The Body Speaks: Trauma and the Recognition of Nonverbal Behavior Cues in Clinical Practice

Abstract
Therapists face a significant challenge when clients with trauma and dissociation struggle to verbalize their experiences. Nonverbal behavior (NVB) often holds critical information in such cases. This presentation introduces the Nonverbal Behavior Checklist (NBC), a novel tool designed to support therapists in identifying and understanding client NVB within the context of clinical practice. Drawing on over 100 hours of videotaped Adult Attachment Interviews (Goldstein, 2019) conducted at the Family Psychology Centre in Toronto, Ontario, we analyzed nonverbal behaviors (NVBs) that seasoned therapists and researchers identified as salient to the therapeutic process. Informed by reliable observations and coding procedures, the development of the NBC resulted in the identification of 11 key nonverbal behavior categories: hands, arms, legs, body, head/shoulders, face, eye movement, reflexive behaviors, paralinguistics, object use, and proxemics. The NBC offers a structured framework for therapists to track NVB across session phases (entrance, session, exit, and post-session) and consists of two components: (a) a worksheet for noting observations during and post-session and (b) a supporting document that provides examples of nonverbal behavior to consider and guiding questions to help support the observation process.

By providing a systematic approach to understanding nonverbal cues, the NBC can help therapists build trust, enhance therapeutic alliance and rapport, and facilitate deeper therapeutic engagement with clients who have experienced complex trauma or struggle with verbal expression. This presentation will explore the rationale and development of the NBC, emphasizing its importance in treating trauma and dissociation. We will discuss how the NBC can help therapists (a) identify subtle signs of emotional distress or dissociation, (b) gain deeper insights into a client's unspoken experiences, (c) tailor interventions to address underlying emotional states, and (d) enhance therapeutic rapport and build trust. We will conclude by exploring possibilities for further refining the NBC and its potential to revolutionize how therapists can approach trauma treatment by attuning to clients' nonverbal communication.