Abstract
The purpose of the present study was to investigate co-speech gesture use during communication about pain. Speakers described a recent pain experience and the data were analyzed using a ‘semantic feature approach’ to determine the distribution of information across gesture and speech. This analysis revealed that a considerable proportion of pain-focused talk was accompanied by gestures, and that these gestures often contained more information about pain than speech itself. Further, some gestures represented information that was hardly represented in speech at all. Overall, these results suggest that gestures are integral to the communication of pain and need to be attended to if recipients are to obtain a fuller understanding of the pain experience and provide help and support to pain sufferers.
Similar content being viewed by others
Notes
Inspection of results of non-native English participants revealed that their gesture rate, speaking time, and overall gesture production were similar to and within the range of those of the native English speakers. Further, with the exception of information about cause (for which the exclusion of these participants eliminated differences between gesture only and speech only or speech and gesture together), the findings remained the same without these participants.
References
Alibali, M. W., Flevares, L. M., & Goldin-Meadow, S. (1997). Assessing knowledge conveyed in gesture: Do teachers have the upper hand? Journal of Educational Psychology, 89, 183–193.
Alibali, M. W., Heath, D. C., & Myers, H. J. (2001). Effects of visibility between speaker and listener on gesture production: Some gestures are meant to be seen. Journal of Memory and Language, 44, 169–188.
Arnold, R. M. (2003). Do we really care about doctor-patient communication or is it just talk? Journal of Palliative Medicine, 6, 189–192.
Bangerter, A. (2004). Using pointing and describing to achieve joint focus of attention in dialogue. Psychological Science, 15(6), 415–419.
Bavelas, J. B., Chovil, N., Coates, L., & Roe, L. (1995). Gestures specialized for dialogue. Personality and Social Psychology Bulletin, 21(4), 394–405.
Bavelas, J. B., Chovil, N., Lawrie, D., & Wade, A. (1992). Interactive gestures. Discourse Processes, 15(4), 469–489.
Bavelas, J. B., Kenwood, C., Johnson, T., & Phillips, B. (2002). An experimental study of when and how speakers use gestures to communicate. Gesture, 2, 1–17.
Beattie, G., & Shovelton, H. (1999a). Do iconic hand gestures really contribute anything to the semantic information conveyed by speech? An experimental investigation. Semiotica, 123, 1–30.
Beattie, G., & Shovelton, H. (1999b). Mapping the range of information contained in the iconic hand gestures that accompany spontaneous speech. Journal of Language and Social Psychology, 18(4), 438–462.
Beattie, G., & Shovelton, H. (2001). An experimental investigation of the role of different types of iconic gesture in communication: A semantic feature approach. Gesture, 1, 129–149.
Bensing, J., Kerssens, J., & Pasch, M. (1995). Patient-directed gaze as a tool for discovering and handling psychosocial problems in general practice. Journal of Nonverbal Behavior, 19(4), 223–242.
Bergh, I., Gunnarsson, M., Allwood, J., Odén, A., Sjöström, B., & Steen, B. (2005). Descriptions of pain in elderly patients following orthopaedic surgery. Scandinavian Journal of Caring Sciences, 19(2), 110–118.
Butterworth, B. (1975). Hesitation and semantic planning in speech. Journal of Psycholinguistic Research, 4(1), 75–87.
Carlsson, A. M. (1983). Assessment of chronic pain. I. Aspects of the reliability and validity of the visual analogue scale. Pain, 16, 87–101.
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement, 20(1), 37–46.
Cohen, R. L., & Otterbein, N. (1992). The mnemonic effect of speech gestures: Pantomimic and non-pantomimic gestures compared. European Journal of Cognitive Psychology, 4(2), 113–139.
Craig, K. D. (1992). The facial expression of pain: Better than a thousand words? American Pain Society Journal, 1, 153–162.
Crawford, C. S. (2009). From pleasure to pain: The role of the MPQ in the language of phantom limb pain. Social Science and Medicine, 69, 655–661.
Crook, J., Rideout, E., & Browne, G. (1984). The prevalence of pain complaints in a general population. Pain, 18, 299–314.
DiMatteo, M. R., & Hays, R. D. (1980). The significance of patients’ perceptions of physician conduct: A study of patient satisfaction in a family practice centre. Journal of Community Health, 6(1), 18–34.
DiMatteo, M. R., Hays, R. D., & Prince, L. M. (1986). Relationship of physicians’ nonverbal communication skills to patient satisfaction, appointment noncompliance, and physician workload. Health Psychology, 5(6), 581–594.
DiMatteo, M. R., Taranta, A., Friedman, H. S., & Prince, L. M. (1980). Predicting patient satisfaction from physicians’ nonverbal communication skills. Medical Care, 18(4), 367–376.
Dindia, K., & Allen, M. (1992). Sex differences in self-disclosure: A meta-analysis. Psychological Bulletin, 112(1), 106–124.
Ehlich, K. (1985). The language of pain. Theoretical Medicine and Bioethics, 6(2), 177–187.
Emmorey, K., & Casey, S. (2001). Gesture, thought and spatial language. Gesture, 1, 35–50.
Erskine, A., Morley, S., & Pearce, S. (1990). Memory for pain: A review. Pain, 41(3), 255–265.
Feyereisen, P. (2006). Further investigation on the mnemonic effect of gestures: Their meaning matters. European Journal of Cognitive Psychology, 18(2), 185–205.
Frank, A. W. (1991). At the will of the body: Reflections on illness. Boston: Houghton Mifflin.
Freedman, N. (1972). Analysis of movement behaviour during the clinical interview. In A. W. Siegman & B. Pope (Eds.), Studies in dyadic communication (pp. 153–176). New York: Pergamon.
Galati, A., & Samuel, A. G. (2011). The role of speech-gesture congruency and delay in remembering action events. Language and Cognitive Processes, 26(3), 406–436.
Gerwing, J., & Allison, M. (2009). The relationship between verbal and gestural contributions in conversation: A comparison of three methods. Gesture, 9, 312–336.
Goldin-Meadow, S. (2003). Hearing gesture: How our hands help us think. Cambridge, MA: Harvard University Press.
Goubert, L., Craig, K. D., Vervoort, T., Morley, S., Sullivan, M., Williams, A. C. d. C., et al. (2005). Facing others in pain: The effects of empathy. Pain, 118, 285–288.
Graham, J. A., & Argyle, M. (1975). A cross-cultural study of the communication of extra-verbal meaning by gestures. International Journal of Psychology, 10(1), 57.
Gullberg, M., & Kita, S. (2009). Attention to speech-accompanying gestures: Eye movements and information uptake. Journal of Nonverbal Behavior, 33, 251–277.
Hadjistavropoulos, H. D., Craig, K. D., Hadjistavropoulos, T., & Poole, G. D. (1996). Subjective judgments of deception in pain expression: Accuracy and errors. Pain, 65, 251–258.
Hall, J. A., Harrigan, J. A., & Rosenthal, R. (1995). Non-verbal behaviour in clinician-patient interaction [Review]. Applied & Preventative Psychology, 4, 21–37.
Hall, J. A., Irish, J. T., Roter, D. L., Ehrlich, C. M., & Miller, L. H. (1994). Gender in medical encounters: An analysis of physician and patient communication in a primary care setting. Health Psychology, 13(5), 384–392.
Harré, R. (1991). Physical being: A theory for a corporeal psychology. Oxford: Basil Blackwell.
Hartzband, P., & Groopman, J. (2008). Off the record: Avoiding the pitfalls of going electronic. New England Journal of Medicine, 358(16), 1656–1658.
Heath, C. (1984). Participation in the medical consultation: The co-ordination of verbal and nonverbal behaviour between the doctor and patient. Sociology of Health & Illness, 6(3), 311–388.
Heath, C. (1986). Body movement and speech in medical interaction. Cambridge, UK: Cambridge University Press.
Heath, C. (1989). Pain talk: The expression of suffering in the medical consultation. Social Psychology Quarterly, 52, 113–125.
Heath, C. (2002). Demonstrative suffering: The gestural (re)embodiment of symptoms. The Journal of Communication, 52(3), 597–616.
Holle, H., Gunter, T. C., Rüschemeyer, S.-A., Hennenlotter, A., & Iacoboni, M. (2008). Neural correlates of the processing of co-speech gestures. NeuroImage, 39(4), 2010–2024.
Holler, J., & Beattie, G. (2002). A micro-analytic investigation of how iconic gestures and speech represent core semantic features in talk. Semiotica, 142, 31–69.
Holler, J., & Beattie, G. (2003a). How iconic gestures interact in the representation of meaning: Are both aspects really integral to the process? Semiotica, 146, 81–116.
Holler, J., & Beattie, G. (2003b). Pragmatic aspects of representational gestures: Do speakers use them to clarify verbal ambiguity for the listener? Gesture, 3, 127–154.
Holler, J., Shovelton, H., & Beattie, G. (2009). Do iconic hand gestures really contribute to the communication of semantic information in a face-to-face context? Journal of Nonverbal Behavior, 33, 73–88.
Holler, J., & Stevens, R. (2007). The effect of common ground on how speakers use gesture and speech to represent size information. Journal of Language and Social Psychology, 26(1), 4–27.
Holler, J., & Wilkin, K. (2009). Communicating common ground: How mutually shared knowledge influences speech and gesture in a narrative task. Language and Cognitive Processes, 24(2), 267–289.
Hurwitz, B. (2003). Looking at pain. In D. Padfield (Ed.), Perceptions of pain (pp. 7–13). Stockport, UK: Dewi Lewis.
Hyden, L.-C., & Peolsson, M. (2002). Pain gestures: The orchestration of speech and body gestures. Health: An Interdisciplinary Journal for the Social Study of Health, Illness and Medicine, 6(3), 325–345.
Jacobs, N., & Garnham, A. (2007). The role of conversational hand gestures in a narrative task. Journal of Memory and Language, 56, 291–303.
Joyce, C. R. B., Zutshi, D. W., Hrubes, V., & Mason, R. M. (1975). Comparison of fixed interval and visual analogue scales for rating chronic pain. European Journal of Clinical Pharmacology, 8(6), 415–420.
Kelly, S. D. (2001). Broadening the units of analysis in communication: Speech and nonverbal behaviours in pragmatic comprehension. Journal of Child Language, 28(2), 325–349.
Kelly, S. D., Barr, D. J., Church, R. B., & Lynch, K. (1999). Offering a hand to pragmatic understanding: The role of speech and gesture in comprehension and memory. Journal of Memory and Language, 40, 577–592.
Kelly, S. D., & Church, R. B. (1998). A comparison between children’s and adults’ ability to detect conceptual information conveyed through representational gestures. Child Development, 69(1), 85–93.
Kelly, S. D., Kravitz, C., & Hopkins, M. (2004). Neural correlates of bimodal speech and gesture comprehension. Brain and Language, 89(1), 253–260.
Kendon, A. (1985). Some uses of gesture. In D. Tannen & M. Saville-Troike (Eds.), Perspectives on silence (pp. 215–234). Norwood, NJ: Ablex.
Kendon, A. (1997). Gesture. Annual Review of Anthropology, 26, 109–128.
Kendon, A. (2000). Language and gesture: Unity or duality? In D. McNeill (Ed.), Language and gesture (pp. 47–63). Cambridge, UK: Cambridge University Press.
Kendon, A. (2004). Gesture: Visible action as utterance. Cambridge, UK: Cambridge University Press.
Knapp, M. L., & Hall, J. A. (2010). Nonverbal communication in human interaction. Boston: Wadsworth Cengage Learning.
Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.
Louwerse, M. M., & Bangerter, A. (2005). Focusing attention with deictic gestures and linguistic expressions. In B. Bara, L. Barsalou, & M. Bucciarelli (Eds.), Proceedings of the cognitive science society (pp. 1331–1336). Mahwah, NJ: Lawrence Erlbaum.
Mahl, G. F. (1968). Gestures and body movements in interviews. In J. M. Shlien (Ed.), Research in psychotherapy (Vol. 2, pp. 295–346). Washington, DC: American Psychological Association.
Makoul, G., Curry, R. H., & Tang, P. C. (2001). The use of electronic medical records: Communication patterns in outpatient encounters. Journal of the American Medical Informatics Association, 8(6), 610–615.
Margalit, R. S., Roter, D., Dunevant, M. A., Larson, S., & Reis, S. (2006). Electronic medical record use and physician-patient communication: An observational study of Israeli primary care encounters. Patient Education and Counseling, 61(1), 134–141.
McDonald, D. D., & Molony, S. L. (2004). Postoperative pain communication skills for older adults. Western Journal of Nursing Research, 26(8), 836–852.
McGrath, J. M., Arar, N. H., & Pugh, J. A. (2007). The influence of electronic medical record usage on nonverbal communication in the medical interview. Health Informatics Journal, 13(2), 105–118.
McNeill, D. (1985). So you think gestures are nonverbal? Psychological Review, 92(3), 350–371.
McNeill, D. (1992). Hand and mind: What gestures reveal about thought. Chicago: Chicago University Press.
McNeill, D. (2000). Gesture in thought. In D. McNeill (Ed.), Language and gesture (pp. 139–140). Cambridge, UK: Cambridge University Press.
McNeill, D. (2005). Gesture and thought. Chicago & London: University of Chicago Press.
Melzack, R. (1975). The McGill Pain Questionnaire: Major properties and scoring methods. Pain, 1, 277–299.
Melzack, R. (1987). The short-form McGill Pain Questionnaire. Pain, 30, 191–197.
Oldfield, R. C. (1971). The assessment and analysis of handedness: The Edinburgh Inventory. Neuropsychologia, 9(1), 97–113.
Özyürek, A., Willems, R. M., Kita, S., & Hagoort, P. (2007). On-line integration of semantic information from speech and gesture: Insights from event-related brain potentials. Journal of Cognitive Neuroscience, 19(4), 605–616.
Prkachin, K. M. (1992). The consistency of facial expressions of pain: A comparison across modalities. Pain, 51, 297–306.
Prkachin, K. M., Berzins, S., & Mercer, S. R. (1994). Encoding and decoding of pain expressions: A judgement study. Pain, 58, 253–259.
Prkachin, K. M., & Craig, K. D. (1995). Expressing pain: The communication and interpretation of facial pain signals. Journal of Nonverbal Behavior, 19, 191–205.
Puntillo, K. A. (2003). Pain assessment and management in the critically ill: Wizardry or science? American Journal of Critical Care, 12, 310–316.
Riseborough, M. G. (1981). Physiographic gestures as decoding facilitators: Three experiments exploring a neglected facet of communication. Journal of Nonverbal Behavior, 5, 172–183.
Rogers, W. T. (1978). The contribution of kinesic illustrators toward the comprehension of verbal behavior within utterances. Human Communication Research, 5(1), 54–62.
Roter, D. L., Frankel, R. M., Hall, J. A., & Sluyter, D. (2006). The expression of emotion through nonverbal behavior in medical visits. Journal of General Internal Medicine, 21(S1), S28–S34.
Roter, D. L., & Hall, J. A. (2006). Doctors talking with patients/Patients talking with doctors: Improving communication in medical visits (2nd ed.). Westport, CT: Praeger.
Roter, D. L., Hall, J. A., & Aoki, Y. (2002). Physician gender effects in medical communication. JAMA: The Journal of the American Medical Association, 288(6), 756–764.
Ruusuvuori, J. (2001). Looking means listening: Coordinating displays of engagement in doctor-patient interaction. Social Science and Medicine, 52, 1093–1108.
Ryle, G. (1949). The concept of mind. London: Hutchinson.
Salovey, P., Smith, A. F., Turk, D. C., Jobe, J. B., & Willis, G. B. (1993). The accuracy of memory for pain: Not so bad most of the time. APS Journal, 2(3), 184–191.
Scarry, E. (1985). The body in pain: The making and unmaking of the world. New York: Oxford University Press.
Schott, G. D. (2004). Communicating the experience of pain: The role of analogy. Pain, 108, 209–212.
Shreve, E. G., Harrigan, J. A., Kues, J. R., & Kagas, D. K. (1988). Nonverbal expressions of anxiety in physician-patient interactions. Psychiatry: Interpersonal and Biological Processes, 51(4), 378–384.
Spiers, J. (2006). Expressing and responding to pain and stoicism in home-care nurse-patient interactions. Scandinavian Journal of Caring Sciences, 20(3), 293–301.
Wilkie, D. J. (1995). Facial expressions of pain in lung cancer. Analgesia, 1, 91–99.
Willems, R. M., Özyürek, A., & Hagoort, P. (2009). Differential roles for left inferior frontal and superior temporal cortex in multimodal integration of action and language. NeuroImage, 47(4), 1992–2004.
Wittgenstein, L. (1953). Philosophical investigations. Oxford: Blackwell. (Trans., G. E. M. Anscombe).
Wu, Y. C., & Coulson, S. (2007). How iconic gestures enhance communication: An ERP study. Brain and Language, 101(3), 234–245.
Acknowledgments
We would like to thank Judith Hall, Lorenza Mondada, Mandana Seyfeddinipur, Adam Kendon, and two anonymous reviewers for their helpful comments on earlier versions of this manuscript. We would also like to thank the participants for taking part in this study and Rebecca Cleary for her help with data analysis.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Rowbotham, S., Holler, J., Lloyd, D. et al. How Do We Communicate About Pain? A Systematic Analysis of the Semantic Contribution of Co-speech Gestures in Pain-focused Conversations. J Nonverbal Behav 36, 1–21 (2012). https://doi.org/10.1007/s10919-011-0122-5
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10919-011-0122-5