Though we often refer to psychotherapy as the talking cure, those who practice it know that something aside from just talking happens. This non-verbal communication — what British psychoanalyst Adam Phillips calls “the change that falls out of the client’s pockets” — is often much more accurate, and more powerful, than anything a client says.

Yet understanding how to interpret non-verbal communication, and, equally important, how to respond it, is a less-than-clear science. This is something that Gill Westland, author of Verbal and Non-Verbal Communication in Psychotherapy, has recognized for some time. Westland, who has worked for more than thirty years training other therapists and teaching at the Anglia Rustin University in the UK, admits that she never set out to be what she calls a body psychotherapist. And what is that?

Westland describes body psychotherapy as “embodied relating.” And it is relating that puts emotional and physiological regulation central. But, Westland reminds us, it honors the “organic impulse to heal, which can be experienced phenomenologically and that moves towards increased complexity and wholeness.”

In her new book, Westland shows us how to move clients toward this increased wholeness. She also provides a foundation from which to understand both the verbal and non-verbal processes that may pave the way.

Westland introduces us to the neurological foundations of nonverbal communication. We come to see that “exteroception” — the process of receiving information from the world — is dependent on the use of all five senses. And these senses, in turn, determine the nervous system response.

Westland explains how the process affects therapists. Through mirror neurons, therapists learn to pick up on their clients’ feelings, often before they are cognitively aware of them. That’s why, as a therapist, monitoring your own physiological arousal is key.

How a person is wired neurologically often defines their relational behavior, and it begins from the early attachment experiences. Westland describes how the first interaction a therapist has with a client reveals whether that client is securely or insecurely attached. For example, those with insecure-avoidant attachment patterns may be “unobtrusively watchful but find it hard to look at people.” And as in the mother-child relationship, affect attunement — or tuning in to a client’s emotional state — is more important than responding to the overt behavior.

But in order to tune in to our clients, Westland writes, we must first learn to regulate ourselves. To help us understand how, Westland presents cases that we follow through several years of therapy. For instance, we meet Tony, who entered therapy because he was diagnosed with cancer — a form that was not immediately threatening, but that his wife wanted him to explore his feelings about. Tony, Westland tells us, “always talked easily, but his words did not convey his deeper feelings.” Because his words hid his feelings, Westland first learned to be with him, paying attention to her inwardly body sensations, thoughts, and feelings. And when she presented him with a “contrast to (his internal) chaos” — a room always arranged in a predictable way, mindfulness that “taps into his direct experience,” compassionate acceptance, an awareness of his energetic space, and resonance with him — Tony slowly learned to speak in a more “rooted” or authentic way.

Of particular interest is Westland’s description of short and long rein holding. Short rein holding keeps the dialogue and sensory experiences close and is helpful for clients who tend to dissociate, she writes. Long rein holding, on the other hand, opens psychic space and gives emotions room to emerge. Holding the reins is “like a dance,” Westland writes, as the client explores their feelings. And, she emphasizes, it is important that we as therapists be “proficient in awareness practices so that we may observe the gestures, postures, and movements of clients” while at the same time we point our awareness inward, and get the feel of clients as we resonate with them.

Here, Westland underscores the importance of collaborative relating — especially with those clients with insecure attachments. Collaborative relating begins with the working assumption that “the client has the capacity to be moved and to find her way to express her inner movement in words, in her own way.” Like a midwife, Westland writes,“We enable the client to give birth to her inner experience.”

But while we resonate with and relate to the client in an embodied way, we must also be aware of the client’s “window of tolerance,” which regulates how we should respond to them. For example, we can use our breathing to help clients regulate on a physiological level: Westland provides many exercises to help us do this. We can also pay attention to our own “felt sense” for any somatic markers that might signify areas of intense emotion for clients.

Lastly, Westland shows us how we can use free association through the body, and describes the process of “vegetotherapy” for emotional deepening and attuned relating. Here again, she reminds us: “Speaking evocatively and reaching the client happen only when the therapist has a direct, felt connection with the client’s emotional being.”

If it is true, as Westland suggests, “that the basic work of health professionals in general, and of psychotherapists in particular, is to become full human beings and to inspire full human-beingness in other people,” her book is a wonderful guide.

Verbal and Non-Verbal Communication in Psychotherapy
W. W. Norton & Company, August 2015
Hardcover, 320 pages
$34

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