5.5: The Channels of Nonverbal Communication

Seven Types of Nonverbal Communication

Have you ever seen a mime perform? They never speak one single word yet you are able to understand what they say. That is because they use general nonverbal codes that we all can interpret. For example, Marcel Marceau was a very famous French actor and mime. He referred to mime as the "art of silence."

One reason that nonverbal communication is so rich with information is that humans use so many different aspects of behavior, appearance, and environment to convey meaning. These types of nonverbal communication can vary considerably across cultures. Figure \(\PageIndex{1}\) identifies the seven types of nonverbal communication that we will examine in this section:

1. Kinesics
2. Vocalics
3. Haptics
4. Proxemics
5. Artifacts and Environment
6. Olfactics
7. Chronemics

Figure \(\PageIndex{1}\): Types of nonverbal communication by Armeda C. Reitzel is licensed CC BY-NC-SA 4.0

As you read through this section, remember that the cultural patterns embedded in nonverbal codes should be used not as stereotypes for all members of particular cultures, but rather as tentative guidelines or examples to help you understand the great variation of nonverbal behavior in humans. Culture influences what nonverbal behaviors mean and how these meanings are displayed.

Kinesics

Kinesics refers to the study of hand, arm, body, and face movements. We will look specifically at three different types of kinesics: facial expressions, eye behavior (oculesics) and gestures.

Facial Expressions

You may have heard the expression “a smile is worth a thousand words.” We have been smiling most of our lives, ever since the fourth week of life. These spontaneous smiles turn into smiles of genuine enjoyment known as Duchenne smiles. What is a Duchenne smile? According to the Paul Eckmann Group (2022):

FACS [Facial Action Coding System] research has shown that in a true enjoyment smile, the skin above and below the eye is pulled in towards the eyeball, and this makes for the following changes in appearance: the cheeks are pulled up; the skin below the eye may bag or bulge; the lower eyelid moves up; crows feet wrinkles may appear at the outer corner of the eye socket; the skin above the eye is pulled slightly down and inwards; and the eyebrows move down very slightly. A non-enjoyment smile, in contrast, features the same movement of the lip corners as the enjoyment smile but does not involve the changes due to the muscles around the eyes.

The photograph in Figure \(\PageIndex{2}\) shows a great example of a Duchenne smile, that “genuine smile.”

Figure \(\PageIndex{2}\): Smiling girl by Jonathan Borba on Unsplash

One of the first foundational studies of culture and emotion was conducted by Paul Ekman and Wallace Freisen in the 1970s. The research conducted across the world led to the development of the Facial Action Coding System (FACS) that we mentioned earlier. FACS analyzed specific facial muscle movement associated with specific emotions (Tsai, 2021). Across cultures, individuals were able to correlate facial movements to specific emotions, leading to the development of what is now known as the seven “universal” facial expressions. These seven facial expressions include happiness, surprise, contempt, sadness, fear, disgust, and anger. Examples are depicted in Figure \(\PageIndex{3}\). You might consider the acronym SADFISH as a way to remember these seven universal facial expressions.

Figure \(\PageIndex{3}\): The Seven Universal Facial Expression of Emotion from the US Department of Justice CC0

While these universal facial expressions were recognized across cultural groups, research also showed that there were distinct differences in how each culture interprets and displays these emotions (Tsai, 2021). These became known as cultural display rules. Cultural display rules are intrinsically held within a culture's norms and standards of behaviors. They help to govern the types and frequencies of acceptable emotions (Spielman, et al., 2014). Different cultures have different structures of behavior and, therefore, different rules regarding how they display their emotions.

Research has shown that collectivistic cultures, where social harmony is emphasized, are less likely to showcase negative emotions, such as disgust or anger, in social settings. Individualistic cultures, where personal self-concept is emphasized, are more likely to showcase emotions of anger or disgust no matter the social context (Dzokoto et al., 2018). Research suggests that people from individualistic cultures, like the United States, use exaggerated facial expressions to showcase emotion as a way to influence others and gain attention from those around them (which is accepted within an individualistic culture). This is opposed to the actions of people from collectivistic cultures, such as Japan, where the tendency is to suppress or not show their emotional expressions as a way to observe the social context and interaction between interpersonal relationships. Because collectivistic cultures put primary concern on the interdependence of the cultural group, emotional displays are direct reflections of the family system, and the primary driver is to maintain relationships (Anonymous, 2022).

Understanding emotions in the context of culture is important to making sure we are aware of the ways that differences in communicating emotions may occur. The perception of emotional display rules differs between cultures, where different rules and norms are established and subconsciously understood amongst members. While these elements are rarely spoken about explicitly between cultural group members, they impact the way we interpret and communicate emotions in our relationships. Knowing the ways in which a person may express or not express an emotion will allow us to better regulate our own emotional reaction as well.

We rely on reading facial expressions so much in our interpersonal interactions. This was quite a challenge when we needed to wear face masks during the COVID-19 pandemic. About 50% of our face was covered with some sort of cloth or covering. This often created some ambiguity when it came to deciphering what a person might be saying. In addition, Deaf individuals were not able to see the movement of the lips, face, or tongue to engage in lip reading when their conversation partner’s nose and mouth were covered. Some people, such as the person in Figure \(\PageIndex{4}\), started wearing masks with a clear mouth window so that at least their mouth could be seen.

Figure \(\PageIndex{4}\): Showing a smile under a COVID-19 face mask by Armeda C. Reitzel is licensed CCBY-NC-SA 4.0

Oculesics

The study of eye contact is known as oculesics. Eye contact provides indications of social and emotional information. People, perhaps without consciously doing so, probe each other’s eyes and faces for signs of positive or negative mood. Eye contact can establish a sense of intimacy between two individuals, such as the gazes of lovers or the eye contact involved in flirting. Alternatively, avoiding eye contact can establish distance between people. When in crowds, people tend to avoid eye contact in order to maintain privacy. The customs involving eye contact vary widely between cultures. Muslims are taught to lower their gazes and try not to focus on the features of the opposite sex, except for the hands and face. Japanese children are taught to direct their gaze at the region of their teacher’s Adam’s apple or tie knot. As adults, Japanese tend to lower their eyes when speaking to a superior as a gesture of respect. In Eastern Africa, it is respectful not to look the dominant person in the eye, whereas such avoidance of eye contact is negatively interpreted in Western cultures. It is important to keep in mind that eye contact is culturally determined (LibreTexts, 2021).

Gestures

Gestures are movements of the body that carry meaning. Gestures may be categorized as emblems, illustrators, affect displays, or regulators.

Emblems

Emblems are gestures that correspond to a word and an agreed-on meaning. Many gestures are emblems that have a verbal equivalent in a culture. Since emblems are culturally determined, you might run into instances of ambiguity or miscommunication. For example, in the United States the “everything is OK or good” is represented by the index finger touching the thumb so that a “ring” is made. When we teach classes to international students, we avoid using this nonverbal gesture because it could mean very different things in different cultures, from “money” in Japanese culture to offensive meanings in other cultures.

Illustrators

While emblems can be used as direct substitutions for words, illustrators help emphasize or explain an idea. Think about a person who went fishing and then shows how big that fish that they caught was by extending their arms to show its size.

Affect Displays

Affect displays show feelings and emotions. Consider how music and sports fans show enthusiasm. It is not uncommon to see people jumping up and down at sports events during a particularly exciting moment in a game. However, there are different norms depending on the sport. It would be inappropriate to demonstrate the same nonverbal gestures at a golf or tennis game as a football game. The gesture displayed in Figure \(\PageIndex{5}\) shows the “pure joy” of a person who just made a strike.

Figure \(\PageIndex{5}\): A man smiling in a bowling alley by Pavel Danilyuk on Pexels

Regulators

Gestures that help coordinate the flow of conversation, such as when you shrug your shoulders or wink, are called regulators. Raising your hand during class indicates that you want to say something. Even the Zoom videoconferencing platform uses a “raise hand” icon to help regulate communication during a session. Regulators often include head nods, eye contact or aversion and changes in posture. They are considered to be turn-taking cues in conversation. Individuals may sit back when listening but shift forward to indicate a desire to speak. Eye contact shifts frequently during a conversation to indicate listening or a desire to speak. Head nods are used as a sign of listening and often indicate that the speaker should continue speaking.

Consider This: Five Common US Hand Gestures that Are Insulting in Other Cultures

We think nothing of using the following gestures in our everyday interactions with each other here in the United States. Like words, these gestures don’t mean anything until we assign meanings to them. In the United States, these gestures have harmless interpretations. However, in other countries, using these very same gestures can have dire consequences as they have very different meanings.

Gesture Meanings and Contexts

Graphic of Nonverbal	Meaning in United States	Meaning Elsewhere
Thumbs-Up by Tumisu from Pixabay	Positive meanings including: everything is good/OK, and good going.	Considered a very rude gesture in the following countries: Australia, Sardinia, Iran, Nigeria, Ghana, and Soviet Union. If counting - In Germany “thumbs up” = !; in Japan “thumbs up” = 5
Fingers-Crossed by Evan-Amos from Wikimedia Commons	Wish for luck or good results. Sometimes used by children as an excuse to tell a little lie or break a promise made.	This same gesture in Vietnam is equivalent to us “giving someone the bird.”
Kid saying OK from Freesgv.org Public Domain	OK; good; everything is fine.	In the South of France this means “zero” or “worthless.” In Japan, this is a symbol for money because it looks like the shape of a coin. In Brazil, this indicates female private parts and is considered extremely rude. It is also insulting in Malta, Sardinia, Greece, Tunisia, Italy, Turkey, and Paraguay.
Sign of the horns from Freesgv.org Public Domain Hand sign by ChininiProductions from Pixabay	Hang loose = chill; be relaxed; don’t take things too seriously Rock on = positive exclamation expressing enthusiasm, excitement Hook ‘em Horns = official hand sign of various universities in the United States whose mascot has some kind of horns (University of Texas, Austin, Texas Christian University, North Carolina State, North Dakota State).	In Argentina, Brazil, Colombia, Cuba, Spain, Italy and Portugal this is a sign that tells someone their spouse is cheating. In some African countries, flashing this gesture indicates you’re placing a curse on them.
Hand-man-number from pxhere.com CC0	In the United States, this sign (with the palm facing in or out) can have several meanings, none of which are negative. It could mean “peace.” It could also signal “V” for victory, or it could signal the number “2.”	In Ireland, United Kingdom, Australia, New Zealand, and South Africa, displaying this same gesture with the back of the hand facing outward is an obscene and insulting gesture.

Discussion Questions

1. Have you come across misunderstandings as a result of using one of the above gestures? Briefly discuss what happened.
2. What are some other nonverbals you have come across that could have very different meanings and/or cause confusion/misunderstandings from culture to culture?
3. Do you know of any universal gestures? Explain.

Video Resources

• American Hand Gestures in Different Cultures: 7 Ways to Get Yourself in Trouble Abroad
• How to Describe Hand Gestures in English
• Gestures Around the World
• Handshake Etiquette Around the World

Vocalics

Vocalics focuses not on the words that we choose, but the manner in which we say the words using our vocal cords. It includes the study of paralanguage, which is the set of physical mechanisms that we use to produce sounds orally. These mechanisms involve the throat, nasal cavities, tongue, lips, mouth, and jaw. The specific aspects of vocalics that we will focus on are pitch, pace, disfluencies, and volume.

Pitch

Pitch is how harmonically high or low you say something. The rate at which your vocal folds vibrate in your throat are responsible for the pitch of your voice. Low-frequency vibrations make for a lower-pitched sound, while higher frequency vibrations make for a higher-pitched sound. If you end the sentence on a high note (known as “uptalk”), you might be perceived as sounding uncertain about the claim (Linneman, 2013). If you end it on a low pitch, it might sound like you are stating a fact confidently.

Pace

Pace refers to how quickly you utter your words. Often, beginning public speakers will talk fast out of nervousness or too much excitement. Their area of improvement then is learning to slow down to allow the audience to “digest” the words. In high-energy humorous speeches, the speaker might talk faster, whereas in more serious dramatic speeches, the speaker would slow down to build the drama.

The use of pauses is a natural aspect of pacing. There are two types of pauses: grammatical and non-grammatical. Grammatical pauses are used to highlight something in a sentence or to build suspense. An example would be a host saying, “And the winner is ... Corey,” where the ellipsis (...) is a pause to build suspense. Non-grammatical pauses are not planned and may occur when a speaker loses their train of thought or is self-correcting.

Disfluencies

Both grammatical and non-grammatical pauses can either be filled or unfilled. Unfilled pauses have no sounds associated with them; they are pure silence. Filled pauses have some kind of noise associated with them, typically “uhh” and “umm.” The use of these non-grammatical sounds as pauses are known as disfluencies. Disfluencies can also include the repetitive use of a word during a pause, such as “like,” “so,” or “and.”

Volume

Volume refers to the loudness (prosody) of the language being spoken. You might have a friend who is a “loud talker” and can be heard from far distances having conversations with someone within social distance. On the opposite end of the spectrum, you may have a friend who is a “soft talker” who may be hard to hear in loud settings. In any case, we may have expectations for volume in certain settings. At a football game, loudness is encouraged by fellow fans. In a fine-dining romantic restaurant, soft-talking is expected by fellow patrons.

Haptics

Haptics is the study of communication by touch. Touch may indicate liking, attraction, or dominance. It is a form of communication that can be used to initiate, regulate, and maintain relationships. It is a very powerful form of communication that can be used to communicate messages ranging from comfort to power. Duration, frequency, and intensity of touch can be used to convey liking, attraction, or dominance. Duration refers to the length of time of a touch. Frequency is how often touch is used. Intensity is the amount of pressure that is applied. Touch is a powerful interpersonal tool along with voice and body movement.

Proxemics

The study of proxemics, which is the study of communication through space, was strongly influenced by the anthropologist Edward T. Hall back in the 1968. He categorized space into four “distances” based on observations of the use of space in cultures, such as the United States.

1. Intimate space: The intimate zone is typically reserved for only the closest friends, family, and romantic/intimate partners. It involves any communication that is 18 inches or less from a person’s body. It is impossible to completely ignore people when they are in this space, even if we are trying to pretend that we’re ignoring them. While some people are comfortable engaging in or watching others engage in PDAs (public displays of affection) others are not.
2. Personal space: The personal zone is typically reserved for friends, close acquaintances, and significant others. Much of our communication occurs in the personal zone, which is what we typically think of as our “personal space bubble” and extends from 18 inches to 4 feet away from our body.
3. Social distance: Communication that occurs in the social zone, which is 4 to 12 feet away from our body, is typically in the context of a professional or casual interaction. This distance is preferred in many professional settings because it reduces the suspicion of any impropriety. The expression “keep someone at an arm’s length” means that someone is kept out of the personal space and kept in the social/professional space. If two people held up their arms and stood so that just the tips of their fingers were touching, they would be around 4 feet away from each other, which is perceived as a safe distance. Students in large lecture classes should consider sitting within the social zone of the professor, since students who sit within this zone are more likely to be remembered by the professor, be acknowledged in class, and retain more information because they are close enough to take in important nonverbal and visual cues.
4. Public distance: Public space starts about 12 feet from a person and extends out from there. This is the least personal of the four zones. It is typically used when a person is engaging in a formal speech. It would be difficult to have a deep conversation with someone at this level because you have to speak louder and don’t have the physical closeness that is often needed to promote emotional closeness and/or establish rapport.

Figure \(\PageIndex{6}\): Hall’s Zones of Interpersonal Distance created by Armeda Reitzel CC BY-NC-SA 4.0.

You may read a full description here: Hall's Four Zones of Interpersonal Distance

You might be questioning Hall’s “social” zone of distance, because a new phrase entered our everyday vocabulary in 2020: social distancing. During the COVID-19 pandemic, social distancing became a that concept we saw and talked about. That term has been replaced with the phrase physical distancing. 

What is physical distancing? “Physical distancing is the practice of staying at least 6 feet away from others to avoid catching a disease such as COVID-19” (Maragakis, 2020). Figure \(\PageIndex{7}\) displays the outline of two shoe prints along with the verbal explanation to “Please help by keeping a safe distance of 6 feet. Thank you for social distancing.”

Figure \(\PageIndex{7}\): Please help by keeping a safe distance of 6 feet. Thank you for social distancing. by Elizabeth McDaniel on Unsplash.

A song that became popular again during the early days of the pandemic was “Don’t Stand So Close to Me.” There was a remix of the song done by Sting, Jimmy Fallon, and The Roots using the Zoom conferencing platform and at-home instruments in April 2020. You might consider checking it out at “Jimmy Fallon, Sting & The Roots Remix "Don't Stand So Close to Me" (At-Home Instruments).”

Artifacts and Environment

Artifacts are items with which we adorn our bodies or that we carry with us. Artifacts include glasses, jewelry, canes, shoes, clothing, or any object associated with our body that communicates meaning. That includes tattoos and piercings!

Tattoos have become mainstream among young people in the United States and elsewhere. Now there are policies for each branch of the military as to what and where tattoos are permitted (DePastino, 2021). Even Disney has updated its policy, according to Josh D'Amaro, chairman of Disney Parks, Experiences and Products:

Our new approach provides greater flexibility with respect to forms of personal expression surrounding gender-inclusive hairstyles, jewelry, nail styles, and costume choices; and allowing appropriate visible tattoos. We’re updating them to not only remain relevant in today’s workplace, but also enable our cast members to better express their cultures and individuality at work. (D’Amaro, 2021)

Keep in mind that tattoos in different cultures, communities, and countries may still have a negative connotation. What do the tattoos in Figure \(\PageIndex{8}\) communicate to you nonverbally?

Figure \(\PageIndex{8}\): Woman with Tattoo by Annie Spratt on Unsplash

Clothing stimulates meaning. For example, my father always asked me, “How do you know if someone is a priest, painter, judge, police officer, or doctor?” It is because they have a uniform that represents that profession. Dress and physical appearance can be important identifiers for membership in particular groups. What do the casual sweatshirt and shorts worn by the person in Figure \(\PageIndex{9}\) say to you? How does the environment that this person is in affect your reading of their clothing?

Figure \(\PageIndex{9}\): Appearance by Aiman Zenn on Unsplash

Differences in power and status may be seen in the size and location of an office. Even the presence or absence of a window might influence perceptions. Think about your reactions to someone with a spacious office with expensive-looking furniture and wall-hangings and a huge window overlooking a great view versus someone in a tiny, cramped cubicle with cheap particle-board furniture and no windows. Even classrooms are designed in different ways that may encourage group interactions or keep the students’ focus on the front of the room and the instructor.

Olfactics

The sense of smell communicates messages. The term olfactics refers to the influence of scent on perceptions. Does the smell of gingerbread bring back fond, positive memories of holidays when the kitchen was full of those delicious cookies that you used to make (and eat!) when you visited your grandparents? Have you ever purchased a candle or a particular type of bubble bath because of its scent, which perhaps reminded you of something positive?

Scent can draw others in or repel them, and the same scent can have different affects on different people. The United States places a lot of emphasis on smell. Consider the impact of failing to manage one’s natural scent in the workplace. Countless articles in the popular media address how to deal with a “smelly coworker.” Thus, it is crucial to be aware of one’s scent, including the ones we wear in an effort not to offend those around us. Although smelling “bad” may end a relationship or at least create distance, an attractive scent may help individuals begin a new relationship. Have you ever purchased a new scent before a first date? If so, you are aware of the power of scent to attract a mate.

Although we regularly try to cover our scent, we also attempt to control the scent of our environments. The air freshener market in 2016 was valued at $1.62 billion US dollars. Go to your local grocery store and investigate the number of products available to enhance environmental scents. Be prepared to spend a significant amount of time taking in the many products to keep our environments “fresh.” Remember that what is considered “pleasant” or “smelly” is culturally based.

Chronemics

Chronemics refers to the study of how time affects communication. Time can be classified into several different categories, including biological, personal, and cultural time (Andersen, 1999).

Biological Time

The rhythms of living things are referred to as biological time. When our natural rhythms are disturbed, by all-nighters or jet lag, our physical and mental health and our communication competence and personal relationships can suffer. Keep biological time in mind as you communicate with others. Early morning conversations and speeches may require more preparation to get yourself awake enough to communicate well. A more energetic delivery may be needed to accommodate others who may still be getting warmed up for their day.

Personal Time

The way we experience time is referred to as personal time. This varies based on our mood, interest level, and other factors. Think about how quickly time passes when you are engaged in something that really interests you. People with past-time orientations may want to reminisce about the past, reunite with old friends, and put considerable time into preserving memories in scrapbooks, photo albums and on Instagram. People with future-time orientations may spend their time making career and personal plans, writing to-do lists, researching future vacation spots or deciding what program they’re going to binge-watch next month.

Cultural Time

How a large group of people view time is called cultural time. There are cultures that tend to value polychronic time. There are other cultures that operate on monochronic time. The term polychronic contains the idea of “many” (poly) and refers to the idea of many things happening in a fluid, flexible fashion. Polychronic people tend to engage in multiple activities at the same time and do not create specific time frames to work on particular tasks. We might view such people as “simultaneous multitaskers” who juggle multiple activities and people at the same time. Time is not seen as linear, and schedules may be regarded as only suggestions. For example, polychronic people tend to “go with the flow.” They would never think of telling someone when a party is scheduled to end. Why? They would say that it is because a party ends when it is over.

Monochronic people tend to schedule their time more rigidly and focus on one task at a time. They make schedules and stick to them as much as possible. Events begin at a specific time and they end at a specific time. An invitation to a party hosted by a monochronic person might even announce an ending time as well as a start time for the festivities. A monochronic person might interpret the behavior of a polychronic person as rude or uncaring because they did not bother to show up on time. A polychronic person may perceive a monochronic person as uptight or harsh because they seem to care more about time than about people. As you can see, our concepts about time influences our social realities and how we perceive and interact with others.

Our status may influence the way that we view and use time. For example, doctors can make their patients wait, and executives and celebrities may run consistently behind schedule, making others wait for them. Promptness and the amount of time that is socially acceptable for lateness and waiting varies among individuals and contexts. One of the authors is an English as a second language teacher-trainer who has traveled all over the globe, and can share the following: "The sense of time definitely differs from culture to culture. I learned to be flexible about the start time for my workshop sessions in Nicaragua. When I was in Germany, a train conductor apologized to the whole trainload of passengers for arriving one minute late to a stop."\

What instances of time differences have you experienced that may have been influenced by culture?

Nonverbal Communication in Different Settings

Nonverbal communication covers a lot of territory. It’s important to consider our nonverbal communication in different contexts: from the classroom to the grocery store to the courtroom to the job interview. Think about the different situations that you find yourself in and how you might need to adjust your nonverbal communication to fit the circumstances. How would you characterize the role of nonverbal communication with friends and family? How is that the same or different from the nonverbal communication appropriate in a professional setting? Let’s take a quick look at recommendations to healthcare professionals in interacting with their patients for a context-specific example.

Figure \(\PageIndex{10}\): A doctor looking forward and thinking by Usman Yousaf on Unsplash.

Example \(\PageIndex{1}\): Example of nonverbal communication in a specific context: Healthcare settings

There is great interest in the study and teaching of confirming nonverbal behaviors in interpersonal communication in healthcare contexts.

In addition to effective verbal communication, nonverbal behavior is critically important for achieving patient satisfaction, adherence to treatment, and shared medical decisions. Patients are calling for more compassionate care, and the government and third-party payers are now basing hospital reimbursement on patient satisfaction ratings. (Reiss & Kraft-Todd, 2014)

For example, a doctor will focus on a patient’s facial expressions and tone of voice to tap into their concerns while a patient relies on a doctor’s nonverbal behavior to figure out what the doctor means (Ishikawa, et al., 2006). Patients have identified eye contact as being significant in their interactions with their doctors. According to Timmermann, Uhrenfeldt, and Birkelund, "Eye contact substantiated the patients' experience of being confirmed. Simultaneously, it became apparent that eye contact alone was not enough for the patients to feel confirmed. It was the body language as a whole that the patients interpreted" (2017).

There are two acronyms that address how nonverbal communication might be used effectively in healthcare settings: EMPATHY is one; SOFTEN is the other. As suggested by Reiss and Kraft-Todd (2014), a healthcare professional should show empathy by paying attention and listening to the nonverbal communication of their patients:

• E = Eye contact
• M =Muscles of facial expression
• P= Posture
• A = Affect
• T = Tone of voice
• H = Hearing the whole patient
• Y = Your response).

Roger (2002) shared a framework proposed by Joan Damsey for making patients feel more comfortable through positive nonverbal communication behavior. The acronym SOFTEN captures the key suggestions:

• S = Smile. This can create a positive interactional climate that can lead to more open communication between the healthcare professional and the patient.
• O = Open posture. An open posture (no crossed arms or legs) indicates a willingness to listen to what the patient has to share.
• F = Forward lean. This may suggest to the patient that you want to listen to them.
• T = Touch. A touch can signal a positive nonverbal message and provide some information about how the patient is feeling.
• E = Eye contact. Maintaining eye contact for about 80% of the time may make the patient feel as if you are focusing your attention and efforts on them.
• N = Nod. Nodding occasionally tells the patients that the healthcare professional is listening to them and what they have to say.

These specific suggested nonverbal cues tend to be confirming communication behaviors and can actually lead to a faster, more productive exchange of information.

So, as you can see, nonverbal communication is important in establishing a positive communication climate between patients and healthcare professionals. Would you like to learn more about this topic? Then check out this resource on “Basic Non-verbal Communication Skills” in a healthcare setting.

Figure \(\PageIndex{11}\): Healthcare professional with a patient by the National Cancer Institute on Unsplash.