Intended for healthcare professionals

Student Education

Emotions revealed: recognising facial expressions

BMJ 2004; 328 doi: https://doi.org/10.1136/sbmj.0404140 (Published 01 April 2004) Cite this as: BMJ 2004;328:0404140
  1. Gavin Yamey, assistant editor1
  1. 1BMJ Learning

In the first of two articles on how recognising faces and feelings can help you communicate, Paul Ekman discusses how recognising emotions can benefit you in your professional life

There are seven emotions that are expressed on the face in the same way in every different culture (box 1).1 These universal facial expressions are innate; they are not learnt. This explains why congenitally blind people show the same facial expressions attached to each of these seven emotions as sighted people.2 If you can learn to recognise these facial expressions in your patients (and some of the expressions may be brief or subtle), you will have greater insight into their emotions.3

Box 1: The seven emotions universally expressed on the face

  • Sadness

  • Anger

  • Surprise

  • Fear

  • Enjoyment

  • Disgust

  • Contempt

How can reading faces be valuable?

In any except the most trivial relationships, how the other person is feeling, and our acknowledgment of that, can make all the difference in the world. For example, if we can recognise that someone is feeling sad--whether it's our child, our spouse, our patient, or a junior doctor--it can be helpful to be able to respond to his or her sadness. If we can identify people's emotions early on, we are better able to deal with people in a variety of situations. We are also better able to manage our own emotional responses to their feelings.

Patients bring a variety of emotions with them when they see you, but you are unlikely to see these emotions fully expressed. Because of their embarrassment, fear, guilt, or shame, patients do not put their emotions into words or into full facial expressions. So you will usually see only subtle traces of these emotions on their faces.

Brief or subtle facial expressions

You do not need to be taught how to spot full facial expressions of emotion, as these are easy to recognise and we already have a natural …

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