Tips for More Expressive Communication for People with Parkinson’s

A young girl tries to understand the basic emotion of today's mood.

Written by Kelsey Phinney, BS

In part one of my blog and podcast about facial masking, I explored the “what” of facial masking. I wanted to elaborate on what a masked face actually looks like, how easy it is to take our ability to communicate with our faces for granted and to know more about its impact on social relationships. These questions led me to find Professor Linda Tickle-Degnen to discuss her life’s work in occupational therapy and social psychology and her particular focus researching facial masking.

I learned that facial masking is an important symptom of Parkinson’s to pay attention to because it can limit the ability to communicate emotion.

Impacts of Facial Masking

Facial masking can affect relationships with partners and peers, which in turn, can lead to social isolation. This is paramount, because social interaction has been found to be as important as exercise for health and longevity in older adults. Dr. Tickle-Degnen and I discuss this more in my first podcast on this topic, which you can listen to here.  

After my dad listened to my first facial masking podcast, he told me that he spent the rest of the day very conscious of the way he interacted with people and how he expressed himself with his face. It was amazing to talk with him about how much more positive his interactions with people close to him and with random people at the grocery store were when he consciously tried to smile more throughout conversation.

This gave me hope, because it meant that, at least on a good day, a person living with Parkinson’s might have more control over their facial expressions than they think.

It may not be as innate or easy as it is for a person without Parkinson’s, but it is possible to show more expression with some effort.

How to Improve Facial Masking in Parkinson's
click to enlarge

Improving Facial Expression

So, what are other ways people can improve facial expression? What can care partners do to create an environment that encourages more non-verbal expression, and what can people living with Parkinson’s do to address their own facial masking?

I learned in the second part of my interview with Professor Tickle-Degnen that one of the easiest and most essential ways of overcoming facial masking is for us — the care partners, children, friends and even health care practitioners — to ask “positive questions.” These questions that elicit positive emotions can be about stories from the past, some recent occurrence that brought a smile or a laugh, or something in the future that the person with Parkinson’s is looking forward to.

Another method that has been shown to improve facial masking, at least in the short-term, is LSVT LOUD® speech therapy. It is possible that because the respiratory system and the face are neurologically connected, working on vocal exercises will in turn, improve facial expressions. Another explanation is that LOUD therapy is usually performed in a group, so the social stimulation may augment the positive effects LOUD exercises have on improving facial masking.

Mimicry and More

The other fascinating topic that I explored with Professor Tickle-Degnen is the controversial research surrounding mimicry and its role in our ability to empathize with other people. Since a person with facial masking is less able to mimic another person’s facial expressions, it is possible that they will be less able to empathize with that person (to read some of the research behind this thought, click here).

Researchers have found that it is more difficult for people living with Parkinson’s to discern negative emotions than positive emotions, which makes sense, given that negative facial expressions are usually more nuanced than positive facial expressions.

I concluded my second podcast with an interview with John Baumann about his experience living with Parkinson’s and facial masking. A Parkinson’s advocate, John told me how masking affects his relationship with his wife and children, as well as shared practical encouragement for those looking to improve their facial masking.

Listen to Kelsey’s Podcast

Everyone’s Parkinson’s experience is unique, just as everyone’s day-to-day living looks different. I’ve learned throughout the process of creating my podcasts on facial masking that relying almost exclusively on the verbal aspect of communication is not something that comes naturally to people, but it is crucial for the success of relationships with people whose facial expressions are masked. I’ve also come to realize that we, care partners and children, can work to practice patience as well as the way we ask questions.

At the same time, with awareness, practice, intention and sometimes outside intervention, facial masking seems to be an effect of Parkinson’s that people can take action to address.

Click to listen to the podcast below

Kelsey Phinney’s dad, Davis Phinney, was diagnosed with Parkinson’s when she was five years old and she has been interested in learning more about the brain and ways to help people living with Parkinson’s ever since. Kelsey graduated from Middlebury College in May of 2016 with a degree in neuroscience and is currently cross country skiing professionally in Sun Valley, Idaho. Learn more about Kelsey at

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