The interaction between our facial expressions and our emotions is much more complex than it may seem. In fact, a significant and growing body of research has shown that this relationship is actually a two-way street – that, just as our brain processes a thought and responds by activating a neural circuit to produce a smile, the intentional act of smiling can produce an internal emotional state of happiness or contentment. Now, I know that sounds complicated, so try it out. Go stand in front of a mirror and see for yourself… you see!? Isn’t that amazing! As silly or obvious as the old adage may seem, “put a smile on your face” actually works. And now we have the advanced brain imaging scans and some recordings of neuronal activity to prove it! (By the way, if you find these ideas compelling, you should check out a really interesting book by the neuroscientist Antonio Damasio, called Looking for Spinoza.)
There is an important but very real caveat, however, to the exciting discoveries in the field of neuroscience and emotion research. Imagine, for example, having a feeling of joy but not being able to show it… or hearing a funny story with friends, and not being able to laugh with them. The absence of an integral part of the feedback loop of facial expression, emotional state, and social interaction can be devastating. This is why reconstructive surgery for facial paralysis is one of the most meaningful things that I do.
Not all patients can smile – and I don’t mean that in the figurative sense, I mean literally the muscles of the face do not work. Facial paralysis, whether it be from Bell’s Palsy, stroke or traumatic brain injury, cancer or a congenital defect, has a tremendous impact on the quality of life of patients affected. I was recently reminded of this when I saw an elderly patient for a consultation. An elegant older woman, as a side effect of a life-saving radiation treatment, she has unfortunately lost all function of her facial musculature on one side. With tears in her eyes, she asked me if I could help her to “look like me again.” And though reconstructive techniques are far from perfect, improving the symmetry and function of a patient’s face can be a truly life-altering event.
To learn more about facial nerve injury and other neurological disorders, including Bell’s Palsy, please visit the National Institute for Neurological Disorders and Stroke (NINDS) website (http://www.ninds.nih.gov/index.htm).