Everyone blushes, but no one knows why.
In old novels and plays, the woman who blushes is invariably described as lovely and virtuous. Jane Austen, for instance, created charming characters whose blushing was a sign of modesty and sincerity. Paintings from the 18th and 19th centuries often display pink-cheeked women looking sweet. Think of the many beautiful and blushing young women Auguste Renoir painted over the years.
But today, instead of being viewed as attractive, blushing is seen as an expression of shame and embarrassment. Contemporary accounts of the blush portray it almost entirely in negative terms. The blusher’s red face seems to unmask a person who just isn’t right with the world, quite literally an uncool character, one who has somehow crossed the boundary between the outside social world and the private inner life.
People who blush a lot are sometimes called “pathological” blushers. They blush at unexpected moments over nothing in particular. The psychological-physiological tic is involuntary and cannot be controlled. Oh that it could be. Take it from me, a problem blusher.
Is there anyone more graceless than a problem blusher? People get seriously uncomfortable and confused when I blush. “What happened? Is it something I said?” I imagine them wondering. I have to assume that they think I have a crush on them, or that I am hiding something. At the very least, they must think that I am highly immature. These are the common-knowledge opinions on why people blush.
But just what blushing really reveals, even the blusher often cannot explain. There is a vicious circle in which a blush is both a sign of, and reason for, self-deprecation, according to Professor Ray Crozier, the chair in psychology at University of East Anglia in Norwich and a leading expert in research on shyness and blushing.
Indeed, scientists like Crozier really don’t know why people blush. This is not for lack of trying. Blushing has fascinated scientists for centuries. Even Charles Darwin held a “theory of blushing.” In The Expression of the Emotions in Man and Animals published in 1872, 13 years after The Origin of Species and one year after The Descent of Man, he describes blushing as “the most peculiar and the most human of all the expressions.” People of all races blush, no matter what their skin color, he asserted, but other animals do not.
Although blushing is a uniquely human characteristic, behaviors that often accompany blushing — such as avoiding eye contact or smiling — are used in appeasement displays by other primates, and overt attention — such as staring — triggers these responses in both humans and nonhuman primates.
Darwin advanced the idea that the extent of blushing depends partly at least on the area of the body with which the mind is concerned. He suggests that the tendency to excessive blushing is inherited, with origins in an acquired habit rather than natural selection, hypothesizing that “by frequent reiteration during numberless generations, the process will have become so habitual, in association with the belief that others are thinking of us, that even a suspicion of their depreciation suffices to relax the capillaries, without any conscious thought about our faces.”
Whether an acquired habit or natural selection, it is hard to see what human advantage could come from the phenomenon of blushing. Self-consciousness is the only feeling universally associated with blushing, and other emotions, such as embarrassment, gratitude, or pleasure, may accompany this feeling of conspicuousness. In support of this hypothesis, blushing behavior first becomes common in children of kindergarten age, a time when they begin to interact in more complex social situations and develop a "social self." Blushing peaks in adolescence, when social anxiety and self-awareness also peak, and it decreases with age. It is, overall, more common among women than men.
Notably, blushing is the principal symptom of social anxiety disorder, a disabling condition affecting 7 to 13 percent of the population at some point in their lives. Social anxiety disorder is easily distinguished from other anxiety disorders: The situations in which these patients experience fear and avoidance always involve social interaction or scrutiny by other people.
People who are problem blushers are often driven to distraction by the problem. Blushing tends to happen for people when they experience undesired social attention. Drawing attention to the problem — “Look, she’s blushing!” — just makes it worse.
Trust me, I blush a lot, so I should know. I will hope against hope to never blush again, but then someone — a good friend, an authority figure, a family member, even my husband — will ask me some innocuous question about my work, comment innocently on my appearance, strike up a conversation with me while I’m out for a walk, and there I go again. I would, in all sincerity, rather be a problem burper or a problem farter, because at least people would get that. They could just chalk it up to a bad stomach, an ulcer, or some such medical problem. Blushing is not really considered a medical problem.
There is medical treatment, although it is limited. It consists primarily of biofeedback. There is a surgical intervention for intolerable cases called endoscopic thoracic sympathectomy, which cuts the nerves that allow a person to blush, but it can have serious and sometimes undesirable effects like heavy sweating of the lower body. The treatment — developed in Sweden more than a century ago — is not popular, and some countries have banned it in recent years.
That might not be a bad trend. For as odd and uncomfortable as blushing can be, it is an important and essential part of what makes us human. If we lost the ability to blush, we might lose part of our moral compass. We might lose the notion of true emotion — a concept that might yet regain popularity in social interactions. Or at least I like to think so. • 16 November 2007
SOURCE: "In praise of blushing," Crozier WR, J Cosmet Dermatol, 2007;6:68-71. "Darwin in the world of emotions," Black J, J R Soc Med, 2002;95: 311–313. "Ask a Scientist: Andrea N. Ladd," Howard Hughes Medical Institute, on why we blush, Dec. 11, 2000. "Recognizing the patient with social anxiety disorder," Ballenger JC, Int Clin Psychopharmacol, 2000;15 Suppl 1:S1-5. "Effectiveness and safety of endoscopic thoracic sympathectomy for excessive sweating and facial blushing: a systematic review," Malmivaara A, Kuukasjärvi P, Autti-Ramo I, et al, Int J Technol Assess Health Care, 2007;23:54-62.
Jennifer Fisher Wilson is the science reporter for Annals of Internal Medicine. Her stories are available at www.annals.org.