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Fake it till you Make It: Can Smiling Improve Mental State?

Allison Nelson

October 24, 2008




Depression is the most prominent mental health issue in society today.  There are a host of “treatment” suggestions that flood the media and internet.  One such treatment is humor, which focuses on increasing laughter and smiling.  Smiling is a painless and free treatment, but can these simple motor movements be enough to have an effect on mental health?  Recent studies suggest that smiling does have a measurable influence on emotion, but the influence does not seem large enough to permanently alter mental state.  Evidence more strongly suggests short term emotional benefits.


The Claims:

Some psychologists and sites on the internet declare that the act of smiling is the key to a positive outlook on life.  Cliff Kuhn, M.D claims that “the natural medicine of humor” is enough to help alleviate sever anxiety and depression.  This approach to treating mental illness involves implementing humor into all social and professional aspects of life to increase laughter and smiling.  The treatment is called “Fun Factor Rx.”  There is a list of commandments that are meant to increase humor in daily activities.  Patients must purchase a book on the internet to learn the course of the treatment.  Dr. Kuhn has a set of 5 books to help implement humor in all aspects of life.   Dr Kuhn claims, “Within our personal chemistry we carry a medicine that reduces stress and prevents depression even more effectively than any pill.” (


In this treatment, smiling is effective by changing your psychological and physiological state.  The only biological mechanism that is mentioned is an increase in endorphins.  One of Kuhn’s articles said that they have measured improved immunity, increased tolerance for pain and frustration, and higher levels of creativity - even from a "fake" smile.  There are no references to studies or how they measured improvement in mental state.  The only evidence for the theory is testimonials.


The website does include a list of ways to increase smiling ( ):

 Stretch your smile muscles each morning while you brush your teeth - all athletes know that warming muscles up is the key to getting maximum use from them

 Practice saying everything with a smile, like Gary Cooper told the bad guy in The Virginian

 Surround yourself with as many personal props or cues that stimulate your thoughts to smile

Develop an internal "smile file" of images and thoughts which you can recall at any time, regardless of your circumstances

 Use my Fun Factor prescription to amplify your current depression treatment and you'll soon find yourself having to remember to stop smiling


To learn the rest of the techniques, you must buy the books.  All of the information on the site supports Dr Kuhn’s hypothesis.  The facts seem bias and are lacking substantial evidence.  The purpose of the articles, testimonials, and websites is to encourage the viewer to buy his book.


Dr. Mark Stibich has written several articles about the positive health effects of smiling.  He says that smiling stimulates the immune system, increases positive affect, lowers stress, and lowers blood pressure.  Duchene smiles are the only type of smile that induces this effect.  These smiles involve muscles in the mouth, cheeks, and eyes, and are considered real smiles ( 

Scientific Response:

The facial feedback response theory dates back to Darwin in 1895. It states that “facial expressions provide feedback to the expresser that is either necessary or sufficient to affect emotional experience.”(2). He believed that facial expression intensified emotion, and the suppression of facial expression lessened emotional response.  The theory was relatively untested until the 1980 when studying nonverbal communication became popular.  There have been many studies directly examining the effect of facial expression on emotion since this time.  These studies show heated debates between researchers



In 1985, R B Zajonc was interested in revisiting Darwin’s theory. In relation to mental health and facial expression, he said that emotion can be influenced by temperature of the blood.  The temperature in the brain causes different neurotransmitter release.  Facial expression can change the temperature of the blood going to the brain.  So by controlling expression, emotion is influenced (4).  Yoga and meditation are based on this idea. He does not know if voluntary facial expression evokes the same change in blood temperature as spontaneous expression.


Lairde’s (1984) review of facial feedback sites 16 studies that confirm hypothesis.  Then he agues against 1 that undermines the hypothesis (1).  He argues that there is a connection between facial feedback and hunger, self-evaluation, and attitude change.  There were two experimental methods used. The first was muscle by muscle manipulation.  Subjects were asked to contract specific muscles in their face that gave specific expressions.  The other was to exaggerate facial expressions when an emotion was induced.  The measure of emotion was self report and heart-rate and skin conductance. Trials that do not support the hypothesis generally are a result of subjects discovering the motive of the experiment.  In well designed studies the subjects were mislead to another assumption about the study.  He concluded that “facial feedback does occur and, in fact, is a major component of normal emotional processes” (1).


A study at Berkley evaluated smiles and life satisfaction.  Women that had Duchene smiles in their year book pictures were more likely to be married and have higher well being than those with non Duchene smiles (   


David Matsumoto (1987) disagrees with these claims.  He reports that the self report technique is not accurate in that it does not account for subjects’ differing verbal explanations.  The methods of measuring do not allow for a measure of the magnitude of influence, so the feedback effect can only be proven to be very small to moderate.  In general, he believed the results were an overestimate.  He sites other effects as more important, such as Visceral/autonomic feedback (2).


Ross Buck also believes that there is not enough evidence for facial feedback. Humans have peripheral physiological clues such as a dry mouth for thirst, stomach growling for hunger, and a smile for happiness.  These clues are not necessary for the state, they just help alert the organism of their state.  So emotion is not caused by facial expression, expression just helps alert us how we are feeling. He concludes, “visceral feedback may make a more direct contribution to emotional processes than facial feedback does and that the "readout" functions of facial expressions are more important than any feedback functions”(3).



The assumption that smiling can improve mental health is unclear.  Experts argue about the significance facial feedback has in modulating emotion.  There does seem to be at least a small correlation across the board.  So smiling probably does not have the ability to cure sever anxiety or depression but it may have smaller transient effects on emotion. The good news is smiling can never hurt, so go ahead and try it out!




1  Laird, James D. The Real Role of Facial Response in the Esperience of Emotion: A Reply to tourangeau and Ellsworth, and Others. Journal of Personality and Social Psychology. 1984, Vol 47, No 4, 909-917.


2 Matsumoto, David. The role of facial response in the Experience of Emotion: More Methodological Problems and a Meta-Analysis. Journal of Personality ad Social Psychology. April 1987, vol 52, No4, 769-774. 



3 Buck, Ross. Nonverbal behavior and the Theory of Emotion: The Facial Feedback Hypothesis.  Journal of personality and the social psychology. 1980, Vol 38, No 5, 811-824.

4 R. B. Zajonc. Emotion and Facial Efference: a Theory Reclaimed.. Science, New Series, Vol. 228, No. 4695 (Apr. 5, 1985), pp. 15-21 Published by: American Association for the Advancement of Science Stable URL:




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