The Extraordinary Power of a Smile

The Extraordinary Power of a Smile article by Dr. Sam Goldstein

If a tree falls in the forest but no one is around to hear it, does it make a sound? If you smile behind your N95 are you really smiling? Neurologist Debashish Mridha writes “A smile has a magical power; it makes everyone smile back.” But what if you can’t see me smiling? My daughter, based on her experiences over the last two years at work and interacting with her eight-year-old’s classmates, claims she knows if they’re smiling, even behind a mask. She believes that the human connection we create with a smile is something much less tangible and much more complex than just seeing each other’s mouths. She’s points to the examples of her son’s fully-masked classmates delighting in an in-person class party, versus the despondent Zoom sessions when school was remote, but mask-less, as well as the way her colleagues interact completely naturally in masks, but so differently over Zoom. I agree with the challenges of Zoom based upon hundreds of such meetings I’ve had in the past two years but I’m not convinced smiling isn’t the essential component of facial expression. Maybe if we wear masks over our faces forever, we will evolve the ability to smile effectively with our eyes much the same as Kevin Costner grew gills in that future fantasy movie Water World. They never told us though how many generations it took for him to return to the sea from whence our ancestors came. I’m not prepared to be masked the rest of my life no matter what version of SARS happens to be in style.

But for now, smiling has been put on the back burner for safety. I get it. Virologists like Dr. Fauci and his clan care only about limiting the spread of the virus. I suspect their first recommendation was for everyone to stay home forever with the door nailed shut from the outside by the forces of good health. Even with the restrictions, we put in place, a new Johns Hopkins study suggests minimal benefit in slowing the spread of the virus nor its’ ability to mutate. Now two years later, more people will succumb to adversity because of our restrictions than to the virus itself. Just look at the studies coming out. As I have written in a previous article (click here) many more people then have died from COVID will succumb to non-virus-related illnesses because of unavailable treatments, alcoholism, murder, and suicide in the next five years. If the powers that be are so worried about our health, then why not ban tobacco (130,000 deaths from lung cancer in 2020), alcohol (95,000 deaths in 2020) or drug overdose of prescribed and non-prescribed drugs (at least 93,000 deaths in 2020) in the United States alone. The rates of mental illness, particularly among teens have reportedly doubled in the past two years. How free is free will? I will address this issue another time.

Back to smiling. It’s claimed that smiling is good for you in a number of ways. It can reduce stress, help heart health, lower blood pressure, and boost your immune system by decreasing cortisol (our chemical alarm system) in the body. A simple smile, genuine or even forced we’re told, prompts the brain to produce endorphins (the chemicals that relieve pain and stress) and serotonin (a neurotransmitter), causing positive emotions. But why? Primatologist Signe Preuschoft traces our smile back over 30 million years of evolution to a "fear grin" stemming from monkeys and apes. They used barely clenched teeth to portray to predators that they were harmless, or to signal submission to more dominant group members. Smiling is thought to increase mood-enhancing hormones while decreasing stress-enhancing hormones, including cortisol, and adrenaline. It also reduces overall blood pressure. And because you typically smile when you're happy, the muscles used may trigger your brain to produce more endorphins.

Newborns will often smile in their sleep. Sometimes a smile in the early weeks of life is simply a reflex. But starting between 6 and 8 weeks of life, babies develop a "social smile". This is an intentional gesture of warmth meant just for adults. But not just any adult. Babies are born with the muscles of their ears tuned to the frequency of female voices. They prefer to gaze at a female face. And their first smile is towards Mom. They instinctively know where their next meal is coming from. And in response to that smile a parent's brain reacts with a flurry of activity. The substantia nigra, the striatum and the emotional networks in the frontal lobes of our brain release the neurotransmitter dopamine. Dopamine raises our mood, focuses our attention and makes us feel good. Not only that, when babies make an authentic smile, the left frontal part of their brains is activated, the same part of the brain that is activated when adults experience happiness.

But, it’s not so simple. According to some sources, many people smile when they are sad or depressed. They might not even be aware of their depression or want to acknowledge their symptoms due to a fear of being considered “weak.” The hallmark of Smiling Depression is sadness. The smile and external façade, is a defense mechanism, an attempt to hide their true feelings. According to NAMI Smiling Depression involves appearing happy to others and smiling through the pain, keeping inner turmoil hidden. It’s a major depressive disorder with atypical symptoms, and as a result, many don’t know they’re depressed or don’t seek help. People with Smiling Depression are often partnered or married, employed, are quite accomplished and educated.

Certainly, we can take this smiling thing a bit too far. China is embracing facial payment technology, which allows consumers to purchase goods simply by posing in front of point-of-sale (POS) machines equipped with cameras and smiling after linking an image of their face to a digital payment system or bank account. In fact, in 1972 researcher James Reisenger paid a very depressed, hospitalized female to smile when she passed others and took payment away if she failed to do so. At the conclusion of this study Reisenger wrote “The most reliable indicator of post-treatment effectiveness was that within the 14 months after discharge there was no recommendation for rehospitalization and no referral for additional treatment. As the patient has continued to function in the community, it can be assumed that the depressive behavior remains stabilized at a low rate.” Hmm. Why don’t we all know this? Because it would be another fifteen years before Prozac revolutionized treatment for depression and convinced us that the path to treating mental illness lies in your neurotransmitters. So where does this leave us?

More smiling means more happiness. In masking our children and ourselves we have (maybe) slowed the spread of a virus at the expense of our happiness and mental health. Some studies show the act of smiling changes the way we perceive the world. “Pretend you are happy, and you will feel happy, pretend that you are angry, and you will feel angry,” writes one scientist. And when our perception changes, maybe, just maybe, our responses to others also change. Perhaps when we protect (or hide) our faces behind masks we sacrifice one of the fundamental phenomena of what it means to be human. Masking an entire society is a grand experiment, diving head in without a pilot study or control group. I’m still not convinced even the smartest among us understand and appreciate the consequences of this act.

Mother Theresa wrote that “Peace begins with a smile”. And Christie Brinkley, of all people, wrote “Share your smile with the world, it’s the symbol of friendship and peace”. Could it be that simple? If Xi, Putin and Biden take off their masks will the world as we know it survive? If Pelosi, Schumer, Jordan and Paul cuddle babies as they debate can we avert the total meltdown of the American way of life? I doubt it, but at least it would be a rational start.

Before you judge me a “one trick pony”, I understand the mental health challenges we face will not be solved with a smile. So, for what it’s worth here’s my suggestion. If you believe that you must wear a mask by all means wear it. When you greet someone, stop a few feet away, pull down your mask, and smile. Finally, at the risk of drawing the ire of the virologists and their disciples, I will opine that the educational and mental health risks of wearing masks for children and teens in school far outweigh the risk of they and their teachers becoming seriously, medically ill. It’s time to take off their masks and get on with the arduous task of trying to raise the next generation in the chaotic world we have created for them. So, smile, maybe even a hug once in a while, and the world will smile with you, but only if they can see you. ◆