Friday, February 1, 2008

The Mask

(Cartoon by Peter Dunlap-Shohl, special thanks to the Gord Carley archive! Click to enlarge)

Anyone can see some of the damage Parkinson's disease visits on those who have it. Tremor and shuffling are painfully obvious. But there is another set of problems spawned by what you don't see.

With the loss of control of facial muscles we also lose a significant chunk of our ability to communicate. Instead of expressive smiles and frowns, we present a deadpan, blank mask that unnerves others.

Much of the sense of what we all say is not in the voice or words, but in the subtle visual cues and signals the face sends. We all interpret speech in the light of what we read in a person's expression. People with Parkinson's can slowly lose the ability to enhance communication this way without even knowing it.

Think about the problem of misinterpretation of e-mail. The sender composes a message in which the words seem clear as the send button is pushed.

The recipient looks at the cold, expressionless type on their screen, and without the guidance of the visual and tone cues that we all use to correctly interpret meaning, assigns meaning that isn't there. Often the missing meaning is misread, and the interpretation negative.

Then consider the way we get around this problem. We insert little faces that clarify our intent ;-)

This is exactly what those of us with Parkinson's Disease are not doing in face-to-face conversation. We are sending spoken email, without the emoticons :-(

Instead of this :-) , or this :-( , what we send is this :-| . Nothing but :-|

To complicate things further, we are often unaware that we are not sending the proper cues. And worse, as people look for these cues and cannot find them, they get frustrated, confused and eventually angry.

Once while taking care of some support group business at a bank with my friend Lory, I sensed rising irritation in our banker. I was at a loss as to the cause, but then realized she was interpreting our Parkinsonian lack of expression as anger. I stopped the rapidly deteriorating meeting, and explained our featureless expressions.

The change was immediate and dramatic. She went from grim to jovial in seconds flat. And Lory and I, having solved the mysterious problem, were elated :-|


dr s said...

Pete, you might consider anthologizing/publishing these--brilliant!
and very helpful to P W/O P (as well as, i hope PWPs)

Peter Dunlap-Shohl said...

It's at least helping me. To quote a proverb from Primo Levi "Troubles overcome are good to tell."

Anonymous said...

Amen. I can't tell you how many times I have been asked what I'm mad about, when I'm actually in a good mood - "well you sure don't look happy..."

Peter Dunlap-Shohl said...

Hey joe, try this "Really? You should see me when I'm angry!" :)

Unknown said...

Peter: your post "The Mask" has inspired my graduate research. I study emotion recognition deficits in PD. Thanks for your inspiration!

Peter Dunlap-Shohl said...

Hi Nic,
That is a thrill to hear! Best of luck, and please keep us abreast of where to look for your findings. You probably already know about this but just in case you may want to check out the link, it will take you to a New York Times story about a woman whose rare disorder, Moebius Syndrome, renders her face paralyzed in a way that is similar to PD. She is doing research along somewhat the same lines as yours, I believe.