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Wittgenstein, mimicry and congenital facial paralysis
Abstract
Mimicry refers to the tendency to adopt the behavioral expressions of interaction partners. According to Wittgenstein, mimicry typically occurs outside of conscious awareness, and without any intent to mimic or imitate. Further, he suggests a bi-directional relationship between mimicry on the one hand, and rapport, affiliation on the other. That is, the ability to imitate and mimic what one perceives in the expression of another person creates affiliation, and affiliation can be expressed through mimicry. We argue that mimicry plays an important part in our form of life. Mimicry increases affiliation, which serves to promote relationships with others.
The congenital absence of facial expression and the inability to imitate facially the expressions of other persons may result in profound changes in the way a person is perceived by others and in a subsequent loss of affiliation. These experiences reveal not merely the importance of perceiving feelings and the capacity for imitating others for the maintenance of human relationships, but also the extent to which adults with a condition such as Möbius Syndrome may have difficulty in engaging in a shared form of life with others. These limitations are partial rather than absolute, however, and people with Möbius may yet maintain social coordination through their other channels of expression; through prosody of voice, gesture, clothes, enriched vocabulary, and so on.
Keywords: Wittgenstein, mimicry, Möbius Syndrome, rapport, form of life
1 Introduction
In his late writings, Wittgenstein notes that humans have a tendency to mimic the observable behavior of others (Wittgenstein, 1958; 1980a; 1980b). He writes:
‘I see that the child wants to touch the dog, but doesn’t dare’. How can I see that? – Is this description of what is seen on the same level as a description of moving shapes and colors? Is an interpretation in question? Well, remember that you may also mimic a human being who would like to touch something but doesn’t dare. (Wittgenstein, 1980a, §1066)
If someone sees a smile and does not know it for a smile, does not understand it as such, does he see it differently from someone else who understands it? – He mimics it differently, for instance. (Wittgenstein, 1958, p. 198)
We can discern three claims in the quoted passages. First, we directly perceive thoughts and feelings in the expressions of other people, and not by way of inference. Second, we have a tendency to mimic others because perception automatically elicits corresponding behavior. Thirdly, behavioral mimicry is relevant for understanding what an expression means. If an individual could not do this, he may not understand what is expressed. Let’s now examine these claims.
2 Social perception
What can we perceive? According to Wittgenstein, we perceive what we may call observables. This grouping involves behavior that we can literally perceive. We can see someone wave, scratch her head and wiggle his foot. Also, we hear people speak. Not only do we listen to the contents of speech, we also perceive other variables such as accents or tone of voice. Finally, we can perceive various facial expressions. We see people smile or frown, for example, and we apprehend the person’s feelings as that person’s feelings, through what we see in the face. Wittgenstein writes:
‘We see emotion.’ – As opposed to what? – We do not see facial contortions and make the inference that he is feeling joy, grief, boredom. We describe a face immediately as sad, radiant, bored, even when we are unable to give any other description of the features. – Grief, one would like to say, is personified in the face. This is essential to what we call ’emotion’. (Wittgenstein, 1980b, §570)
Consciousness in another’s face. Look into someone else’s face, and see the consciousness in it, and a particular shade of consciousness. You see on it, in it, joy, indifference, interest, excitement, torpor, and so on. The light in other people’s faces. Do you look into yourself in order to recognize the fury in his face? It is there as clearly as in your own breast. (Wittgenstein, 1967, §220)
We might also say: ‘It is there as clearly as in your own face’. The substitution is natural because it captures how mimicry is directly connected to understanding behavior as perceived in someone else. We perceive not merely because we need it to analyze and comprehend the expressions of interaction partners, but because we need it to behave. Perception is for doing. If the behavior of others communicates information, our perceptions of others’ behavior may then be used to guide our own behavior. Wittgenstein’s notion of an express connection between perception and behavior offers an alternative to the view of perception as functioning primarily to give us information about the external environment. He appears to be claiming that understanding and comprehension of the behavior of others are only means by which we act effectively, and do not constitute the basic function of perception. Wittgenstein seems to be hinting at this in the following excerpt:
It comes to this: only of a living human being and what resembles (behaves like) a living human being can one say: it has sensations; it sees; is blind; is deaf; is conscious or unconscious. (Wittgenstein, 1958, §281)
Social perception leads directly to social behavior. The tendency to mimic reveals an uninterrupted link between what we see and the behavior mimicry that corresponds to it. As a result, we often do what we see others doing. This suggests that mimicry is an automatic reaction to the expressions of interaction partners.
As mimicry is the direct consequence of perception, we do not require additional mental processes or private experiences to engage in it. No introspection is required, nor a conscious decision. We just do it. In facial mimicry, for example, we do not typically compare the facial expressions we mimic with the sensations of our facial musculature and decide that they match. Nor do we need to monitor or check the precise disposition of our features in such circumstances. Think how we engage in facial mimicry without seeing one’s own face in a mirror (Wittgenstein, 1958, §285). The difference between a friendly smile and a cruel smile, a wry smile or an ironic smile may be no more than a minute difference (a thousandth of an inch) in the orientation of the facial features, but we perceive it automatically, which also means that we can mimic these expressions without awareness, intent, or conscious control. The behavioral mimicry that corresponds to what we see is not the result of subjecting subtle degrees of behavioral difference to mental calculations. There is no act or process of ascertaining facial dimensions prior to facial mimicry of an expression. According to Wittgenstein, we simply react differently to such different facial expressions, and we would not explain our different descriptions of facial expressions or our mimicry of them by reference to measurement (Wittgenstein, 1958, §285). Just consider what it is like to respond to a broadly smiling infant, for here is an instance of the immediacy of what is called ‘natural reactions of persons to persons’ (Hamlyn, 1974). Wittgenstein writes:
One may also say: ‘He made this face’ or ‘His face altered like this’, imitating it – and again one can’t describe it in any other way’. (Wittgenstein, 1980a, §920)
In sum, Wittgenstein acknowledges that observers mimic behavioral displays. Adaptive perception is in the service of functional behavioral responding to the environment, and mimicry is an automatic response of persons to persons.
3 The absence of mimicry and counter-mimicry
Our next task is to fill out the basic account described above. For it seems that mimicry may not always occur. In other cases, counter-mimicry may result. If correct, the absence of mimicry and counter-mimicry suggests that the tendency to mimic is somewhat less automatic and reflex-like than otherwise thought. In fact, Wittgenstein anticipated these possibilities. He imagines a face incapable of making gradual and subtle movements, and which had a limited number of facial expressions. When it altered, it would snap straight from one expression to another. He asks: ‘Would this fixed smile really be a smile? I might not be able to react as I do to a smile. Maybe it would not make me smile myself’ (Wittgenstein, 1980b, §614). This suggests that facial mimicry and mimicry in general is not obligatory, and can be inhibited. Wittgenstein may support a conception of facial mimicry as ‘default social behavior’: we automatically mimic, as long as other considerations do not have a reason to intervene. For example, ‘a person who had seen only one facial expression couldn’t have the concept ‘facial expression’. ‘Facial expression’ exists only within a play of features’ (Wittgenstein, 1992, §766). This means that a person who had only seen ‘happy’ faces could not mimic them as happy.
Wittgenstein also thinks that the nature of a judgment task may influence the expression or absence of facial mimicry. He hints that facial reactions to facial expressions may be either affective or cognitive. If we were to meet people who randomly mixed up posed and spontaneous emotional facial expressions, it is conceivable that ‘we should not know where we were within them’ (Wittgenstein, 1992, §201). And, if we had to decide whether an emotional facial expression was posed or spontaneous, a cognitive response such as ‘I have no idea what is going on inside of them’ may well inhibit facial mimicry. By contrast, an affective judgment regarding what we see will likely activate automatic facial mimicry. The suggested reason is that mimicry involves an affective response to what we perceive. Imitating the expressions of others indicates affiliation and personal relatedness towards the embodied individual whose expressions they are. Does Wittgenstein therefore imply that facial mimicry is related to affiliation? That is, does facial mimicry lead to feelings of closeness and rapport, and make social interactions smoother and more harmonious? We answer in the affirmative, and propose below that Wittgenstein holds that mimicking the behavior of others ‘bonds’ people together.
4 Mimicry, rapport and interpersonal closeness
The sense of psychological connection members of a form of life feel allows them to live in harmony and accomplish shared practices and activities. Behaviors that facilitate and maintain bonds between life-members are therefore extremely important. Individuals who tend to mimic their peers likely experience this psychological connection, and therefore would be likely to continue to engage in a shared form of life with the others.
The following excerpt suggests that Wittgenstein sees facial mimicry as a means to communicate rapport with another. He writes: ‘for a child to perceive a smile as a smile is for the child to be drawn into a quality of relatedness to the smiling person, such that the child is inclined to smile…’ (Wittgenstein, 1980a, §766) In facial mimicry, what is expressed through the other’s face becomes a component of the mimicking observer’s own affective state. This may explain why smiles are not perceived as mere facial contortions: in mimicking the expressions of another, we apply a kind of perception that means we have an affective response to what we see. Indeed, a person could not acquire the concept of ‘smile’ unless he could be affected by and engaged with a smiling person. Wittgenstein writes: ‘My relation to the appearance [of facial expressions] here is part of my concept’ (Wittgenstein, 1980b, §617). Hamlyn (1974) endorses this theme in claiming that we could not know what a person is, unless we felt a sense of psychological connection with others.
Imagine individuals engaged in a task with a confederate who either mimicked their facial expressions or had mechanical, fixed facial displays that ‘would snap straight from one to another’ (Wittgenstein, 1980b, §614). We may well assume that those who were not mimicked feeling alienated and thinking ‘I have no idea what is going on inside of him’, or even ‘I am not sure he likes me’. By contrast, individuals who were mimicked will likely see the interaction as having been smooth and harmonious and they may even like the confederate more. It appears therefore that Wittgenstein may be credited with the view of mimicry as a manifestation of personal relatedness towards the subject of the feelings.
As we will see in the next section, situational factors that create a desire to affiliate such as the condition of congenital facial paralysis may stimulate more mimicry. Individual differences in the desire to affiliate may also influence behavioral mimicry and contribute to rapport and interpersonal relatedness. For example, empathic individuals who are able to perceive and adopt the perspectives of others as perspectives, both different from and coordinated with one’s own, may mimic people more than people low in empathy. The ability to take the perspectives of others activates mimicry, suggesting that individuals who are able to affiliate with another person or groups of persons because of their ability to assimilate the state of someone else also can employ mimicry behavior. A person unable to mimic the facial displays of others would likely have a reduced capacity to share or otherwise coordinate perspectives with others.
Support for these claims comes from a paper by Hampshire (1976) who develops Wittgenstein’s ideas. He notes that ‘the primitive faculty of imitation’ creates social coordination through affiliation between interaction partners, or as he expresses it, ‘a necessary background to the communication of feeling’ (Hampshire, 1976, p.73). He goes on:
In direct dealings with men, outside the context of fiction, we perceive, and react to, the physiognomy of persons almost as immediately as to the full behavior of which the facial expression is the residue…Because of the connecting arch of expression, we cannot truthfully say, as many philosophers have implied, that we perceive only the behavior of others, if behavior is interpreted as that which is described in terms of effective actions performed and in socially recognized routines. We perceive also that kind of residual, shadow behavior which constitutes an expression. And we can show that we have perceived it by adopting the same expression in imitation, without trying to reproduce, item by item, the physical features of the face or posture of another (Hampshire, 1976, 78-79).
We speculate that rapport and interpersonal closeness may stimulate a person to mimic more. This is a possibility that would allow members to be successful with the interactions. An individual mimics to create rapport and be included in the form of life. The ‘quality of relatedness’ that develops between life members then extends the circle, as it causes life members to continue to mimic each other, which creates more rapport.
5 Mimicry and congenital facial paralysis
We have been proposing that Wittgenstein’s remarks reviewed above are consistent with the claim that one reason people mimic others is that this mimicry has some adaptive value. To the extent that an individual shares practices and activities with other people, and engages in behavior that facilitates this goal, that person will be included in the form of life. The inability to mimic the expressions of others caused by the loss of facial expression may therefore result in a partial failure to engage in a form of life shared with others. The flaccid facial skin and expressionless face characterizing Möbius Syndrome, a condition of congenital facial paralysis, makes an individual appear dissimilar to interaction partners and therefore may diminish the psychological connection with others, especially unknown others (Briegel, 2003). These limitations are partial rather than absolute, however, and people with Möbius may yet maintain social coordination through their other channels of expression; through prosody of voice, gesture, enriched vocabulary, and so on.
5.1 Möbius Syndrome and ‘private’ language
How do words refer to sensations? Here is one possibility: words are connected with the primitive, the natural, expressions of the sensation and used in their place. (Wittgenstein, 1958, §244)
But suppose I didn’t have any natural expression for the sensation, but only had the sensation? And now I simply associate names with sensations and use these names in descriptions. (Wittgenstein, 1958, §256)
In his remarks on the possibility of a ‘private’ language, Wittgenstein imagines a language in which the sensation-words are not connected with sensations as partial substitutes for natural expressions of sensations, as they are in our ordinary languages (Wittgenstein, 1958, §244). Experiences here are conceived to lack any manifestation in behavior, and so the names of experiences are not linked to displays such as facial expressions or behavioral mimicry. In the absence of a connection with facial-behavior, what links name and experience? Cole (2000) describes a woman with congenital facial paralysis who, like the ‘private’ linguist just described, is unable to link words with experiences as substitutes for facial expressions. In her job as a care-worker she had experienced some prejudice from elderly patients, but she successfully surmounted it. He writes:
Her use of body language and intonation in speech had essentially overcome these problems. When she had taken her wedding photographs round to friends they had teased her for not smiling. She had to tell them that she never smiled – her friends had not noticed her lack of facial movement in smiling because she communicated her happiness through other channels. (Cole, 2000, p.253)
Some people with congenital facial paralysis may overcome their loss by linking words and experiences with other expressive-behaviors. These other expressions in turn may be used as behavioral mimicry and could succeed in creating an interpersonal connection with others (Cole, 2001). Indeed, situations where there is a desire to affiliate activate the tendency to mimic the behavior of interaction partners (Lakin & Chartrand, 2003). Consequently, we would expect to see behavioral mimicry in an individual with congenital facial paralysis who is stimulated by the condition to affiliate with others.
There may be evidence showing that the ability to produce facial expressions is not a necessary prerequisite of their recognition. In one study of facial expression recognition by three people with congenital facial paralysis (Calder, A. J. et al., 2000), participants were asked to identify the emotion displayed in 10 examples of facial expressions associated with each of 6 basic emotions selected from the ‘Pictures of Facial Affect’ (Ekman and Friesen, 1976). In a second test computer-morphed facial expressions were used. Even when perceptual impairments were found, people with facial paralysis still perceived many of the facial expressions shown to them. This may suggest that the ability to produce facial expressions is not a necessary prerequisite of their perception.
A difficulty with this study is the employment of prototypical, high intensity, still photographs as stimulus material. Such stimuli may in fact activate an automatic reaction due to their extremity that is not found for weaker non-prototypical expressions. And there is no evidence showing that this primitive response is inhibited in people with congenital facial paralysis. Using expressions that are not chosen according to their correspondence to an emotion stereotype is therefore an important consideration. To enhance ecological validity in studies of facial expression recognition in people with facial paralysis, dynamic facial expressions should be chosen. Like the drawing of an upside-down face, a static face may make it difficult to see clearly what expression the face expresses. Wittgenstein writes:
Hold the drawing of a face upside-down and you can’t tell the expression of the face. Perhaps you can see that it is smiling, but you won’t be able to say what sort of a smile it is. You wouldn’t be able to imitate the smile or describe its character more exactly.
And yet the upside-down picture may represent the object extremely accurately. (Wittgenstein, 1980a, §991)
A facial expression that was completely fixed couldn’t be a friendly one. Variability and irregularity are essential to a friendly expression. Irregularity is part of its physiognomy.
The importance we attach to the subtle shades of behavior. (Wittgenstein, 1980b, §§615-616)
Some people with Möbius Syndrome may reveal perspective taking and rapport through their other channels of expression: gesture, prosody of voice, enriched vocabulary, and so on. Other people with congenital facial paralysis, however, may rely on more introspective means to understand and communicate their experiences. Wittgenstein mentions the possibility of an associative link between language and experience: ‘I simply associate names with sensations and use these names in descriptions’ (Wittgenstein, 1958, §256). There is qualitative evidence that some adults with Möbius form an associative connection between language and experience to compensate for the lack of facial mobility. James, an adult male with Möbius, said in an interview:
Of course since I have never been able to move the face, I’ve never associated movement of the face with feeling of an emotion. When there are things which are sad I tell the person that I feel sorry for you but that I am thinking that rather than feeling it. (Cole, 2000, p.255)
When asked about first meeting his future wife, James replied:
I think initially was I thinking I was in love with her. It was some time later when I realized that I really felt in love. I do think I get trapped in my mind or my head. I sort of think happy or I think sad, not really saying or recognizing actually feeling happy or feeling sad. Perhaps I have had a difficulty in recognizing that which I’m putting a name to is not a thought at all but it is a feeling, maybe I have to intellectualize mood. I have to say this thought is a happy thought and therefore I am happy. (Cole, 2000, p.254)
Some adults with Möbius may consequently experience sensations and feelings quite differently from the others in whose language names of experiences are connected with behavioral expressions, and even from those with congenital facial paralysis who can overcome the loss of psychological connection with others. These individuals may have a reduced capacity for communicating experiences and creating rapport with interaction partners. James added:
I think also that I have a fear of being out of control with emotions, feeling something that I can’t manage. I have also found it very difficult to communicate feelings throughout my life, whether as a child with my wife, though I think I am getting better at it now. I don’t really know how I communicate happiness or sadness. That’s a very hard question. Some people cry when they’re sad. I don’t think I cry. I sometimes felt that I would like to be able to cry but, you see, I am not really able to cry, my tears can come but there’s nothing else. My tears only flow when I eat. I am afraid of such feelings. I try and shut them off. (Cole, 2000, pp.254-255)
5.2 Möbius Syndrome and emotion recognition
Suppose someone had always seen faces with only one expression, say a smile. And now, for the first time, he sees a face changing its expression. Couldn’t we say he hadn’t noticed a facial expression until now? Not until the change took place was the expression meaningful; earlier it was simply part of the anatomy of the face. (Wittgenstein, 1980b, §356)
The blank and expressionless face of congenital facial paralysis appears to be part of the ‘anatomy of the face’, and is not to be taken by itself as a meaningful facial expression. A completely static face would not be an expressive face (Wittgenstein, 1980b, §614). Suppose, however, that a face paralyzed from birth alters for the first time, and smiles. Maybe the face smiles in response to the facial expression of an interaction partner. Or, the face smiles when given the command to do so. In any event, could the statement ‘Make a happy face, and you will feel happy’ be true in this exceptional case?
Think of children with congenital facial paralysis who receive muscle transplants to improve lip movement (Goldman et al. 2003). Suppose a child reports following surgery ‘Now I feel much better: the feeling in my facial muscles and round about the corners of my mouth is good’ (Wittgenstein, 1980a, §454). This statement may be taken by the child’s surgeon as communicating something highly meaningful since it implies the success of the procedure and postoperative rehabilitation. Certainly, it would sound strange under normal circumstances because when talking about myself feeling better I do not intend to talk about what it looks like to feel better. I would be treating myself as if I were a different person. Normally, this is not possible in talking to others, but makes sense in the child who receives a facial muscle transplant. For the procedure is one way to make the child appear similar to others and therefore create a psychological connection. The child may now mimic the facial expressions of others which would make social interactions smoother and more harmonious. These experiences may transform the child’s fragile sense of self. In this case, it would really be as if the child were another person.
Wittgenstein writes:
And how does it come about that … I have a feeling of joy if I merely make a joyful face; a feeling of sadness, if I make a sad one? That, therefore, I can produce these feelings by imitating their expression? Does that show that muscular sensations are sadness, or part of sadness? (Wittgenstein, 1980a, §451)
Wittgenstein’s last question in this remark asks whether there is a conceptual or empirical link between statements of emotions and statements of expressions of emotions. He continues on:
Suppose someone were to say: ‘Raise your arm, and you will feel that you are raising your arm.’ Is that an empirical proposition? And it is one if it is said: ‘Make a sad face, and you will feel sad’? (Wittgenstein, 1980a, §452)
Let us briefly investigate these questions. Is ‘Raise your arm, and you will feel that you are raising your arm’ an empirical statement? This statement can be false in situations where a person is intoxicated by a drug which deadens his limbs, so that he feels nothing. This suggests that it is an empirical statement. By contrast, it will be false only in exceptional situations, whereas typically we feel sure that the feeling that one is raising one’s arm is simply part of raising one’s arm. Finally, it seems unlike what we may wish to call a conceptual truth or analytic statement.
Now, is the same true of the statement ‘Make a sad face, and you will feel sad’? When we mimic intense or prototypical facial expressions of sadness we do not normally observe ourselves to find out how it feels to be sad. Such displays may activate a reflex-like response due to their extremity that may not be found for less extreme expressions. It seems possible in the mimicry of less prototypical or weaker facial displays that we may observe ourselves, trace our feelings, and even compare them with the emotion that causes these changes in us (cf. Wittgenstein, 1958, §§585-588; 1980b, §§156; 722). In such a situation an observer may recognize he is imitating a sad face and literally feels that he is sad. This suggests that the mimicking observers may use their own muscular sensations and feelings as a means to recognize the interaction partner’s emotional state where the emotion displays are relatively weak and non-prototypical.
Wittgenstein himself does not settle the problem of whether there is a conceptual or empirical link between statements of emotions and statements of expressions of emotions, but he does cast doubt on the claim that muscular sensations or affective states are to be included as elements of our emotions. He argues:
Now granted – although it is extremely doubtful – that the muscular feeling of a smile is a constituent part of feeling glad; – where are the other components? Well, in the breast and belly etc.! – But do you really feel them, or do you merely conclude that they must be there? Are you really conscious of these localized feelings? – And if not – why are they supposed to be there at all? Why are you supposed to mean them, when you say you feel happy? Something that could only be accompanied through an act of looking – that’s at any rate not what you meant.
For ‘sorrow’, ‘joy’ etc. just are not used like that. (Wittgenstein, 1980a, §§456-457)
Our words for emotions like sorrow, joy, and so on, are used for affective states which we do not need to find out about. And whatever is part of these emotions is something we automatically perceive, not through making an introspective effort or an inference. Some of Wittgenstein’s remarks on facial mimicry and emotional contagion may employ prototypical, high intensity expressions as primary material, whereas we have argued that the mimicking observers of subtle or weaker facial expressions may use their own muscular sensations and feelings as a means to recognize the interaction partner’s emotional state. Hence, the question of whether individuals mimic the type of expression they perceive in everyday life deserves further investigation.
5.3 Ostracism
Partial or complete ostracism from a form of life is one of the most psychologically damaging experiences that an individual can endure (Williams, 2001). It is possible that being ostracized from a form of life would be a strong contextual factor that would stimulate the tendency to mimic the behaviors of an interaction partner. The inability to mimic through loss of facial expression may therefore place a person at an even greater risk of being ostracized by unknown others. Cole (2001) interviewed a person with congenital facial paralysis who described the ‘daily horror of walking down the street, not knowing if people would say hello to him or not and not knowing how to respond’. The relationship between facial mimicry and affiliation may heighten the fear of rejection in some people with Möbius. Creating rapport and interpersonal closeness with others involves a risk so great to the sense of self that some individuals avoid relationships with others and retreat into themselves. James reported:
I have a notion which has stayed with me over much of my life – that it is possible to live in your head, entirely in your head. Whether that came out of my facial problem I don’t know. I was very introspective. I divided people into two categories: those who didn’t want to have anything to do with me for various reasons and those who did. (Cole, 2000, p. 254)
I had feelings of low self-esteem and loneliness and isolation in company. It is only very recently that the whole area of non-verbal communication has even come to my attention. I know now that since I put out a reduced range of signals I receive back a similarly reduced range. (Cole, 2000, p. 254)
6 A final note
In this paper, we have highlighted what mimicry is and indicated its adaptive significance in Wittgenstein’s thought. We also suggested that Wittgenstein relates mimicry to affiliation, and that mimicking the behaviors of others encourages inclusion in a form of life and maintains harmonious relationships with other life-members. Individual differences in the desire to affiliate may influence behavioral mimicry and contribute to rapport and interpersonal relatedness with others in the form of life. Empathic individuals who adopt the perspectives of others as perspectives may mimic people more than people low in empathy. The inability to mimic through congenital loss of facial expression may lead to an avoidance orientation in some individuals, and intrapersonal disorientation. Situational factors that create a desire to affiliate such as Möbius Syndrome may stimulate more mimicry through remaining channels of expression. This suggests that people with congenital facial paralysis may mimic others through expressive-behaviors such as prosody of voice and gesture.
References
1. Briegel, W. 2006. Neuropsychiatric findings of Möbius sequence – a review. Clinical Genetics 70(2), 91-97.
2. Calder, A.J., Keane, J., Cole, J., Campbell, R., and Young, A.W. 2000. facial expression recognition by people with Möbius syndrome. Cognitive Neuropsychology 17(1-3), 73-87.
3. Cole, J. 1997. On ‘being faceless’: selfhood and facial embodiment. Journal of Consciousness Studies 4(5-6), 467-484.
4. Cole, J. 1999. About Face. MA: The MIT Press.
5. Cole, J. 2000. Living with difficulties of facial processing: some ontological conquences of clinical facial problems. Pragmatics & Cognition 8(1), 237-260.
6. Cole, J., Spalding, H. 2008. The Invisible Smile: living without facial expression. Oxford: Oxford University Press.
7. Ekman, P., and Friesen, W.V. 1976. Pictures of Facial Affect. Consulting Psychologists Press, Palo Alto, CA.
8. Goldberg, C., Delorie, R., Zuker, R.M., Manktelow, R.T. 2003. The Effects of Gracilis Muscle Transplantation on Speech in Children with Moebius Syndrome. The Journal of Craniofacial Surgery 14(5), 687-690.
9. Hamlyn, D.W. 1974. Person-perception and our understanding of others. In: T. Mischel (ed.), Understanding other persons. Basil Blackwell, Oxford, pp. 1-36.
10. Hampshire, S. 1976. Feeling and expression. In: J. Glover (ed.), The philosophy of mind. Oxford University Press, Oxford, pp, 73-83.
11. Hatfield, E., Cacioppo, J.T., & Rapson, R.L. 1994. Emotional Contagion. Cambridge: Cambridge University Press.
12. Hess, U., Blairy, S. 2001. Facial mimicry and emotional contagion to dynamic emotional facial expressions and their influence on decoding accuracy. International Journal of Psychphysiology 40(2), 129-141.
13. Hobson, R.P. 1993. Autism and the Development of Mind. Hillsdale, NJ: Erlbaum.
14. Lakin, J.L., Chartrand, T.L. 2003. Using nonconscious behavioral mimicry to create affiliation and rapport. Psychological Science 14(4), 334-339.
15. Meltzoff, A.N., Moore, M.K. 1977. Imitation of facial and manual gestures by human neonates. Science, 198, 75-78.
16. Partridge, J. 1990. Changing Faces. London: Penguin Books.
17. Williams, K.D. 2001. Ostracism: The power of silence. New York: Guilford Press.
18. Wittgenstein, L. 1958. Philosophical Investigations. ed. G.E.M. Anscombe and R.Rhees. tr. G.E.M. Anscombe, 2nd edition. Oxford: Blackwell.
19. Wittgenstein, L. 1967. Zettel. ed. G.E.M. Anscombe and G.H. von Wright, tr. G.E.M. Anscombe. Oxford: Blackwell.
20. Wittgenstein, L. 1992. Last Writings on the Philosophy of Psychology, Volume II, ed. G.H. von Wright and H. Nyman, tr. C.G. Luckhart and M.A.E. Aue. Oxford: Blackwell.
21. Wittgenstein, L. 1980a. Remarks on the Philosophy of Psychology, Volume I, ed. G.E.M. Anscombe and G.H. von Wright, tr. G.E.M. Anscombe. Oxford: Blackwell.
22. Wittgenstein, L. 1980b. Remarks on the Philosophy of Psychology, Volume II, ed. G.H. von Wright and H. Nyman, tr. C.G. Luckhart and M.A.E. Aue. Oxford: Blackwell.
23. Wittgenstein, L. 1992. Last Writings on the Philosophy of Psychology, Volume II, ed. G.H. von Wright and H. Nyman, tr. C.G. Luckhart and M.A.E. Aue. Oxford: Blackwell.
Appendix I. Services in Taiwan for people with facial paralysis
Sunshine Social Welfare Foundation in Taiwan (SSWFT)
Established in 1981, the mission of the SWWFT is to provide an extensive range of services for burn survivors and people with facial disfigurement; to assist them in their physical, psychological and social rehabilitation; to uphold their human rights and dignity.
http://www.sunshine.org.tw/english/Default.asp
Taiwan Foundation for Rare Diseases (TFRD)
Established in 1998, TFRD assists rare disease patients to receive proper medical treatment and rehabilitation, education, employment and long-term care. TFRD advocates the adoption of relevant legislation that ensures rare disease patients’ rights, encourages rare disease research, and is active in raising public awareness of rare diseases.
Hold the drawing of a face upside-down and you can’t tell the expression of the face. Perhaps you can see that it is smiling, but you won’t be able to say what sort of a smile it is. You wouldn’t be able to imitate the smile or describe its character more exactly.
And yet the upside-down picture may represent the object extremely accurately. (Wittgenstein, 1980a, §991)
In one study of facial expression recognition by three people with congenital facial paralysis (Calder, A. J. et al., 2000), participants were asked to identify the emotion displayed in 10 examples of facial expressions associated with each of 6 basic emotions selected from the ‘Pictures of Facial Affect’ (Ekman and Friesen, 1976). In a second test computer-morphed facial expressions were used. Even when perceptual impairments were found, people with facial paralysis still perceived many of the facial expressions shown to them. This may suggest that the ability to produce facial expressions is not a necessary prerequisite of their recognition.
A difficulty with this study is the employment of prototypical, high intensity, still photographs as stimulus material. As noted above, such stimuli may in fact activate an automatic reaction due to their extremity that is not found for weaker non-prototypical expressions. And there is no evidence showing that this primitive response is inhibited in people with congenital facial paralysis. Using expressions that are not chosen according to their correspondence to an emotion stereotype is therefore an important consideration. To enhance ecological validity in studies of facial expression recognition in people with facial paralysis, dynamic facial expressions should be chosen. Like the drawing of an upside-down face, a static face may make it difficult to see clearly what expression the face expresses. Wittgenstein writes:
A facial expression that was completely fixed couldn’t be a friendly one. Variability and irregularity are essential to a friendly expression. Irregularity is part of its physiognomy.
The importance we attach to the subtle shades of behavior. (Wittgenstein, 1980b, §§615-616)
References
Calder, A.J., Keane, J., Cole, J., Campbell, R., and Young, A.W. 2000. Facial expression recognition by people with mobius syndrome. Cognitive Neurospychology 17(1-3), 73-87.
By Angela Thompson, Illawarra Mercury, August 2, 2008
Leigh Scully and Baxter. Photo by SYLVIA LIBER
To the outside world, Baxter Scully looks like a serious boy, but it is not only his tender years that are stopping him from telling people how he is really feeling.
For the boy who cannot smile, misunderstanding is a danger every day, even for his own mother.
Baxter, of Cambewarra, was born with a mask-like face as a result of moebius syndrome – abnormally developed cranial nerves.
A clear-cut diagnosis has been difficult for Baxter’s parents to come by because, unlike other children with moebius syndrome, he has none of the other telltale signs such as hand and feet abnormalities, respiratory problems and weak upper body strength.
His mother Leigh Scully is grateful her son’s condition is confined to what doctors call bilateral facial paralysis, but she hopes scientists may one day unlock enough of the secrets of the human body to make Baxter’s condition history.
On Jeans for Genes Day, yesterday, it was a denim-only affair at the Scully household.
“Developmentally Dexter’s been doing all his milestones, but even when he’s laughing – he might be chuckling away at something – you wouldn’t know,” Mrs Scully said.
“His face would just go bright red and his jaw would drop but there was no change in facial expression.
“If Baxter goes on to have children, it could happen to his children.
“The more research the better.”
Entire article here.
Moebius Syndrome and pain: neurophenomenology and the ‘lived experience of impairment’.
Extended narrative first-person accounts of the pain-experience in male and female adults with Moebius with attention given to pain facial expression.
My interest is in shared awareness of pain grounded in empathy, and the extent to which facial expression is a mechanism of empathy and second-person consciousness of pain. Given that the experience of pain as a form of human interaction is partly facial and thus mutually reinforcing, what happens to a person in pain closed permanently to pain facial conversation? Is his pain not more intense? Or, cognitive? How do Moebians typically perceive the link between pain and the threat of danger? Does facial paralysis modify the experience of pain by shaping the magnitude of pain and hence the magnitude of suffering?
Science 11, May 2007
Frozen faces
The syndrome is named for Paul Julius Möbius, a German neurologist who published an early description of it in 1888. (He was also the grandson of August Ferdinand Möbius, the mathematician of Möbius strip fame.) According to a statement developed at the conference, the syndrome’s defining characteristics are facial weakness and impaired ability to move the eyes to the side – symptoms that are present at birth and don’t worsen with age. Researchers estimate that Möbius syndrome occurs in 1 of every 50,000 live births, affecting boys and girls equally often.
The core symptoms of Möbius syndrome point to defects in two cranial nerves: the abducens nerve, which innervates the lateral rectus muscles that rotate the eyes toward the side of the head; and the facial nerve, which innervates the muscles of the face. Yet, there doesn’t seem to be a single neuropathological signature of the disorder.
At the conference, George Padberg, a neurologist at the University Medical Center in Nijmegen, the Netherlands, described magnetic resonance imaging studies he and colleagues have done to visualize the nervous system in people with Möbius syndrome, as well as findings from electrophysiological tests of nerve function. This work has revealed a variety of defects. In some patients, the cranial nerves appear to be damaged or even missing. Others have abnormalities in the brainstem that include – and often extend beyond – the region where the abducens and facial nerves originate. Based on these and other findings, Padberg suspects that Möbius syndrome results from genetic miscues that derail the embryonic development of the brainstem.
But the search for the relevant genes has yielded little fruit so far. The rarity of the disorder, coupled with the fact that only about 2% of cases are inherited, makes it difficult to find a sufficient number of subjects for genetic linkage studies, says Ethylin Wang Jabs, a geneticist at Johns Hopkins University in Baltimore, Maryland. The complexity of the disorder and lack of precise diagnostic criteria have also complicated matters, Jabs says. Padberg’s group, for example, has published studies identifying regions of chromosome 3 and chromosome 10 as likely loci of genes related to inherited Möbius syndrome in two Dutch families, but other researchers point out that individuals in these families lack the eye-movement irregularities necessary to qualify as true cases of Möbius syndrome. (Padberg now agrees.)
Now that there’s a more precise definition of the disorder, the next step for finding Möbius genes, Jabs and others say, will be to create a central database in which researchers can share clinical and genetic data on Möbius patients. Jabs has started a database that now includes clinical data and/or DNA samples from 89 people with Möbius syndrome and more than 100 relatives, and other research teams have similar data.
Researchers are also looking to related disorders and mouse models of brain development for clues. At the conference, Elizabeth Engle, a pediatric neurologist at Children’s Hospital Boston, described her team’s research on several inherited neurological conditions that share symptoms with Möbius syndrome. Athabascan brainstem dysgenesis syndrome (ABDS), named for the Native American population in which it was first described in 2003, causes impaired lateral eye movements and sometimes facial weakness as well. Similar symptoms had been reported in mice lacking a gene called Hoxa1, one of a family of genes that guide embryonic development. People with ABDS inherit a truncated copy of the human version of the gene, HOXA1, Engle and colleagues reported in 2005 in Nature Genetics. It’s possible that spontaneous mutations in HOXA1 could be involved in Möbius syndrome, Engle says, but so far no one has looked. Jabs has been screening her Möbius patients for mutations in two other Hox genes, HOXB1 and HOXB2, based on findings of facial nerve abnormalities in mice lacking these genes. So far, however, nothing has turned up.
More here.
The difference between kinds of smile (e.g., a cruel smile, ironic smile, joyful smile) may be no more than a minute difference in the orientation of the facial features. The difference may reside in no more than a thousandth of an inch, but we recognize the difference, and not by measuring it. Moreover, we do not explain our different descriptions by reference to measurement.
We cringe when we hear of another’s fear, and grit our teeth when confronted with someone’s anger (motor mimicry). And we can reproduce such expressions without looking in the mirror, that is to say, without checking on the exact orientation of our features. It is a fact that human beings are extremely sensitive to the play of features on a human face. ‘We see emotion’ (RPP II 570).
A small quantitative difference can make a significant qualitative difference. I think here of Moebius Syndrome. People with Moebius are born without the 6th and 7th cranial nerves which innervate the facial muscles, and so they cannot make facial expressions. This leads to difficulties in communicating emotion on the face, and the ability to read it in others, altered understanding of character and selfhood, being less available to others, and a disturbed self-other balance.
Just as pain can get no foothold in the absence of behavior that expresses pain, the same applies to the emotional experiences of others which we observe in human behavior. Wittgenstein makes out a strong case for thinking that the intelligibility of psychological terms presupposes the possibility of behavioural manifestations. If I cannot make facial expressions, I am denied a mental life by almost every other person except those who know me exceptionally well, and I become less available to others, and therefore less available to myself. The transition ‘from quantity to quality’.
IMAGEWORKS PHOTOGRAPHY
From the Independent, May 13, 2008
Choosing a name for our second child was hard but we finally settled on the name Isaac, which we especially liked because it means “he laughs” in Hebrew, and every parent wants their child to be a smiley, happy person. Ironic that choice was to be – for Isaac will never smile, blink or even frown.
When I walked into hospital to have a caesarean (Isaac was in the breech position) little did we know what a journey we were about to begin. Surgery was uncomplicated, and our first few hours with Isaac were relaxed and beautiful. Me, my husband and our perfect baby son were left in peace for hours before being transferred to the ward. Isaac’s brother came to meet him a few hours later and, other than worrying about whether I would be able to see the last episode of Life on Mars that night, all seemed fine. That all changed as my favourite programme was about to start.
By 9pm that night, Isaac had still not fed properly and we started to be concerned. As he had still not fed sufficiently, every other hour we were woken to try to feed, and in between that time poor Isaac had a needle in his foot (eight times in total) to check glucose levels. When no amount of prompting could encourage him to feed, he was taken to special care at 3am and I was left alone, with no baby to cuddle, in a ward full of crying babies and feeding mothers. It took five days before we could go home and, even then, no one knew why he was having problems feeding.
The consultant paediatrician decided that Isaac should have some genetic tests to see if any specific problems could be identified. Investigations continued and we had two agonising weeks to wait to see what the tests revealed. We cried with relief when those tests came back negative. This relief was, however, short-lived. Although Isaac was feeding slightly better, I still instinctively felt something was wrong.
Entire article here.
Erin Horner (2) with her mother Dawn Maitland
From the Belfast Telegraph, April 11, 2008
A Belfast mum opened her heart today about her toddler daughter’s extremely rare syndrome – which means she has never been able to smile.
Dawn Maitland is still waiting to enjoy that treasured first smile from her two-year-old, Erin Horner, who suffers from Moebius Syndrome.
The rare condition has left the Belvoir tot with facial paralysis which means she cannot smile, squint, frown or move her eyes from side-to-side.
Dawn (36) spoke out about her daughter’s case to the Belfast Telegraph in a bid to raise awareness of the little-known syndrome. She believes there are only three known cases in Northern Ireland.
Erin was just three weeks old when she was diagnosed with Moebius Syndrome. Doctors’ concerns were first raised when she was born with a club foot and had problems sucking from a bottle, classic signs of the condition.
“Babies born with this condition can go on to lead relatively normal lives – some of them just hit their milestones a little bit later than normal,” said the former civil servant.
“Erin does have a slight bit of movement in her face so I can tell from her eyes when she is smiling inside.
“Her eyes can’t move from left to right and she can’t squint which makes life difficult for her. She always has to wear a hat and sunglasses when she’s outside on bright days. She can’t protect herself, say, when the wind is blowing dust into her eyes. She can’t squint or blink like the rest of us would to stop things getting into our eyes.
“I can tell when she happy because her face changes slightly and she makes happy little noises – but I’m still waiting for that first smile.”
Entire article here.
The pediatric neurologist comes to see you in your hospital room after the birth of your baby . You know something is wrong — your baby doesn’t suck — he’s losing weight — he can’t breast feed — he takes two hours to get two ounces of milk from a bottle. But you’re not prepared for this. The neurologist says it is Moebius Syndrome. Your baby will never smile, never have facial expression, never blink his eyes, never move his eyes laterally. Your baby is sentenced to a life with no SMILE. Imagine the shock. You’ve heard of lots of birth defects, you pray during your pregnancy your baby won’t be one of the statistics, but here he is — with a syndrome so rare no one you talk to ever heard of it — or ever met anyone else with it.You spend the first few months of the baby’s life trying to keep him alive. If you’re one of the lucky ones, you can make the bottle hole big and hold his lips together with your hands to force milk down him, hoping he doesn’t choke. If you’re not one of the lucky ones, you feed your baby via a gastric tube through the nose, or worse yet a G tube. It takes months for him to get enough muscle strength to hold his head up alone. Even more months for him to turn over and eventually begin to go the “army crawl.” More months or years, for him to walk.
Through all you wonder how many other parents and children are going through this. You sneek peaks at your baby all day long, hoping to catch his first smile. It never comes. Slowly, you realize it never will. You wonder how other children, other adults, will treat him. You begin a search for other families affected by this rare occurrence. When you finally find the wonderful organizations like About Face, Faces, Forward Face, Let’s Face It, NORD, and publications like the Forward Face Newsletter, you realize you’re not alone . . . your baby is not alone. You revel in the ability to communicate with other parents whose children cannot stand the sun because they can not blink, nor squint to keep the light out of their eyes. You discover that most Moebius children have swallowing problems, malformed tongues and weak muscle tone. You also realize that some Moebius children have it much worse.
Some Moebius children have missing limbs, fingers, toes, or webbed fingers and/or toes. Some Moebius children have club feed, or small limbs. Some Moebius children don’t walk until they are 4-5 years old, if at all. Some Moebius children have respiratory problems or hearing problems.
All Moebius children have one thing in common, they do not have the 6th and 7th cranial nerves. The nerves to the face which control facial expression and allow one to blink and move the eyes laterally.
Entire article here.
Wittgenstein Light: Real Refreshment 
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