The expression of unconscious feelings, impulses, or conflicts through altered functioning of bodily organs; also, nonverbal communication through the body, as in posture, gesture, and facial expression.The clearest examples of the language of the body are found in conversion hysteria, since this disorder consists of somatic expressions of emotional disturbance. In treating this condition, the therapist views the patient’s symptoms as symbols which must be deciphered—and this can only be accomplished by a study of his emotional history and present reaction patterns. As Rosen and Gregory (1965) point out, “A chronically uncontrollable contraction of the hand into a clenched fist, for example, may symbolize hostility as much as angry words do. Hysterical seizures may, in a distorted fashion, express sexuality or tantrumlike hostility and anger. (A single symptom may simultaneously have several meanings.) Blurred vision and functional blindness have been interpreted in various cases as an expression of guilt consequent on real or fancied misdeeds, a fear of the outer world and a magical attempt to do away with it, or a reaction-formation to the unconscious wish to be a voyeur. A hand paralysis may symbolize masturbation guilt or a struggle to inhibit hostility.” See SYMBOLIZATION, SYMPTOM.Many therapists, particularly those of the psychoanalytic school, also explain psychophysiologic (psychosomatic) symptoms in terms of unconscious meanings. Thus, “difficulty in swallowing food has been interpreted by analysts as evidence of something ‘unpalatable’ in the person’s life situation; nausea is inability to ‘stomach’ something unpleasant; vomiting is rejection; asthmatic difficulties symbolize the existence of a load on one’s chest; pain in the shoulder or arm indicates an inhibited impulse to strike out aggressively; and neurodermatitic itching is a somatic expression of the saying, ‘He gets under my skin’ ” (Rosen and Gregory, 1965). Some authors, including Ruesch et al. (1946), believe these disorders represent an infantile use of body language by individuals who are unable to express themselves effectively by verbal means. See CONVERSION REACTION, PSYCHOPHYSIOLOGIC DISORDERS (GENERAL).The functional psychoses offer many illustrations of nonverbal communication through posture, gestures, and other bodily movements. Some of these appear to be on an intentional level; others seem to be completely unconscious. In retarded depression, for example, the facial expression is rigid, posture is slumped, and gesticulation is reduced or nonexistent. Some patients deliberately attempt to mask their despair by looking alert and assuming a particularly energetic posture; others try to show how helpless they are or how much they need affection by adopting a sad expression and a dejected air.The reading of body language is particularly important—and particularly difficult—in schizophrenic patients. It may be the only way to penetrate their minds, and even then it is conjectural. As Spiegel (1959) points out, “Posture, stance, movement, muscle tension, and facial expression give a wide range of information of the patient’s inner state of emotions and of communication, including the following: his emotional attitudes, such as rage, anxiety, beatitude; the age at which he is experiencing or fantasizing himself; often the thought- content he is symbolizing; the degree of withdrawnness from the environment in autism or in catatonic stupor; his inner communication with hallucinated figures; and the changeover to stereotyping of gesture and facial expression from spontaneous expressive movements.”As an example of the symbolic use of body language, Spiegel cites the case of the young girl who had made several suicidal attempts, and who later went into a catatonic stupor for eighteen hours. When she came out of it, she revealed that she had been overwhelmed by rage and the desire to destroy herself, and then said “Isn’t it better to sleep for eighteen hours than to kill myself?” In another case, a male patient who had been hospitalized for ten years and who was practically nonverbal, expressed his longing for closeness by moving his chair nearer and nearer to the therapist until he was almost in physical contact with her.Finally, in a discussion of language and pain, Szasz (1959) makes the comment that “the psychiatrist’s role is like that of a translator and interpreter of a foreign language. He must translate the patient’s body language (for example, ‘I have pains in my chest’) into the language of everyday speech (I am unhappy with my wife, husband, job, children, religion, etc.)” However, patients must be carefully prepared to accept these translations before they are introduced.