What We Feel Is Hard to Hide: Micro-Expressions Reveal What We Don’t Say

Our own lived experience informs us about how complex effective communication can be. That inadvertent misunderstandings do happen. That we can be spoken to in a way that feels uncomfortable, even unsafe, on the receiving side, and at the same time, be unsure if we are right about what we are making of it.

Words can be said in a hundred different ways.

Ask an actor. One of my most distinct memories from high school was the first day in drama class. The teacher had us each get up on the stage and say “Hello” in a way that conveyed a different emotion from those before us. Using just one word, some thirty students figured out how to shift their body language and tone of voice to convey feelings like happiness, fear, anger, sadness, hesitation, jealousy, surprise and disgust.

That experience has stayed with me for years. It was a powerful lesson about all the ways that we communicate, and how our inner experience – what we are thinking and feeling – comes through.

The seminal work of Paul Ekman shed so much light on this topic. Dr. Ekman’s research revealed a group of facial microexpressions that are “universal”. Meaning no matter what culture you come from – Texas or New Guinea – the microexpressions that convey sadness, surprise, or disgust are understood. That doesn’t mean we know why they are sad, but we read “sad”.

Not all microexpressions are universal. Some have a cultural influence. These differences can complicate understanding, for instance, when people in a conversation are from different cultures. That situation of cultural diversity often exists in healthcare settings, and in many workplaces. It’s another filter through which we interpret a communication.

A nurse manager asks a morning shift nurse, “Why wasn’t that done on the night shift?”

Looking at the words alone, it’s a straightforward question. But that’s not all that will play into how the words come across. Or how they are filtered by the listener. The context may not be known.

What is this nurse manager feeling right now?. What thoughts is she having, with the still smoldering upset at home before she got to work, and the deadline she is facing while being short staffed? How is that context impacting her nonverbal communication, if at all?

Our feelings, our thoughts, our past experiences – they all play into what becomes the tone, the body language and subtle facial cues that make up just how those eight words come across.

The same words can be conveyed in a hundred different ways. Facial expressions, vocal tone, gestures, pauses, and changes in posture all contribute to how a message is received. These cues can reveal thoughts and emotional states that a person may not intend, or may not yet be able, to express directly.

We may not be able to control the external stressor around us, but in the moment, we can more flexibly observe, assess and change our own stress responses. This is a distinct set of skills in cultivating psychological flexibility that can be readily learned and put into practice.

It’s been eye-opening to me over many years working in conflict resolution and stress response training, in medical settings, to observe how these competencies, in navigating stress and our own stress response, are so powerful and helpful in health, safety, and interpersonal relationships.

And according to the data we are seeing, they are competencies that participants are learning and reporting to be valuable to them personally, and in providing good care to their patients.

Just published, a research paper on the StressPal Frontline program’s positive outcomes with healthcare professionals participating in our self-paced digital intervention to train cognitive defusion skills of psychological flexibility.

Authored by Pennie Sempell, J.D, Co-founder and co-author of StressPal Frontline: Essential Resilience Self-Care and Burnout Intervention, an innovative professional development intervention specifically developed for healthcare and allied frontline workers.

full citation:

Goldberg D, Monroe J, Sempell P, Cheema J, Vunnam S, Kitsantas P

Resilience and Stress Among Health Care Workers Participating in the StressPal Frontline Program: Quasi-Experimental Pretest-Posttest Study

JMIR Form Res 2026;10:e85388

URL: https://formative.jmir.org/2026/1/e85388

DOI: 10.2196/85388