Tag Archives: Verbal Communication

Observation and Reflection on Affective Experience and Communication

“Civilization seems to require that we inhibit the free play of our emotions, and many have wondered what consequences such emotional inhibition might have.”  (Gross & Levenson, 1997, p. 95)  The word feeling is another word for emotion, and emotions represent the well from which many of our thoughts and actions flow.  “If we can identify and sort out clients’ feelings, we have a foundation for further action.”  (Ivey, Ivey, & Zalaquett, 2010, p. 190)  That further action, if there is to be any, should represent clarification of what has been dubbed “affective experience.”  In my view, that affective experience, properly channeled, is like channeling the flow from an artesian well.  If we are successful “the client will experience and understand their emotional state more fully and talk in more depth about feelings” or emotions.  (Ivey et al., 2010, p. 172)  In essence, clients tap the well of emotion that swells up inside of them… and the release of that pressure will result in both verbal and nonverbal expression.

If we succeed in tapping the well of emotion, the resulting flow of verbal and nonverbal expression of emotion allows us to functionally guide a client through a liquid reenactment of emotion experience.  “Human change and development is often rooted in emotional experience.”  (Ivey et al., 2010, p. 180)  Meaningful change, in my opinion, is difficult to obtain without addressing the emotions that will be leveraged to drive and guide that change… although difficulty dealing with emotions is not an insurmountable issue.  Research seems to support the view that difficulty or discomfort with emotional expression is less important than the bond between therapist and client.  In the same study, perception of treatment helpfulness was also capable of overcoming discomfort with emotional expression. (Cusack, Deane, Wilson, & Ciarrochi, 2006)  While emotions and feelings remain central to our profession, the efficacy of the treatment and the professional relationship continue to trump their significance in some circles.

As a client, I know when a therapy session goes well… it “just feels right.”  “Like other aspects of the non-sensory fringe of consciousness (e.g., feelings of familiarity, knowing, or causation), feelings of rightness are evident instantly, although they may be amorphous and fuzzy.  (Hicks, Cicero, Trent, Burton, & King, 2010, p. 967)  In my view, observing and reflecting feelings make it possible to be “right” more often, at least as it relates to tapping the our clients emotional wells and channeling that emotion to positive ends.

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Cusack, J., Deane, F. P., Wilson, C. J., & Ciarrochi, J. (2006, April). Emotional expression, perceptions of therapy, and help-seeking intentions in men attending therapy services. Psychology of Men & Masculinity, 7(2), 69-82. doi: 10.1037/1524-9220.7.2.69

Gross, J. J., & Levenson, R. W. (1997, Feb). Hiding feelings: The acute effects of inhibiting negative and positive emotion. Journal of Abnormal Psychology, 106(1), 95-103. doi: 10.1037/0021-843X.106.1.95

Hicks, J. A., Cicero, D. C., Trent, J., Burton, C. M., & King, L. A. (2010, June). Positive affect, intuition, and feelings of meaning. Journal of Personality and Social Psychology, 98(6), 967-979. doi: 10.1037/a0019377

Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2010). Intentional interviewing & counseling (7th ed.). Belmont, CA: Brooks/Cole.

Active Listening

Active listening is the process by which we communicate to our clients that they are heard and understood.  There are three specific micro-skills included in the text that all serve this purpose, included among them are encouraging, paraphrasing, and summarizing.  Encouraging can be either verbal or non-verbal, although my personal style is mostly non-verbal.  For me, it’s as simple as a head-not or strategically placed “I understand.”  Restatements are a form of encouraging that I will definitely need to work on, although it is evident to me that restatement is a valuable skill and one that will most certainly be used often.  “Key word encouragers contain one, two, or three words, while restatements are longer.”  (Ivey, Ivey, & Zalaquett, 2010, p. 157)

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“The goal of paraphrasing is facilitating client exploration and clarification of issues.”  (Ivey et al., 2010, p. 158)  Paraphrasing represents an opportunity for the therapist to verify that they have heard and understood what the client has said, as well as to focus (or refocus) conversation on a specific element of the dialogue.  I well designed paraphrase utilizes key word that were used by the client previously, captures the essence of what they client has communicated, and gives the therapist an opportunity to ‘check out’ and verify that they did in fact understand the dialogue correctly.

Summarizing can be employed at the beginning, the end, or during the course of a topic transition.  Summarization is a form of selective attending in which the therapist picks out multiple key points and attempts to restate them as accurately as possible.  (Ivey et al., 2010, p. 159)  The bottom line is that it is absolutely necessary that we continue to be ‘active participants’ in the conversation and that we attend to the details of said conversation so that we are better able to detect slight movement in mood or affect.



Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2010). Intentional interviewing & counseling (7th ed.). Belmont, CA: Brooks/Cole.


Observation Skills

(Pfäfflin & Adshead, 2004) suggest that from a neurobiological perspective the process of affect regulation inexorably links nonverbal and verbal representational domains in the human brain.  This relationship may serve to facilitate the transfer of implicit information in the right hemisphere to explicit or declarative systems in the left.  (Pfäfflin & Adshead, 2004, p. 136)  One might deduce that it would be subsequently impossible to separate verbal behavior from nonverbal behavior.  Recognizing this connection, in my opinion, is the key to improving our observational skills.  No action, verbal or nonverbal, should go un-scrutinized… every action (no matter how small) means something.

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Despite our recognition that nonverbal communication is as important, or more important, than verbal communication; “there is no dictionary of nonverbal communication.”  (Riggio & Feldman, 2005, p. xiii)  There is no standard by which we can judge the inherent meaning of an averted gaze.  Even basic facial expressions that convey emotion are subject to the trials of context and individual differences.  And so, we would be well served to recognize that individual and multicultural issues are paramount in the interpretation of behavior.  Furthermore, the interpretations of those expressions are governed by our own selective attention.  (Ivey, Ivey, & Zalaquett, 2010, p. 124)  “Be careful not to assign your own ideas about what is ‘standard’ and appropriate nonverbal communication.”  (Ivey et al., 2010, p. 125)

I would suggest that we be cognizant of the perceived deficits that our potential clients bring to the table, especially if they have a history of interpersonal problems.  We should approach our observations with a healthy scientific skepticism and mindful that we can not always trust what we see.  Furthermore, we would be well served to approach the perspectives of our clients with the same distance and objectivity.  Take the case a client whom demonstrates deficits in decoding facial expressions…

One can speculate that many interpersonal problems might result from a deficit in decoding facial expression… the most obvious problem is the difficulty in identifying the internal states of others: their desires, emotions, or intentions.  Such information is essential for the understanding of others, of the meaning of their behavior in general as well as during social interaction.  Relating to someone whose intentions and emotions are obscure is virtually impossible.  (Philippot, Douilliez, Pham, Foisy, & Kornreich, 2004, p. 18)

Furthermore, research suggests that both nonverbal and paralinguistic communication play an important role in the retrieval of knowledge in trans-active memory systems.  (Borman, Ilgen, & Klimoski, 2003, p. 348)  Almost invariably, it seems as though individuals will “look up and to their left” when they are retrieving information from long-term memory.  Although I do not recall the specific source, I recall that left handed people actually do the opposite (look up and to their right).  When interpreting the memory retrieval of our clients, we would be well served to know which hand they write with.

You mentioned note taking… which is important not only for our benefit of reviewing previous sessions, but for our ability to self access and determine if we have left a stone unturned.  Process notes really are an art, not a science.  In his blog, Bowden Mcelroy (2005) suggests a couple of different formats for process notes that you may find helpful in your practice.  He terms the first one ‘BIRP.’

B: Behavior. What did the client do?

I: Intervention. How did the therapist intervene?

R: What was the client’s Response to the intervention?

P: What is the Plan? Where does treatment go from here?

A second suggestion, one that is in relatively wide use in the field, is called ‘SOAP.’  (As a sidebar, this is also a great method for self-assessment) (Mcelroy, 2005)

S: Subjective: What did the client say?

O: Objective: What did the therapist observe?

A: Assessment (or, Analysis): What does the therapist think is going on?

P: As always, P stands for Plan.

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Borman, W. C., Ilgen, D. R., & Klimoski, R. J. (Eds.). (2003). Handbook of psychology (Vols. 1-12). Hoboken, NJ: John Wiley & Sons.

Ivey, A. E., Ivey, M. B., & Zalaquett, C. P. (2010). Intentional interviewing & counseling (7th ed.). Belmont, CA: Brooks/Cole.

Mcelroy, B. (2005, Nov. 10). How to write counseling notes [Web log message]. Retrieved from http://mcelroycounseling.com/how-to-write-counseling-notes/

Pfäfflin, F., & Adshead, G. (Eds.). (2004). A matter of security: The application of attachment theory to forensic psychiatry and psychotherapy. New York, NY: Jessica Kingsley Publishers.

Philippot, P., Douilliez, C., Pham, T., Foisy, M., & Kornreich, C. (2004). Facial expression decoding deficits in clinical populations with interpersonal relationship dysfunctions. In R. E. Riggio & R. S. Feldman (Eds.), Applications of nonverbal communication (pp. 17-37). Mahwah, NJ: Lawrence Erlbaum Associates.

Riggio, R. E., & Feldman, R. S. (Eds.). (2005). Applications of nonverbal communication. Mahwah, NJ: Lawrence Erlbaum Associates.