Am I non-verbally leaking with my patients?

As I look at her sat across from my desk I am mentally willing her out of the door. She has been in the consultation for 18 minutes now…that’s nearly double the allotted time. This means too that my stake of patients that are waiting is growing and my morning is fast going from pleasant coffee-managed jaunt to a strained sprint. I nod as she continues to demand more and more. Here hands are raising up and gesturing towards me and in response my arms are now crossed. I never cross my arms (it shows off the hairiness too much). Oh no, I am putting up a barrier! I remember this from medical school, from every argument I have ever had! Am I really having an argument with my patient? Surely not…

You see that day words were heard but the non-verbal communication between us was much much louder. In essence, I didn’t want her there any longer as it was unnecessary, counter productive and my coffee was fast reaching that undrinkable temperature. I should add too that I had already treated, prescribed and managed her specific ailment. I’m not that cruel.

Non-verbal communication is a huge, if not over-riding component of our global communication with other people. It was first commented on back with Darwin who felt that all animals and humans expressed cues about their emotions and feelings through facial expressions and body language. Today the science of non-verbal body language goes beyond that of just body language but includes, use of voice (paralanguage), touch (haptics) and distance (proxemics).

This all got me thinking about how I interact with people around me: my friends, work colleagues, patients, complete strangers in the street. Am I different with each group? Well, I guess to a degree we all much be – particularly when we factor in how comfortable we are with them. I know with the above patient that I was probably had a very negative set of non-verbal signs – my arms were crossed, my face tense, my voice a little slower and deeper (not Barry White slow and deep mind you – – I wasn’t trying to seduce her!). These are aspects to my interaction that I can definitely improve upon, make me a better doctor and make my interactions more successful. When I think about my non-verbal communication in general I have to say though I am happy with it overall – I have always felt that I’m a happy, open, positive person and I take a certain pride, I guess , in helping someone I am talking to feel comfortable. That may be to make a new friend, impress a girl(!), put a patient at ease who is nervous or just make someone smile. This is clearly important as a large part of our “first impression” when we meet someone, in any setting in life is framed and made largely by their body language and non-verbal communication.

It is clear though that for me, when body language and non-verbal communication becomes key is in a negative situation. That is when everything is highlighted and accentuated. Perhaps it is as my mind focuses more on the words that I am saying and less on my body that my body then starts to do its own thing and naturally displays that I am annoyed and frustrated or feeling defensive. This is maybe highlighted with my case patient I have been describing through a concept called ‘non-verbal leakage’. This is essentially where you body displays how you really feel and is in complete disagreement with your verbal communication. For example, as I ended up standing from my chair and gesturing to the consulting room door and I say “no of course not, we always have time to hear every single detail of our verruca’s progression of symptoms over the past 12 months”…I am indeed massively leaking non-verbally. In fact I am flooding.

Right, I must  go now – time for a coffee and a walk to put into practice some of non-verbal communication skills and perhaps practice my non-verbal leakage before my morning GP session tomorrow.

Have a great week everyone.

Dr Nick


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