Being facially expressive is socially advantageous

Kavanagh, E., Whitehouse, J., & Waller, B. (2024)

Scientific Reports, 14(1). 

https://doi.org/10.1038/s41598-024-62902-6

Abstract

Individuals vary in how they move their faces in everyday social interactions. In a first large-scale study, we measured variation in dynamic facial behaviour during social interaction and examined dyadic outcomes and impression formation. In Study 1, we recorded semi-structured video calls with 52 participants interacting with a confederate across various everyday contexts. Video clips were rated by 176 independent participants. In Study 2, we examined video calls of 1315 participants engaging in unstructured video-call interactions. Facial expressivity indices were extracted using automated Facial Action Coding Scheme analysis and measures of personality and partner impressions were obtained by self-report. Facial expressivity varied considerably across participants, but little across contexts, social partners or time. In Study 1, more facially expressive participants were more well-liked, agreeable, and successful at negotiating (if also more agreeable). Participants who were more facially competent, readable, and perceived as readable were also more well-liked. In Study 2, we replicated the findings that facial expressivity was associated with agreeableness and liking by their social partner, and additionally found it to be associated with extraversion and neuroticism. Findings suggest that facial behaviour is a stable individual difference that proffers social advantages, pointing towards an affiliative, adaptive function.

Here are some thoughts:

The study on facial expressivity in social interactions offers valuable insights for psychologists engaging in psychotherapy. A key takeaway is the importance of facial expressions in building rapport with clients. Therapists can utilize their facial expressions to convey empathy, understanding, and interest, thereby fostering a positive therapeutic relationship. Conversely, being attentive to clients' facial expressivity can provide clues about their personality traits, such as extraversion and agreeableness, as well as their emotional regulation strategies.

Therapists should also develop awareness of their own facial expressions and their impact on clients. This self-awareness enables therapists to manage their emotional responses and maintain a neutral or supportive demeanor. Moreover, recognizing cultural differences in facial expressivity and display rules is crucial. Cultural norms may influence clients' facial behavior and interpretations, and therapists must be sensitive to these variations.

Facial expressivity plays a significant role in nonverbal communication, and therapists can harness this to convey emotional support, encouragement, or concern. This can enhance the therapeutic relationship and facilitate effective communication. Additionally, being aware of subtle, involuntary facial expressions (micro-expressions) can reveal underlying emotions or attitudes.

To integrate these findings into therapeutic practice, therapists should strive for authenticity and congruence in their facial expressions to build trust and rapport. Consideration should be given to incorporating facial expression training into therapist development programs. Furthermore, therapists must be mindful of power dynamics and cultural differences in facial expressivity. By leveraging facial expressivity, therapists can refine their approach, foster stronger relationships with clients, and ultimately improve treatment outcomes.

The study's findings also underscore the importance of considering individual differences in facial expressivity. Rather than assuming universality, therapists should recognize that each client's facial behavior is unique and influenced by their personality, cultural background, and emotional regulation strategies. By adopting a more nuanced understanding of facial expressivity, therapists can tailor their approach to better meet the needs of their clients and cultivate a more empathetic and supportive therapeutic environment.

When therapists face discrimination

Zara Abrams
The Monitor on Psychology - April 2018

Here is an excerpt:

Be aware of your own internalized biases. 

Reflecting on their own social, cultural and political perspectives means practitioners are less likely to be caught off guard by something a client says. “It’s important for psychologists to be aware of what a client’s biases and prejudices are bringing up for them internally, so as not to project that onto the client—it’s important to really understand what’s happening,” says Kathleen Brown, PhD, a licensed clinical psychologist and APA fellow.

For Kelly, the Atlanta-based clinical psychologist, this means she’s careful not to assume that resistant clients are treating her disrespectfully because she’s African American. Sometimes her clients, who are referred for pre-surgical evaluation and treatment, are difficult or even hostile
because their psychological intervention was mandated.

Foster an open dialogue about diversity and identity issues.

“The benefit of having that conversation, even though it can be scary or uncomfortable to bring it up in the room, is that it prevents it from festering or interfering with your ability to provide high-quality care to the client,” says Illinois-based clinical psychologist Robyn Gobin, PhD, who has experienced ageism from patients. She responds to ageist remarks by exploring what specific concerns the client has regarding her age (like Turner, she looks young). If she’s met with criticism, she tries to remain receptive, understanding that the client is vulnerable and any hostility the client expresses reflects concern for his or her own well-being. By being open and frank from the start, she shows her clients the appropriate way to confront their biases in therapy.

Of course, practitioners approach these conversations differently. If a client makes a prejudiced remark about another group, Buckman says labeling the comment as “offensive” shifts the attention from the client onto her. “It doesn’t get to the core of what’s going on with them. In the long run, exploring a way to shift how the client interacts with the ‘other’ is probably more valuable than standing up for a group in the moment.”

The information is here.

It turns out empathy can be taught

By Craig Dowden
Special to Financial Post
Originally published July 7, 2013

There has been increased emphasis on empathy in the field of medicine in recent years. Empathy, it turns out, is directly related to key outcomes of interest to medical observers, including improved patient satisfaction, better patient adherence to proposed treatments, and increased well-being in doctors (including lower burnout). It has also been linked to a reduction in errors by doctors and fewer malpractice claims. As a consequence, the desire to enhance empathy in doctors is not only a noble and laudable goal, but also a valuable one from a bottom-line perspective.

Seeing the profound significance of empathy in medical settings, Dr. Helen Riess, an Associate Clinical Professor of Psychiatry at Harvard Medical School and Director of the Empathy and Relational Science Program at Massachusetts General Hospital, set out to explore whether it was possible to bring about observable improvements in physician empathy. Drawing on Daniel Goleman’s work in the area of emotional intelligence, as well as elements of the neuroscience of empathy, Dr. Riess designed and implemented an empathy training program for physicians.

The entire story is here.

Physicians build less rapport with obese patients

By K.A. Gudzune, M.C. Beach, D.L. Roter, & L.A. Cooper
Obesity (Silver Spring). 2013 Mar 20. doi: 10.1002/oby.20384.

Abstract

Objective: 
Physicians' negative attitudes towards patients with obesity are well documented. Whether or how these beliefs may affect patient-physician communication is unknown. We aimed to describe the relationship between patient BMI and physician communication behaviors (biomedical, psychosocial/lifestyle, and rapport building) during typical outpatient primary care visits.

Design and Methods: 
Using audio-recorded outpatient encounters from 39 urban PCPs and 208 of their patients, we examined the frequency of communication behaviors using the Roter Interaction Analysis System. The independent variable was measured patient BMI and dependent variables were communication behaviors by the PCP within the biomedical, psychosocial/lifestyle, and rapport building domains. We performed a cross-sectional analysis using multilevel Poisson regression models to evaluate the association between BMI and physician communication.

Results: 
PCPs demonstrated less emotional rapport with overweight and obese patients (IRR 0.65, 95%CI 0.48-0.88, p=0.01; IRR 0.69, 95%CI 0.58-0.82, p<0.01, respectively) than for normal weight patients. We found no differences in PCPs' biomedical or psychosocial/lifestyle communication by patient BMI.

Conclusions:
Our findings raise the concern that low levels of emotional rapport in primary care visits with overweight and obese patients may weaken the patient-physician relationship, diminish patients' adherence to recommendations, and decrease the effectiveness of behavior change counseling.

And, click here for a blog post on this article, with the excerpt below:

Are Doctors Nicer to Thinner Patients?

By TARA PARKER-POPE
The New York Times - Well Column
Originally published April 29, 2013

Here is an excerpt:

“When there is increased empathy by the doctor, patients are more likely to report they are satisfied with their care, and they are more likely to adhere to recommendations of physicians,” Dr. Gudzune said. “There is evidence to show that after visits with more empathy, patients have improved clinical outcomes, so patients with diabetes have better blood sugar control or cholesterol is better controlled.”

Dr. David L. Katz, director of the Yale-Griffin University Prevention Research Center, says that overweight patients often complain to him that doctors appear judgmental about their weight, at the expense of other health concerns.

“You come in with a headache, and the doctors say, ‘You really need to lose weight.’ You have a sore throat, and the doctor says, ‘You really need to lose weight,’ ” he said. “These patients feel like the doctor doesn’t help them and they insult them, and so they stop going.”

In dealing with patients who are overweight, Dr. Katz added, doctors often show the same biases and prejudices as the culture at large. The problem may be compounded by the fact that doctors are trained to deal with immediate medical problems that have specific solutions, like a pill to lower blood pressure or emergency treatment for a heart attack. But obesity is a far more complex problem that isn’t easy to solve, and that can be frustrating to doctors.

“When we can’t fix what is broken we tend to behave badly,” he said.