Body language plays an important role in our interpersonal relationships as well as in our Counseling roles. Research has shown that approximately 60-65% of communication is through non-verbal behaviors. This can include our posture, hand movements, facial expressions, eye contact, extremity movements, and the tone of our voice. Keep reading to learn more about body language in counseling and what your clients’ body language really means.

Using communication methods such as texting and email fails to include body language which can easily lead to miscommunication and misunderstandings between two persons. These forms of communication leave room for personal biases, thoughts, and emotions to influence our interpretation of what is being said.

Someone who is driving may send you a voice-over text that is 2-4 words in length. Without knowing that the person is driving, you may find yourself wondering if you are bothering them or if they are upset with you. Whereas, if we were on the phone with an individual in the same situation, we may hear characteristics in their speech that lets us know that they are paying attention or are invested in what we are sharing. 

What is Body Language?

As Counselors, we learn to pay attention to our client’s body language in counseling sessions and outside of sessions. Our client’s body language is often unconscious and can show a more accurate representation of their thoughts and feelings compared to what they are sharing. As an example, if you notice that one of your clients is acting differently than in previous sessions, you may ask them how they are doing. If their answer is something like “okay” or “doing well”, you may decide to circle back when you observe a lack of eye contact, that they are as far back in their chair as possible, and their sitting with their arms crossed. This is an example of being able to see the disconnect between what the client is sharing with us verbally and what their body language is telling us. When counselors are assessing the risk of harm to self and others, it is crucial to focus on incongruence with their body language and shared thoughts and emotions.

Similar to other topics in counseling, it is important for Counselors to interpret our client’s therapy body language while incorporating the appropriate context. As an example, a client may be sitting with their arms and legs crossed as if they are feeling sad, or they may simply be chilly. Additionally, there are cultural differences that can impact the rate, volume, pitch, and tone of a client’s voice that we need to take into consideration.

A client’s body language is often included in assessments, such as the Mental Status Exam (MSE). This information combined with counseling observation words can help us determine risk factors that our clients may be struggling with. This can be helpful information to include in progress notes to monitor your client’s non-verbal behaviors throughout your time working with them.

Types of Body Language in Therapy

Body language therapists look for different aspects of nonverbal communication. This includes the three principles of body language identified by M. Pell. Being aware of the physical space the client chooses to have between themselves and you would be an example of proxemics. As an example, if your client has an option of chairs to sit in for their session, do they choose to sit closer or further away from you? The client’s chosen location can help you gauge their comfort within your shared space. Proxemics also includes changes in nonverbal communication when around different individuals. You may see these changes if you meet with a client individually and in a family or couples counseling session.

Kinesics refers to a person’s specific body movements. This category includes movements that we visually observe within a session including the following:

Posture

Sitting with crossed arms, and sometimes legs are known as a “closed-off” posture. By sitting this way, the client’s extremities are protecting their body which may unconsciously be a way of them trying to protect themselves. This may represent worried body language, that the client is uncomfortable, is not open to sharing, does not want to be engaged, or has yet to develop trust and rapport.

Clients who are leaning back in their seats, have their heads lowered, and are not facing you directly may feel uncomfortable or nervous at that moment.  This can also be considered sad body language. Additionally, constantly moving in their seat and fidgeting may signify that they are feeling unsettled or anxious. 

Hands

Anxious body language in a client can include hand fidgeting and being unable to keep their hands still. Clients whose hands are clenched in a fist, or are digging into their seats may be feeling anger or tension. Similar to posture indications, sitting with an object on their lap such as a bag, purse, or pillow, can be an unconscious defensive stance. 

Facial Expressions

Facial expressions are arguably the most studied aspect of nonverbal behaviors. Research has identified 6 facial expressions that are recognizable on a cross-cultural basis. This is a powerful piece of information because it means that we are capable of communicating with others without using any spoken words. The six facial expressions that can be recognized include surprise, fear, disgust, anger, sadness, and happiness. 

Eye Contact

Eye contact is a form of nonverbal communication that can tell us a lot, however, there are cultural differences to be mindful of. As an example, in Japan, maintaining eye contact can be a sign of disrespect which may account for a lack of eye contact with a client who has this cultural background.  Individuals who avoid eye contact without this or a similar cultural context may be considered to fear body language or show that they are feeling sad, nervous, or uncomfortable. Looking away while speaking may be indicative of the client being untruthful. 

Paralanguage

Paralanguage is another category of nonverbal behavior that can be informative during therapy sessions. Paralanguage refers to the prosody, rate, rhythm, tone, and pitch of the client’s speech.

Research from M. Pell in 2009 showed that participants could accurately identify a person’s emotions while speaking a foreign language. This study investigated the presence of anger, disgust, fear, sadness, joy, and neutrality in Spanish, English, German, and Arabic. The only information participants had to evaluate what was being said was the paralanguage aspects of the individual’s speech. 

Tone

There are many tones of voice that we can pick up within a Counseling session. This can include formal, serious, optimistic, respectful, assertive, and sad. As an example, someone who is speaking slowly and softly may be feeling sad, embarrassed, or hesitant about what they are going to share. 

Rate

Someone who is speaking with pressured or fast speech may be feeling anxious, nervous, excited, or passionate at that moment. Whereas someone whose speech is slow may be feeling sad, or confused, or they are still forming their thoughts.

Body Language and Mental Health

When we review the diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, we can see that several mental health illnesses impact nonverbal communication. Mental Health concerns are an example of context that should be taken into consideration when evaluating a client’s body language.

As an example, an individual diagnosed with Schizophrenia may present with flat affect, poor eye contact, negative symptoms, and bizarre postures. Without knowing the individual’s mental health diagnosis, these behaviors will stand out during therapy sessions. Understanding their diagnosis can help you narrow down what typical behaviors are for your client during sessions.

Other mental health illnesses that can impact a client’s body language include Autistic Disorder, ADHD, Substance Intoxication, Substance Withdrawal, Schizophrenia, Major Depressive Disorder, and PTSD. 

Final Thoughts on Body Language in Counseling

Thank you for reading our resource on body language in counseling. As much as we observe our clients’ body language, they are noticing ours. Our clients can pick up on our attentiveness, focus, positivity/negativity, and coordination. As an example, if we are conducting an intake session and typing answers into the program, we risk the client feeling as though we are not fully focused on them. Additionally, we may miss opportunities to reflect on behaviors that they exhibit, such as smiling.

More often than not, we work with individuals who are interested in improving their mental health and wellness. For many, this is a challenging process and the vulnerability can be uncomfortable. If we are speaking fast, or are using a ton of voice that is not perceived as neutral or welcoming, clients may feel reluctant to share with us.

In an ideal environment, Counselors have time to themselves in between sessions where we can check in with ourselves and use our own emotion regulation skills as needed. This can include deep breathing, grounding exercises, stretching, and meditation. Even with a small window to yourself, take the time you need to check in and take care of your own needs.

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Resources:

American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed.,text rev.). https://doi.org/10.1176/appi.books.9780890425787

Foley, G. N., & Gentile, J. P. (2010). Nonverbal communication in psychotherapy. Psychiatry (Edgmont)7(6), 38–44. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898840/#B10

Pell, M,D., Monetta, L., Paulman, S., Kotz, S.A. (2009). Recognizing Emotions in a Foreign Language Journal of Nonverbal Behavior, 33, 107-120. https://link.springer.com/article/10.1007/s10919-008-0065-7

Uono, S., & Hietanen, J. K. (2015). Eye contact perception in the West and East: a cross-cultural study.PloS One, 10(2),e0118094.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4340785/#:~:text= In%20fact%2C%20in%20Japanese%20culture,their%20peripheral%20vision%20%5B2%5D

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