Fake It Till You Make it

When you are down and sad, your shoulders likely are drooping, your head hanging down, and your face is frowning. When you are happy, your body is probably more upright, and you may show a smile and twinkle in your eyes. These feelings expressing themselves in facial expressions and body posture is nothing new. That this connection is two-way is not as well known. That it can be used intentionally to change one’s mood has mainly been promoted by the self-help literature rather than scientific exploration. Singing happy songs or forcing an authentic smile while looking in the bathroom mirror in the morning – even when you definitely don’t feel like doing so—are some of the suggested strategies to garner the confidence and strength that make dreams happen.^{(1; 2; 6)} Fake-it-till-you-make-it now finds validation in the scientific literature. I found reports intriguing that cosmetic Botox injections would lift people’s mood by paralyzing the muscles and thereby prevent frowning.^{(3; 4)} One may debate that this emotional uplift resulted solely by finding oneself “prettier” but more serious research showed a true link between facial expressions and feeling.

Authors from Germany, Switzerland, and the US randomized patients with depression to receive Botox injections into their forehead.⁽⁵⁾ They wanted to see whether paralyzing the muscles that make a person frown would make patients who hadn’t responded to the usual medications less depressed. They had an about 60% success rate, particularly for chronic and treatment-resistant cases of depression. Then they went about to check which patients responded best. They found that those who actively frowned the most at onset had the best results. The conclusion is that there is a reinforcing feedback between feelings and facial expressions in a self-reinforcing loop. If one interrupts the cycle by stopping the frown—in this case by paralyzing the respective muscles—frowning no longer feeds the signal to the brain that things are worrisome. Instead, the smoothed-out forehead makes the brain believe that things are ok. Great trick to outwit the circuits of the brain!

Better yet, and without cost: Watching oneself when frowning or smiling more may be equally effective. Thus: Fake it till you make it and you will feel great.

 

References

1. Grout P. E-Squared: Nine do-it-yourself energy experiments that prove your thought create your reality: Hay House; 2013.
2. Bettger F. How I raised myself from failure to success in selling Fireside.
3. Lewis MB, Bowler PJ. Botulinum toxin cosmetic therapy correlates with a more positive mood. Journal of cosmetic dermatology. 2009 Mar;8(1):24-6. PubMed PMID: 19250162. Epub 2009/03/03. eng.
4. Magid M, Reichenberg JS, Poth PE, Robertson HT, LaViolette AK, Kruger TH, et al. Treatment of major depressive disorder using botulinum toxin A: a 24-week randomized, double-blind, placebo-controlled study. The Journal of clinical psychiatry. 2014 Aug;75(8):837-44. PubMed PMID: 24910934. Epub 2014/06/10. eng.
5. Wollmer MA, Kalak N, Jung S, de Boer C, Magid M, Reichenberg JS, et al. Agitation predicts response of depression to botulinum toxin treatment in a randomized controlled trial. Frontiers in psychiatry. 2014;5:36. PubMed PMID: 24744738. Pubmed Central PMCID: PMC3978251. Epub 2014/04/20. eng.
6. Nicholas A. Coles, Jeff T. Larsen, Heather C. Lench. A meta-analysis of the facial feedback literature: Effects of facial feedback on emotional experience are small and variable. Psychological Bulletin, 2019; DOI: 10.1037/bul0000194