microexpression

Using Microexpressions in Psychotherapy

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The last two weeks, we’ve covered using Microexpressions to Make Microconnections and the  Microexpressions of Fear, Surprise, Disgust and Creating Connection. We discussed what microexpressions are, what each of the different emotions are, and how they look on the face.

Learning about microexpressions develops a deeper connection with others—whether in therapy, or just in everyday relationships.

Microexpressions are tiny facial movements that give us cues to what someone is feeling. Their eyebrows might twitch down for a moment to display anger. Or the sides of their mouth might stretch horizontally to show they are afraid.

Our goal as therapists is to understand what emotion our patients are feeling, and to develop our empathy towards them through understanding the reason behind that emotion. Understanding microexpressions can lead to micromoments of connection by developing a greater closeness between you and your patient.

Microexpressions happen out of our awareness, and can be great cues to what someone is unconsciously feeling.

Using microexpressions to understand the unconscious

Microexpressions develop our identity

We are always picking up on some level of people’s microexpressions, whether we are trained in it or not. Many people intrinsically understand what others feel. This understanding can become our social mirror as we are growing up.

If we have an ability to make people smile when we are children, we may try to reinforce that reaction from others by building our interactions around humor. Then we are known as the “funny” one. These cues people give us can become a part of our identity.

One of my patients had a facial deformity. She noticed, and internalized, the messaging that she was “disgusting” to look at, based on other people’s facial expressions when they saw her. That led to deep feelings of disgust about herself. She often showed a microexpression of disgust on her face when she was talking about herself. Over time spent in therapy, she was able to create her values, her beliefs, and determine that as a human, she was more than her deformity.

Internalizing people’s microexpressions as feedback about ourselves can be helpful or harmful. When we learn more about microexpressions, we are able to develop techniques to delve deeper into people’s reactions and understand that those reactions are often not about us, but about the other person’s experience.

Through understanding microexpressions, we learn that we do not need to take every reaction and internalize it as part of our identity, either positive or negative. With our patients, seeing microexpressions as they talk about themselves can help us uncover deep seated beliefs—whether it’s disgust, arrogance, or any number of other emotions.

Microexpressions reveal object relations

Object relations is a theory about how we internalize early attachment figures and then subsequently understand future in relationships. For example, if we have a tense relationship with our father, and then we might expect or recreate tense relationships with our male teachers, male boss, and male therapist, as a way to make sense of the world and hope to have a different outcome.

We most often create these emotions towards early developmental relationships, then paint our beliefs about them on others throughout our lives, unless we deal with our feelings towards those people, and begin to be able to distinguish and differentiate, i.e., “not all authority figures are evil.”

In therapy, microexpressions can be helpful to unearth some of these emotions. The relationship between a therapist and a patient can represent, to the patient, many different relationships. Being a safe person for them to discuss their feelings with is the most important part of therapy.

Reading microexpressions can help us understand the emotions still present that the patient feels towards early attachment figures. These may come out as they discuss a current issue, and then express a strong emotion. If you focus in on the part of the story where the emotion was present, then they might start eventually talking about early attachment figures like their emotionally distant dad or angry mother.  

The microexpression allows us to know where to focus in, and listen closely in their story. They are not only important to pay attention to when it comes to how a patient feels about others, but also how they feel about us. Knowing how they feel about us, as their doctors, helps to be able to identify what are overarching, negative early life experiences and how we can help them work through those feelings so that they can live more present and thriving in the present.  

 

Talking about Dreams reveals microexpressions

As therapists, listening to dreams can give you a great glimpse into your patient’s inner emotional life. Studies show that memories more easily develop around negative emotions, and those negative moments can form points of organization for our memory. They found that PET scans showed that the parts of the brain that store our memories are also the ones activated during REM sleep.

Dreams usually demonstrate what’s most emotionally relevant to work on during psychotherapy. As patients are telling me their dreams, they will show microexpressions while reporting the narrative of the dream. Through discussing the dream, they can talk about emotions and desires they might not have consciously allowed themselves to have.

For example, if a patient is feeling trapped in a job or relationship, she may have a dream she is trapped in a box, or stuck underwater. She will be able to express her emotions during the description of the dream—her fear, anger, surprise, disgust. She may not be ready to talk about her relationship or job, but she can unearth the unconscious emotions of the dream and feel comfortable talking about that. In the end, her thoughts will go to areas of her life where she feels stuck, and then suddenly realize what the dream might mean.

As psychotherapy progresses and the person unpacks their emotions, the dreams change to be more positive. When a patient feels supported, heard and psychologically safe, they begin to unpack deeper, unconscious emotions they once only felt in dreams.

 

Psychological Defense and microexpressions

People experience psychological defense as a way of creating an alternative, safe reality for themselves. It’s an adaptive way to defend against their feelings, their reality, and the state of their mental health. Psychological defense is largely an unconscious, adaptive process.

Sometimes a patient will have a thought that is too distressing to pay attention to. Their brain will then send what we call “signal anxiety,” or a message that this thought, emotion, or desire must be suppressed from consciousness. As a result, they might have a psychological defense act as a way to adaptively defend against these thoughts. For example, they might suppress a thought to later deal with, deny that it happened, or go wash the car to get their aggression .

Another example where microexpressions will help is if a patient says they aren’t angry at a person. They may believe that, or may try to believe that. Maybe that person harmed them in a huge way. Prior to saying, “I’m not angry,” their face may have flashed a microexpression of anger, letting you know that perhaps they are denying what is truly going on.

The best thing to know here, is that psychological defenses are there for adaptive reasons, and the patient needs to feel safe enough to have them soften. If you empathize with the distress that comes with the defense you will be helping them get to what is under it.

 

Warnings about using microexpressions in therapy

Miscategorization

When I first started learning about microexpressions, I would tell people, “When you told that story, you flashed an expression of anger.” Then the patient would be angry at me for assuming they were angry. Maybe the patient hadn’t even had the chance to process on their own that they were, in fact, angry. Or maybe I was just wrong about what I was assuming! Either way, I didn’t give them the space to find their own emotions.

It’s important to allow people to mine their own feelings, and even discover the meaning behind the feeling. If they are telling a story and show a microexpression of anger, be curious about their feelings in that moment. Ask them to draw out the emotion and describe it. Be gentle with your word choices.

The danger is when we are wrong about what we think someone is feeling, but we aren’t accurate, and we assume we are still correct.  

 

Emotional contagion

As we learn about microexpressions, we see that there are hundreds of them being expressed in any one-hour therapy session. It can be overwhelming if we take responsibility for another person’s emotional life. It’s important to know the difference between their feelings and our own feelings, so we don’t own their emotions.

When I first started in my psychiatry rounds in medical school, I didn’t understand emotional contagion. I began to feel depressed after different conversations with suicidal patients. After talking to several mentors about it, I realized I was internalizing my patients’ emotions, and having issues with self/other distinction. Their emotions were contagiously experienced in my head, and I had little defenses against feeling overwhelmed.  

Now, before I go into any therapy session with a patient, I take an emotional gauge of myself. I see how I’m feeling, what my natural, resting emotional state is. When I enter the therapy session, I am able to categorize what is additional to my experience—sadness, anxiety, joy, fear, as the other person's, not mine. I am also able to deeper empathize with their feelings because I am not in a confused emotional state.

When we delve too deeply and become emotionally distressed with our patients, it inhibits our ability to offer insight, reflect, or therapeutically help the other person. Feeling deeply can be a tool in therapy for developing connection, but make sure you have healthy boundaries, too.

Being able to understand the patient and their reality can also help us own our own reaction to them. Maybe the patient reminds us of someone we know, and we are putting negative feelings on them.

 

Rushing the process

Maybe you repeatedly notice anger on your patient’s face during conversations about their father. Here’s the catch—maybe they don’t know they are angry at their father yet. If you rush that revelation, you are taking away their emotional experience of uncovering their feelings.

Letting someone use their words, and not forcing word choice, is important. If they say “frustration” and not anger, you should also say “frustration” and not the word anger. Allow them to have their own process.

 

Allow feedback

People are the experts of their own inner world. Microexpressions, though incredibly helpful, only give us hints. They do not give us a perfect map of someone’s entire emotional experience.

When you express curiosity about what someone is feeling, allow them to correct you if you offer specific word choices or suggestions. Ask them to clarify, and accept their explanations about what they were feeling.

 

Learn about microexpressions

It is helpful, when implemented correctly, to learn about microexpressions and use that knowledge to develop micromoments of connection.

To learn more about microexpressions, download the Emotion Connection IOS app.

For full PDF of the episode with citations and further notes go here

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Microexpressions: Fear, Surprise, Disgust, Empathy, and Creating Connection Part 2

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On the last Psychiatry and Psychotherapy podcast and blog, we talked about how Microexpressions make Microconnections, their role in therapy and how learning about them can increase our emotional connection to others.

This week, we will continue uncovering how different microexpressions look on the face and feel in our body, and their corresponding emotions.

Fear

Fear is an adaptive emotion—its original goal is to keep us safe and alive. When someone pulls into our lane on the interstate, it’s fear and our ability to quickly jerk the steering wheel straight that saves our lives. When we encounter heights, snakes, or frightening people in a dark alley at night, fear is the emotion we feel.

 

As children, we have fears of abandonment from our mothers, and at around two years old, we begin to experience stranger anxiety. As we grow, we read our parents and see what they are afraid of, so we can form protective fear patterns. Even different genders receive different messaging about fear. Parents teach male children to be more fearless, empowering and enabling, more courageous. They teach females to be more cautious, careful and more fearful.  

Fear, demonstrated on the face in a microexpression, looks like:

  • Eyebrows drawing up and together with tension in the forehead

  • Lower eyelids tensing

  • Mouth opening horizontally in an interaction

Fear can bond people together but also separate us from having an emotional connection. In any emotional interaction, we are experiencing a state of calmness, fight/flight, or disconnection.

Fear and anger come into play in both fight and flight. When we notice someone exhibiting fear when we are interacting with them, it’s important to be curious as to why. Are they fearful because of the interaction with us? Or are they fearful because they are accounting a story about something that scared them?

When someone experiences fear, it’s important to strive for a healthy connection again. That person may experience fear because of vulnerability or shame. Because fear’s goal is to stay safe, it can cause disconnection. Establish a psychologically safe place for them to feel connected, rather than fight or flight.

Dealing with fear

Listen to your voice of courage that’s inside of you. Anytime there is fear, there is also a courageous part of us that is sending different messages too, we just need to focus on it and therefore turn up the volume of the courage signals. When we get stuck, frozen, in a state of fight or flight, we can choose to engage the object of fear anyway. We can choose courage.

Experiencing fear during sporting events or performances is a great way to think about this. Fear can be decreased over time. When we train often enough, or compete often enough, that fear response slowly decreases. After plenty of performances, after plenty of sport competition events, we start to normalize that fear and courage takes over—training gives us confidence in the face of fear.

We can learn how to handle fear without being totally overwhelmed by facing the cause of our fear in slow, small increments. It can create an adaptation, rather than stress. Even cardiovascular health is tied to your emotional ability to handle fight or flight. By training physically, you are actually training for interpersonal stressors as well by spiking your adrenaline, breathing and heart rate.

Beyond behavioral therapy help, you can do mental exercises to regain control of your body during fear. Even simply saying out loud, “I am experiencing fear” can feel normalizing. Also, through meditation and breathing, you can reset your heart rate and breathing, and calm your body’s fear responses.

Surprise

 

On the face, the microexpression of surprise looks similar to fear, but where fear affects the face on a more horizontal axis, surprise affects the face on a more vertical axis. Surprise looks like:

  • Rising and rounding eyebrows

  • Rising upper eyelid

  • Sometimes mouth falling open with lips relaxing

  • Note: rising eyebrows can also be a conversational signal emphasizing something.

Surprise can be awe, curiosity, a revelation. It can be a more transitory emotion—quickly moving on to fear, anger or joy. When someone is exhibiting surprise on their face, be curious about why, ask them if the answer isn’t obvious—such as them arriving at their own surprise party—and you may learn something new about them.

Disgust

People rarely use the word “disgust.” They’ll talk about happiness, anger or fear or other emotions. But disgust is something that we don’t understand as easily without dipping back into the primal reasons for the emotion, and how it is helpful in modern day interactions.

Originally, disgust was an important emotion for survival. It standardized hygiene and behavioral norms. If a caveman or woman ate something gross, or fell out of line with the accepted hygiene of the day, they were shunned from the group. If they slept with a relative or animal, ate another human, or did not clean food properly, they aroused disgust in their tribe, and were exiled or even killed.

Without disgust, there would be less social norms, less “rules” for relating to each other and maintaining health codes. It’s a powerful emotion that drives behavior.

Disgust as a microexpression looks like:

  • Wrinkling around the nose

  • Upper lip rising

  • Eyebrows move down without tension (contrast this with anger where the eyebrows are pulled together and the eyelids are raised and tense).

I feel that people need to be more aware of disgust as a microexpression, and learn what it is trying to communicate to them. It’s not just about a survival mechanism, such as smelling rancid milk and being able to avoid getting sick. It’s also about how our spouse treats us, how we feel when we watch interactions between other people.

The negative effects of disgust, when it is taken too far, can be damaging and horrific. Racism and sexism are examples of disgust gone wrong. It can be dehumanizing. Even listening to Hitler’s conversation at his dinners, experts have analyzed disgust-oriented language. Much of his propaganda was even disgust-provoking propaganda.

People who are an object of someone’s disgust experience deep shame. Sometimes, that is warranted—such as when that person has broken a societal rule like pedophelia. But as a therapist, I have to have a lower threshold of disgust when it comes to hearing people’s secrets.

After awhile, I think that disgust, like fear, can be adaptable. I have heard all manners of secrets, and I rarely feel disgust anymore. Instead, I feel I need to exhibit psychological safety, so the patient feels open to talking about the things they cannot tell anyone. Through talk therapy, hopefully I can help them feel less shame and understand their unique journey and struggles more fully.

Using microexpressions in interactions

The first key to using microexpressions is to pay attention. Look at the person’s face, be interested and curious about what emotional state they are in. Notice the facial movements, and listen to what they are saying. Is what they are expressing maybe outside of their awareness as they talk? Does the emotion they are showing match what they are talking about?

As a therapeutic tool, understanding microexpressions is a way of gathering information about someone else. Use that information to respond in a way that shows the person you are desiring to connect.

Paying attention to microexpressions actually creates empathy. We have mirror neurons—neurons in our brain that are devoted to telling us what someone else is feeling. Those neurons light up when we watch someone else doing something, or feeling something. When we see someone bite into hamburger on a commercial, it might make us hungry, even causing our stomach to rumble or our mouths to make extra saliva. When we see someone cry, it might make us cry. Your brain will light up, to some degree, as if you are experiencing someone else's emotions. We can train ourselves to pay attention to those neurons to better be able to connect with people.

Some people experience either less or more empathy than what is considered normal. This can be because of a disorder, or because of emotional burnout. Even experiencing emotional overload causes a decrease in empathy.

Being able to determine the difference between yourself and the other person is another important part of empathy. Learning about microexpressions can help you do that—you can see their emotions, and recognize they are the one experiencing it, and you can respond to the emotion, but you do not have to own it as your own.

Tune in next week to hear part three of Microexpressions. If you'd like to try out the app that trains people how to read microexpression, go here: IOS Emotion Connection App

For full PDF of the episode with citations and further notes go to: https://psychiatrypodcast.com/resource-page/

Microexpressions to Make Microconnections Part 1

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What are microexpressions?

Microexpressions are brief, involuntary facial expressions that are cues to the true emotions that someone is feeling. We see microexpressions in tiny twitches of the brows, the lips and nose. They can last for as little as 1/15th of a second on the face.

Microexpressions are helpful because they send messages, both to ourselves, and to those we are trying to communicate with. Some are naturally better at sensing what someone else is feeling, but if you want a deeper clue into emotions and emotional connection, start to study microexpressions. We can even begin to understand ourselves a little better when we pay attention to them.

What are emotions?

Emotions are adaptive brain networks, expressed rapidly on the face and in the body. They carry messages about our environment or thoughts, and they have a specific goal or intention.

Although they appear ethereal in nature—fleeting feelings of happiness or sadness—emotions are actually grounded, measurable reactions. Each person, based on their experiences in life, will react differently to each stimuli. With each person, the reaction and meaning of the emotion lies within the lens we have.

 

  • Emotions have a purpose.

  • Emotions move us to action.

  • Emotions themselves are not good or bad.

  • We often do not decide to have emotions.

 

Emotion is a survival mechanism that we all have. For example, the purpose of anger is to protect and reconnect. Anger surfaces when we feel threatened—when a lion tries to attack our family—it gives us the physical response we need to attack what is attacking us. Fear is helpful to trigger our body to be able to outrun that lion when we need to—our heart starts pumping, adrenaline rushes in, survival mode turns on. In modern society, we’ve tried to suppress or deny those emotions, but they’re still there, and they’re still helpful. We just have to know what they are, and what to do with them.

 

What are the different emotions?

 

Scientists have lumped all of our complex feelings into seven, basic categories.

Happiness

Emotion: Happy, Joy

Body Sensation: Positive warmth throughout the body, grounded feeling.

Microexpression: Mouth going up symmetrically, cheeks pulling up and change in contour, and eyes contracting (especially on the outside with classic “crows feet”).  

Meaning and Goal of Emotion: Heartfully rejoicing, finding pleasure and wanting more of something, noting what brings you pleasure, feeling safe connection, having mutuality with someone, moving towards a goal.

Sadness

 

Emotion: Sadness

Body Sensation: Heavy feeling in chest, decreased limb activity.

Microexpression: Inner eyebrows rising and outer eyelid dropping, pulling down of the lip corners, chin moving up, and lips showing a pout.

Goal of Emotion: Express loss over connection, an object, or attachment, invite solace and concern.

Fear

Emotion: Fear

Body Sensation: Weight on chest, constriction around neck, butterflies in the stomach.

Microexpression: Upper eyelids rising high and longer than surprise, lower eyelids tensing, eyebrows drawing up and together with tension in the forehead, mouth opening horizontally.

Goal of Emotion: Preserve and maintain life, freeze to analyze danger, prepare to run or attack, puff up (to look dangerous). 

Disgust

 

Emotion: Disgust

Body Sensation: Queasy, feeling of wanting to vomit, gag feeling in the throat.

Microexpression: Wrinkling around the nose, upper lip rising, and eyebrows move down without tension (contrast this with anger where the eyebrows are pulled together and the eyelids are raised and tense).  

Goal of Emotion: To move away from, avoid, reject, spit out, get away from.

Pride/contempt

Emotion: Pride, Smug, Contempt

Body Sensation: Increased sensation in the chest and head of euphoria, puffed up feeling in chest

Microexpression: One side of the lips rising faster than the other, or one side coming down slower than the other.  

Goal of Emotion: To take pride in another’s success, proud when I succeed, feel superior, or diminish inferiority.

Surprise

 

Emotion: Surprise

Body Sensation: Startle and jolt to the body

Microexpression: Rising and rounding eyebrows, co-occurring with rising upper eyelid, and sometimes mouth falling open with lips relaxing. Note: rising eyebrows can also be a conversational signal emphasizing something.

Goal of Emotion: Prepare for the next step, achieve familiarity with an object/situation so that you are better prepared when encountering a similar situation in the future.

Anger

 

Emotion: Anger, Frustration

Body Sensation: Tight chest, tension in neck and back, knots or burning in stomach.

Microexpression: A short tightening of the eyelids, eyebrows moving down and together, and sometimes lips pressing together. Rarely, showing of teeth. The tightening of eyelids and eyebrows for an extended period of time can also be seen when a person is concentrating or focusing, so context is important.   

Meaning and Goal of Emotion: Overcome obstacle to move towards a particular goal (desire to reconnect with a loved one). Protect self or significant others—set up boundaries, have a voice, or be assertive. Attack when you feel no escape is possible either physically or psychologically.

Why should you learn about microexpressions?

Learning about microexpressions is helpful for emotional connection. Connection is largely based on empathy, and when we know what someone else is feeling, studies show we experience more empathy.

It can help raise the level of connection in personal life, in work, and even for people who have disorders that can cause emotional disconnection, such as schizophrenia.

Therapists and mental health workers, when tested, demonstrated they were no better at reading microexpressions than the average person. Another study also showed that therapists and mental health professionals overestimate how good they are at reading micrexpressions. We believe microexpression training would benefit therapists, and help them build a therapeutic alliance with their patients.

One study of 21,000 patients, showed that those who were under the care of doctors who demonstrated higher empathy, had 40% less life-threatening instances related with their diabetes. Higher empathy = better health outcomes. In another study about psychotherapists, the overall therapeutic connection impacted how well someone responded to both the placebo and the active medication.

Learning about microexpressions will help therapists be able to diagnose or identify depression, anxiety, and find underlying emotional responses to a story a patient is telling.

How do you learn about microexpressions?

Anyone can learn how to read microexpressions, and studies show that it really does help us feel more connected to people, and it helps us develop empathy.

Even when we lean in, and specifically pay attention to someone else’s emotions, we are better able to empathize with that person and connect. That’s a simple way to feel closer to someone, but to really go deeper into the science of emotional connection, you have to study microexpressions.

The most effective way to learn microexpressions is through a training program. I built a training app that can help. The app has over a hundred recorded videos of real facial expression responses. After the video plays, it will prompt you to guess the emotion the person expressed. Once you respond, the app gives you immediate feedback of the correct answer, along with what facial movements are involved in each emotion. Repetition is key in learning microexpressions.

The positive effects of microexpression training

There are incredible benefits to microexpression training, whether you are a healthcare professional or just someone who is interested in emotional connection.

It develops psychological safety.

When we read a microexpression, it shows we are demonstrating an appreciation for the person you are listening to. You are giving time and attention to their feelings. Often, when we recognize a microexpression, we tend to mimic it on our own faces. When someone is sad, we are sad with them. When someone shows anger, we shake our head and demonstrate anger with them. When they feel heard and understood, they feel psychologically safe to give you accurate feedback.

It normalizes emotions.

When we cognitively understand that we are feeling anger or disgust, and not just living in the feeling, it allows us to begin to breakdown the why behind it. When we dig that deep, we can process responses that are out of context. Emotions should happen in the appropriate time, in an appropriate amount. Checking the why can help us untangle complex situations from our past, and help us deal with emotions in healthier ways in the future.

Also, rather than judging emotions, when we learn microexpressions, it brings our brains into the equation, so our responses are rarely trigger-happy. We are able to be curious about the why behind it, which is much more helpful in the long run.

If you’d like to keep learning about microexpressions, download a PDF with more detailed notes from this episode with all citations: https://psychiatrypodcast.com/resource-page/

If you'd like to try out the app that trains people how to read microexpression, go here: IOS Emotion Connection App

 

 

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