Why does my therapist watch my hands?

Hands. Your client's hands can give you clues about how they're reacting to what comes up in the session. Trembling fingers can indicate anxiety or fear. Fists that clench or clutch the edges of clothing or furniture can suggest anger.

goodtherapy.org - What Is Your Client's Body Language Telling You? - GoodTherapy

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Body language, or nonverbal communication, plays an important role in social interactions. Much of what we say to others might be misunderstood without added factors of tone, facial expression, or hand gestures. We often say a great deal with our bodies alone before we even open our mouths to speak. According to 2010 research published in Psychiatry, experts estimate around 60% of communication happens nonverbally. Strong relationships rest on good communication skills, and since so much of our communication happens with the body, it follows that what we say silently is just as important as what we say aloud. But language isn’t a solo act. Part of effective communication involves understanding what other people are trying to tell us. This becomes particularly important in the therapy room, where picking up on inconsistencies between spoken and unspoken language might reveal what a client is really saying. Being able to notice and understand a client’s body language generally means the therapeutic relationship, a key to effective therapy, is fairly strong. But this skill doesn’t come naturally to everyone. The tips below can help you get better at recognizing body language in the therapy room.

How Body Language Helps Us Communicate

People often say things they don’t truly mean, but you might not always recognize when someone’s lying. The person lying may not even realize, especially when it comes to painful emotions or experiences that are difficult to discuss. Body language becomes so important to therapy for this very reason. As a 2010 article published in the journal Psychiatry points out, awareness of nonverbal cues—what a client isn’t saying—can give therapists more information about what the client really thinks and feels. Part of a therapist’s role involves paying attention to inconsistencies in someone’s story and gently drawing attention to these details. People tell their stories using not just words, but also their bodies. When therapy focuses mainly on verbal communication, the therapist may miss a lot of nonverbal information that provides a more complete picture of the client’s emotional state. This is one drawback of digital therapy. Say you’re working with a client to address a phobia of dogs. The first step in graduated exposure therapy may involve viewing photos and talking about dogs. When conducting a session in-person, you might notice the client shifts in their seat, fidgets, or breathes more rapidly. These small changes may not be easily visible in a digital session, and it’s easy for someone to say, “Oh, yeah, I’m doing fine!”

Types of Body Language in Therapy

People can express themselves in a near-infinite range of ways, and the meaning of specific expressions or gestures can vary from person to person. Nevertheless, recognizing small changes in posture, facial expressions, eye movements, and more can help you notice when there might be more to what your client says. Even if you don’t yet know what that is, you can still respond to these cues.

Posture

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People often indicate how they feel through the way they carry themselves. A person who feels unsettled, nervous, or afraid may:

Draw back into their seat

Slouch or hunch forward

Turn their body slightly away

Shifting position frequently or leaning away can also suggest discomfort or unease.

Hands

Your client’s hands can give you clues about how they’re reacting to what comes up in the session.

Trembling fingers can indicate anxiety or fear.

Fists that clench or clutch the edges of clothing or furniture can suggest anger. Fidgety hands (twisting, wringing, playing with objects) can suggest anxiety or nervousness. While some people do these behaviors when lying or embellishing a story, this isn’t always the case. Placing a hand on the head, or rubbing the head, neck, or lap can all be self-soothing gestures, but they can also suggest unease or nervousness. Holding something up as a barrier (handbag, briefcase, pillow, or book) can suggest a need to protect the self or block others out.

Facial expression

Many people have no trouble picking up on overt facial expressions. But with practice, it’s generally easy to control your expression and cover up what you’re really feeling, by half-smiling when sad or angry, laughing when disappointed, and so on. Microexpressions, however, are rapid expressions that are very difficult to fake. You might notice something shift in another person’s face but feel less certain about what that was. If you do catch a microexpression, know that these typically convey what someone’s really feeling.

Eyebrows raised or drawn together can suggest fear or disgust.

Lowered eyebrows, tense lips, and a set jaw can suggest anger.

Raised cheeks, drawn-back lip corners, and wrinkles between the outside of the nose and lip can suggest happiness. Low lip corners, pouting lower lip, and a crease between the eyebrows can suggest sadness. Lip biting might indicate nervousness, while pursed lips could suggest disagreement or disapproval.

Eye contact

Someone who can’t meet your eyes could be nervous, especially if they look down. They might also be bored, uncomfortable, or doubtful. Looking away and to the right side could indicate a lie. Some research suggests people may look to the right when making things up and to the left when remembering something. But again, this isn’t a sure guarantee of deceit. Follow a person’s gaze. People often look toward something meaningful to their current experience. Looking at the window or door might suggest they’d rather be elsewhere. Looking at the clock could mean they want the session to be over. It also helps to notice blinking patterns. Rapid blinking could indicate stress, so someone speaking calmly but blinking rapidly might be more upset about what they’re saying than they let on.

Arms and legs

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The position and movement of legs and arms can also provide insight.

Crossed arms can suggest defensiveness, a desire to protect the self, or a lack of willingness to share information.

Open or relaxed arms could suggest a willingness to communicate.

Crossed legs, especially when they point away from you, might suggest your client feels uncomfortable with you or the direction the session is going. A person might cross their legs when they want to shut down or don’t feel like discussing a particular topic. Tapping or jiggling the legs or feet can indicate nervousness, restless, boredom, or even irritation.

Tone

Tone of voice can also be informative.

Is a client terse, biting off their words, putting emphasis heavily on certain words? They might be angry or frustrated. Do they speak slowly, as if they’re weighing each word? They might be considering something new or sharing something painful. A lowered, quiet tone of voice could indicate sadness or embarrassment. Speech that’s higher-pitched or faster than usual could suggest nervousness, dishonesty, or fear.

Body Language and Mental Health

While mental health conditions cannot, by any means, be diagnosed by body language alone, someone’s body language may have value when exploring possible diagnoses. Many people with certain conditions, including social anxiety, bipolar, autism, and schizophrenia, have trouble making prolonged eye contact. Fidgeting, difficulty sitting still, or needing to pace regularly can also relate to anxiety, ADHD, schizophrenia, or autism. People experiencing a period of mania could also display increased restlessness or more rapid speech. Self-stimulating behaviors (stimming) can be part of anxiety, autism, ADHD, and other conditions. Stimming can include hair twisting, rocking, tapping, nail biting, knuckle cracking, or other repetitive movements. Trouble keeping control of posture, or trouble balancing and standing still, could also relate to bipolar or schizophrenia. One study suggests this difficulty might even be a key feature of bipolar, rather than a symptom. Body language can offer clues about a person’s thoughts and feelings, but it isn’t definitive, so it’s most helpful to avoid making assumptions based on body language. In other words, don’t automatically equate leg jiggling with anxiety or decide a person who won’t meet your eyes must be lying. Instead, use body language as one of several road markers on the path you and your client take toward emotional wellness.

References:

goodtherapy.org - What Is Your Client's Body Language Telling You? - GoodTherapy

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