Reasons to start smiling
How we feel is reflected in our face through our facial expressions. We smile when we are happy and frown when we are cross. The reverse is also true – our facial expression can influence how we feel. For example, we smile when we feel happy but smiling can also make us feel happy. This is called the facial feedback hypothesis which suggests our facial expression can play a role in regulating our emotional state.
Movement of the facial muscles, as we express ourselves, communicates how we feel not only to others but also to ourselves. This means our facial movements directly influence our mood and how we feel. Smiling can make us feel happier and frowning can make us feel more cross.
Facial palsy and Smiling
Smiling is something we do automatically. It is how we communicate friendliness towards other people and forms part of the building blocks in establishing relationships both professional and personal. It is how we show supportiveness, empathy, express happiness and affection for others. Smiling forms part of a person’s identity so when facial palsy strikes there may be feelings of grief and loss for the smile you once had. Being unable to smile in a normal way can have a negative impact on how people feel.
Often people with facial palsy describe the following:
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- Feeling they need to cover their face every time they smile
- Feeling unable to act spontaneously
- Feeling unable to show signs of friendliness or empathy
- Feeling anxious when people want to take photographs
- Keeping a frozen face to mask the asymmetry
- Dreading parties or dates
- A loss of identity
- A loss of confidence
- Feeling exhausted by the need to cover up, hide, avoid or mask expressions because it emphasises their facial asymmetry
Inhibition of smiling or avoiding smiling when you have facial palsy, whilst understandable, can have a negative impact on how positive you feel. According to the facial feedback hypothesis, the less you smile the less positive you will feel, and you may start to experience low mood or even depression.
You might be able to start thinking about how the facial feedback hypothesis could help you begin to take control of some of your behaviours and improve the way you feel.
Things that you could try:
You could throw all caution to the wind and just decide to smile regardless of your degree of asymmetry and see how you feel. However, you may not feel that brave so the following are some suggestions of how you might proceed.
During the Flaccid stage
If your muscles are still immobile you won’t be able to practice symmetrical smiles. However, you can practice minimising the dominance on the uninjured side of the face. This means making a smaller smile on the uninjured side. A small, closed mouth smile might suit this situation better than an open mouth smile. This smaller smile is less likely to emphasise your asymmetry and much more likely to help you engage with other people more positively. In turn, your mood may improve, and you may feel more like yourself.
During the Paretic stage
If your rehabilitation programme indicates that if you have started showing some flickers of spontaneous smiling (paretic stage of recovery), then you can start to work on a slow, gentle and symmetrical smile. The movement only has to be 1 mm for it to show on your face but remember if the affected side can only move 1mm the unaffected side must only move 1mm.
During the Synkinetic stage
If your rehabilitation programme indicates that you have developed synkinesis, you may find that your smile has improved but that your eye narrows or closes whenever you smile. This may deter you from smiling. In this situation, you should practice a small, symmetrical smile whilst keeping the affected eye open/relaxed. Work for millimetres of movement as this is likely to be more achievable.
Once you have managed to create either: a small asymmetric smile (flaccid stage); a small symmetrical smile (paretic stage); a small smile inhibiting the eye from closing or narrowing then start to use it as much as you can, as our smile shows in our eyes as well as our face.
At any stage
You could reinforce your smile with a thumbs up to encourage others that you are feeling positive. This will be dependent on the context/situation.
Set yourself some experiments, for example, think of a situation where you avoid smiling and see how your new small smile works and how it makes you feel.
Keep a diary of any avoidance behaviours you are working on. This will allow you to track how you are doing. Make a note of any changes in how you feel and whether you notice any changes in how other people interact with you.
Help and support
Feelings of low self-esteem, anxiety and low mood are commonly reported by people living with facial palsy. If you feel you need help with how you feel contact your GP for advice. Alternatively, explore the support section on the facial palsy UK charity website https://www.facialpalsy.org.uk/support/.
Many people are encouraged by reading personal stories written by people with facial palsy https://www.facialpalsy.org.uk/personalstories/
Read more
The emotional impact of living with facial palsy
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