Non-verbal communication is an effective way to gauge the reactions of people, learn what they are feeling and for them to stress meanings. It often originates in the subconscious of the subject and expresses what he or she may not be able to put into words. This realization is utilized by those observing non-verbal communication and is particularly important to those who work with people at risk. Expressions and perceptions of emotions, the tone of voice, and other characteristics are channels that can be used to obtain information from patients. The process is so subtle to the person communicating in this way that he or she will usually fail to recognize what is being perceived on the other side. This leaves an open door for analysts to explore that which a patient may intend to keep secret. While several forms of expression are mentioned in this article, it is important to understand, particularly for those who descend from different cultures and backgrounds, that expressions can have various meanings and implications between cultures. For example, in some cases, Nepalese people shake their heads side to side to imply the answer "yes." We recommend that the interpretation of non-verbal communication not be based on only a few non-verbal messages. A series of communication will be necessary to properly read the feelings of patients and to express personal ideas. Modes of non-verbal communication follow.

FACIAL EXPRESSION:

Facial expressions are perhaps the most important non-verbal way in which emotions are manifested. A number of studies have indicated that the facial expressions of certain primary emotions can be judged accurately by people from diverse cultures. Facial expression is an indicator of emotions and attitudes as well as stress makers. For example, to change the statement into a question, you might raise your eyebrows as you raise the pitch of your voice at the end of a sentence. Facial expression and voice tone are the most important channels that indicate emotions and attitudes. Emotions should be compatible with desired intentions. If one appears angry while trying to convey a friendly attitude, one is not likely to be successful. Norms define the standards regarding what can and should be expressed where. The norms related to expression of emotions vary according to culture.

GAZE:

The term gaze refers to a person's behavior while "looking." Gaze is an important function to the gathering of information. Although gaze avoidance deprives us of valuable information about how others respond, this may be normative in some cultures and in certain situations. Gaze avoidance may occur because of deference to the speaker, fear of revealing feelings, or fear of negative feedback. We use gaze to express feelings, intentions, and attitudes.

POSTURE & POSITION:

We indicate our attitudes and emotions not only by gaze and facial expressions but also by our posture and body position. The objective is to convey a relaxed and confident posture while maintaining a socially appropriate posture and position. Tightly crossing your arms over your chest may give the impression of anger or tension. A lean forwards (leaning toward rather than away from others) with separated arms and legs (rather than tightly crossed) communicates warmth and friendliness. Indifference may be communicated by shoulder shrugs, raised arms, and outstretched hands. Clenched fists and hunching convey anger. Slouched shoulders may convey a lack of confidence. In contrast, good posture with the shoulders rolled back in a relaxed position (not "at attention") - make it more likely that others will view you as self confident. How we position or orient our bodies (e.g. whether we face toward or away from others) communicates different degrees of intimacy or formality. The meaning of and reactions to different body orientations depend on a number of factors including ethnicity, status, and gender differences.

PROXIMITY:

Rules for proximity vary in different countries and ethnic groups. There are, however, established distance zones ranging from intimate, personal, social and public that can be generally applied to situations. An intimate distance can range from love making and comforting to the far phase of 6 to 18 inches. A personal distances range from 18 inches to 4 feet and a social setting can range from 4 to 7 feet at the near phase and 7 to 12 feet at the far phase. In public distances are typically greater do to unfamiliarity from 12 to 25 feet or more. Preferences for spacing will influence where the people sit or stand. If you remain distant from others when you speak to them, you may unintentionally communicate indifference or disinterest. If you approach people too closely, they may feel uncomfortable. People who like each other tend to stand closer together than people who do not like each other.

GESTURES:

We use gestures such as head and hand movements to reveal or conceal feelings. We can use them to add emphasis, to illustrate points, and to manage turn taking. You can encourage others to continue talking by nodding periodically, whereas some gestures such as scratching your head or face indicate impatience or disinterest. Different gestures can be observed throughout societies like a social or polite touch, such as handshake or helping someone on with a coat. People also make gestures using friendly touch, for example, putting an arm around a friends' shoulder when you say goodbye and loving or intimate touch, such as kissing or holding hands (Knapp, 1980). What kind of touch is appropriate depends on the situation and the relationship between the people involved. Norms for touching vary from culture to culture. Touching plays a role in communicating status or dominance (Henley, 1977). High-status or confident people engage in more touching than do lower-status people. People tend to touch each other when a) giving information or advice rather than receiving it; b) giving an order rather than responding to one; c) requesting a favor rather than reacting to it; d) attempting to persuade someone rather than being persuaded; e) engaging in deep rather than casual conversation; f) attending social events such as parties rather than being at work; g) conveying excitement rather than receiving it from someone else; h) receiving reactions of concern rather than communicating them. Misunderstandings can arise over a touch, which can lead to a variety of undesired results. One can avoid misinterpretations by complementing touches with other cues that match your intentions. For example, to get someone's attention, one could touch him or her on the arm while saying, "excuse me". You could avoid the misinterpretation of a touch as being aggressive by accompanying it with a smile and appropriate comments.

PHYSICAL APPEARANCE:

One can influence how others respond by offering a physical appearance that complements intended outcomes. Components of physical appearance include facial features, hygiene, neatness, hairstyle, skin, jewelry, cosmetics, posture and style of clothing with accessories such as hats. These characteristics convey impressions to others about attractiveness, social class, status, degree of conformity, intelligence, personality, style, taste, sexuality, and age. Many studies document the importance of physical attractiveness in initial social contacts (Calvert, 1988). A person's skills, the extent to which people view him or her as similar or compatible with themselves, and their confidence in the person's ability to get things done efficiently affect how credible and attractive he or she appears to others.

The application of these modes should never be dealt with lightly. It is important to form a sound psychological perspective before even initiating a counseling session with a patient. Many harms can be inflicted if an unknowledgeable counselor attempts to build upon another's psyche without the proper mentality and tools. Often a patient is required to deal with unpleasant thoughts and memories when confronting the issues that assail his or her psyche. However, when non-verbal communication and counseling is properly executed it come as a great gift to both the patient and the counselor.