Exploring why families remain volatile despite therapeutic intervention, examining the research on nonverbal communication and what continuous body signals reveal about relationships
A pattern emerges in child protection and family support work that deserves closer attention. Families who have received therapeutic intervention—sometimes months or years of professional support focused on processing trauma, understanding feelings, and improving communication—remain volatile. Relationships that should be stabilising instead oscillate between relative calm and explosive conflict with little apparent warning. Parents and children report feeling heard in therapy, understanding more about their experiences, yet something fundamental isn't shifting.
The puzzle becomes more interesting when these same families demonstrate considerable verbal sophistication. They can articulate attachment patterns, identify triggers, explain the impact of past trauma. They've learned the language of therapy remarkably well. Yet the volatility persists, erupting from what seems like nowhere, catching everyone—family members and professionals alike—by surprise.
What if the problem isn't that therapy has failed, but that it's been looking in the wrong place?
When professionals and academics discuss the importance of nonverbal communication, they often reference Albert Mehrabian's famous "7-38-55" formula: 7% words, 38% tone of voice, 55% body language. This has become shorthand for "most communication is nonverbal." The problem is that Mehrabian's research—conducted in the late 1960s and published in 1971 (Mehrabian & Ferris, 1967; Mehrabian & Wiener, 1967)—had very specific limitations that have been largely forgotten as the percentages became popularised.
Mehrabian was studying communication of *feelings and attitudes* in laboratory conditions, not general communication. His research design involved people listening to recorded single words spoken with different emotional tones whilst viewing photographs of facial expressions. This is quite different from how humans actually communicate in real-world settings.
Contemporary research provides a more nuanced and clinically useful understanding. Patterson, Fridlund, and Crivelli published a comprehensive review in *Perspectives on Psychological Science* (2023) explicitly debunking common misconceptions about nonverbal communication, including the oversimplified application of Mehrabian's work. Their analysis reveals something more fundamental than percentages: **nonverbal communication is always "on"**.
Unlike verbal language, which occurs in discrete utterances, nonverbal communication operates continuously and reciprocally. You cannot turn it off. Even silence communicates. Even stillness sends signals. Facial expressions, posture, proximity, touch, gaze direction, tone variations, speech rate, breathing patterns, olfactory cues—all of these channels operate simultaneously and constantly, with each person both sending and receiving signals in response to the other. Patterson and colleagues term this the "always on" principle, distinguishing nonverbal communication fundamentally from verbal language.
This matters because it means humans are constantly sending and receiving far more information than the words being spoken. Most of this happens outside conscious awareness for both sender and receiver—and crucially, everyone is simultaneously both sender and receiver, creating continuous reciprocal exchanges that shape interactions more powerfully than the verbal content.
A systematic review and meta-analysis by Henry and colleagues (2012), published in *Patient Education and Counseling*, examined 26 observational studies of nonverbal communication in healthcare settings. The findings are striking:
Subsequent research has strengthened these findings. Studies of medical students demonstrate that those with better nonverbal communication skills receive significantly higher patient-physician interaction scores, even when verbal content remains constant. Patients demonstrably respond better to treatment—both physically and mentally—when practitioners show appropriate nonverbal attunement.
Perhaps most significantly: **when verbal and nonverbal messages conflict, people consistently believe the nonverbal message**. Carmichael and Mizrahi's 2023 review in *Current Opinion in Psychology* confirmed this across multiple contexts. If someone says "I'm fine" whilst their jaw clenches, their shoulders rise, their breathing becomes shallow, and they avoid eye contact, observers don't believe the words. They believe the body.
The research establishes several principles that apply directly to how families interact:
There is no "body language dictionary" where crossed arms always mean defensiveness or eye contact always signals honesty. The same behaviour can mean entirely different things depending on who is communicating, to whom, about what, in which cultural context, with what history between them. This is why Patterson and colleagues emphasise that effective interpretation requires attending to context, clusters of behaviours, and congruence between channels.
When verbal and nonverbal channels send contradictory messages, the nonverbal typically determines what is believed and remembered. This applies even more strongly in emotionally charged situations. Carmichael and Mizrahi note that in contexts requiring empathy and understanding, nonverbal cues often carry more weight than explicit verbal statements.
This has profound implications for how we understand truth and deception. Traditional definitions of "lying" focus almost entirely on verbal dishonesty—saying things that aren't true. Yet when someone's words contradict their nonverbal communication, observers consistently judge the nonverbal as the more truthful statement. The person who says "I'm not angry" through clenched teeth with rigid posture is perceived as lying through their words, not through their body. The body, in this sense, tells a truth the words attempt to conceal.
Both sending and receiving nonverbal communication happens largely unconsciously, and crucially, this occurs simultaneously between people. People regulate proximity, match breathing patterns, mirror postures, adjust vocal tone, and respond to microexpressions without deliberate intention—whilst the other person is doing exactly the same in response to them. This unconscious reciprocal coordination—or its absence—fundamentally shapes whether interactions feel comfortable or tense, safe or threatening, connected or alienated.
Return to those families who have received extensive talk therapy yet remain volatile. What if the therapeutic focus on verbal processing—on talking about feelings, understanding triggers, articulating needs—has inadvertently trained everyone to focus on the 7% channel whilst remaining unconscious of the 93%?
Consider what this means for concepts like honesty and trust. Therapeutic interventions often emphasise "open communication," encouraging family members to "say how they really feel" or "be honest about their needs." But if honesty is defined primarily through verbal expression, whilst the continuous nonverbal reality remains unconscious and unaddressed, then families may develop sophisticated verbal honesty whilst remaining fundamentally disconnected at the level where most communication actually occurs.
Imagine a therapeutic intervention that teaches family members to verbalise their emotions more clearly, to express needs more directly, to discuss conflict more openly. All valuable skills. But if the therapy doesn't address how family members *read* each other's continuous nonverbal signals, or how to recognise when their own nonverbal communication contradicts their words, then a crucial dimension remains invisible.
A teenager might say "I'm fine with it" about a parental decision, but their entire body—slumped posture, averted gaze, flat tone, clenched hands—communicates distress. If the parent has been trained by therapy to focus on the words, to take what's said at face value, to "respect their child's verbal communication," then the parent misses the actual message being sent. Is the teenager lying? In the traditional sense, perhaps. But their body is telling the truth continuously, and the parent who can read that nonverbal truth has access to reality the words obscure. The teenager, whose distress goes unacknowledged, escalates behaviourally because they *have* been communicating their state continuously—just not through the privileged verbal channel. Meanwhile, the parent's body begins signaling frustration at the "sudden" escalation, which the teenager reads as further threat, creating a reciprocal cycle of miscommunication where each person responds to what the other is actually transmitting whilst both remain focused on what's being said.
Similarly, a parent might verbally express care and concern whilst simultaneously communicating threat through rigid posture, pointed finger gestures, raised volume, and facial tension. The child, responding to the nonverbal reality rather than the verbal content, becomes dysregulated. Their dysregulation—visible in their own nonverbal signals—then triggers further threat response from the parent, who experiences the child's reaction as unreasonable given the "caring" words they used. When professionals focus on what was *said* ("I told you I care about you"), they miss what was actually *communicated* in this reciprocal exchange of threat and distress signals.
This isn't a failure of the family members. It's a systemic consequence of privileging verbal processing in therapeutic intervention.
Berne's Transactional Analysis (Berne, 1961; 1964), developed in the 1950s and 60s, is sometimes misunderstood as simply a theory about ego states (Parent, Adult, Child). But Berne was explicit about how transactions are actually identified and analysed. From the Eric Berne website's description of his method:
*"When analyzing transactions, one must look beyond what is being said. According to Dr. Berne, one must look at how the words are being delivered (accents on particular words, changes in tone, volume, etc.) as the non-verbal signs accompanying those words (body language, facial expressions, etc.). Transactional Analysts will pay attention to all of these cues when analyzing a transaction and identifying which ego states are involved."*
Berne's framework explicitly requires nonverbal awareness. You cannot properly identify ego states from words alone. A statement like "You should do your homework" might come from Critical Parent (stern tone, pointed finger, furrowed brow) or Nurturing Parent (warm tone, encouraging smile, open posture). The words are identical. The transactions are entirely different.
This matters for understanding why Berne developed Transactional Analysis through observing therapy groups rather than individual sessions. In group settings, he could watch how people *actually* communicated with each other—the complete picture, not just the verbal content. His framework emerged from noticing patterns in tone, posture, facial expression, proximity, and gesture as much as from the words being spoken.
The companion essay on this platform—Eric Berne's Transactional Analysis: From Freudian Theory to Observable Interaction (Young, 2025)—explores how Berne's approach represented a fundamental shift in psychology from intrapsychic processes (which can't be directly observed) to interpersonal transactions (which can be). But that observation required attending to all communication channels, not just verbal language.
Berne's insight was that transactions could be classified and predicted based on observable patterns. But "observable" didn't mean only what could be transcribed. It meant the full multimodal reality of human communication—tone, expression, gesture, proximity, all operating simultaneously with the words.
Kate Cairns, a UK social worker and foster carer who provided permanence for twelve children over twenty-five years, developed practical approaches to trauma-informed care that illuminate dimensions of nonverbal communication rarely discussed in research literature. Her work, documented in books such as *Attachment, Trauma and Resilience* (Cairns & Cairns, 2016) and through her training organisation KCA (Knowledge Change Action), explicitly addresses how traumatised children communicate and respond through sensory channels that operate entirely outside verbal processing.
One example from Cairns' practice illustrates this particularly well. She would create small handkerchiefs from familiar fabric—pieces of the child's or her own old pyjamas—which children could keep in their pockets at school. When a traumatised child became dysregulated in the classroom, they might wipe their nose on the hankie and unconsciously process the familiar scent. The smell communicated "home" and "safety" at a level the nervous system could recognise and respond to, even when the child's capacity for verbal processing had been compromised by stress.
This approach works precisely because olfactory communication operates continuously and unconsciously. The child doesn't need to consciously think "this smells like safety." Their nervous system responds automatically to the familiar scent, potentially triggering the calming mechanisms associated with secure attachment. No words. No visual cues requiring processing. Just continuous sensory information their body can read and respond to.
Cairns' work demonstrates that for children who have experienced complex trauma, verbal therapeutic interventions alone may miss crucial dimensions of how safety and threat are actually communicated and perceived. A traumatised child's nervous system is continuously scanning the environment for danger signals—what trauma researchers call "neuroception." This scanning operates largely through nonverbal channels: tone of voice, facial microexpressions, body tension, proximity, touch, and sensory cues including smell. Simultaneously, the carer's nervous system is reading and responding to the child's signals, creating a reciprocal dance of regulation or dysregulation that operates almost entirely outside the verbal domain.
When therapeutic approaches focus primarily on helping traumatised children "talk about their feelings" or "express their needs verbally," they may inadvertently privilege the very channel that trauma has most disrupted. Trauma often impairs language centres whilst heightening sensitivity to nonverbal threat cues. The child whose words say "I'm fine" whilst their entire nervous system screams "danger" isn't being dishonest—they're operating from a different communication reality than the verbal-focused therapist.
Cairns' sensory approach—like Berne's attention to observable transactions—recognises that healing happens through the same channels where harm occurred: in the continuous, largely unconscious, multimodal communication that bodies use to signal safety or threat to each other.
This brings us to another phenomenon documented elsewhere on this platform: the Feedback Paradox (Young, 2025). Organisations and families sometimes formally request feedback—"Tell us what you think," "We want to hear from you," "Open communication is important"—whilst simultaneously ignoring the continuous feedback already being communicated through behaviour and nonverbal channels.
When an organisation asks for formal feedback surveys whilst the CEO's body language communicates defensiveness every time concerns are raised, employees notice the incongruence. They stop providing honest feedback, not because they weren't asked, but because the continuous nonverbal communication signals that honest feedback isn't actually safe or welcome.
Similarly, when a parent says "You can tell me anything" whilst their facial tension, crossed arms, and clipped tone communicate threat, children learn that certain topics aren't actually safe to discuss. The formal invitation exists in the verbal channel. The actual message operates nonverbally.
This isn't necessarily conscious deception. The organisation leaders or parents may genuinely want honest communication. But if their unconscious nonverbal signals contradict their stated intentions, people believe the nonverbal reality.
The Feedback Paradox operates precisely because nonverbal communication is always "on" and, when it conflicts with verbal messages, typically determines what people actually believe and how they respond.
The same principle operates at institutional and organisational scales through documented behaviour. The UK's Post Office Horizon scandal and the ongoing Williams Inquiry (Statutory Inquiry, 2021-present) provide a striking example of how this works in contexts of institutional accountability.
Senior management from the Post Office and Fujitsu have testified repeatedly using variations of "I can't recall" or "I don't know" when questioned about what they knew regarding the Horizon system's capacity for errors. Witnesses can deny emails, claim never to have known about them, or attempt to recontextualise their meaning—"it didn't mean what it appears to mean" or "that's not how we understood it at the time."
But what the inquiry's barristers are skilfully demonstrating is something more fundamental: the emails and meeting minutes are not themselves the evidence. Rather, they reveal patterns of organisational **behaviour**—decisions actually made, prosecutions actually pursued, warnings actually received yet actions continuing unchanged. **What the organisation actually did reveals what it actually knew, regardless of what testimony now claims.**
A witness can say an email "meant something different" or that they "don't recall" a meeting, but the organisational behaviour that followed—the decisions to continue prosecutions, the patterns of response to system concerns, the allocation of resources, the actual actions taken—reveals what the organisation actually knew and prioritized.
This operates on precisely the same principle as face-to-face nonverbal communication. The documentary trail—emails, minutes, decision records—functions like the "body language" of institutions, providing visible traces of what the organisational "body" actually did. Just as someone can say "I'm not angry" whilst their body demonstrates fury, an institution can claim "we didn't know" whilst its documented behaviour demonstrates knowledge through action. In both cases, when verbal statements and actual behaviour conflict, people believe the behaviour.
For professionals working in institutions, this reality has several implications:
Organisational integrity requires congruence between what institutions say publicly and what they actually do operationally. The "talk" must match the "walk"—not because written records will reveal discrepancy, but because the pattern of organisational behaviour will eventually demonstrate any incongruence between stated values and actual actions.
When investigating organisational failures—whether in child safeguarding, corporate malfeasance, or systemic injustice—inquiry barristers use written records not as evidence itself, but as traces revealing organisational behaviour. The question isn't "what did this email say?" but "what does the pattern of organisational action reveal about what the organisation actually knew and chose to do?" Meeting minutes don't prove knowledge; the decisions and actions that followed demonstrate what was actually known and prioritized.
Those working within institutions must recognise that their actual behaviour—what they actually decide, implement, continue or stop doing—constitutes authentic communication about priorities, knowledge, and values. Written records provide traces of this behaviour, but the behaviour itself reveals truth. "We didn't know" becomes unconvincing not because of the paper trail, but because the pattern of organisational action demonstrates knowledge through continued behaviour despite emerging evidence of problems.
If contemporary research demonstrates that nonverbal communication operates continuously and often determines what gets believed and remembered, then therapeutic approaches focused primarily on verbal processing may need to explicitly address nonverbal dimensions. This doesn't mean abandoning talk therapy—verbal processing remains valuable. Rather, it suggests that effectiveness might improve when interventions help family members become more conscious of the continuous nonverbal reality they're already creating and responding to.
For work with traumatised children and families, this becomes particularly important. As Kate Cairns' practice demonstrates, trauma-informed approaches that attend to sensory and nonverbal dimensions—recognising how safety and threat are communicated through channels that operate below verbal awareness—may be essential for creating the conditions in which verbal processing can eventually become possible. The therapeutic relationship itself is built through continuous nonverbal communication long before words can be processed effectively.
If people consistently believe nonverbal messages over verbal ones when they conflict, then organisational leaders genuinely seeking honest feedback might benefit from attending to what their own nonverbal communication signals about safety, receptivity, and consequences. This isn't about "better body language techniques"—that would miss the point entirely. It's about congruence between stated intentions and the complete communication being sent.
Similarly, institutional accountability requires recognising that organisational behaviour—what actually gets decided, implemented, continued, or stopped—constitutes an organisation's authentic communication about priorities, knowledge, and values. When verbal statements conflict with actual behavioural patterns, investigators and the public consistently believe the behaviour. Organisations cannot credibly claim ignorance when their actual behaviour demonstrates knowledge through continued action, nor claim different priorities when their actual behaviour reveals what they genuinely valued and protected.
If much of human communication operates outside conscious awareness, this suggests that relationship difficulties attributed to "poor communication" or "not talking enough" might actually involve patterns in the unconscious nonverbal dimension that no amount of verbal discussion can resolve without becoming conscious first.
The research on healthcare communication demonstrates that practitioner nonverbal behaviours significantly impact outcomes. If you work with vulnerable people, your nonverbal communication—whether you intend it or not—continuously signals safety or threat, attunement or dismissal, genuine interest or professional distancing. Crucially, you are also continuously reading and unconsciously responding to their nonverbal signals, creating a reciprocal exchange where each person's nervous system is affecting the other's state. Awareness of this reciprocal reality doesn't require learning "techniques." It simply means recognising that the communication is happening bidirectionally whether you're conscious of it or not.
The research evidence is substantial and growing. Patterson and colleagues' 2023 review in *Perspectives on Psychological Science* provides comprehensive theoretical grounding. Henry and colleagues' 2012 meta-analysis in *Patient Education and Counseling* offers quantitative evidence across multiple healthcare contexts. Subsequent studies in educational settings, relationship dynamics, and cross-cultural communication continue to strengthen the evidence base.
Berne's Transactional Analysis (1961; 1964), developed decades before contemporary neuroscience confirmed his clinical observations, explicitly positioned nonverbal awareness as essential for understanding transactions. His framework assumed practitioners would attend to the complete picture, not just the words.
For families experiencing volatility despite therapeutic intervention, for professionals puzzled by persistent dysfunction despite verbal insight, for anyone seeking to understand why relationships sometimes feel at odds with what's being said—the research suggests looking beyond words to the continuous nonverbal reality everyone is already communicating and responding to, whether consciously or not. This is not about one person sending signals and another receiving them. It's about reciprocal exchanges where each person's nervous system continuously affects and responds to the other's, creating patterns that determine whether relationships feel safe, threatening, connected, or alienated.
The body, it turns out, never lies. But it also never stops talking. The question is whether we're listening—and whether our definitions of "truth" and "lying" have been too narrowly focused on words whilst ignoring the more reliable communication happening continuously through every other channel.
This principle operates at every scale of human interaction. In face-to-face encounters, bodies continuously signal states that words attempt to manage or conceal. In organisational contexts, actual behaviour reveals institutional knowledge and priorities regardless of official narratives, documentary records, or subsequent testimony claiming ignorance or offering recontextualisations. Whether examining a parent-child interaction or an institutional inquiry, the fundamental reality remains: **what people (or institutions) actually do reveals what they actually know, regardless of what they now say**.
Companion essays on this platform explore related dimensions of truth and communication. When children lie, their nonverbal signals often reveal the distress, fear, or developmental needs that words attempt to conceal or manage. When professionals evaluate honesty in safeguarding contexts, attending only to verbal statements whilst missing nonverbal communication creates blind spots to children's actual experiences. When institutions face accountability inquiries, the pattern of organisational behaviour speaks truth that verbal testimony and document recontextualisation attempt to obscure. The research presented here suggests that truthful communication operates across all channels simultaneously—verbal, nonverbal, and behavioural—and that incongruence between channels is itself meaningful information about what someone or something is actually experiencing, knowing, and expressing.
Contemporary Research on Nonverbal Communication:
Patterson, M.L., Fridlund, A.J., & Crivelli, C. (2023). Four misconceptions about nonverbal communication. Perspectives on Psychological Science, 18(6), 1388-1411.
Henry, S.G., Fuhrel-Forbis, A., Rogers, M.A., & Eggly, S. (2012). Association between nonverbal communication during clinical interactions and outcomes: A systematic review and meta-analysis. Patient Education and Counseling, 86(3), 297-315.
Carmichael, C.L., & Mizrahi, M. (2023). Connecting cues: The role of nonverbal cues in perceived responsiveness. Current Opinion in Psychology, 53, 101663.
Khan, M., Zeb, S., Batool, R., & Gasiorowska, A. (2024). Non-verbal communication questionnaire: A measure to assess effective interaction. Frontiers in Psychology, 15, 1409675.
Pang, H.T., Zhou, X., & Chu, M. (2024). Cross-cultural differences in using nonverbal behaviors to identify indirect replies. Journal of Nonverbal Behavior, 48, 323-344.
Historical and Theoretical Foundations:
Mehrabian, A., & Ferris, S.R. (1967). Inference of attitudes from nonverbal communication in two channels. Journal of Consulting Psychology, 31(3), 248-252.
Mehrabian, A., & Wiener, M. (1967). Decoding of inconsistent communications. Journal of Personality and Social Psychology, 6(1), 109-114.
Berne, E. (1964). Games people play: The psychology of human relationships. Grove Press.
Berne, E. (1961). Transactional analysis in psychotherapy: A systematic individual and social psychiatry. Grove Press.
Cairns, K., & Cairns, B. (2016). Attachment, trauma and resilience: Therapeutic caring for children (2nd ed.). CoramBAAF.
Douglas, H., & Ginty, M. (2001). The Solihull Approach: Changes in health visiting practice. Community Practitioner, 74(6), 222-224. [Foundational framework emphasising reciprocity as the continuous two-way process of communication between parent and child]
Darwin, C. (1872). The expression of the emotions in man and animals. John Murray.
Institutional Accountability:
Post Office Horizon IT Inquiry (2021-present). Statutory Inquiry chaired by Sir Wyn Williams. Available at: https://www.postofficehorizoninquiry.org.uk
YoungFamilyLife Essays:
Young, S. (2025). Eric Berne's Transactional Analysis: From Freudian Theory to Observable Interaction. YoungFamilyLife Ltd. Available at: https://www.youngfamilylife.com/repositorium/essays/psychology/b/berne-transactional-analysis.html
Young, S. (2025). Executive Mobs: From Civil Unrest to Corporate Scandals. YoungFamilyLife Ltd. Available at: https://www.youngfamilylife.com/repositorium/essays/psychology/e/executive-mobs.html
Young, S. (2025). The Feedback Paradox: When Asking Signals Not Listening. YoungFamilyLife Ltd. Available at: https://www.youngfamilylife.com/repositorium/essays/psychology/f/feedback-paradox.html
Young, S. (2025). Navigating Truth and Deception: Student Conduct, Safeguarding, and the School Community. YoungFamilyLife Ltd. Available at: https://www.youngfamilylife.com/repositorium/essays/psychology/s/safeguarding-truth-essay.html
Young, S. (2025). Truth, Lies, and Raising Resilient Children. YoungFamilyLife Ltd. Available at: https://www.youngfamilylife.com/repositorium/essays/psychology/p/parent-lying-essay.html
Topics: #NonverbalCommunication #TransactionalAnalysis #TherapeuticPractice #TraumaInformedCare #FamilySupport #ProfessionalDevelopment #Psychology #Relationships #Communication #YoungFamilyLife
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