Motions creating Emotions?
Part of the appeal of Botox is how you feel once you've seen your reflection improve by degrees after the treatment.
But what if it goes deeper than that? It makes sense if you really think about it: you've heard that smiling has mental health benefits, but why? The facial feedback hypothesis, first conceived by Charles Darwin, suggests that a smiling expression, for example, uses muscles that play a key role in how the brain evaluates mood. In other words, our facial expressions contribute to the way we feel. So just employing the same muscles that we subconsciously use to smile naturally can put us in a better mood. The same is true of more negative facial expression such as the frown. When we frown subconsciously and repetitively over the day (over 90% of the time you do it you do not mean to) we are having a direct negative impact on our mood and emotional state. It also effects your interactions with others and how they perceive you.
Botox injections allow relaxation of facial muscles involved in making negative expressions, in my experience patients often report benefits on their emotional and psychological state following their treatment. The best anecdotes are the ones where my clients report having less arguments with their partners because they are not expressing strong negative facial expressions during conversations. They feel relaxed and they look refreshed. People who meet them tend to react more positively and aren’t put off engaging in conversation with them because of a negative frown.
It's as though facial muscles are more in tune with how a person is feeling than their actual consciousness. My patients report feeling more in control of their emotions, which can prove to be a significant advantage in certain situations. The ability to maintain control over emotions and to mask raw, unfiltered and often unnecessary negative emotions is a useful skill.
My clients are aware of my dual training as a Psychiatrist and are encouraged to discuss any aspects of their overall emotional and psychological state during our consultations. With all my patients, it's not just about how they look, but how the way they look makes them feel. Many people come to see me with a lack of self-confidence, or just needing "something", and it is often triggered by life-changing events. After a consultation and series of treatments, I generally note a change in the mood of the patient, and, more importantly, they notice a difference.
Is it possible to influence mood just by restricting the face's ability to frown?
To test the facial feedback hypothesis (FFH), clinical studies asked whether the strength of self-reported emotional experience would be decreased by Botox induced paralysis of specific facial muscles, which render an individual unable to generate facial expressions (specifically the frown) and therefore to experience facial feedback.
An unexpected but intriguing finding was that Botox injections affected responses to mildly but not strongly emotional stimuli suggesting that one critical factor determining when facial feedback may matter is the strength of the emotional impulse. This would appear to indicate a benefit in psychological and emotional responses on a general day to day level. We experience background emotions of anger, frustration and worry which are fuelled by low level, sometimes unconscious thoughts. Our facial muscles unconsciously express these negative emotions through frowning and relay this information to the emotional control centres of our brains like the amygdala. Some research indicates that Botox can have a beneficial effect on these general, low-level negative emotions but will not have a significant impact on very high emotional stimuli which illicit strong emotional responses. I would view this as a positive distinction; most people would not want their emotional responses to very clear, strong and obvious triggers to be removed but a reduction in the everyday negative emotional expressions that you are mostly unaware of can have a significant positive effect on your psychological state. Once the face is set into a relaxed natural resting state, the mechanisms of the body behave differently and less stress response is created.
Is it safe, though?
Botox has been around since the early Nineties and is widely used worldwide for all sorts of medical conditions other than cosmetic use. The chances that the treatment improves the patient either psychologically or cosmetically are far greater than the potential side effects.
Having said that, Botox is definitely in my opinion a medical treatment and not a purely cosmetic one, I would strongly advise against receiving Botox or any other “cosmetic injectables” from anyone who is not a qualified medical practitioner with a license to prescribe and practice. An understanding of all aspects of facial anatomy, potential side effects and how to manage complications post-procedure should be a clear requirement in anyone who offers these procedures which is unfortunately not always the case. An additional knowledge of psychological medicine and an ability to screen for psychological disorders in patients are also very important in ensuring a thorough understanding of your patient and their needs.
Please do contact our clinic directly if you would like to discuss any treatments we offer and how they could be suited to you.
Dr Louay Azoo, MBBS, MRCPsych