious Voluntary Left hemisphere Past, present, future Feelings more at a

distance Always learned

Cs and Non-Cs Vol./involuntary Right hemisphere Only in the present Feelings are more

immediate May be unlearned

A non-verbal realm of interpersonal exchange exists…. body to body, biology to biology

The body speaks

The body listens

The anaylst’s involuntary, innate, nonverbal responses provide additional sources to understanding the meaning of the patient's material.

"Language is inadequate to the task of communicating internal states.” Stern

Language causes a rupture between what one says and how

one feels

Darwin understood emotional expression

similar in man and animals activity of nervous system can be non-conscious has survival value often unlearned

Functions of NVC Communicate:

emotion, state, intention

Trigger: response in others

Regulate: other’s emotion/physiology

Organize social relatedness

Share mental states Organize spoken

conversation

trigger/release non-verbal behaviors in others

Trigger Threat display

Mating display (male)

Released behavior Submission

“Presentation” display (female)

Regulate Social Interaction Smiling

invites ‘face to face’ engagement controls aggression in others

Direct eye contact: creates threat activates aggression

Regulate Affect & Physiology

Lowered head of “shame” initiates ‘repair response’

Infant distress cry Activates nurturance, ‘care-taker’ response

Animal “alarm calls” Basis of human calls: grunt, shout Not semantic: not symbolic Function to regulate behavior in others

in the ‘here and now’ Vervet ‘lion call’….run up a tree Vervet ‘eagle call’….run in the bushes

Alexithymia Lack verbal expression of emotion Lack nonverbal expression of emotion But ANS still indicates emotional

arousal Because of lack NVC, they don’t elicit

empathy in others

Crying and Grief Reaction Crying (even in adults): elicits

responses in others to alleviate the person’s distress

Grief reactions (even without crying): activates social relatedness between the mourner and others

Infant-Caretaker: earliest NVC

Smell- infant can find the breast in the dark Touch- increases feeding and weight gain Babyish appearance- promotes the

“nurturant response” in caretakers

Protoconversation: 2months infant focuses on face and voice of

mother responds in “listen and reply” manner Voice, gesture, body enters “back and

forth” exchange with mother

Mirroring/Expectancy: 3-9mos

0- 6 mos: caretaker responds with same modality (vocalization, face, gesture)

3-4 mos: express emotion 8-9 mos: caretaker uses multi-modal

response, attachment is cemented Distress: if “expectancy” fails to occur

Matching of NVC: “adult-adult” Affiliation Sense of warmth Feeling of friendship

Empathy and Theory of Mind Empathy: requires “theory of mind”

development Theory of Mind: others have mental

states which differ from one’s own Shared point of view/pointing (9 mos):

early step in development of “theory of mind”

NVC regulates infant exploratory behavior Social referencing: infant checks

caretaker’s response to exploration Shame response: abrupt interruption of

exploratory behavior Construction of childhood narratives:

what is OK to say and what is not

A special system for detecting “Social Signals” Amygdala, anterior temporal lobe, OFC Special cells for detecting social cues Ex: direct eye contact, arched

eyebrows, open mouth Signal feelings and intentions Angry, hungry, lonely, fight, mate, play

Facial expression and ANS

Facial expression linked ANS

6 basic emotions (anger, fear, sadness, disgust, happiness, surprise)

Emotion and Reason

Body changes: integral to all emotion

Body changes of emotion: play an important role in reason and adaptive problem solving

Brain Circuit: NVC

AMYGDALA

CORTEX

THALAMUS

HYPOTHALAMUSBRAIN STEM

Autonomic Nervous System•Sympathetic: Fight or Flight•Parasympathetic: Rest and Digest

Motor System•Posture•Head Position•Gesture•Facial expression

Endocrine System•Oxytocin•Vasopressin•HPA-cortisol

Visual inputs

Facial expression:sadness

OFC

Autonomic Nervous System

Sympathetic Dilate pupil Inhibit salivation Increase heart rate Increase respiration Inhibit digestion

Parasympathetic Constrict pupil Stimulate salivation Decrease heart rate Decrease respiration Stimulate digestion

Separation & loss of regulation Cry of distress Decreased activity & exploratory behavior Ignore food and non-nutritive sucking Decreased temperature, heart rate Increased cortisol Neurotransmitters: GABA, endorphins, 5-

HT

Grief Reaction Even adults regulate one another Adult grief reaction parallels infant

separation Initial “protest phase”: acute grief Followed by “despair phase”:

dysregulation, sleep, eating, activity, CV status, immune response

Reunion Response

Each species has unique reunion response

Reunion behaviors increase endogenous opiates

Reunion is “rewarding” and “addictive”

Stress hormones and NVC Stress stimulates catecholamines (NE) Continued stress stimulates cortisol PTSD: increased NE, but ‘blunted’

cortisol response ‘blunted’ cortisol may be associated

with decreased RH/LH integration

Take Home Lesson

People are designed by nature to communicate nonverbally at all times

The analysts non-verbal response guides the verbal one

We will soon have the “non-talking” as well as the “talking cure”

“Right Brain-Left Brain” Normally function in integrated fashion Right hemisphere: non-verbal aspects

of emotion and communication Left hemisphere: spoken language,

functions as ‘interpeter’ of RH emotion