Video Nonverbal Communication in Telehealth

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HERE IS HOW

Using Nonverbal Communication to Detect Deceit or Lying on Video

Good therapists are good listeners. However, listening well is as much about being able to accurately interpret a client’s nonverbal communication as it is to interpret what they’re speaking. But in a telehealth setting that relies on video conferencing, determine whether a client or patient is lying on video can be extra challenging.

Clients may have various motivations or pathologies that make them more likely to lie to a therapist or hide key facts that are essential clues to their health status. This can include:

• Denial (for example, denial of a growing addiction)
• A personality disorder that—by its official clinical definition—is characterized by deceitfulness or lying
• The normal human tendency to want to hide embarrassing details that stir up feelings of guilt or shame

Nonverbal Cues That a Client May Be Lying on Video

In any of these scenarios, certain nonverbal cues can be an indication that a client is not telling the truth. These nonverbal cues are more reliable indicators of lying on video “when they occur in clusters and clusters of clusters,” as Jack Schafer, Ph.D., a professor of law enforcement at Western Illinois University and retired FBI agent, noted in a November 2014 article in Psychology Today.

Dr. Schafer lists a number of nonverbal signs that may indicate someone is being less than truthful, or actually lying on video. All of these can be applied to a clinical setting mediated through video conferencing. Here are those that may be especially instructive in a teletherapy context:

• The “Adam’s apple jump” (or “hard swallowing”) – All of us have probably experienced this sensation before. It’s when you get so nervous that your mouth becomes dry and it’s hard to swallow. It’s not dissimilar to what happens when you’re at the dentist getting your teeth cleaned and after finally getting a chance to swallow, you swallow hard.
• Darting eyes – When a client’s eyes keep pointing to the nearest exit or another prop, like a watch or smartphone, it may be caused by the anxiety of lying on video and a gut impulse to flee before they are found out.
• A lack of emphatic gestures with head or upper body – A client who is lying on video will be less likely to move their head or upper body forward (towards you the listener) when they are making their point. On the contrary, they may actually tilt their body backward in a nonverbal effort to put more distance between you and them.
• Covering the “suprasternal notch” – As “the indentation at the base of the neck,” this area is “one of the most vulnerable parts of the body,” according to Dr. Schafer. That’s because “any infiltration of it can interfere with normal breathing.” If you notice that a client is fiddling with the top of their shirt or a necklace at the base of their neck, they may be angling to wiggle out of telling you the truth.

Lying on Video and the Fight or Flight Response

Many of these nonverbal cues can be the physiological manifestations of a “fight-or-flight” response, which is how our bodies are evolutionarily wired to react to what we perceive to be an imminent threat to our survival. Our ancestors usually did not sit still and speak calmly in the face of an oncoming predator. And to be sure, a client’s fight or flight signals may be triggered by lying or anxiety about the truth coming to light. (People manifesting symptoms of psychopathy are the exception here. In their case, lying usually will cause no visible signs of distress.)

However, it’s also important to keep in mind that there can be other explanations for why a client or patient may be giving off stress signals during teletherapy / in telemental health treatment sessions. One prevalent cause is past trauma and symptoms of post-traumatic stress disorder (PTSD). For example, an invitation to revisit a traumatic memory such as childhood sexual abuse can cause a client with PTSD to fidget, swallow hard, shift in their seat and have trouble giving sustained eye contact. Does that mean that the client or patient is being deceitful? No. You may want to exercise caution before jumping to a conclusion about a client’s honesty (or lack thereof) purely on the basis of nonverbal communication.

Instead, try to compare what you’re seeing in the way of body language with what you’re hearing, with a view to noting any dissonance. If you notice a disparity, it may be an opportunity to invite further exploration of what’s really beneath and conflict between a client’s speech and their body language. These and other clinical issues need to be recognized by practitioners who wish to master the competencies required for legal and ethical telepractice of telehealth, telebehavioral health, distance counseling and telemental health.

Anna Ciulla, the Clinical Director at Beach House Center for Recovery, is responsible for designing, implementing and supervising our delivery of the latest evidence-based therapies for treating substance use disorders. She has a passion for helping clients with substance use and co-occurring disorders achieve successful long-term recovery.

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