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Pained: The Story of a Survivor's Struggle and Healing



Mice with a mutation that has been linked to migraines in humans showed pained expressions that subsided when they were given an anti-migraine drug. "I'm very confident that we're measuring pain here," Mogil says.




pained



Presenting a series of images evokes empathy for pain from subjects in the former paradigm. Most of the images depict painful injuries in limbs or neutral situations (Kam et al., 2014), and some record pained expressions (Vachon-Presseau et al., 2012). Abstract visuals are applied in the cue-based paradigm. Most studies suggest that the insular and cingulate cortices are activated by empathy (Singer and Lamm, 2009). Brain mechanisms differ because of diverse factors, including positive and negative experience (Enzi et al., 2016). The brain regions activated can change according to changes in activation intensity. However, there are few studies concerning the mechanisms of empathy for pain elicited by pained expressions.


The suboccipital region (BA18) is the secondary visual cortex, and together with BA19 constitutes the visual cortex. However, the visual cortex was not highly activated. This indicates that during pain empathy caused by watching a pained expression, the production of visual information is only a relatively minor stage. Combined with the fusiform gyrus, which is highly activated, it can be seen that the recognition and processing of faces and facial expressions are the leading steps: in other words, the activation of the brain area involved in facial recognition distinguishes stimulation by facial expression from stimulation by nonfacial images.


From the results of our study, the occipital lobe, the frontal lobe, the temporal lobe, and the limbic system were differently and strongly activated. Based on the existing studies and combined with this meta-analysis, we can make assumptions that an image of a pained facial expression produces a pain sympathetic activation of the brain regions as follows:


The pained facial expression image can stimulate the emotional network, which produces spontaneous emotion processing. The image activates the occipital lobe first, followed by the temporal lobe, the insula, the limbic system, and other emotional networks. Among them, the frontal lobe processes the emotional stimulation. In other words, the frontal lobe processes awareness through the integration of physical and subjective feelings and objective information (Osborn and Derbyshire, 2010).


Smiles are universal but nuanced facial expressions that are most frequently used in face-to-face communications, typically indicating amusement but sometimes conveying negative emotions such as embarrassment and pain. Although previous studies have suggested that spatial and temporal properties could differ among these various types of smiles, no study has thoroughly analyzed these properties. This study aimed to clarify the spatiotemporal properties of smiles conveying amusement, embarrassment, and pain using a spontaneous facial behavior database. The results regarding spatial patterns revealed that pained smiles showed less eye constriction and more overall facial tension than amused smiles; no spatial differences were identified between embarrassed and amused smiles. Regarding temporal properties, embarrassed and pained smiles remained in a state of higher facial tension than amused smiles. Moreover, embarrassed smiles showed a more gradual change from tension states to the smile state than amused smiles, and pained smiles had lower probabilities of staying in or transitioning to the smile state compared to amused smiles. By comparing the spatiotemporal properties of these three smile types, this study revealed that the probability of transitioning between discrete states could help distinguish amused, embarrassed, and pained smiles.


To our knowledge, this study constitutes the first exploration of the spatiotemporal properties of three types of smiles: amused, embarrassed, and pained. Although no specific hypothesis is proposed, some predictions can be made based on previous related studies. Several studies have reported that the smile during a depressed or embarrassed state included more tense facial movements, such as a dimpler, lip corner depressor, and lip press (Girard et al., 2013; Keltner, 1995). Moreover, Girard et al. (2021) showed that the frequency of Duchenne smiles was decreased when in pain. Prkachin (1992) suggested that the prototypical pain expression includes lowering of the brows, constriction of the eyes, and raising of the upper lip. Therefore, compared to amused smiles, embarrassed/pained smiles are expected to be more tense, and pained smiles are also hypothesized to show activation of prototypical facial muscles (Prkachin, 1992) instead of the Duchenne smile. Regarding temporal properties, the exploratory nature of the study did not permit directional hypotheses.


In summary, the pain condition was associated with a lower rate of Duchenne smiles and increased facial tension. As a complementary analysis, we compared the number of frames in which AU12 (lip corner puller) appeared and found similar results (amused: 78%; embarrassed: 78%; and pained: 32%). However, there was no spatial difference between the amusement and embarrassment conditions.


Compared to an amused smile, an embarrassed smile tended to transition from facial tension and the relatively neutral state to a weak smile state. The embarrassed smile also tended to change from facial tension to a tensed smile state. Regarding the pained smile, the probability of transition from a tensed or weak smile state to a strong smile state was low, although a weak smile changed readily to a relatively neutral state.


This study aimed to clarify the spatiotemporal properties of amused, embarrassed, and pained smiles via analysis of spontaneous facial behaviors. The results revealed the key spatiotemporal properties of the different smiles. First, NBMF identified six facial patterns. One of these was based on a combination of AUs that could be interpreted as facial tension: AU4 (brow lowerer), AU7 (lid tightener), AU10 (upper lip raiser), AU14 (dimpler), AU15 (lip corner depressor), AU17 (chin raiser), AU23 (lip tightener), and AU24 (lip pressor). The other five combinations comprised several types of Duchenne smiles, with various degrees of nasolabial deepener (AU11), dimpler (AU14), mouth stretching (AU20), and mouth opening (AU16). Second, while there was no spatial difference between amused and embarrassed smiles, the pained smile showed more tension compared to the amused one. Finally, a hidden Markov model revealed the probability of transitioning from one specific state to another. The embarrassed and pained smiles had high probabilities of remaining in a state of facial tension, and the pained smile had a low probability of staying in a state related to smiling. Furthermore, the embarrassed smile was more inclined to transition from facial tension to tensed smile states, and from facial tension and relatively neutral states to the weak smile state, than the amused smile. The pained smile changed from a weak smile state to a relatively neutral state more frequently than from a tensed/weak smile state to a strong smile state.


For pained smiles, transition from a tensed or weak smile state to a strong smile state was infrequent in this study, whereas transition from a weak smile state to a relatively neutral state was common. This finding is consistent with the spatial properties of pained smiles. The degree of difficulty of transitioning to a strong smile state when experiencing pain may depend on the reason for smiling. Amused smiles reflect a desire to convey a positive emotional state, to increase rapport with another person (Martin et al., 2017), whereas pain smiles may be expressed as a form of social appeasement (Singh & Manjaly, 2021) or facial feedback (which shows intraindividual differences) (Coles et al., 2019; Kraft & Pressman, 2012; Pressman et al., 2020). The current study corroborated evidence that differences in communicative gestures elicited by a given emotion can result in idiosyncratic state transitions.


In conclusion, this study provides data on the spatiotemporal properties of amused, embarrassed, and pained smiles. There was no difference in static spatial properties between embarrassed and amused smiles, whereas the pain condition was associated with a lower rate of Duchenne smiles and greater facial tension compared to amused smiles. Moreover, embarrassed and pained smiles were more likely to remain in a state of facial tension than were amused smiles. Embarrassed smiles showed a more gradual change from tension to smile states than amused smiles. Pained smiles were less likely to transition to other smiling states than amused smiles. The present study provides the first empirical data on the spatiotemporal patterns that differentiate amused, embarrassed, and pained smiles.


Price: $2600Stock Number: 2221600Origin: FranceCirca: 1870Height: 66.5"Width: 44"Description: Black double pained mirror


McGill Method Certified Practitioners: Those attaining certification in the McGill Method have also attended the clinical training courses and passed an exam to demonstrate competency in exercise technique and basic assessment skills. They have not been audited for their ability to get back pained people better. 2ff7e9595c


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