Facial Expressions for those with Facial Paralysis

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By Kathleen Bogart, Assistant Professor of Psychology, Oregon State University

Facial expressions are important parts of how we communicate and how we develop impressions of the people around us. In “The Expression of Emotion in Man and Animals,” Charles Darwin proposed that facial expressions evolved to quickly communicate emotional states important to social survival. He hypothesized that certain facial expressions are innate, and therefore universally expressed and recognized across all cultures.

In 1971, psychology researchers Paul Ekman and Wallace Friesen tested Darwin’s hypothesis. They enlisted members of the Fore tribe in Papua New Guinea, who at the time had little contact with Western culture, to do an emotion recognition task. An interpreter read stories about emotional events to members of the tribe, such as “her child has died, and she feels very sad.” The Fore were then asked to match photos of Americans’ facial expressions to the story. The researchers also took photos of the facial expressions of the Fore people and showed them to Americans later.

People from both cultures showed the same facial expressions for six “basic” emotions (anger, disgust, fear, happiness, sadness and surprise) and were able to recognize their meaning in others. This is strong evidence that certain emotions are evolutionarily based. In the decades since, research has continued to support Darwin’s hypothesis: for instance, showing that congenitally blind people display the same spontaneous expressions as sighted people. Indeed, facial expression may be one of the only universal languages.

So where does that leave people with facial paralysis? As a psychology professor with Moebius syndrome, a condition involving facial paralysis, I’m personally and professionally interested in what happens when the face is no longer the primary means of expression. My Disability and Social Interaction Lab at Oregon State University has been investigating this question.Kathleen Bogart’s Disability and Social Interaction Lab presenting research about Moebius Syndrome Awareness Day. Author provided

Types of facial paralysis

Each year, approximately 225,000 Americans are diagnosed with facial paralysis. It can be congenital, like Moebius syndrome or hereditary facial paralysis. It can also result from birth trauma if the facial nerve is damaged in the birth canal or by forceps delivery.

Acquired facial paralysis from an illness or an injury is far more common. Bell’s palsy, acoustic neuroma, Lyme disease, stroke, multiple sclerosis, ear infections, injury to the facial nerve and others can all lead to facial paralysis. Bell’s palsy, which typically affects one side of the face, is the most common. While it’s usually temporary, approximately 15 percent of people with Bell’s are left with paralysis that does not improve.

In a series of published and unpublished focus groups and interviews, my colleagues and I found that people with facial paralysis reported hearing all sorts of “interpretations” of their appearance. Strangers asked them if they had just gotten a Novocain shot, if they were having a stroke, or if the condition was contagious, deadly or painful. Some people made connections to the person’s character, assuming them to be unfriendly, unhappy or even intellectually disabled.

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