11.07.2016

Few attach importance to the importance of non-verbal communication between doctor and patient. Meanwhile, a person perceives only 23% of the information by ear, the remaining 77% he receives with the help of visualization of the object.

If these numbers seem unconvincing to you, I suggest doing a little experiment. Remember your student years and everything connected with this period. Including their teachers. Surely among them was a bright personality, a teacher with a capital letter, you tried not to miss his lectures. But the manner of presenting the material of another lecturer made you have only one desire - to sleep. Remembered? And now - attention, a question. What did both teachers talk about at the very first class? And on the last one? God grant that you remember at least the name of the subject and the general essence of the lectures. But here are the gestures, the manner of speaking, laughing, the timbre of the voice and, in general, the whole appearance, we remember quite clearly.

This little digression into your student past convincingly demonstrates how badly we remember What we are told. At the same time, the memory keeps for a long time what How we are told this. That is, non-verbal communication is more informative than verbal.

Non-verbal communication ("body language") - this is a communication wordless interaction between people (transmission of information or influence on each other) through intonation, gestures, changes in the mise-en-scene of communication, that is, without speech and language means presented in direct or any sign form. The instrument of such communication is the human body, which has a wide range of means and methods of transmitting information or exchanging it.

The ability to "read" gestures and facial expressions is one of the most important skills of a doctor in communication not only with patients, but also in ordinary everyday practice. Unfortunately, people who do not possess this skill will be able to successfully interpret non-verbal communication methods only in 50% of cases. In other words - guessed / did not guess. And to be able to "read" the facial expression of the interlocutor means to be able to properly build a dialogue with him.

To date, a considerable number of scientific papers have been published (mainly in the United States and Western European countries) on the topic of non-verbal behavior of patients and the doctor's ability to understand the psychological aspects of patients' emotions, etc. They began to pay more attention to this problem in our country.

In this case, we are interested in the practical side of non-verbal communication between a doctor and a patient. But before moving on to it, you need to add a few comments:

• Human gestures and facial expressions are a physiological reaction to an external stimulus. In other words - if you saw/read/heard/remembered something that you think is funny, you will definitely smile at least for a split second.
• Non-verbal communication can be viewed as a kind of international method, the same for all nations, ages, languages ​​and cultures. Because people in all countries equally express joy, sadness, pain, disgust, admiration, etc.
• It is extremely difficult to control your non-verbal behavior, it requires many years of professional training (for example, in law enforcement agencies, agents spend years learning "body language" and controlling their emotions).

Over the several years of the existence of the “Academy of a Successful Doctor” project, one often has to deal with the fact that a doctor who has only 12 minutes to examine each patient and fill out a medical card simply does not have the opportunity to pay attention to the study of facial expressions, postures, or options. your patient's behavior.

For example, the patient sits with his legs and arms crossed - the so-called "closed posture". It would seem that it is familiar to many, and few doctors pay attention to it. But in vain. It serves as a kind of signal - the patient is experiencing discomfort. This is a signal for the patient, if he sees the doctor in front of him in the same position.

It also happens that the patient during a conversation or examination from time to time squeezes his shoulders. This suggests that he either feels insecure or doubts what the doctor is telling him. This, again, can be ignored, but if the doctor wants to achieve success in treatment, he needs to earn the trust of the patient, if only in order to increase his compliance with the prescribed therapy. This largely ensures the achievement of a favorable result, which means that it will serve as proof for the doctor of his success as a specialist. That is, the trust and favor of the patient is almost half the success. Otherwise, very unpleasant situations can arise. Let's consider them.

During an examination or anamnesis, the patient frowns, looks askance, clenches his fists tightly, putting out his index finger, twists his lips - in a word, with his whole appearance he shows that he is set up for conflict.

Unfortunately, as a rule, the doctor prefers to pretend that he does not notice the aggressive mood of the patient, and sometimes, even worse, “accepts the challenge” and begins to behave rudely in response. Of course, there is nothing to talk about any trust between the doctor and the patient in such cases, there is nothing to hope for any success in treatment, and therefore it would never occur to anyone to call such a doctor successful. And all just because he did not consider it necessary for himself to learn how to correctly interpret non-verbal methods of communication.

So why should a doctor pay such attention to nonverbals? The answer is simple - it will allow him to spend less time talking during the examination, seize the initiative in time, overcome objections, prevent conflicts and establish a long-term trusting relationship with the patient.

Let's consider one more situation. After a routine examination of an infant, a pediatrician, giving young parents various kinds of prescriptions, abundantly uses in his speech not always clear medical terms to refer to even the most mundane things. But what is a routine for a doctor, then for ordinary moms and dads it is a solid dark forest. Parents, instead of memorizing appointments, begin to blink in confusion, exchange glances, wrinkle their foreheads, trying to understand whether they mean the same thing as the doctor, as a result, they begin to ask a lot of questions. But if the doctor paid attention to the non-verbalism of his counterparts in time, he would begin to use words that are more understandable to a non-specialist, which would give him the opportunity to reduce the time of admission, and this is very important when your patient is a baby.

A few tips for a doctor who wants to learn to recognize the non-verbal manifestations of a patient, but does not have the time and opportunity to undergo training in this skill:

1. Try to define norm your patient's behavior. Whether he is calm during communication or, on the contrary, is too active or even nervous, sociable or laconic, whether active gestures are characteristic of him, or he is stingy in movements. This will be your starting point for further dialogue.
2. While communicating with the patient, try to look at him, and not at the documents, at the computer, etc. That is, show interest and attention.
3. With any deviation from the norm in the behavior of the patient - do not bother trying to interpret these deviations. You do not have time for this and, most likely, not enough experience and special knowledge.
4. If you notice a deviation from the norm, ask the patient a question. For example: during the consultation, he behaves calmly, but at the end he begins to speak faster, gesticulates more. Why did he start behaving like this? There can be 1000 and one reasons! It is best to ask a clarifying question: “Do you understand everything?”, “Do you have any questions?”, “Is there anything else I can be of help to you?”. We assure you - the patient will be grateful to you for your attentiveness.
5. Remember, the patient can have a lot of reasons for this or that gesture or this or that posture! During a normal, friendly conversation with you, he suddenly crossed his arms over his chest. What could be the reasons? He may have a stomach ache, he may become suddenly cold. Perhaps he is chilled. But it is also possible that something is not clear to him, etc.
6. To become well versed in nonverbalism, it is not enough just to ask leading questions to your patients. If you really want to understand what is behind this or that gesture, try to copy it! The human body is an amazing mechanism. Any of our sensations, feelings, any of our emotions will receive their non-verbal embodiment - in a gesture, grimace or pose. Most often they are read quite easily, because almost everyone has the same. After all, we are unlikely to confuse a grimace of disgust with a joyful and happy expression. Therefore, to figure out what your patient was thinking during his last visit to you, when he looked somewhere over your head and impatiently tapped his fingertips on the table, reproduce all this at home, in front of a mirror. And when you see your face, you will understand that the patient does not consider you a major specialist in his field, and therefore, he will be skeptical about your prescriptions.

A successful doctor must be able to read the patient's non-verbal in order to adequately and timely respond to its changes. This will simplify the relationship with the patient, allow you to establish a trusting relationship with him, save time, prevent conflicts and directly contribute to the transfer of the patient from the category of "patient" to the category of "client".

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1. Are there "sets" of verbal and non-verbal skills that can be used in medical practice?

The following is an overview of the four main "skill sets" of verbal and non-verbal behavior - A B C And G which includes things like:

1. why these skills are important;

2. supporting resources;

3. a clinical case illustrating how to apply these skills in practice;

4. studies confirming the effectiveness of the communication skill;

5. some tips,

A. Patient involvement.

1. What is it for?

“If doctors are from Mars and patients are from Venus, the problem is that the logic of clinical decision making and the experience of the patient's illness often do not match. As a result, the clinician may get the facts but miss the story."

2. Supporting resources.

Patients may be sick but not have the disease. For example, patients complaining of lethargy, insomnia, migraine; or a child with school problems that caused abdominal pain.

The patient-centered approach expands the clinician's task to include both "illness" and "experiencing illness".

Many physicians assume that patients seek medical advice and help because of a simple, primary complaint—and that this complaint is the priority. That is, the doctor chooses such a tactic: "I will save the patient from complaints - then I will help." However, many studies do not support this assumption. As Frankel (1994) noted, "The order of complaints is not related to the clinical importance of the patient's problems and is not a reliable guide to importance from the patient's point of view."

Just because patients share a lot of concerns with their doctors doesn't mean they want them all to be taken into account. Experience suggests that in fact one of the three problems a patient brings involves wanting to be heard by the doctor rather than getting some action.

Some Tips

The process of obtaining information from the patient includes such important aspects of his condition as the identification of feelings, thoughts, functions and expectations, as well as the establishment of a personal and cultural aspect of the problem.

· Begin by inviting the patient to tell the story of the problem from when it first started to the present day;

For example:

"Tell me everything from the beginning..."

Use words, sounds - "successors" to identify additional problems and feelings;

For example:

"Mmm, hmm", "I see", "I understand".

· Wait for the patient to complete the description of one complaint before asking another question;

Determine with the patient what worries him most and agree to postpone non-essential issues for another visit;

· Ask questions that will help determine how the problem affects the patient's daily functioning;

· Ask the patient what they think caused the problem. This will help reduce the possibility of misunderstandings and misunderstandings;

For example:

"What do you think caused it?"

· Determine the patient's expectations of what kind of help he wants to receive. Since patients come with their own expectations of possible solutions to problems, your recommendations may not be accepted because the patient does not agree with them or is not interested in them;

"What do you want me to do to help you?"

· Find out the personal and cultural context of the patient. The actions and actors involved in experiencing the patient's illness, the patient's perspective on their illness, can help you refine a clinical decision faster, more economically, and with a minimum of frustration for both parties;

For example:

"What else is going on in your life right now?"

· Summarize what you understand by the patient's key issues, what you think caused the problem, and what should be done about it. Encourage the patient to complete the information they have already provided and/or correct what you have said.

Clinical example.

Doctor:"Hello. What do you have today?

Patient:"I'm not happy with the arthritis medicine you gave me."

Doctor:"Hmm."

Patient:"Yes, I don't sleep well. I'm sure it's from the medication. Maybe I shouldn't take it so much, or maybe I should take something else."

Doctor:“Okay, let's talk about it. But tell me, is there anything else that worries you? Do you have other health problems? Are there any specific stresses in your life right now?”

Patient:“Well, there really is more…”

Doctor:"Go on, tell me more."

Patient:"I'm sure it doesn't matter"

Doctor:(Silence)

Patient:"I have a little swelling in my chest."

Doctor:"Is that so?"

Patient:“I’m sure it’s nothing special, but sometimes I get a little uneasy…”

Doctor:“Yes, now I see that you are concerned about this. Why don't we discuss this and then we'll see what can be done with your medicine."

5. Research.

The following are selections from studies on "patient involvement".

· The presence of a physical illness does not explain many of the patients' problems: in 50% of cases in which patients presented to the GP with chest pain, the cause was not proven within the next six months;

· When the patient and physician agree on the nature of the problem and the proposed solution (ie, diagnosis and treatment), treatment outcomes improve;

· 40% to 80% of patients who received recommendations did not follow them; in many cases, the recommendations may not have been appropriate to the questions, needs, or conflicted with the patient's priorities;

· Identifying the patient's beliefs about their illness is key to understanding and recalling clinically relevant information;

· Unrecognized differences between patients' and doctors' beliefs about health can lead to patient dissatisfaction, lack of adherence to therapy, treatment and outcomes;

· The amount of information received by the doctor is related to the adequate use of open and closed questions. Open-ended questions encourage more prompt discovery of relevant information than closed questions.

B. Managing emotions

1. Why do it?

There is a direct relationship between empathy and support for the doctor, on the one hand, and patient satisfaction with the results of communication with the doctor, on the other. Many studies have found significant relationships between the degree of empathy on the part of the doctor and the patient's adherence to treatment recommendations.

2. Supporting resources.

Why, given the compelling evidence that building a positive therapeutic relationship changes the treatment process and outcomes, why do many clinicians find it difficult to consider the patient's feelings?

Spiro (1992) believes that until now in medicine the importance of an impartial and neutral clinical approach, where only the fact is important, prevails. In contrast, empathy is based on the manifestation of feelings and relationships, joy and sadness, and the experience of being (existence) in the world.

Some Tips

· Express your receptivity to uncovering and discussing complex emotional issues. One way to achieve this is by asking about patients' feelings, for example:

- "What do you feel about this?";

- "What is the biggest concern for you in all this?";

- "What is happening at home or at work that worries you?".

· Look for and recognize signs of mental stress in patients. This means being attuned to both verbal and non-verbal cues, observing discrepancies between what the patient said and how the patient said, and being sensitive to what is not said. Consider, for example, the patient who said she felt great but was clutching her purse nervously during the interview, or the patient who avoided eye contact and did not mention anything about his wife when asked how things were at home. Suchman et al. (1996) suggests that patients will often use "neutral" statements as trial balloons to test whether it is safe to talk about emotions. For example, “I don’t see my husband that much lately. He was very busy with work”;

· Listen more, talk less. Since physicians are willing to actively solicit information from their patients, it can sometimes be difficult for them to listen. The use of active listening techniques often encourages patients to express their emotions. Active listening may include, for example:

Head nodding;

Saying "mmm-hmm", "I see", "continue";

Position directly in front of the patient;

Maintaining eye contact;

Position close to the patient.

· Accept verbal and non-verbal cues that indicate tension. It is important to “seize the moment” and not let emotional problems go unresolved. Branch and Malik (1993) speak of the decision to pursue emotional expression as a "window of opportunity". By giving a signal to the doctor, patients express their feelings at this stage;

· Check the feelings of patients. Patients often need to be reassured that their feelings are acceptable and normal. Point out that these kinds of feelings are natural in the circumstances and there is nothing inappropriate in expressing them. You can use one of the following phrases:

- “It would be amazing if you didn’t feel angry or scared after hearing the diagnosis”;

- “I completely understand you. Many people in similar circumstances would have reacted the same way as you”;

- "Your reaction is absolutely normal."

· Give and demand feedback. For example:

- "It sounds like you feel ... Is it true?";

- "It looks like what you said .. Is it true?";

· Express partnership and support to show that you are "on the side of the patient" and will help him solve medical problems.

- “We will decide together what course of treatment is best”;

- "If you have questions or problems, I will always find time for you."

Clinical example.

A 47-year-old woman came to the doctor with swelling in her chest. Seeing the woman's excessive arousal and her unwillingness to be subjected to further research, the doctor gives her verbal and non-verbal clues that he would like to know more about how the patient feels. By demonstrating openness, empathy, and support, the clinician creates a safe and friendly environment that encourages the patient to express her feelings and concerns. The doctor is able to determine the primary source of a woman's fears - the demand for a radical mastectomy and that her new husband will not be able to accept this defect of hers.

Once these concerns have been identified, the doctor is in a position to provide direct support and suggest some possible solutions to the situation. For example, the doctor and patient may decide that it would be better to include the husband in a discussion about possible treatment options.

If the doctor had not expressed empathy and willingness to listen and understand the emotional problems of the patient in time, the patient would hardly have been ready to express her concerns openly. In this situation, the outcome could be unclear, and a belated decision could significantly increase the patient's psychotrauma.

Research.

Research shows the important impact of clinician empathy and support on patient outcomes and satisfaction.

· A classic study of cross-cultural facial expression portraits found that Americans were significantly less successful at recognizing anger than Brazilians, Chileans, Argentines, and Japanese.

· In a study of American physicians, half of the respondents indicate that angry or hostile patients are particularly difficult to work with, and more than two-thirds believe that medical schools (institutes) do not pay enough attention to skills for successfully dealing with patients' emotional problems.

· The doctor's empathy and support has a positive effect on patient satisfaction and reduces their problems.

· Patients' dissatisfaction and perceived lack of help from some specialists leads to written complaints against doctors.

· There is a link between a physician's lack of empathy and professional incompetence.

· Most studies have found a relationship between empathy and adherence to treatment recommendations.

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Everyone who has ever been to a doctor or psychotherapist knows that the result of the visit largely depends on the exchange of non-verbal signals during the visit itself. In this section, we will look at four aspects related to the treatment of a physical or mental illness in which it is especially important.

1. Illness recognition. How do professional clinicians recognize various diseases, in particular depression?
2. Diagnosis. Does the clinician make the right conclusions about the problems, condition and prospects of the patient?
3. Therapy. Is the clinician able to help the patient solve his/her problems and maintain his/her physical and psychological well-being?
4. Relationship. Has a positive and trusting interpersonal relationship developed between clinician and patient?

To achieve each of these goals, non-verbal cues are extremely important. As far as disease recognition is concerned, the study of non-verbal behaviors and skills can help researchers generate theories about the nature of a given disease. Non-verbal behavior may be one of the symptoms of the disease. For example, one of the symptoms of depression is the expression of sadness, and one of the symptoms of schizophrenia is inappropriate non-verbal behavior. In the same way, one of the symptoms of autism is the inability of people suffering from it to draw conclusions about what is going on in the head of another person; therefore, failure to correctly assess the manifestations will be one of the defining symptoms of this ailment. Many people with mental illness, including depression, schizophrenia, alcoholism (Philippot, Kornreich, & Blairy), and autism (McGee & Morrier), assess the meaning of nonverbal cues less accurately than control subjects. At present, it is not clear to what extent the inability to decode non-verbal signals, so obvious in people suffering from these ailments, is associated solely with the nature of their diseases, and is not a consequence of other factors, in particular, a general deficit in cognitive abilities, a lack of proper motivation necessary for in order to focus on the performance of experimental tasks, or the result of taking medications. To unequivocally answer this question, more research is needed, including acceptable controlled tasks along with tests of non-verbal sensitivity.

Non-verbal signs are also important for the diagnosis of the disease by practitioners. The work of a doctor and psychotherapist requires special knowledge and cognitive skills acquired in the process of education and training; however, the bulk of their work is interpersonal. Clinicians and patients mostly talk to each other, and it is through speech that the therapeutic effect is carried out. It is clear that non-verbal behavior is a critical component of this interaction.

Usually the doctor pays attention to non-verbal signs that can shed light on the patient's problems and the course of the disease. During a visit to a psychotherapist, his ability to "read" the signs of emotions, especially those emotions that were not expressed verbally, which deprive the patient of peace of mind or are denied by him, plays a major role. When accepting a patient, the doctor is tuned in to the perception of those emotional and psychological signals coming from him, which may be the cause or consequence of his physical standing. For example, after a heart attack, the patient may be depressed.

Many researchers have studied the relationship between various non-verbal manifestations and mental disorders. For example, the lowered gaze and delayed reaction, a stereotyped idea of ​​the behavior of people who are depressed, has been shown to be valid. It is also shown that such patients are characterized by a decrease in overall mobility, reduced expressiveness, they are less talkative, gesticulate less and smile less often, avoid eye contact; they have stammering speech and are unable to express emotions.

Some forms of schizophrenia are characterized by an extremely inexpressive and monotonous voice; compared to control subjects, they have subtle activation of the facial muscle that causes skin wrinkling (associated with the position of the eyebrows, indicating that a person is sad), even when they are shown positive stimuli (Krig & Earnst) . Other non-verbal signs of schizophrenia include a sedentary face, inappropriate displays of affect, touching yourself frequently, and avoiding eye contact with others. Some forms of non-verbal behavior clearly indicate autism and a related condition called Asperger's syndrome, primarily the avoidance of visual contact, as well as infrequent smiles and gestures (McGee & Morrier).

Another illustration of the use of non-verbal manifestations for diagnostic purposes is the identification of pain. Researchers have identified combinations of facial features that are characteristic of pain sensations of different origins in both adults and children (Patrick, Craig, & Prkachin; Prkachin). Common indicators of pain include lowered eyebrows, narrowed eyes, raised cheeks, a raised upper lip, and a wrinkled nose. The analysis of these signs can provide information that cannot be obtained from the patients themselves. For example, patients suffering from chronic or acute temporomandibular disorders and experiencing pain when moving the jaw, create that they suffer from this pain in the same way, however, facial indicators indicate that chronic patients experience more severe pain and when left to themselves and when undergoing painful procedures (LeResche, Dworkin, Wilson, & Ehrlich). Non-verbal facial cues also make it possible to distinguish between a person who is actually in pain and a faker (Prkachin).

There are also known forms of non-verbal behavior that are associated with type A personalities (that is, with people more prone to myocardial infarction): loud and fast speech and other manifestations that indicate aggressiveness. Indeed, the results of many studies suggest that aggressiveness is a harbinger of a heart attack. The results of a recent study show that facial expressions coded according to the Facial Movement Coding System are associated with transient ischemia, a disease in which insufficient blood is supplied to the heart muscle, which can cause serious and even fatal consequences. Interviews with healthy men and with men suffering from ischemic disease were recorded on videotape and the necessary physiological measurements were taken. It turned out that patients with ischemia showed more facial expressions indicating anger and more insincere smiles than healthy men (Rosenberg, Ekman, Jiang, Babyak, Coleman). Results such as these may affect the treatment of such patients.

In the process of training future doctors and psychotherapists, an increasingly prominent place is given to their acquisition of knowledge about communication factors. However, as a rule, they receive clearly insufficient training in terms of communication with patients, including recognizing the state in which the patient is located, using the non-verbal signals sent to them. It is clear that doctors need such knowledge. However, it is very important that doctors not only notice the non-verbal signals sent by patients, but also know how to correctly interpret them. There is a known study in which surgical professors erroneously concluded that students were underprepared if they looked away during an oral exam. It is important to notice non-verbal signals, but even more important is to interpret them correctly and be able to ignore them if what the patient is expressing in words matters most at the moment.

Non-verbal cues can also be used as a source of information about the effectiveness of treatment. So, as a result of psychotherapeutic influence, the sound of the voice, smiles, movements and other forms of non-verbal behavior can change (Ellgring & Scherer; Ostwald).

So far, we've talked about how nonverbal cues can be used by doctors and therapists. But patients also watch them, wanting to see signs of understanding, interest, liking or disliking, or finding peace.

The therapist's non-verbal behavior can help establish a good, trusting relationship and a full exchange of information, that is, the so-called "therapeutic alliance", but can also lead to the fact that the patient feels left out and misunderstood. Both patients and doctors can judge with some, though not very high, accuracy how likable they are to each other, which can have far-reaching consequences (Hall, Hoggan, Stein, & Roter). According to the results of this study, patients who were treated less sympathetically by doctors were less satisfied with communication and were more likely to think about changing doctors. Patients are more satisfied with their interactions with doctors and believe that they show sympathy for them if they make eye contact, lean in, nod their heads, come close and speak in a sympathetic, energetic voice. Sometimes some combination of these forms of non-verbal behavior brings the best results. Thus, it has been shown that patients were most satisfied when the doctor's negative intonations were combined with his positive words (Hall, Roter, & Rand). Sometimes non-verbal behavior of doctors can indicate a difficult relationship with patients. The surgeons who were most frequently sued had voices that suggested they were dominant.

Patients of doctors who are able to understand the meaning of nonverbal cues are more satisfied with communication with them and do not miss visits (DiMatteo, Taranta, Friedman, & Prince; DiMatteo, Hays, & Prince). The authors of these studies also showed that doctors who more accurately demonstrated non-verbal signs of emotion when performing a staged task had more satisfied and accommodating patients. So far, we do not know how these doctors use their good non-verbal skills when communicating with patients, but we can assume that they are able to express sympathy, create a trusting atmosphere and pay attention to those problems of the patient that he did not mention.

Today, future doctors know how important a good relationship with patients is. It is misleading to think that doctors and patients only play well-rehearsed roles, or that doctors are cognitive machines that "give out" professional behavior without experiencing any feelings, is a delusion. There is always a relationship between clinicians and patients; they may be strictly formal, but they are still relationships. Therefore, everything that we know about the role of non-verbal behavior in the formation of sympathy, attitudes, impressions, mutual understanding, emotions and beliefs is most directly related to them.

Verbal or verbal communication realized through speech. Therefore, it is called verbal (verbum-lat.: word, verb). Speech performs the function of communication. The communicative function of speech allows you to establish contact between people. In the communicative function of speech, one can single out 3 aspects: informational(speech acts as a way of transmitting information from one person to another and from generation to generation ); expressive(a means of conveying feelings, relationships, while intonation, expressive, paralinguistic components - gestures, facial expressions, pantomimics are of great importance); speech as a call to action, will. The communicative function is of great importance, organizing the interaction of people. A word spoken by a doctor or other medical worker can drastically change the patient's emotional state, his attitude to the disease, help mobilize strength, but it can also cause so-called "iatrogenic", suggestive diseases.

In the system of interpersonal communication, non-verbal communication is very important, which is associated with the mental states of a person and serves as a means of expressing them. In the process of communication, non-verbal behavior is the object of interpretation not in itself, but as an indicator of individual psychological and socio-psychological characteristics of a person hidden for direct observation. On the basis of non-verbal behavior, the inner world of the personality is revealed, the formation of the mental content of communication and joint activity is carried out. Non-verbal communication spontaneously, unconsciously and non-verbal language shows the attitude towards the communication partner, what a person really thinks and feels, in contrast to verbal communication, which represents pure, factual information.

More than half of the attention is paid to non-verbal accompaniment of speech. The studies of A. Meyerabian showed that in the daily act of human communication, words make up 7%, sounds and intonations 38%, non-speech interaction 55%.

Non-verbal behavior of a person is polyfunctional:

Creates an image of a communication partner;

Expresses the relationship of communication partners, forms these relationships;

It is an indicator of the actual mental states of the individual;

Supplements speech, replaces speech, represents the emotional states of partners in the communicative process;

Acts as a clarification, a change in the understanding of a verbal message, enhances the emotional richness of what was said;

Maintains an optimal level of psychological closeness between interlocutors;

It acts as an indicator of status-role relations.

Realized and manifested without the participation of consciousness, non-verbal means are independent and can either correspond to the incoming verbal information or diverge from it and even contradict it. In the first case, they speak of congruence, in the second, respectively, of incongruity, which is understood as a discrepancy, a discrepancy between incoming verbal and non-verbal information. With congruence, speech utterances and non-verbal manifestations must match. The contradiction between gestures and the meaning of statements is a lie signal. For example, a person who says that he is very happy to see N and at the same time takes a closed posture, touches his mouth or nose with his hands, is incongruent, since these non-verbal manifestations indicate that his joy is most likely not sincere.

Research on non-verbal communication proves that non-verbal signals carry 5 times more information than verbal ones, and if the signals are incongruent, people rely on non-verbal information, preferring it to verbal.