The smile response pattern activation proves to my patient he can smile. When he sees my exagerated,smile, an image of a smile is formed in his brain. This smile image helps to animate or rouse his own smile-conditioned response pattern homunculus and to facilitate the lower pathway smile response pattern. The image functions like a template or behavioral "mold," shaping and helping the release of his feeling-good response, even though the patient had been stuck, inhibiting it a moment earlier.
Some patients are feeling so bad, they say they don't want to or can't smile. Then, smile biofeedback can be useful. Patients use zygomaticus EMG feedback to tell them what strategies help to boost their smile muscle strength and boost the EMG amplitude.
They learn to voluntarily create a genuine smile that helps them let go of their positive experience inhibiting behaviors. The concrete, muscle strength oriented feedback helps them to strengthen their smile reflex without initially expecting wonderful feelings. Over and over again, we've found in our research that people, when asked to smile as strong as they can, work and strain to make a smile. Sometimes, in their beginning efforts to intensify their smiles, they screw their faces into distorted smiles, very artificial in appearance (just as other physical therapy patients suffer from unwanted co-contraction of antagonist muscles). We crack some jokes, kid around. Making any feeling good sound, like laughter, humming, cheering, seems to strengthen the smile activity. When we coax them into laughing, the smile comes effortlessly with the help of the lower motor neuron pathway, and is 20% to 100% stronger than the strained effort. This approach actually teaches feeling relaxation-- the ability to stay relaxed and comfortable while feeling deep emotions.
Kicking in the lower motor-neuron pathway is a very important step for the so many people suffering from alexithymia and other emotional dysregulation disorders. Learning to at first tolerate, then remain comfortable while experiencing strong feelings is often a sign of improvement for patients in many different forms of psychotherapy. The anxiety of feeling emotion is a common one that can be coped with very effectively. The feeling biofeedback and facial muscle exercises allow people to take small, safe steps. The patient's begin to take risks. The smile becomes more symmetrical, more natural and more robust. The goal of smile aided relaxation is to go beyond feeling nothing, to feeling deeply, to be able to comfortably enjoy strong, deep feelings. You can learn to turn on the full range of your emotions with comfort and joy.
The most basic smile muscle is the zygomaticus, named after the zygomatic arch-- the cheek bone-- which it attaches to at one end. The other end of the zygomaticus attaches to the corner of your mouth.
Activation of the Zygomaticus
Try exercising your zygomaticus now. Pull the corner of your mouth towards your cheek. Palpate for the zygomaticus. Smile and tighten or contract the zygomaticus. Then relax it, so you can feel the muscle moving under your facial skin. Put your index finger near your cheek and your pinky near the corner of your mouth and contract your zygomaticus. Use all four of your fingers to feel along the muscle. Relax and then tighten the muscle so you can feel around your cheek to find the most activity. Try a little smile, then full faced, beaming grin. Feel your zygomaticus bulge as your smile intensifies. Palpate along your cheekbone then down towards your mouth until you find the most activity. Focus on the sensations in your skin as you smile.
Because of genetic variation, some people will have bigger zygomaticus muscles than others. Some zygomaticus muscles will be built up more around the front of their cheek while in others, the zygomaticus is further back on the cheek bone. Though there's little research, it makes sense that humanity's genetics has included smiles in its approach to biological diversity. There may be people who were born with easier, bigger, wider smiles. There may be people with more smile inhibition nerve paths.
I instruct patients to get to know their zygomaticus, the most important and central of the smile muscles. The other smile muscles act as modifiers, adjective-like descriptors and smile flavoring components.
The eye muscles involved in smiling, the lower lateral orbicularis Oculi pars palpabraeus, which crinkle up our lower eyelids and produce crow's feet, seem solidly connected with lighthearted, open-hearted good feelings and warmth.