PAWELCZYK

GESPIN – GESTURE & SPEECH IN INTERACTION – Poznań, 24-26 September 2009

‘Your head is moving, do it out loud!’: Therapist’s uptake of clients’ non-verbal cues in Relationship-Focused Integrative Psychotherapy sessions Joanna Pawelczyk School of English, Adam Mickiewicz University Al. Niepodległości 4, 60-874, Poznań, Poland pasia@ifa.amu.edu.pl

Abstract In everyday interactions there is a paradox about interpreting non-verbal behavior. On the one hand, interlocutors treat non-verbal messages as primary to speech (cf. Argyle et al. 1970; Richmond, McCroskey 2000), yet their indeterminacy and ambiguity make them not fully reliable for interpretation of communicative behavior (Jaworski, Galasinski 2002). Contrary to everyday settings, in the context of psychotherapeutic interaction, the therapist extensively relies on the client’s potentially indeterminate and ambiguous non-verbal signals in order to help him/her explore conflicting motivations. Non-verbal behavior as a representative of ‘the unconscious’ (cf. Beier, Young 1998: 252) occupies a significant place in the psychotherapeutic process. Since much of non-verbal communication entails the communication of emotion, psychotherapists devote a lot of attention to clients’ voice tone, facial expression, and body language. The focus of the paper falls on exploring the relationship between speech and nonverbal cues in Relationship-Focused Integrative Psychotherapy sessions. More specifically I will examine the instances in which client’s (unconscious) nonverbal behavior is directly oriented to by the psychotherapist. By applying the methods of discourse analysis and conversation analysis, I will demonstrate 3 types of interactional contexts in which clients’ non-verbal cues are taken up by the therapist for further work. These contexts represent different patternings in terms of verbal non-verbal relationship. I will also discuss what such orientation accomplishes in the interactional here-and-now as well as will address the potential benefits that the work on client’s non-verbal behavior can have for his/her future everyday interactions.

1

Introduction

As early as 1969, Ekman and Friesen underlined that the non-verbal aspect ‘can repeat, augment, illustrate, accent, or contradict the words’ (1969: 53). Similarly, Key (1982: 9) states that verbal message ‘is accompanied, modified, reinforced, enhanced, and nullified by nonverbal concomitants’. These statements undoubtedly point to the unique relationship between the verbal and non-verbal aspects of communication.

Much of non-verbal communication entails the communication of emotion. Riggio (1992) discusses the concept of ‘non-verbal communication skill’ which refers to people’s abilities to communicate through non-verbal channels. This concept implies a high degree of awareness not only to one’s own, but also to another interlocutor’s aspects of non-verbal communication. It can be assumed that certain professions should involve greater adeptness at the ‘non-verbal

GESPIN proceedings, vol. I

communication skill’ for the benefit of the involved participants. One such professional area is the field of psychotherapy.

Aspects of non-verbal communication feature prominently in psychotherapeutic interactions.

Researchers (e.g. Ekman, Friesen 1969; Zuckerman et al. 1986) state that inconsistencies between client’s different channels of communication may be indicative of the client feeling ambivalent or attempting to hide certain information from the therapist. Therapists claim that the message conveyed in a nonverbal manner nearly always carries more significance than the words it accompanies (cf. Moursund, Erskine 2004). In fact, Labov and Fanshel (1977) in their groundbreaking study on therapeutic discourse assert that in the case of some sort of incoherence between the text (i.e., the verbal message) and the accompanying paralinguistic cues, the latter define the underlying meaning of what the client is trying to communicate. Similarly, Philippot et al. (2003) state that nonverbal messages may be more indicative of the client’s true affect and attitude.

The methods of discourse analysis and conversation analysis applied to the data under scrutiny revealed 3 types of interactional contexts in which the client’s non-verbal behavior is directly addressed to by the therapist for further therapeutic work. Since the current study is strongly CAoriented, it is based on audio-only recordings: CA’s explicit focus on the organization of talk-in-interaction means that gesture, body movement and facial expression tend not to be studied in their own right, as may be the case in the field of interactional kinesics (Kendon 1990), but rather in exploring the relationships between speech and body movement. It is entirely feasible, within CA, to analyze audio-only recordings even when the participants have visual access to one another (Hutchby 2007: 21).

2 2.1

Data analysis and discussion

Data

The data used for the analysis stem from a corpus of 65-hours of recorded therapy sessions collected during fieldwork at two residential Integrative Psychotherapy workshops (Erskine, Moursund 1988; Moursund, Erskine 2004). Although the name ‘workshop’ may be confusing, the recorded interactions constitute actual psychotherapy sessions, conducted by the same male psychotherapist, who talked with the clients individually, but in the presence of other clients. There were twenty five clients (five males and twenty females) at both workshops. The recorded material has been transcribed with a focus on both utterance and interactional content. Even though the discussed excerpts are verbatim transcripts of the actual therapeutic sessions, participants’ confidentiality has been fully protected at the stage of data transcription, as any personal information that could potentially reveal their identities has been omitted or changed.

Relationship-Focused Integrative Psychotherapy is premised primarily on four theoretical perspectives: Transactional analysis, Gestalt therapy, client-centered therapy, and behaviorism and as such ‘attends seriously to what has been observed by all the major schools’ (Wachtel 1990: 235).

2.2

Data analysis

In the following section, I will present examples from my data to illustrate 3 patternings of therapist’s uptake of client’s non-verbal cues.

2.2.1

Type 1: Contrastive patterning: Lack of congruence between verbal — nonverbal cues

Psychotherapists often look for a lack of congruence between the verbal and non-verbal messages communicated by the client. Such incongruence frequently points to some therapeutically relevant material that should be first verbalized by the client and then worked on by both parties. Arndt and Janney (1987: 66; cf. also Caffi, Janney 1994) explicate that since speakers in an ordinary interaction expect ‘schema-consistent behavior’, they pay more attention and are communicatively more alert to those communicative choices where the verbal mode is either not sufficiently confirmed by nonverbal modes, or where it is clearly contradicted by prosodic or kinesic choices.

2

Joanna Pawelczyk: ‘Your head is moving, do it out loud!’: Therapist’s uptake of clients’ non-verbal cues in Relationship-Focused Integrative Psychotherapy sessions

In cases of such contrastive, there is a tendency to trust the nonverbal information more than the verbal information, as such indexical information is considered more ‘caused’ or unintentionally communicated than ‘causal’ or intentionally communicated (cf. also Besnier 1990).

Yet as Arndt and Janney (1987: 139) claim there seems to be an unwritten rule in interaction (i.e., an ordinary conversation) that partners only interpret those communicative choices, which are supposedly intentionally communicated, i.e., those choices that reflect speakers’ attitudes towards their partners and their (communicative) relationship. Since this unintentionally communicated ‘caused information’ features a fleeting quality, it can be assumed that speakers are often not very much aware of proffering such information and interlocutors usually deliberately overlook it.

Instead, their next utterances are built on information they take as intentionally communicated.

Nevertheless, the other information (‘caused’) is not ignored or considered irrelevant but contributes to the receiver’s overall judgment of the communicative interaction with the partner.

There is however, a difference between an ordinary conversation where such incongruence tends to be neglected and the communicative situation of psychotherapy where this unintentionally communicated (‘caused’) information is treated as more significant and closer approaching the client’s real attitude or emotional state. For example, in the collected data, the psychotherapist often loudly commented on the evident discrepancy between the client’s verbal input (‘casual’) and the accompanying non-verbal contribution: Extract 1 1 C: 2 3 4 5 6 7 8 T: 9 C: 10 T: 11 12 C:

If I relax and I’m I’m myself (.) then it’d be somehow (2.0) something a::wful, >even though< I kno::w intellectually that (.) when I’m myself >people tend to like me< even more ‘cause I’m with sane ↑people (1.0) but that was never my experience, >you know<, (2.0) I always had crazy people arou::nd and it’s kindda hard to trust that there are non crazy people (.) (.hhh) who would respond in a non-crazy way= = so when X comes and gives you a kiss?

Then (.) I >could< just think, oh, that was nice.

That’s still only half way there and I’m watching your shoulder shake her off. (.) Yeah, guess it’s hard for me to accept it, kind of like, why?

In Extract 1, the therapist poses a hypothetical situation for the client in which he is offered some unsolicited affection from another client whom he knows (line 8). Even though the client seems to be willing to accept the warmth from a female colleague (line 9), the therapist overtly comments on the accompanying non-verbal leakage from the client (cf. Ekman, Friesen 1967) which undermines the verbalized acceptance (lines 10-11). Thus the movement of the shoulder stands in stark contrast with the declared acceptance of the fondness (verbal information). The incongruence points to serious therapeutic relevance of the discussed issue as psychotherapists often interpret the ‘unintentional’ messages as information about internal states of their clients. As the extract evinces, the therapeutic setting permits the client to explore the conflicting motivations and, ideally, understand the consequences of the hidden nonverbal communication. The professional Stocks of Interactional Knowledge (Peräkylä, Vehviläinen 2003) of Integrative Psychotherapy refer to the therapist’s recognition of a client’s incongruence between verbal and non-verbal input as confrontation, and subsume it in the category of therapist’s interpretations: ‘the client’s facial expression may not match his voice tone, for instance and neither of them may fit with the content of what he is saying’ (Moursund, Erskine 2004: 166). The aim of such confrontation is to broaden and deepen the client’s awareness and enhance his/her well-being.

2.2.2

Type 2: Redundant patterning: Congruence between verbal and non-verbal cues

Redundant patterning involves a congruence between the client’s verbal and non-verbal messages.

The therapist however, explicitly asks the client for an interpretation of his/her non-verbal behavior

3

GESPIN proceedings, vol. I

that accompanies the proffered verbal message. This is a particularly salient strategy, as the proffered non-verbal behavior does not seemingly contradict the client’s verbal message. Let us consider the following example: Extract 2 1 C: 2 3 T: 4 C: 5 T: 6 7 C: 8 9 T: 10 11 C: 12 T: 13 C: 14 T: 15 16 C:

I think the whole situation was a TORTURE, I couldn’t trust my mother who I stayed with the who:le day (.) she lied to me.

Tell me about that. °How did she lie?° Sometimes she said if you do thi:s then you can go out // >So she made conditional promises.< Yeah, and >when I did everything< I couldn’t go out anyway because I supposedly did things ba:dly the day before.= = So she makes a contract with you and then breaks the contract because of an old crime.

Yeah.

Your head is moving, do it out loud. °I hate to be a victim.° I think that’s true of all of us (.) I don’t mean to discount what you said but that’s pretty normal.

Yeah.

In Extract 2 the client expands on his difficult and in effect traumatic relationship with his mother when he was a child (lines 1-2, 4, 7-8). The therapist, with his interactional behavior, manifests his involvement by providing a concluding comment (lines 5-6), and latching rejoinders to the client’s statement (lines 9-10). In fact, both parties actively collaborate in building the interaction. In line 12, the therapist overtly comments on the client’s gesture and in the second part of the statement the client is asked to account for the act. The client’s explanation (line 13) constitutes an elaboration of his previous statements. He must have felt like a victim, being a (vulnerable) child, but that kind of treatment has always been rejected by him. The gesture performed by the client functions as a reflection and reinforcement of the accompanying verbal message and the therapist’s overt comment (line 12) helped the client to give voice to another aspect of his childhood experience (being a victim) that had grave consequences for his adulthood.

The meaning of the client’s gesture has become transparent, i.e., the client accounted for it in terms of his personal experience.

This strategy, as applied by the therapist, performs a number of important functions that aim at enhancing the therapeutic endeavor. First of all, drawing the client’s attention to his/her non-verbal behavior has the potential of boosting the client’s awareness of his/her emotional states (cf. Labov, Fanshel 1977). The recognition and realization of displaying certain non-verbal behavior has the potential, in turn, to reassure the clients about their real emotional stances. A client’s displayed non-verbal behavior can also manifest aspects of his/her suffering that have not yet been talked about by him/her during the sessions with the therapist, due to their emotional load. Thus they can be used as triggers to prod the client to talk about the as-yet unexpressed. Finally, the therapist’s careful observation and reading of the client’s communicative patterns significantly contributes to building a therapeutic alliance between them.

2.2.3

Type 3: Incomplete patterning: Verbal component is missing, non-verbal signal is present

In this type of patterning, the therapist overtly comments on the client’s non-verbal signal. In extract 3, a client begins to talk about her suicidal feelings: Extract 3 1 C: 2

Well, I’ve sometimes felt ↑suicidal and it’s not been about killing here and now.

4

Joanna Pawelczyk: ‘Your head is moving, do it out loud!’: Therapist’s uptake of clients’ non-verbal cues in Relationship-Focused Integrative Psychotherapy sessions

3 4 5 6 7 8 9 10 11 12

T: T: C: T: C:

Have you talked to other people about your relationships?

Keeping diary? Talking to other people about it?

(6.0) Are you shaking your head? Wh:y are you shaking your head now?

I try.

I don’t know what the phrase means, ‘I try’, what do you mean when you tell me ‘I try’? (.) I don’t even exactly know myself, I don’t know what to say to anybody anymore (.) I just don’t know.

The second part of the client’s disclosure in lines 1-2 (‘it’s not been about killing here and now’) reveals that the suicidal feeling has been accompanying the client in her daily endeavors.

This is a very powerful statement as far as its content is concerned, yet it does not get completed.

Even though the client says that ‘it’s not been about killing here and now’, she, in the same turn, does not continue what in fact ‘it has been about’. It can be assumed then that in lines 1-2 the client is attempting to introduce a new topical angle into the session (cf. the use of discourse marker ‘well’). It might be that due to the emotional load of the disclosure, the client is bringing in the new story gradually, awaiting the therapist’s reaction. In line 3 and 4 the therapist attempts to encourage the client to talk about the ways she has dealt with the tragic situation. The series of therapist’s questions is followed by a six-second pause. The client does not continue with expanding on the ‘suicidal’ theme. Even though not responding in a verbal way, the client still communicates in a non-verbal way. In lines 6-7, the therapist openly comments on the client’s shaking her head. This comment takes the form of a question aimed at eliciting from the client the function of this gesture at this particular point of the therapeutic session. In line 8 the client provides the interpretation of the gesture, yet it is regarded by the therapist as not satisfactory as far as the therapeutic effect is concerned. Consequently, the therapist directly confronts the client in line 9 with the question ‘what do you mean’. This interactional move elicits from the client another example of her suicidal feeling, that is, a feeling of hopelessness (lines 11-12).

The therapist’s explicit comment on the client’s non-verbal behavior enables her to talk about the difficult experience. It is important to underline that the therapist resorts to a most confrontational routine to make the client uncover further aspects of her suffering when she, in the therapist’s view, did not manage to account for the significance of her gesture earlier in the exchange. It might also be that the client is not aware of the particular gesture she has displayed and, consequently, is not able to precisely define its meaning. Yet, drawing the client’s attention to her non-verbal acts enhances the awareness of emotional states. It is also noteworthy that the client’s gesture could potentially function as an answer to the therapist’s questions in lines 3-4.

Thus it would indicate that she neither talked to other people about her problem nor kept a diary. If the therapist had not confronted the client about the construal of the non-verbal act, she would not have revealed the traumatic aspect of the ‘hopelessness’ of her life.

3

Conclusion

Arndt and Janney (1991: 542) state that emotive messages which are not explicitly verbalized can be signaled vocally and kinesically, and that they are functionally equivalent to verbal expressions but not as binding. It seems that clients’ reliance on aspects of kinesics and additionally on verbal yet general, abstract notions helps them to convey to the therapist personally important yet difficult to verbalize experiences. The non-verbal means of expression emerge as highly effective in the context of psychotherapy, enabling the client and psychotherapist to access therapeutically relevant material. By attending to the intricate dynamics between client’s verbal and non-verbal communicative behavior, the therapist underlines his presence and involvement in the client’s personal work. By focusing on their non-verbal behavior, clients gradually deepen their awareness of emotional states. This in turn leads to enhanced emotional presence that clients experience in the everyday situations (being here-and-now).

5

GESPIN proceedings, vol. I

Bibliography Argyle, M., Slater, V., Vicholson, H., Williams, M. and Burgess, P. 1970. The communication of inferior and superior attitudes by verbal and non-verbal signals. British Journal of Social and Clinical Psychology 9, pp. 221-231.

Arndt, H. and Janney, R. W. 1987. Intergrammar: Toward an Integrative Model of Verbal, Prosodic, and Kinesic Choices in Speech. Berlin New York: Mouton de Gruyter.

Arndt, H. and Janney, R. W. 1991. Verbal, prosodic, and kinesic emotive contrasts in speech. Journal of Pragmatics 15, pp. 521-549.

Beier, E. and Young, D. M. 1998. The Silent Language of Psychotherapy: Social Reinforcement of Unconscious Processes. Third Edition, New York: Aldine.

Besnier, N. 1990. Language and affect. Annual Review of Anthropology 19, pp. 419-451.

Caffi, C. and Janney, R. W. 1994. Towards a pragmatics of emotive communication. Journal of Pragmatics 22, pp. 325374.

Ekman, P. and Friesen, W. V. 1969. Nonverbal leakage and clues to deception. Psychiatry 32, pp. 88-106.

Erskine, R. and Moursund, J. 1988. Integrative Psychotherapy in Action. Newbury Park, CA: Sage Publications.

Hutchby, I. 2007. The Discourse of Child Counselling. Amsterdam: John Benjamins Publishing Company.

Jaworski, A. and Galasinski, D. 2002. The verbal construction of non-verbal behaviour: British press reports of President Clinton’s grand jury testimony video. Discourse & Society 13/5, pp. 629-649.

Kendon, A. 1990. Conducting Interaction. Cambridge: Cambridge University Press.

Key, M. R. 1982. Overall considerations of human beings interacting in their world. In M. R. Key (ed.), Nonverbal Communication Today. New York: Mouton de Gruyter, pp. 3-13.

Labov, W. and Fanshel, D. 1977. Therapeutic Discourse: Psychotherapy as Conversation. New York: Academic Press.

Moursund, J. and Erskine, R. 2004. Integrative Psychotherapy. The Art and Science of Relationship. Thompson & Brooks/Cole.

Peräkylä, A. and Vehviläinen, S. 2003. Conversation analysis and the professional stocks of interactional knowledge.

Discourse & Society 14/6, pp. 727-750.

Philippot, P., Feldman, R. S. and Coates, E. J. 2003. The role of nonverbal behavior in clinical settings: Introduction and overview. In P. Philippot, R. S. Feldman and E. J. Coats (eds), Nonverbal Behavior in Clinical Settings. Oxford New York: Oxford University Press, pp. 3-16.

Richmond, V. P. and McCroskey, J. C. 2000. Nonverbal Behavior in Interpersonal Relations. Fourth Edition, Needham Heights, MA: Allyn & Bacon.

Riggio, R. E. 1992. Social interaction skills and nonverbal behavior. In R. S. Feldman (ed.), Applications of Nonverbal Behavioral Theories and Research. Hillsdale, NJ: Lawrence Erlbaum Associates, pp. 3-30.

Wachtel, O. L. 1990. Psychotherapy from an integrative psychodynamic perspective. In J. K. Zeig and W. M. Munion (eds), What is Psychotherapy? Contemporary Perspectives. San Francisco: Jossey Bass, pp. 234-238.

Zuckerman, M., DePaulo, B. M. and Rosenthal, R. 1986. Humans as deceivers and lie-detectors. In P. D. Blanck, R. Buck and R. Rosenthal (eds), Nonverbal Communication in the Clinical Context. University Park: Pennsylvania State University Press, pp. 13-35.

6