Before emojis, before writing, before speaking, there was non-verbal communication; body language, touch and use of physical space.
In all the ways in which we communicate, the roots of non-verbal communication go deepest. Showing it and knowing it is part of the human being.
How we express our emotions
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Non-verbal
Vocal (tone, rhythm, inflection)
Verbal
The coronavirus pandemic has robbed us of the closeness that we are biologically programmed to look for when we are vulnerable, lonely or fearful - exactly when we need it most. Face masks, video chats and personal protective equipment make it more difficult to visualize facial expressions and body movements, while social distance forces us to be abnormally separated and the invisible presence of a virus permeated contact. of a sense of danger.
Health workers rely on positive non-verbal communication to show care to their patients: close physical proximity, touch, nod, smile, open body language and focused gaze. It is such an important part of their work that the world's largest nursing profession, the Royal College of Nursing in the United Kingdom, has a section of its website dedicated to the importance of body language.
The six universal expressions
Humans use facial features to convey many basic emotions. Researchers working on automatic expression detection are studying this range of motion, including raised eyebrows, tight lips, and tight jaws.
The body language of a doctor or nurse defines the trajectory of treatment from the moment the patient sees them for the first time. Positive non-verbal communication has been shown to decrease patient anxiety and work better. And it gives the patient the assurance that a doctor is sensitive and understanding. As a result, the patient is more confident and communicative.
Even with pain, patients who receive high non-verbal support from their doctor show increased tolerance. The detachment and aloofness of doctors - like the absence of a smile and direct gaze - have the opposite effect and are linked to poorer patient outcomes. A recent study of 719 cold patients found that the more empathetic they perceived their doctor - the faster they recovered. Each patient was asked to rate the doctor for the empathy shown to him on a scale of 1 to 10. Those who gave the doctor a perfect score of 10 (approximately one-third of the patients) had severity of symptoms reduced, recovered faster and also had higher immune function, about 50% better than the others.
How masks disrupt communication
Face covers significantly limit a doctor's ability to assess a patient's emotions. Masks can hinder health workers' attempts to provide non-verbal support to those in their care.
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Author and scientist David Hamilton, who studies empathy, says that with Covid-19, it was a tough battle with hospital patients.
"If you go to the hospital, the system and the brain are stressed and scared, which can have a moderating effect on the immune response. So you need more confidence to bring the body back to a baseline, "he told CNN.
"The more empathic the patient, the better their potential immune response."
David Hamilton, Scotland
According to Hamilton, the behavior of health personnel has a powerful role because "we capture the emotions of the other person".
"The more expressive a person - apparently - the greater the degree of emotional contagion," he added. "If someone shows compassion, kindness and empathy, you feel a sense of connection that causes chemical changes in the brain that have a powerful anti-inflammatory effect and a positive effect on the cardiovascular system and immune. "
The key chemical involved is oxytocin, which Hamilton calls "the kindness hormone".
"The more empathic the patient, the better their potential immune response," he added.
Why masks make us so hard to express how we feel
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Emergency doctor Ara Suppiah, who works in a Covid-19 department in Florida, says he feels communication barriers intensely.
"Masks on both sides severely limit our ability to interpret a patient's emotions and feelings. Not getting along through layers is frustrating. Expressing feelings with masks, glasses, face shield and overalls is a serious but rewarding challenge, "Suppiah told CNN.
Suppiah does what many health workers, including Welsh doctor Sharan Chugani, do.
"I write my name on my dress and draw a smiling face," Chugani told CNN. "It makes a difference in that people like to put a face on a name and being able to see you smile makes a big difference with confidence and comfort."
"It has certainly been a challenge, probably the most difficult being unable to use your smile or your laughter to comfort people and make them feel more comfortable."
Hamilton says that just seeing a smiling face drawn on a dress would help because the patient can recognize the effort of making the connection. It also activates the same mirror neurons in our brain as a real smile, just to a lesser extent, which helps build relationships, he added.
PART 2Distance and personal space
You don't need a scientist to tell you that when you are more than 6 feet apart from your closest and dearest, you aspire to be closer - and when someone you don't know or that you don't like is at a touching distance, you feel this force field being invaded.
Personal space is like a bubble surrounding a person they consider psychologically their own - almost like an extension of their body. When someone gets closer, the part of our brain that processes emotional responses reacts automatically - it is put into flight or combat mode to search for a threat of survival. If someone is accepted into our inner circle - we appreciate intimacy, but if presence is not desired, we will feel the need to push back the violation of space. Physical closeness reflects the emotional closeness of others.
Being able to flit between distances is a key element of relationship development as it offers opportunities to test the reciprocity of the desire to deepen a friendship, build intimacy or develop romance. Now governments and scientists are prescribing the distance we keep. Even if the closures are relaxed, social isolation remains the new norm before an effective vaccine or treatment is found.
The physical dance of dating and the fluidity of friendship training have become clumsy and difficult. Creating new face-to-face relationships will require more effort. Not only to follow the guidelines, but also because socialization will require deeper trust. Everyone will know that he is responsible for his closest friends and family members by his own social choices.
Dave, twenty-eight, who preferred not to give his last name for fear of embarrassing his date, had a first socially distant meeting with a woman to whom he had sent messages for several weeks. They met in a park in London, he said "awkward" was the only way to describe it.
"I couldn't kiss her on the cheek, or even shake her hand when we met. It was as if the hyper-conscience created even more distance between us," he said.
"The conversation was pleasant, but all the romance was killed. I did not know how warmly greeting an appointment broke the ice. "
- Intimate distance (close person)
- Personal distance (knowledge)
- Social distance (foreigner)
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How interpersonal distances vary around the world
Our physical proximity preferred to others varies according to culture. These instinctive boundaries shape even the closest relationships.
Evidence suggests that human behavior adapts to epidemics and that we have been shaped by parasites and diseases that we have encountered in the past.
Research from evolutionary and cultural psychologists Mark Schaller and Damian Murray indicates that people living in areas that have historically suffered from high levels of infectious disease are less extroverted, have higher levels of social compliance, use less physical contact, and enjoy stand further apart.
In contrast, countries that have historically had lower levels of disease, have more deviation from social norms, individualism and higher levels of social extraversion.
How exposure to disease affects culture
Societies tend to become more introverted if they have been exposed to pandemics throughout their history. Here we use 2005 research to see how the two numbers are correlated.
Tap to see individual countries
Hover to see the different countries
Murray, from Tulane University, studies the cultural consequences of the threat of disease. He told CNN that in response to the coronavirus pandemic, we could see "more distrust of strangers and strangers" and "lower levels of sociability and extraversion in general."
"Societies that have had higher levels of pathogen prevalence have more restrictions on civil liberties and higher levels of authoritarian governance and compliance in society"
Damian Murray, Tulane University
"We will likely see a resurgence of traditionalism, more emphasis on meeting established standards in the coming years and, not surprisingly, lower levels of physical contact in greetings," he added.
Murray highlighted studies showing that where "the threat of disease is higher, you are less likely to see a hug or kiss or even a handshake as a cultural greeting but more likely to see a bow or something like it".
He said the effect goes beyond individual and social behavior.
"Societies that have had higher levels of pathogen prevalence have more restrictions on civil liberties and higher levels of authoritarian governance and compliance in society," added Murray.
There are many reasons why some companies will find that social distancing is not natural than others. Our preferred distance from foreigners already varies between cultures, gender, environment and personal preferences.
A study by the University of Warwick found that the preferred distance for talking to strangers was greatest in Romania, Hungary, Saudi Arabia and Turkey, and almost half the distance in Argentina, Peru, in Bulgaria and Ukraine. Cultural practices in the United States and in northern and central European regions involve minimal body contact - often a handshake. While Mediterranean societies prefer closer and more tactile greetings.
PART 3Touch and virtual connection
From birth to our last moments, we need a human touch. It is the first sense developed in the fetus. Skin-to-skin contact builds trust between the child and the parent in the early years. Nourishing touch is essential for the development of a child's physical and cognitive capacities and their general well-being. Later, it becomes the foundation for forming strong attachments in life.
When we are stressed, fearful or sick at any age, touching it helps. It produces oxytocin which slows the release of stress hormones and boosts the immune system.
Prolonged touch - like massage - decreases the stress hormone, cortisol, and increases serotonin and dopamine, which are important for mood regulation and well-being. And in patients with depression, autoimmune diseases and HIV, our system has been shown to be even more powerful.
The benefits of touch also go both ways - giving, as well as receiving touch has physical and psychological benefits.
Humans need to touch, especially when we cry
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Hunger to the touch or on the skin is well documented. Different from loneliness, it is a physical need to stimulate the skin, which is why phone calls or video chat will not remove the feeling.
Professor Tiffany Field, who works with the Touch Research Institute at the University of Miami, suggests that isolated people get more physical exercise - walking, brushing hair, yoga, and stretching. Any activity that physically moves the skin will help curb desire.
"Touch is necessary for immune function. Stimulating pressure receptors under the skin slows down the nervous system and stops the release of stress hormones, "Field told CNN.
The comfort of human touch is deeply rooted, which is why it is so difficult to kiss or comfort others when they are suffering.
Nowhere is the lack of capacity to alleviate suffering more difficult to bear than when a patient dies without a family near his bed. It deepens the despair of the darkest moments of life.
Fiona Boardman, whose mother died in early April in a nursing home in England from a suspected coronavirus, told CNN that lack of contact during her last visit with her was the most difficult.
"(The) doctor brought us. We were not standing anywhere near her. We didn't mean to say we came to say goodbye, so we said we just wanted to say that we think of her, love her and pray for her, "said Boardman.
"We couldn't hold her hand and say goodbye. You just slip a little love under the radar and hope it was better than nothing. "
"We couldn't hold her hand and say goodbye. You just slip a little love under the radar and hope it was better than nothing. "
Fiona Boardman
David Kessler is an author and grieving expert who says that the need to be with loved ones when they die is one of the greatest challenges facing society today.
"It is very rare in history that we have had times when we are physically isolated from each other," he told CNN.
"When we are in deep sorrow, we yearn for physical relationships. Our beloved was physically torn from us. So at least we want other people to be with us, reach out to us, touch us, "added Kessler.
"You know many times when we are alone, we miss being affected. Missing this person, holding your hand while you cry makes all the difference in the world. That is why it is so devastating for people right now. "
Kessler applauds the efforts of health workers to hold the phones so that families can make video calls during the last moments of a parent.
"It is important that we find ways to connect, and when someone dies, we still have to cry in real time," he said.
But he says video calls can't go that far.
"The virtual connection will never compensate for the real touch, the real presence, but it's the best thing we have right now," he said. "So it is very important to do something, instead of nothing."
Something, instead of nothing, is a popular refrain these days. The richness and depth of the interaction have been replaced by necessary, but empty, substitutes. A smiling face is not a smile and the pixels do not evoke proximity - physically, emotionally or biochemically.
The coronavirus pandemic has stolen lives and the way we comfort ourselves on the most deeply human level. Behaviors that could help alleviate suffering - showing empathy through body language, being physically close to our loved ones and the healing power of touch - have been taken away from us due to the nature of the disease.
The absence of the simplest of all human behaviors reminded us of why they are the most precious and the most difficult to replace.