Psychiatry & Psychotherapy Podcast - Using Microexpressions To Improve Empathy, Therapeutic Alliance & Emotional Intelligence (Therapeutic Alliance Series Part 8)

Episode Date: June 14, 2021

In this episode, I am going to build on the therapeutic alliance series to express my thoughts on how understanding emotion, specifically microexpressions, can better help you make connections with your clients. The research is amazing; there are thousands of articles on the subject. I thought I would share a bit about the evolution of my interest in emotion and microexpression in this episode and how I translated it from the forensic world into a psychotherapy setting. By listening to this episode, you can earn 0.75 Psychiatry CME Credits. Link to blog. Link to YouTube video.

Hello and welcome to the Psychiatry and Psychotherapy Podcast. I'm here to talk about getting rid of burnout, increasing job satisfaction, and feeling like an expert in what you do. One thing that created a lot of burnout and angst for me was trying to get continued medical education right at the last minute. So why not join the CME membership and do CMEE while listening to this podcast. Go to Psychiatrypodcast.com, sign up, sign in, take the test, and the certification is email to you in seconds. All right, welcome back to the podcast. In this episode, I'm going to be taking you through some of the basics of microexpression, the journey that I had, a discussion on how it can improve your connection. And then I'm going to end, and I really hope that you get it, I hope you get through to this part. I'm going to end with a prolonged case story of how I might use this with someone with binge eating disorder or someone who recently had a bunch of binges and how I might use the emotion that's flashing on their face to, to increase connection, to decrease shame, to help them through the conflict. I hope it's therapeutic, just listening to it. I am with this episode launching a new sort of online training that you can purchase on EmotionConnection.com, not emotional, not emotions, no, emotionconnection.com.

And I've been waiting to release this for around eight years. So this is really exciting. this is a manifestation of a lot of hard work of teaching many years, resonance, psychotherapy, of doing some research on this topic, of creating an app, and looking through hundreds of different small clips of emotion. So I'm going to be going through my process that I went through to create this and to understand microexpression. I think it's a unique contribution I am bringing to the field. It definitely was informed by many people before me. like Paul Ekman, who does it more for forensic types of issues.

But bringing it to psychotherapy is something that I think I uniquely have done and will continue to do. And I hope that it helps you. So let's begin. For me, it's starting by watching the TV show lie to me. It was a TV show in which a person named Paul Ekman, who was a real person, who was sort of, you know, one of the early researches, microexpression. Well, this was the TV show. and sort of creating a character like him that solved different issues with, you know, the FBI and the police force and the cops and stuff like that using micro expressions. It's sensationalized.

It is, for me, very interesting to watch. And that kind of got me started. I subsequently read a book called Emotions Revealed, which was by Paul Ekman. It was on some of the science, summary of the science of the different emotions. And I started reading a lot of the core research beyond Paul Ekman and other authors who have, you know, written about this. From there, I also Googled a microexpression course, and I saw what was out there, and I started learning about microexpressions through these courses. The courses at the time were kind of built more for the sales and business industry and the, you know, and not really, there were a couple issues with them.

One was it was largely by actors. And so, you know, these emotions were basically put on the face through the manipulation of, you know, them trying to make the micro-expressions. And I think that this is why, actually, when I started making my initial iOS app, Emotion Connection, and I started looking at these emotions, it was actually kind of hard to see what was going

on. And so I really had to go back continually to the research. So as a result of that, I started to notice the flashes of emotion on people's faces during real life and patient encounters. And initially, it was kind of clunky. You know, it was kind of like, you know, I had this new knowledge. I was trying to understand it more. And it felt really clunky. subsequently I filmed a bunch of friends on my couch watching YouTube videos that I put together. I put together this 20-minute reel of YouTube videos and some probably from the dark web. I don't know. I had a medical student helping me out pick the videos.

And so we had these videos in a sequence and they were very jarring at times. They evoked a lot of emotion. And so I cut these, I put the... video of their face and the video of what they're watching together on my editing software, and I went through and cut little pieces of them, and I labeled them what they were watching, and then what emotion they were having. And a lot of the times, like, I would really struggle for like 10, 15 minutes trying to think through what emotion that they were having. And so from that, I developed an iOS app called Emotion Connection. It has about 70 of the easier

emotions on it. It was super cheap compared to anything out there. And it was kind of hard for some people to get into it, I think, because it didn't have a lot of the education. It didn't really explain what was going on, why what they were seeing was the emotion. So I think like it's, it was a pretty, you know, early beta version of what I have now on emotionconnection.com. So I put the project EmotionConnection.com on the back burner for several years. You know, life happens. You have kids. You know, you're busy.

And so in this season, moving to Florida, I decided to release this. Finally, I finally got together with some time and put this together. So going back a couple years, I had a research team and we were looking at videos of medical students. reacting to talking about their most connected and their least connected moments with their supervisors. And so this was something that we were interested in at the time. We got trained in FACS and then read a lot about EMFACS. So FACS is the facial action coding, which is kind of the formal Paul Ekman version of how to code these. emotions. And then the translation of that to EMFACS is something that we did through, you know,

reading and through our understanding of how the FACS applied. And we tried to, in the process of that, we took all of these videos over 300 that I had pre-recorded. And we tried to independently validate that we were able to, all four of us, basically look at the video and call it the same emotion. And so that was what really helped me, you know, understand, okay, that I am seeing exactly what these other three medical students are seen, or why are we seeing something different? And so we looked at the videos and we went over them in more detail. And then I wrote up a description eventually of each video. I went through slowly, each video, and I wrote out what I considered to be the definitive description. of the video, and that is 300 plus videos. Took a long time. Wanted to write them out very clearly. So it says things like, this is down and together.

Of the eyebrows, you know, this person is seeing a dog attack, a cat, or something like that. And so you get both the expression on what's happening in this individual video plus the description of what's happening. So in this process, there were a couple points from kind of the general. general Paul Ekman research that I moved away and disagreed with him on. Or I saw things a little bit differently. So I'm going to explain that real quick. One was when I started watching these very, these faces of people watching these very emotionally evocative videos, and I couldn't see a particular coherent facial expression, but I felt nausea. And I didn't really know what they're watching when I would watch these clips. I tried to watch them blind, and then I would go back and see what

they were watching. And then I was like, wow, they're watching something very disturbing, and they have this sort of expression on their face, which is, like, why does it make me feel nauseous? And so one thing that I noticed was that my mind would go a little bit blank at times, and I would like, almost like dissociate in the midst of this nausea. And one thing I noticed was that their eyes were defocusing. The content of the material that they were watching was so disturbing that they were dissociating. And my brain was lighting up in a very similar way. I was actually experiencing some level of dissociation myself.

And so one of the things that I've coded uniquely in these videos is dissociation. So another thing that I noticed was that sometimes when they were watching someone experiencing pain, physical pain. They had an expression like disgust on the face, but it didn't really make sense why they would have disgust. And so what I realized was when I was experiencing it, what I was experiencing more in my head was pain. I was experiencing physical pain watching these people have this expression that looked very similar to disgust. Now disgust is it down and together of the eyebrows, a wrinkling around the nose, the upper lip goes up, but the upper lip wouldn't really go up as much as the face would go wide.

And I looked up pain, and I found this article that talked about how this is actually the expression of pain on someone's face. So that's another way that I sort of differentiated between myself and Pockman. For example, circumcision. Some people would create disgust. Some expressions were actually pain. So that was another thing that I sort of differentiated. And so after spending hundreds of hours looking at these 300 clips, categorizing them, looking at the relationship between what I was seeing,

what I was categorizing, and now playing that out in real life, seeing that on my friend's faces when they discussed certain things, conversations that I was having with people. My kids, it was the same around that same time. My daughter was born, my son was born. And so I'm watching my daughter express anger on her face wanting to get to my wife's milk supply. I watched anger on my daughter's face reaching for some object. And so I would respond to these expressions.

And I was so fascinated that these young, young children could actually have this whole language of emotion from day one, from absolutely day one. and she would put something in her mouth that she didn't like the taste of, she would express disgust, she would get hurt, she would express pain, she would express anger, she would express happiness, right? When she saw something novel or something was pleasurable, you know, I noticed that every time I, you know, some people carry babies, I tried to carry my daughter on a front pouch, and every time she was facing towards me,

she kind of had this grimace on her face of anger. And so she wanted to face outwards. So she would face outward. And we would go on walks and we'd go up to a tree. And, you know, she would get like a little smile on her face when she would touch the bark of the tree and the sensation of the different textures or just singing songs. So I really found that this improved my ability to parent.

And I would put words to things. Oh, you experience anger because of this, you know? And so very early on, you know, our kids have a full. vocabulary for what they feel and how different that was probably from my own experience of not maybe having a place to feel some emotions, right? You know, sometimes I'll have in my mind this thought like, oh, you shouldn't feel this, right? Because that was a message. Maybe that was given me at times. I also saw it with my relationships with my friends. You know, I'd have friends who would flash an emotion of anger. And then the subsequent conversation was about

something that they were angry about, or they felt there was an injustice, or maybe they were passionate about something. I saw anger a lot of times when people were passionate about something. And so it really kind of deconstructed my thought that anger is always a bad emotion or disgust is always a bad emotion or even pain, you know, that these are actually adaptive functions, these are here for a reason. So I kind of like, I kind of just allowed this to teach me about things that I maybe didn't quite understand, you know, or intuitively understood, but didn't know how to consciously register. You know, it helped my relationship with my wife. I noticed if I said something and then that created an expression of anger on her face, you know, a quick down and together

of her eyebrows, one-tenth of a second. I could use that information to backtrack and figure out where the disconnection was. And so our arguments were not escalating as much as before because I was able to sort of catch the smaller moments of anger so that they never needed to get to very large. Once in a while, I get to large emotions still, but I would say by and large, it helps. Actually, my programmer, who ended up working on Emotion Connection, he learned microexpression really well through making this app with me. And I think it really helped him understand his now future wife and even dating. It helped him quite a bit. He was someone who maybe was a little bit more disconnected from people's emotions and experiences, but then it allowed him to

register what might be going on and then use that. You know, most people, when they watch politics, they're not thinking about what people are expressing on their face, but really that's something that I really enjoy doing. Debates became fun to watch, you know, why is this politician expressing anger on their face when they're talking about this or disgust on their face when they talk about this. You know, a lot of decision-making occurs around emotion. And so it gave me, it gave me insight. And it also gave me, you know, like when you're watching them, someone says something in the debate, they immediately flash an emotion. It's like, okay, that's something right there. That stirred up some emotion. That got to them, even though they're denying that it got to them. So, you know,

this was the same time I was working on these projects with medical students and residents. If you listen to three of my prior episodes on microexpression, you'll hear a conversation with Dr. Ariana Cunningham, who's now a wonderful psychiatry resident going into child and adolescent psychiatry this coming year, and she did a great job with me exploring these topics. So I had different students to kind of help me with this and to kind of explore these articles together. I worked with the team of these now residents, coding microexpressions, flashing on the face medical students looking at the disconnection. I talked a little bit about that. And all along, I have been considering in the midst of this is how do we increase our empathic experience in

those we work with, you know, the patients that I have, the people that I coach, how do we increase our empathic experience of what they are going through? You know, and microexpression is something that I can focus in on emotion. And it gets me out of my own experience, right? My own ideas. And I can then better imagine what might be going on in them. So I'm going to take you through what the course looks like. And I'm going to teach you some of the pearls along the way.

So in part one, I give a tutorial video on disgust, pain, and anger. And it's about an hour long. And I start by teaching those because they're very similar. Anger is down and together of the eyebrows. Disgust is down into the eyebrows plus a wrinkling around the nose, plus the upper lip goes up. And then in pain, it's very similar to disgust, but instead of the upper lip going up in a pronounced way,

there's more of a horizontal movement of a widening of the mouth. And then so you learn some of the sort of the theory behind this, and then you go through videos, these clips, and you go through one clip after another, and you try to guess the right ones. And if you think you're pretty good at this, go on EmotionConnection.com. There's a free test you can take and you can see how you do.

Most people score 30 to 40%. So just because you're a therapist, just because you're a psychiatrist, doesn't mean you read these better than other people. Actually, they found that police. read them worse than the average person. And that therapists are pretty average themselves. So in part two, what we do is we look at happiness and then this other expression, which is smug, pride, or contempt. Now, Paul Ekman calls this contempt. I add smug and pride because

I saw that it wasn't always negative. Okay, so this is the one-sided smile. So one side of the mouth goes up faster or comes down slower than the other side. That's con. That's contempt, classically. Contempt carries a little bit of a pejorative message in it, like to have contempt for someone else as something you wouldn't want to have. Whereas what I saw in videotaping people watching videos of my children in this series of videos that they watched was even though they weren't my brother or sister or someone in a bloodline, they would have pride over the achievements of my kids. And so this was that this is why I called it pride and pride it can be a good thing you know i mean it's not probably the same thing of what you

consider pride in the spiritual sense which is only thinking which is probably more akin to a pathologic narcissism so happiness is a wrinkling around the outer eyelid you know as you smile there's a contraction of the obicular oculi the eye muscles so it's like smile with your eyes right um if you want to if you want to do good selfies, don't just smile with the bottom part of your face. That's a fake smile. The full smile, the zygomaticus, the cheek goes up. There's a contraction of the eyes. You get that little crow's feet. And, you know, why people want to put Botox there is, puzzles me. But this is something that's really beautiful. It's like to do the full smile, it's like you really do feel that joy. Right. And so,

Differentiating between those two things, I think, can be important, and it's like a step to understanding this. So in forensic settings, when you watch someone do the one-sided smile, often it is with an edge of vindictiveness, that vindictive triumph over your adversary can create that one-sided smile. But for many people that I watch, it's actually just feeling proud about someone else's accomplishment. and I'll catch myself when a patient reaches a goal, maybe gets a raise, has some good interactions with their kids. I'll catch myself feeling on my face that one-sided smile. And that really touches on another point I would like to emphasize is that when you have a one-sided smile on your face, be curious about what you're proud about. And, you know, if you have a one-sided smile, when someone else is. talking about their accomplishment, put it towards, wow, I feel so proud for you for accomplishing that.

So what you're doing there is you're utilizing what is going on on your face to give feedback to the other person and kind of like creates more depth in a congruent fashion, right, for what you're feeling. And so when you start to practice this stuff, you'll feel it on your own face. I can feel my own face, flash emotion of anger at times. I can feel on my own face a flash of disgust. I can feel on my own face a flash of pain when I hear someone talk about a painful thing. And that's really interesting to me because it gives me information about my own experience of their experience, which sometimes in mentalization, more of a mentalization-based therapy can be so powerful because you can talk to the other person about your true experience of what they're sharing.

You know, often people will fear that you feel critical towards them, that you feel anger at them, that you feel, you know, all sorts of different things towards them that create shame in their own experience. And that's because shame and trauma just go together. So when someone talks about something that's traumatic, they often will feel shame. So in my mind, what I do is I register like, oh, I felt pride when they talked about that, or I felt happy that they talked about something that was difficult. And I may, you know, empathize with their distress and then express my own experience so that they better understand what I was feeling more accurately. Okay, so in part three, I talk about fear, sadness, surprise, dissociation. Fear has eyebrows going up and together. So there's like in the middle of your forehead, there's some tension there, whereas sadness, the eyebrows in the middle part just go up. So there's less tension in the middle of the forehead. Surprise, the eyebrows are going up with the middle portion of the eyebrows. So it's kind of more like a, like the arches of McDonald's, right? Surprise. So with fear, you have up and together with sadness, just up the middle part of the

eyebrows, whereas surprise, the whole thing goes up. In sadness, there's also a pucker of the lips. the mouth that drops open. In fear, the mouth widens. So you can start to differentiate the emotions based on the combination of these two things. And I'll talk about dissociation in this part. Dissociation being the defocusing of the eyes being the main thing that we're looking for. So then the question becomes, how do you use this information? First of all, I'd like to share a mistake I made at first. Seeing the emotion can make you either connected or disconnected with someone really quickly. You know, if when someone knows you see their emotion, it can stir up shame.

Usually when I'm at a dinner table and they're asking me about this, immediately people start to feel self-conscious. If you're a patient of mine watching this or listening to this, I can, we may need to talk about this. This may stir up some feelings of like, oh, what are you seeing inside of me? Well, I'm using this information for connection. I'm using this information to help you. And I'm good at it.

I would consider myself really good at it. But I'm not going to be the definitive person to tell you what you're feeling. So, for example, if someone flashes anger like your spouse and you say, I see that you feel angry, that may make them more angry. pointing it out will make it worse right you can't just say i see i see you feel angry or you just flashed an emotion of sadness that's that's not a way to use it this is off putting and often people don't know what they just flashed so they will immediately deny that they were feeling that or you know anger in general in our society has such a negative connotation that no you know people don't want to say that they experience anger at all. So instead, I note the emotion in little brackets. And if I'm typing,

I'll put little brackets. And in my mind, I'm just curious about what it meant. So, you know, there's part four when I go through empathy in general. And I give you guys, I would give you guys access to this like grand rounds I did at a residency program, doing a lot of sort of role playing on how to give empathy. And this kind of gives you a glimpse. into different areas where you can make mistakes. And these sort of mistakes can lead to a lack of an empathic experience. So the program, let me just finish talking about the program, and then I'll go to kind of like how to use this information.

So the program then ends up with over 300 videos that are easy, medium, and hard. The hard ones sometimes contain up to three emotions flashed in progression. so they're very difficult to do, and it may take some time. So you just go through it over and over again until you hit like 90% consistently. And during this period, every three days or so, you'll get an email, which has another video of me talking about some topic, a little write-up that I did on different topics and how you can relate this to connection. So in this series of this progression of emails,

We have topics such as empathy, logotherapy, how to use it in dream work, and how to use it in all sorts of different applications. Now I'm going to go through a case and show you how complex this is. And so in this episode, in this sort of summary here, I am going to tie together a lot of different psychotherapy concepts to show you the delicate dance of therapeutic alliance, of empathy. of transference and all that stuff. Okay, so let's say the patient starts by flashing an expression of anger, so down and together with the eyebrows, and they say, this thing happened today I want to talk about. Okay, so already this lets me know that even before they tell me

that they're angry about something that happened, I listened for what the goal is, what the obstacle is. They go on. I was thinking about coming here to session. and I'm not sure how to put this. So, I'm thinking in my mind, it's hard for them to express something.

Likely the anger they feel at me. I think about that as a possibility. Now, it's not normal to want to think about someone experiencing anger towards you, but I actually get excited about that. They go on. I feel the work we are doing is not getting anywhere.

So then in my own mind, I'm thinking I approach this with one, real gratitude, okay, because they're expressing something interpersonal, something between us, okay, about us. That is hard to express. And two, knowledge of the emotion. Okay. So I say, first of all, thank you for sharing something that it's difficult to share. At times, you might have critical thoughts towards myself. self, maybe even anger, and have a hard time expressing it. But I want you to know that I'm enthusiastic if you are able to, knowing that it allows us to do work that is necessary to help you. Okay, I really believe that negative interpersonal feedback is a gift to work in the work of psychotherapy. This is rooted in my thoughts that transference work is so important. also rooted in the fact that I have actually done something that maybe wasn't right. Maybe they didn't feel heard or understood in the way that they wanted to feel, you know, heard and understood.

And then putting this to words allows us to heal the threat and disconnection. They felt disconnected. And so it allows us to heal that. Okay. The patient goes on. they flash disgust. I overate this week a series of binges and this chaos just keeps happening. So this is interesting. It's a shift, right? Maybe in that last moment when I said, thanks for sharing this, it lessened the shame just enough. And now he's able to express something

deeper. Okay. So he said he's talking about disgust. Something in him, the flash of disgust. and the expression of these binges, he was feeling maybe discussed towards something he did. What is going on between us? Is the disgust partly, is it, what might he be feeling or she be feeling in expressing disgust towards sharing this, and the difficulty of sharing this, right?

The intensity of the shame, maybe they're thinking that I want to reject them in some way. Maybe they're wanting to reject me. So they go on. A flash of anger crosses their face. I just think our work is not solving this issue. I know another flash of anger. I should be able to not feel this way.

Okay, so you can see how there's a partial, there's a goal that they have of solving this issue. There's also internal frustration, anger towards themselves for feeling the way that they're feeling. But I'm excited that they're able to express this. My thoughts, the anger they feel towards themselves is at times pointed at me. This is normal. And maybe it is easy to be angry at me than to be angry at themselves, to blame me rather than to blame themselves. I say, it is hard to feel critical towards yourself for feeling some revulsion, some disgust, and it is understandable that you would want this time together here to be something that solves things, and it's understandable that you are frustrated that things

have not been solved yet. They say, no, actually, I feel the disgust towards myself. I am the common denominator, and then they flash down and together of their eyes, wrinkling of their nose, and mouth widens. That's pain, and they look down, which often happens when someone feels shame. I say, I know it's hard to talk about this, but thank you for having the courage to. As we are sitting here together, the revulsion you feel towards yourself, beating yourself up, is brutal to sit in. painful even, and I'm enthusiastic about your ability to share it with me. Now, I know what I'm saying this out loud.

I'm critical of myself for saying it the way that I'm saying it because it seems so rehearsed. It's horrible acting, of course. But honestly, if I feel this, if it's congruent, it comes out more authentic. And it's always been hard for me to act because I don't have a person in front of me. I'm imagining this scenario. So that's some of my internal dialogue as I say that. But that being said, let's look at several of the things that I did say in there. First of all, I understand the disgust is pointed at themselves.

They have internalized it, and that is associated with shame. I feel into the pain and suffering and sitting in this, even expressing it, is difficult. I am thankful they are vulnerable, feeling drawn towards their honesty, feeling thankful for their courage to speak out about this. this is why I express gratitude for them opening up. Expressing that gratitude shifts the narrative for them. It is not weakness but strength that is occurring right now. Thirdly, it takes courage to talk about vulnerable and shameful things. Looking at core, the core internalized emotion is very hard.

I relay the emotion in words. Revolion is something very similar to disgust. often we use them interchangeably it is worse to feel internalized disgust and shame alone therefore the power is in the weeness right we are here together it is in that power that we speak together right so i use the word we instead of shaming him which maybe he felt growing up when he expressed some emotion. I am enthusiastic to hear and take part. The opposite of shame is enthusiasm, right?

Often when we were kids, we were venturing out, we were exploring, we turn around, we want our parents to get excited for us, and instead we're met with a blank face or fear. I remember watching a kid play in the yard, and she's like, Daddy, Daddy, watch me. And Daddy yells back, careful with the car. You know, that's all he can say. And, of course, there were no cars.

There was no danger. The kid wasn't running in the street. But every interaction, instead of being met with enthusiasm, was met with fear or a blank, blank face. So in those same ways, I react because I truly believe that it is courageous to share. So this isn't some theoretical idea. I know that when I did my own work, it took a lot of courage to share. share. Okay, let's go on. He goes with an expression of fear. So often the micro-expression

will precede the statements. Expression of fear. He says, you know, I know last week in between our sessions, I had thought you had enough of me. Flash is discussed. I thought you wanted to cancel me as your client, pain. Flash of pain there. I thought this, after message, up. Notice in this statement the client fears that I have discussed, which leads to wanting to cancel, which causes internal pain. Now we know he feels this towards himself, but now he is projecting that I have felt this towards him. This is transference of some sort. He is projecting that I have discussed towards him. And I want to reject him. And I want to reject him. him and abandoned him if he is not successful. Success was linked to getting good things,

failure linked to disgust and abandonment. Common theme. So with that in mind, I say this. I'm glad you were able to share this with me. I imagine it felt scary thinking that I might feel revulsed with you to the point of rejecting you, not wanting to see you anymore, which would be very painful. Okay, notice I'm not leading, notice I'm leading with empathy and thanking him for sharing. I'm not stating that I was, I'm not stating what I was thinking yet when he, you know, like, wow, in between appointments. So I don't lead with like, in between appointments, I thought positively of you, which is, you know, probably what we'd say in a friendship. But in this case, we're leading with empathy. with the distress of how scary it was to feel that I might be revulsed towards him,

might have disgust towards him and want to reject him, want to abandon him. We are in the midst of his shame. We are deep in the internal working object relationships going on. Somewhere, likely implicitly, some internalized representation of another person, having discussed towards him occurred. Maybe this was preverbal, something he couldn't even register consciously. So the process is transferentially represented on to me. He does not have a secure attachment with me in the moment. He anxiously feels I will reject him.

In this process, I respond with one thanking him. Once again, rejoicing that I openly, am happy that he shared this with me. And number two, I'm putting towards the emotions of fear and also perceived disgust I felt towards him. I'm putting together his perceived disgust that I felt towards him, not that I actually felt this towards him, right? I'm not just saying what he is feeling, but imagining how it would lead to suffering in him

to imagine this. This really does shift me from someone who is rejecting to someone who is concerned and wants to know and be present with him in the midst of his suffering. It shifts, it makes that shift without even correcting him. That's the power of it, right? For me, this is a core desire because, meaning this is something I really believed, the importance of doing this, because I know in sharing of suffering of another, we can find a healing embrace. And sometimes I'll feel this positive heart pull from my heart into the other person. I'll feel this positive warmth. He says, of course, I think that when I feel bad about myself, when I'm stressed out, I eat more. And I say, I know we talk a lot of the stressors you have,

and it's understandable that you eat more as a way of coping. Towards the end of session, I might say, before we close, I want to check in to make sure that you don't feel that this week I will be rejecting of you, I'll be thinking critically of you in our time apart. Is there any part of you that might think that? Maybe he says no, not at this time. maybe they say yes, and we can explore that a little bit before the end of session. If he says no, I might say something like, if you have any of these thoughts this week,

I do want to hear about it next week. It will be important for us to explore it. So I'm thinking about this example, and I'm thinking about why I think this is such an important example to share with you. And it's because this type of work is so transformative. When you take someone from that point of shame to feeling that warmth of connection, that heart pull, that warmth, you know, it's just like all of a sudden all that shame melts away. Often it's the shame, it's the internalized, personal feeling of disgust that leads someone to overeat or do anything, like any other coping mechanisms. Like pornography is another common one.

Maybe it's, you know, all these sort of self-soothing. things that of course people want to self-soothe when they're distressed, but underneath it, the core issue may be that early transferential relationship in which they didn't get empathy. They got a lot of shame. They got some internalized disgust. Right. So when we talk about object relations, we talk about like there's this person in your mind that existed as this, you know, maybe it's your mom, for example. And maybe you experience disgust. So there's this object, and disgust is pointing away from the object to you,

and then you have emotion pointing towards the object of shame. And so this is where it gets transferentially represented on the therapist, on the other person. And let's say you're not a therapist, but let's say you're some sort of leader, people will do this to you and you will be confused on why they feel such strong emotion. And it's because of this. they're trying to work out these transferential early relationships on you. So in summary, I think you can see from this example how reading microexpression is something powerful that gives you a bit more information on what is going on.

And my hope from this episode in the program on EmotionConnection.com is that you will have a better ability to read people's emotion. I think it's a comprehensive training program. And as you go through it, if you have any feedback, I would love to have it. It's launching this month, June, you know, 2021. So if you're listening to this months or years in the future, it may be updated a little bit from today. You know, there may be more emails.

There may be more tutorials based on what people tell me is helpful. If you are in academia and you want to use this in research, you can reach out to me, and I can talk to you about options for that. And if you're a group, like you're a teacher and you want access for all of your students, you can shoot me an email as well, DR at psychiatrypodcast.com. And yeah, I'm really hoping that this helps people. And if you have any questions, thoughts, concerns, you can always send me a DM. On my Instagram, people are surprised that I shoot them a little voice message back to show that I'm a real person.

I don't have anyone else replying to DMs for me, like some people. If you are thinking about hiring a social media person, I would recommend that you do all of your own commenting and direct messages. So, okay, in summary, I hope that this is helpful. I hope it's a little bit of information to help you improve your ability to connect with other people. If it does that just 10%, 20%, I think it has incredible value. and we will leave it there for today. Thank you.