Thinking with Your Body

The situation is not entirely uncommon.

A woman has undergone years of psychotherapy. She has gotten in touch with her feelings, has explored her emotional depths, and has enhanced her sensitivity.

And then one day she decides to try some Botox. Nothing out of the ordinary there. She wants to look better, and why shouldn't she?

In a flash her wrinkles are gone, strange facial lines are erased, and her skin looks as smooth as it did when she was a teenager. Everyone tells her how great she looks. All in all, she considers it a worthwhile investment.

Or is it?

Researchers have just discovered the downside of Botox. We already knew that a Botoxed face is far less expressive than a face that can use all of its muscles to express your feelings, but now we also know that Botox stunts your emotions.

Immobilized facial muscles make it more difficult to feel your feelings. They limit your sensitivity and your sensibility.

See reports in the New York Times and Newsweek, here and here.

We have known for some time that if you want to improve your mood, to feel happier, you can, among other things, force your mouth into a smile. Hold it a while and you will feel better. It feels counterintuitive, but it works.

Similarly, since Botox inhibits your face from falling into frown expressions, some people believe that it helps you to maintain a positive mood and outlook. Botox was considered to be an antidote to depression.

This came with a price. We all know the uncanny sensation we experience when we are conversing with someone whose face barely moves. Such faces are so mask-like that they elicit a perceptible emotional disquiet. For all of the feeling of connecting, there is also a slight disconnect.

And also an irony. What does it mean for one person to accuse another of not expressing his or her feelings? Among those who are slightly older, people should start asking themselves whether they themselves might be causing their interlocutor's relative inhibition about expressing feeling.

Facial expressions are an important part of human communication. We use them to communicate more than mere words could say, and, through them, we establish a better and more complete connection.

Therefore face-to-face communication connects people better than any other form. When Freud decided that he wanted to prevent his patients from connecting with him on a human level he made them lie down on a couch and look away from him.

Thus he was asserting that psychoanalysis was a mind game that would be compromise by the least interjection of a human element.

The newest research shows that if you inhibit the facial expressions that accompany emotion, you will also be inhibiting your ability to experience the emotion yourself. If your face cannot assume the expression that denotes anger your ability to experience anger will be constrained. If your face cannot show fear, you will feel less fear.

However much we believe that facial expressions express some inner emotional state, the reality is that the expressions also sustain and produce these inner emotional states. We always think in inside/out terms. Do we now have to start thinking in outside/in terms?

For many of us this just does not feel right. We have spent years, even decades, exploring the inner reaches of our minds, the better to correct our mental defects. We have assumed that once all was right within our minds our words and deeds, to say nothing of our gestures, would express that inner rightness.

And even if it does not, therapists have assured us that we will have attained to a higher level of self-understanding, and that this has intrinsic value no matter how well we connect with other people.

If, however, you are forcing your face into a smile, the good feeling you produce might not feel authentic, it might not feel like it is welling up from the depths of your soul.

In cultural terms, this means that we have a mind/body problem. We believe that mind and body are fundamentally detached and that if you want to work on the body you should do some physical exercise but that if you want to work on your mind you should lie down on a couch, supine, nearly bodiless, and work exclusively on your mind.

We believe that only medicine and exercise can heal the body, and that only ideas can heal or grow the mind.

When people are trapped in a mind/body problem they will not understand why forcing your face into a smile can alleviate some of the pain of depression, and they will resist doggedly the counsel to treat the depression by doing aerobic exercise. It does not matter how many scientific studies have shown the value of exercise; people will not do it because it does not make sense to them that physical activity can effect autonomous mental states.

By now, most people understand that mental states can have an effect on treatment and cure. Surely, there are limits to what a good attitude can do, but it is better to be optimistic about your ability to heal than pessimistic.

Other studies have suggested that the nature of your connection with your physician can effect how well the medication that he prescribes will work. A close personal relationship, even a connection, will facilitate the working of what we would have assumed to be a purely biochemical process.

If your physician likes you, and vice versa, and if he believes in what he is prescribing, then it is more likely to work better than if it had been prescribed by a robot.

The same applies to psychotherapy. Freud notwithstanding, recent research into what works in therapy has concluded that a good interpersonal connection between patient and therapist is responsible for therapeutic progress.

Of course, that has nothing to do with science, or with the application of scientific principles. It feels much closer to ethics, especially to the branch of ethics that shows people how to connect with other people and how to sustain friendships.