The author is a certified somatic therapist in practice for over 35 years, the director of sbHealthSource.org for health professionals and services, and a longtime health activist.
Overhearing a conversation in the locker room at my gym, I was alarmed to hear that my dermatologist was promoting the cosmetic use of Botox. At my next office visit, I confided my concern, whereupon my doctor perked up enthusiastically, confirming that she does lots of Botox treatments and not just for cosmetic reasons, but also to treat headaches. I was taken aback by her animation — clearly such treatments not only address patients’ facial lines but the doctor’s “bottom line” as well!
I have spent over 40 years professionally addressing the relationships of mind, emotion, and habit to muscular tension patterns. It disturbs me personally and professionally to witness the increasingly disconnected beauty-industry consumer flocking to paralysis as a solution to address age lines in the face.
Here are the facts: Botox is Botulinum A, a neurotoxin produced by Clostridium botulinum, one of the most potent and poisonous substances in the world. What the poison does is block the release of the neurotransmitter acetylcholine from the endings of motor nerves, so that the muscles they enervate are paralyzed. Although the FDA approved Botox for cosmetic use in April 2002, there are no valid medical benefits. However, it has been used with uneven success in medicine since 1980 for treating the excessive contractions in cerebral palsy, spinal injury, and carpal tunnel syndrome, as well as excessive glandular secretions.
From cocktail parties in Manhattan to spas to my own dermatologist’s office, Botox treatments are simple. It is injected subcutaneously into areas of concern (the worry lines of the forehead, for instance), and it works by temporarily paralyzing the muscles for three to four months. Although the toxin permanently binds to the targeted nerve endings, eventually the nerve will regenerate a new branch to the muscle and the wrinkle contraction will begin again — requiring either another injection or learning to live with a face that appears to be aging really fast. At a cost of approximately $300 an injection, it’s obvious Botox is a multimillion dollar industry.
What are the downsides? We haven’t a clue of the long-term effects of small amounts of this poison (used as a bioterrorism agent along with anthrax!) on the liver, immune system, nervous system, etc. We do know that if it gets into the blood stream, it can kill us.
With the repeated treatment protocol, there is a risk of the body becoming used to the botulinum toxin and generating antibodies to it, thus preventing its future effectiveness. For some patients, the treatments render a loss of expression and a disagreeable mask-like appearance. It has also been observed that people may develop new wrinkles as a result of Botox treatments. Furthermore, with repeated treatments, atrophy or thinning of the muscles occurs, which can produce longer-lasting results. In areas where atrophy has occurred, the skin and underlying tissue are permanently rigid and hardened. This is a startling contrast to the enlivened pliable surrounding skin.
Our facial expressions are wired into our emotional tension patterns, so people will unconsciously recreate facial expression in the area where muscles have been paralyzed. This causes nearby muscles to compensate for the paralyzed ones, creating new wrinkles. Dr. David Shawn Becker, professor of dermatology at Cornell University’s Weill Medical College, cautions that the popular Botox target of the area between the eyebrows can spawn future problems: “Following treatment, the muscles in the upper nose, middle eyebrow, and eyelid may try to recreate the expression of scowl. Repetition of this action causes new wrinkles.”
Using paralysis as a means to an end perpetuates the disconnect from our physical bodies, which can exacerbate rather than ameliorate low self-esteem, relationship problems, self-destructive behaviors, and depression. Last year alone, more than 3 million men and women used Botox, with patients as young as teenagers. It’s becoming so common that many people view it on a par with a manicure!
I personally love the individualized expression that each of us cultivates through the art of aging. Each line is part of a résumé we can be proud of. But, for those of you who reject this sculpting of the aging process, consider this: Using Botox to eliminate facial lines is like trying to make orange juice by hitting oranges with a hammer. The actual wrinkles you are targeting are muscle contractions which can be substantially diminished through awareness training and physical manipulation. The way to approach the lines in your face is to connect with them; explore the expression underneath these lines; increase your awareness of how and when you contract them.
As an experiment, squeeze your forehead to replicate the wrinkles of, say, George Bush or George Clooney. Now see if you can observe what squeezing underlies your unique facial expression. Can you soften the intensity just a bit? Can you get underneath the contraction and let there be a softer space? You might not need Botox after all.

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