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Moebius Syndrome: Facial Paralysis

Moebius Syndrome: Facial ParalysisMoebius syndrome is the name given to facial paralysis, and is characterized by an individual who is incapable of expressing their emotions or any kind of reaction through their face because of it. It is a rare congenital condition that only affects about 1 in 100,000 children at birth. Moebius syndrome typically results in total or near total paralysis of the face, including eyes that don’t blink.

The New York Times has the story of researcher Kathleen Bogart, who was disappointed to learn of the dearth of psychological research into this condition. Having it herself, she decided to help fill the gap, and began researching people with Moebius syndrome.

In a new study, the largest to date of Moebius syndrome, Ms. Bogart and David Matsumoto, a psychologist at San Francisco State, found that people with the disorder, whatever their social struggles, had no trouble at all recognizing others’ expressions. They do just as well as anyone else in identifying emotions in photographed faces, despite having no way to mimic.

The findings strongly suggest that the brain has other systems to recognize facial expressions, and that people with facial paralysis learn to take advantage of those.

Typical social interactions, including everyday conversations, can be difficult for people with Moebius syndrome, since the person interacting with the individual with Moebius syndrome isn’t getting any facial feedback. Such feedback is often a mirror of our own reactions to the topic of conversation, which we express in our eyes and face. When you’re talking about a funny story, I’ll look at you with wider eyes and a smile ready to break into a chuckle or full blown laugh as you get to the punch line. It’s the natural give-and-take of our social interactions.

However, for someone with Moebius syndrome, there’s none of that. Their face is a stone wall, expressing nothing. As Ms. Bogart says, “A lack of facial expression can result in people being perceived as dull, unhappy, or disinterested.” You can imagine how challenging an ordinary conversation may be with such a person.

The results do not imply that socializing is easy or natural for people with such paralysis; most do struggle, Ms. Bogart and Dr. Matusmoto found in a follow-up study. The main reason for this (beyond the immobile features, which distract some people) has little to do with a deficit in recognizing emotions in others, the studies suggest.

It most likely comes back to mimicry, or the lack thereof. In a series of studies, psychologists have found that social bonding between conversation partners is highly dependent on a rhythmic and usually subconscious give and take of gestures and expressions that creates a kind of shared good will. “Part of that could be the buying in on the interaction itself,” Dr. Chartrand said.

If the timing is not just right — the Moebius study did not account for timing — then the buy-in can feel uncertain, and interaction fizzles. The way that many people with complete, or near complete, paralysis overcome this problem is by relying on channels other than the face: eye contact, hand gestures, posture and voice tone. Many people with paralysis can make that expressive instrument as subtle and potent as a string section

This is fascinating research that helps us learn and understand more about the subtle communications that occur when we interact with one another. It also helps us better understand the brain, and how it compensates and then adapts for these kinds of deficiencies with other strategies to impart similar, important non-verbal information. It’s amazing to see the brain adapt in the way the article describes, and reminds us that it is a dynamic, flexible organ — not some hunk of stone set at birth with pre-defined limits.

And kudos to Kathleen Bogart for pursuing research into this phenomenon and figure out, as she notes on her web page, “how reduced facial movement affects social interaction, and how to facilitate emotional communication in people with facial movement disorders. An additional goal of this research is to identify effective verbal and nonverbal communication strategies that people with facial movement disorders use to enhance communication.”

Excellent goals that may help us better understand not only people who have facial paralysis, but also all of the facial behaviors that go into everyday social interactions.

Read the full article: Seeking Emotional Clues Without Facial Cues

Photo: Michele McDonald for The New York Times

Moebius Syndrome: Facial Paralysis

John M. Grohol, Psy.D.

Dr. John Grohol is the founder of Psych Central. He is a psychologist, author, researcher, and expert in mental health online, and has been writing about online behavior, mental health and psychology issues since 1995. Dr. Grohol has a Master's degree and doctorate in clinical psychology from Nova Southeastern University. Dr. Grohol sits on the editorial board of the journal Computers in Human Behavior and is a founding board member of the Society for Participatory Medicine. You can learn more about Dr. John Grohol here.

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APA Reference
Grohol, J. (2018). Moebius Syndrome: Facial Paralysis. Psych Central. Retrieved on December 2, 2020, from
Scientifically Reviewed
Last updated: 8 Jul 2018 (Originally: 8 Apr 2010)
Last reviewed: By a member of our scientific advisory board on 8 Jul 2018
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