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UNDERSTANDING NON-VERBAL COMMUNICATION: HOW WHAT YOU DO NOT SAY, SAYS A LOT Presented by Stefani Eichelberger, M.S.W., LCSW, CBIS Community Skills Program® Brain Injury Association of Pennsylvania 16th Annual Conference June 27, 2016 Objectives for This Session At the conclusion of this session, participants should be able to: • Identify different types of non-verbal communication • Identify the functional implications of ineffective non-verbal communication • Identify approaches to improve non-verbal communication What Is Non-Verbal Communication? “The means by which individuals convey information through conscious or subconscious gestures, bodily movements, or facial expressions” (Lambert, 2008) When Do We Use Non-Verbal Communication? • In Place of Speech • Gestures • As a Reflection of Mood • Facial expressions, posture/bodily movements, eye contact • To Reinforce Speech • Gestures Types of Non-verbal Communication • Non-verbal Expressive Communication • The ability to express oneself through non-verbal communication • During a conversation, what are some ways we show the speaker we are interested in what he or she is saying? • Sit or stand facing the person who is speaking • Maintain eye contact • Provide affirmative responses (e.g., nod) Types of Non-verbal Communication (cont.) • Non-verbal Receptive Communication • The ability to understand others through non-verbal communication • During a conversation, when would you conclude the listener is not interested? • • • • He or she is looking away and avoiding eye contact He or she is turning away from the speaker No affirmative responses are given Facial expression is flat or conveys indifference NON-VERBAL COMMUNICATION AFTER BRAIN INJURY Structure of the Brain and Communication Two Hemispheres • Left Hemisphere • Logical, literal, language, verbal memory, sequencing • Right Hemisphere • Visual-spatial abilities, figurative, visual memory, creativity, “big picture” thinking Four Lobes • Frontal Lobe • Initiation, problem-solving, judgment, inhibition of behavior, attention/concentration, self-monitoring, speaking • Temporal Lobe • Memory, hearing, understanding language, organization, sequencing • Parietal Lobe • Sense of touch, visual and spatial perception • Occipital Lobe • Vision Structure of the Brain and Communication (cont.) • Broca’s Area • Left frontal-temporal lobe • Controls facial muscles • Allows the production of speech • Wernicke’s Area • Left temporal-parietal lobe • Controls the ability to understand speech (Brain Injury Association of America, 2007) Communication after Brain Injury • Right Hemisphere Injury • Difficulty conveying emotions through facial expressions or voice inflections • Difficulty judging others’ moods and interpreting voice inflections • Left Hemisphere Injury • Language difficulties • Difficulty understanding propositions and humorous situations (Parenté & Herrmann, 2010) Communication after Brain Injury (cont.) • Frontal Lobes • Difficulty processing signals from the environment, making decisions, controlling emotions, behaving and interacting socially • Temporal Lobes • Difficulty speaking and understanding language • Parietal Lobes • Lost sense of body awareness, difficulty with visual-spatial skills (Brain Injury Association of America, 2007) Non-verbal Communication after Brain Injury • Non-verbal Expressive Communication • A person with a brain injury may not be sending non-verbal cues to show the speaker he or she is interested • What happens? • Speaker ends conversation, may develop misconceived perception • Listener becomes upset because conversation ends Non-verbal Communication after Brain Injury (cont.) • Non-verbal Receptive Communication • A person with a brain injury may not pick up on the non-verbal cues that show the listener is no longer interested • What happens? • Speaker keeps talking (verbosity) • Listener is uncomfortable • Listener may not want to speak to the person again Common Problems in Communication after Brain Injury • Tone of Voice • Affect • Voice Inflections Remember: It’s not what you say, but how you say it. Consequences of Ineffective Non-verbal Communication • Problematic Relationships with Others • Unsatisfactory Vocational Performance • Limited Community Involvement • Family Stress Functional Implications • Relationships with Others • Reestablishing friendships after brain injury can be a significant challenge (Klonoff, 2010) • Difficulty developing new relationships • “Individuals who behave awkwardly in social situations are likely to be rejected by peers and, in turn, often exhibit depression, loneliness, negative self-concept, anxiety, low academic achievement, and higher dropout rates, further reducing social interactive competence” (Ylvisaker, et al., 2005) • Frustrations of not understanding Functional Implications (cont.) • Vocational Performance • Job searching • Unsuccessful interviews • Unemployed or underemployed • On the job • Relationships with co-workers and supervisors are strained • Interactions with customers are ineffective • Behaviors may be misinterpreted: may be seen as uninterested Functional Implications (cont.) • Community Involvement • Social isolation and a lack of hobbies and recreation are often problems after brain injury (Klonoff, 2010) • “Impaired social perception, including weak recognition of emotional signals from others, can interfere with social reintegration as the individual misinterprets the behavior of others and responds accordingly” (Ylvisaker, et al., 2005) • Group settings more challenging • May be overstimulating • More non-verbal cues to read “Deficient social skills after brain injury have a negative impact on quality of life, life satisfaction, and psychosocial outcome, especially social reintegration.” (Klonoff, 2010) Treatment Approaches and Strategies • Modeling • Increase Self-awareness • Individually and/or in a group • Study body language, voice inflections, and facial expressions • Brain Injury Support Groups and/or “Out & About Groups” • Self-monitoring Treatment Approaches and Strategies (cont.) • Pay Attention during Conversation • LISTEN • Look at the person to whom you are speaking • Interest yourself in the conversation • Speak less than half the time • Try not to interrupt or change the topic • Evaluate what is said • Notice others’ body language and facial expressions (Parenté & Herrmann, 2010) Treatment Approaches and Strategies (cont.) • Videotaping • “Most useful for training complex or abstract social skills, such as communication or social interactions” (Parenté & Herrmann, 2010) • Role-playing • Repetition • Preparation for job interviews • Videotaped mock interviews • Assistance/feedback from a vocational rehabilitation counselor, cognitive rehabilitation therapist, or job coach • Supported Feedback Non-verbal Communication Scenarios “What would you do?” QUESTIONS?? For more information, contact: Stefani Eichelberger, M.S.W., LCSW, CBIS Community Skills Program® [email protected] (717) 668-9883 References • Brain Injury Association of America. (2015). Living with Brain Injury. http://www.biausa.org/. • Brain Injury Association of America. (2007). Essential Brain Injury Guide (4th ed.). Ypsilanti, MI: Rainbow Rehabilitation Centers, Inc. • Klonoff, P. (2010). Psychotherapy after Brain Injury: principles and techniques. New York, NY: The Guilford Press. • Lambert, D. (2008). Body Language 101: the ultimate guide to knowing when people are lying, how they feel, what they are thinking, and more. New York, NY: Skyhorse Publishing, Inc. References (cont.) • Matsumoto, D. & Sung Hwang, H. (2011).Reading facial expression of emotion. Psychological Science Agenda, 25 (5). http://www.apa.org/science/about/psa/2011/05/facialexpressions.aspx. • Parenté, R., & Herrmann, D. (2010). Retraining Cognition: techniques and applications (3rd ed.). Austin, TX: PRO-ED, Inc. • Ylvisaker, M., Turkstra, L., & Coelho, C. (2005). Behavioral and Social Interventions for Individuals with Traumatic Brain Injury: A summary of the research with clinical implications. Seminars in Speech and Language, 25 (4), 256-267.