Open Door Review III

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! I$%67#_!=>!G!F0%*2%&4_!I>![+,,d^>!L$3%)942! '(A?-":@,-"B"LA _!],_!+,PE+,b_! We studied the facial affective behaviour (facial expression) of female fibromyalgia (FM) inpatients which was compared to healthy woman (absence of mental/psychiatric disorder according to ICD-10). The facial affective behaviour was coded with the Emotiona Facial Action Coding System. Videotaped psychodynamic interviews of each of 15 female FM inpatients and healthy women were analyzed. The facial expression was related to gazing behaviour and emotional experience. FM patients exhibited neither a reduction in total activity of facial expression nor in absolute frequency of primary affects compared to healthy women, who, however, in mutual gaze and eye contact showed a significantly higher proportion of “genuine joy” and a lower one of “contempt”. No congruence between the patient’s emotional experience and facial expression was found. We concluded that the absence of reduced total activity of facial expression is in contrast to the elaborate descriptions of complaints provided by the patients. Nevertheless, our analysis (amongst others) showed a lack of elements that stabilize a relationship. Especially genuine smiling stabilizes the relationship between two persons, it keeps the communication going on, which has also an impact on the countertransference of the therapist. The healthy women in our study hardly differed from the patient according to negative, distance inducing affects like anger and disgust. Contempt, however, was shown more than twice as often by the patients. Contempt is an affect that serves to abandon a relationship with another person or prevents it from establishing. Furthermore, it contains a devaluation of the interaction partner, in this case the therapist. The patient gives an impression of facial affective lifeliness and “health”, at the same time stabilizing elements do not occur, and distance inducing ones are implemented. G$#.1/.!

Prof. Dr. A. Kirsch. University of Heidelberg

PVL

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