Clinician's Digest - Page 3
Botox and Emotions

Smile, and the world smiles with you. Let a smile be your umbrella on a rainy day. If this advice is true, then encouraging depressed people to smile might be a quick, effective therapy. A widely cited study by dermatologist Eric Finzi of Chevy Chase, Maryland, in the May 2006 Dermatologic Surgery supports the wisdom of this adage. Finzi reported that 9 of 10 depressed women he treated said they felt significantly better after their frown muscles were deadened by Botox. The study, however, lacked a control group and objective measures of depression. Even if the "depressed" women felt better, it could have been due to self-image changes following Botox injections.

At first glance, a study by neuroscientist David Havas of the University of Wisconsin, Madison, in the forthcoming issue of Psychological Science seems to support Finzi's contention. Havas found that when Botox deadened muscles involved in frowning, people's comprehension response when they read angry or sad sentences was slower. They showed no delay in responding to happy sentences, however. Havas says there's a bidirectional feedback loop between facial expressions and emotions: the brain, receiving a cue to register an emotion, sends a direction to appropriate facial muscles; the consequent physical act of, say, frowning, then sends a signal back to the brain, prolonging or intensifying the feeling. But, he says, his study also suggests a more complex relationship involving the translation of words into feelings. The delay of negative reactions in his study, he thinks, was partly caused by the brain's difficulty in interpreting frown-inducing sentences when the brain–frown feedback loop was interrupted.

His study joins a growing body of research that finds links between physicality and emotions. In a review in the May 18, 2007, issue of Science, psychologist Paula Niedenthal of France's Blaise Pascal University reports that people slouching when they receive praise respond less positively than people sitting straight. In another experiment, instructors subtly placed a pen on the table while people were instructed to either nod or shake their heads vigorously, ostensibly to test how their headphones fit. Later those who'd shaken their heads affirmatively reported more positive reactions to the pen than did people who shook their heads no.

Smiling may or may not alleviate depression—that research remains to be done—but Botox may actually increase feelings of disconnection from others by interrupting an interpersonal feedback loop. Facial expressions evoke emotional responses from others, and a split-second delay in showing a feeling, or showing less of that feeling, may impair or sever the emotional connection with others. Actress Meryl Streep has said she'd never use Botox because attention would be drawn to the part of her face that's frozen. We rely on our inner selves and others for communicating truth and emotion and, says Havas, Botox just may create enough static to impair those essential human connections.

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