Expressionless FaceAs I continue to read Tomkins and Nathanson, focusing on the human face as the seat of our affects, I’m reminded of clients from long ago whom I didn’t fully understand at the time. In particular, I think of Noah and the completely deaded facial expression he presented throughout every session. If I were still working with Noah, I would say to him, “You’re terrified that I might read your shame in your face, so to stop me, you keep your expession flat and fixed, immobile so it won’t give anything away.”

Vanessa, one of my current clients, begins her sessions with a flat facial expression that conveys indifference. I don’t think it’s about hiding shame, not in the way Noah used to do, but it’s related. Allowing her face to reveal that she’s glad to see me, that she might have been looking forward to our session, feels unbearably vulnerable. She’s afraid to smile. What if I didn’t smile back? In a microcosm, it’s the problem of unrequited love, once again. Core shame results when mother repeatedly fails to reciprocate the baby’s joy in her. Could anything be more excruciatingly painful?

I’m also beginning to recognize the warning signs when Shane is about to enter one of his shut-down, shame spirals. It begins with a subtle change in his facial expressions. When things are going well for Shane, our sessions are lively, full of mutual warmth; we smile a lot. As he encounters obstacles in his career and begins to doubt himself, the first thing to go are the smiles. All the warmth disappears from our sessions and his face seems to have no expression whatsoever. This past week, I knew he was heading toward hibernation mode when the warmth disappeared from his face.

One guilt-ridden memory from my early, psychoanalytically-correct years: Deidre, a client who had stopped therapy when she went away to college decided to transfer so she could resume treatment. On her first day back, I went out to the waiting room, wearing my professional face with no expression. She was overjoyed to see me, happy to be continuing our work together … and I gave her almost nothing back. Unrequited love all over again! She wept. I feel ashamed when I think back on that day, so cautious in my professional role that I had to hide behind an apparently unfeeling mask. Ugh.

Do other therapists have these agonizing moments of regret? They must.