We know that the bullying of children with unusual appearances is all too common in schools.

Communicating with confidence

Part 1: Join the conversation

contentimage_image695This guide aims to:

  • Look at the meaning of an ‘unusual appearance’
  • Explore the challenges of looking different and how to manage these.

Talking about communication

This guide is for people living with an unusual appearance who may find communicating with others difficult.  Worrying about seeing and talking to people is one of the most common concerns for people with an unusual appearance.  However, communication skills can be learned.  Developing communication skills can lead to a big improvement in a person’s ability to cope with their difference in social situations, leading to a happier, more relaxed social life.

Changing Faces uses the terms ‘unusual appearance’, ‘condition’, ‘looking different’ and ‘disfigurement’, when appropriate.  ‘Disfigurement’ is used in the UK Equality Act 2010 to protect people from discrimination.  However, we recognise that disfigurement is not a term preferred by many people who are affected.  Many people prefer, when describing themselves, to name their condition, by saying “I have a birthmark” or ‘I have neurofibromatosis’ or similar.

People usually think that communication means talking and listening; however, there is much more to communication than just what we say.  Our body language gives people extra information about who we are and what we are thinking and feeling.  This includes:

  • Our posture
  • The expression on our face
  • Eye contact
  • The tone and pace of our voices
  • Extra sounds or short words like hmmm, yes, uh-huh
  • Our personal style, clothes and hair.

What if I look different?

If you have an unusual appearance, this may affect how you feel about yourself – and how you feel about or respond to others.  People may stare out of curiosity, seem uncomfortable or like they are avoiding you.  As a result, you may feel anxious, self-conscious, shy or uncomfortable about communicating with other people.  You might blush or hang your head or turn away.  Some people find a change to their body equally difficult to adapt to, even if it is hidden, and may still feel embarrassed or worried when out in public.

Five helpful techniques for social interaction:


Changing Faces has identified these five simple techniques to help you with managing social interactions.  You might also find these useful to bear in mind when thinking about communication and socialising.  There is a lot more information about this and managing the challenges of an unusual appearance in the two guides Living with confidence and Communicating with confidence Part 2: Handling other people’s reactions.

What if I’m worried about communicating?

“I appreciate that I have grown up with my disfigurement and realise how difficult it must be for people acquiring a disfigurement when they are older but social skills are worth persevering with.”  Alison

People are naturally interested in each other.  When we communicate, we instinctively look at each other’s’ faces and eyes.  Although, it is true that some people may partly be more interested in you because you look different.  This is a common reaction – most of us are curious when presented with a new or different situation.

Understandably, you may long to walk down the street anonymously with no-one taking any notice of you.  Constantly being looked at may feel like you are ‘on duty’ all the time – it’s tiring and intrusive – and it can make some people feel anxious and worried.  It may be tempting to stay at home, to avoid other people and social situations altogether.  Your attempts to escape unwelcome looks and attention are understandable, especially if being out makes you feel wary or anxious.  And, once you start regularly avoiding social or public situations, it is likely to become more and more difficult to go out and socialise with others.

A note about anxiety and unusual appearance:

Some people experience difficult symptoms of anxiety. This is a ‘fear’ response, creating the instinct to ‘fight or flight (ie: run away)’, including:

  • Physical feelings, like: a pounding heartbeat, sweating, feeling faint, nausea, chest pains, not able to breath, shaking, blurred vision, jelly legs
  • Feel constantly frightened, panicky, very stressed out or on high alert
  • Feel powerless, out of control, like they are about to die or go mad.

If you experience these feelings, some of the techniques in Living with a Disfigurement may help. You may also consider visiting your GP or speaking to us at Changing Faces.

Feeling worried can translate into our body language. You may, without realising, seem defensive and come across as unfriendly or unapproachable. People may then be uncertain whether they should talk to you. In turn, this may make you feel like they are avoiding you and you may become even more anxious, wary or defensive.

Changing Faces understands how difficult social interactions can be and offers people support to help them communicate more confidently.

Body Language

Make eye contact

Eye contact is an important part of social interaction.  Most people naturally look at the eyes to understand someone better, to sense their mood and to engage someone’s attention.  When we are talking, we naturally glance at our listeners to show we are interested in their reactions.  In a group conversation, people look at the person speaking.  When someone else starts to talk, people will move their gaze to look at the new speaker.

Although you may feel shy or apprehensive, not looking someone in the eye during a conversation may leave them thinking you are not listening or you are disinterested; or they may not understand you.  Although you’re avoiding eye contact because you are worried, unfortunately, the person you are talking to might interpret your behaviour to be unfriendly or aloof.  It may help to think about how you feel if someone avoids looking you in the eye.  Does this make you feel uncomfortable?  Perhaps you feel unsure if they even want to talk to you?

If you have difficulty making eye contact

  • Practise lifting your head and looking around you
  • Practise gradually building up eye contact talking to people you know
  • Progressively try practicing with people who are less familiar – look away and then look back if you need to
  • If you feel anxious, try looking at the bridge of the person’s nose, this can look like making eye contact.

“Looking at the bridge of the person’s nose – this is an excellent tip and one that I use all the time (on a daily basis).  I deal a lot with students and external visitors to an organisation – and when I am meeting and greeting – this tip works every time!!” Linda

Eye contact may be especially difficult for you or others if you have a condition affecting your eyes – see Communicating successfully when you have a disfigurement which affects your eye(s).

Use your face and your body

From birth, we naturally look at faces to give us information about other people.  Without even knowing it, most of us constantly watch other people’s expressions and body language – and use these to make assessments about what they are thinking, feeling or doing.  You may find it useful to think about the following tools:

Your facial expressions may reflect how you feel
Our faces often reflect our true feelings (although it’s possible to hide our emotions sometimes too).  To give the impression you are open, friendly and want to talk, it may help to be aware of some of the feelings that might affect your facial expressions.  For example:

  • If you are nervous, you might frown or look worried or look away
  • If you are wary or uneasy, you might look guarded or defensive or cross your arms
  • If you feel shy or unsure, you might cover your mouth or face with your hand or look at the ground.

Try to work on recognising these feelings – think about your face and what it might be saying to the other person – then make a conscious effort to try to relax, look interested and smile.

“Everyone smiles in the same language” (Anon).

Smiling is worth highlighting as it is a particularly important communication tool.  It is one of the simplest ways of encouraging people.  A smile says that you are warm, approachable, and open to talking.

If your smile is affected in some way, see the section on What if your vision or expression is limited.

Nodding is another important signal.  It shows you are listening and invites the speaker to continue.  Nodding can show agreement and understanding.  Nodding quickly can indicate you would like to say something.

Use your hands
Using your hands to gesture can emphasise or clarify what you are saying.  It can also distract people away from how you look.

Use sounds
When listening to someone, making sounds like ‘mmm’, ‘ah’, ‘uh huh’ or even saying ‘yes’ or ‘ok’ indicate to the other person that you understand what they are saying and give them a cue to continue.

Control your voice
Your tone of voice, pitch, and speed of delivery are very important.  For example, if you introduce yourself in a whisper, other people may not only struggle to hear you, but they may also assume that you lack confidence and may feel uncomfortable speaking with you – not because of how you look, but due to how you are presenting yourself.  If you talk loud enough for people to hear (but not too loudly), with an even tone and regular pace of speech, people will see you as confident and in control.

Hold your head up
If you bow your head or turn away, the other person will feel you are less engaged with the conversation or avoiding talking to them.  However, if you lift your head up, this shows interest and confidence.  Tipping your head to one side can show you are thoughtful or absorbed by the conversation.

Stand tall
It is not just your face that is important.  Communication involves your whole body and the way you stand tells other something people about you.  If you stand with your head up and your shoulders back you will look welcoming, confident and assertive.  If you stand with your shoulders bent over and your head down, you may convey the opposite impression.

If you feel shy or self-conscious about your looks, it is very easy to fall into the habit of stooping, hunching over or looking down if you feel, in an attempt to be less noticeable.  Unfortunately, this can have the opposite effect and may draw attention to your lack of confidence.

Use your style
Instinctively, we use first impressions to decide what we think about people.  How we dress and present ourselves gives people information about us.  So, finding a style that suits you and communicates something of your personality can really enhance your confidence and tell people who you are.

All the above may seem like a lot to remember.  Don’t worry, a lot of it is natural to us and it may be a case of learning new ‘habits’.  A Changing Faces Practitioner can help you to feel more confident.

What if your vision or expression is limited?

You may be concerned that people cannot read your expression if part or all of your face is paralysed, for example.  Or, you may feel self-conscious about smiling if you know that your smile is uneven or absent; or about eye contact if you have only one eye.  Try to use as many of the things listed above as possible.  For example:

  • Don’t hide your mouth or look down
  • Stand tall with your head up to give people the opportunity to see as many of your communication skills as possible
  • Show that you are smiling – a smile is far more than just the movement of the mouth – your eyes and the expression they show are equally as important – tip your head to the side to show interest
  • Nod, use hand gestures and non-verbal sounds
  • Use the tone and pace of your voice to show your feeling
  • Use eye contact – this is equally significant with one eye or two.

People will respond to your whole ‘message’ and pick up information from all the different information you give through body language.

What if your speech is affected?

If your speech is affected by your condition, sometimes it may be harder to make yourself understood verbally.  If this is the case it is even more important that you use all the tools above to make your body language work for you.  Try looking directly at the person when you are speaking.  Put plenty of expression and enthusiasm into what you say.  These will help the other person to understand you.  It can also be useful when you first meet someone to say something along the lines of, ‘Please listen carefully as my speech is not very clear.’  You can also let people know it is okay to ask you to repeat what you’ve just said.

How to join a conversation

What do you do when you want to join in a conversation or start speaking to someone?  Depending how close you are to the person, of course, you may call their name (if you know it).  But what if you don’t know the person or you are on the periphery of a group?  How do you get the attention to let people know you want to start a conversation?  Using some of the following actions will help:

  • Look at the person’s face
  • Raise your hand or beckon
  • If you know them well enough, touch the person gently on the arm
  • Raise your eyebrows or tilt your head towards them
  • Look confident and smile
  • Listen – and nod to show you are listening.
Make the most of your strengths!

To summarise, the way you present yourself gives people information about you.  Using your strengths and making the most of the tools above will convey far more about you than your disfigurement.  Changing Faces recognises this may feel challenging and offers support to help work on the areas you feel less confident about.

Speaking and listening

Starting a conversation

When meeting someone new for the first time, many of us feel blank and can’t think of anything to say.  Some people clam up; others talk too much or are inappropriately humorous.  If you are worried, it can be hard to think clearly.  And if you know nothing about the other person, it can be difficult to know where to start.  Here are some tips:

Talk about the weather

“Thank goodness for the good old British weather – I find it the best icebreaker there is.” Alison

People often start a conversation by talking about general experiences most people have in common, like the weather or the place they have met.  This ‘small talk’ is a perfectly normal social function and is very useful when striking up a new conversation.

What do you have in common?

The first thing you have in common is the place and circumstances where you have met.  Think about why you are there and use this to identify what else you might have in common.  For example, if you met at:

  • Your local neighbourhood watch, you may  both be interested in crime prevention or your local community
  • The school gate, you both are likely to have children at the school
  • At a party, you probably both know the host
  • The theatre, you could discuss the play you have seen.

Use this information and start the conversation from there.

Show interest in the other person

One of the best ways to start a conversation is to ask questions about or show interest in the other person.  Listen carefully to what they say and try to remember things about them to use in conversation, now or later.  Look at the person in front of you and use the information you have to ask a question or make a comment.  Or you may ask questions about the person’s life.  For example, you could:

Make a comment about an item of clothing or a particular piece of jewellery the person is wearing

  • Ask where someone works and their role there
  • Ask about hobbies
  • Ask a question about music, films or books
  • What town do they live in?

“I find it important to really listen to the other person and if I’ve met them before to remember something about them and ask them about it, for example a holiday or how their dog is? And, if you’re perhaps not part of a conversation first time round – listening is just as important – and maybe next time you will have something to say.” Alison

Other people may try to use this strategy to talk to you.  One thing they will notice about you is your disfigurement and some people may ask you about this. You may feel self-conscious or upset about this, but it is important to remember that most people are simply trying to find out more about you.

Keeping the conversation going

So, once you have started talking to someone, how do you keep the conversation flowing?

Show you are interested and listening to what the other person is saying:

  • Make sure you acknowledge their contribution
  • Use your non-verbal communication, as well as words
  • Ask questions – although try not to ‘interview’ the person by asking too many in a row
  • Comment on or summarise in your own words what the other person has said
  • Share your own thoughts or experiences.

For example:

You: ‘What did you think of the music?’
Other person: ‘Great, they are one of my favourite bands!’
You: ‘You’re obviously a big fan. I liked their last album. Do you see a lot of live music?’

Ask the right kind of question
Different types of questions lead to different types of replies.

A closed question will produce a ‘yes’ or ‘no’ answer.  Although useful, these types of questions can sometimes stop the conversation from flowing quite as well.  For example, if you ask:

“Did you like the music?”

The answer is likely to be a simple ‘yes’ or ‘no’ rather than something that invites more comment.  This is not a major problem – you can still remark on the person’s answer or ask another question in response, but it will most likely come back to you to think of something to say.

You might like to think about asking open questions – these are more likely to elicit a longer and detailed response.  Open questions start with the words:

  • Who…
  • What…
  • Where…
  • When…
  • How…

Think about how the other person might respond if you asked:

“What did you think of the music?”

Changing the subject
Pay attention to how the other person is responding to you.  What can you pick up from their body language?  Are they interested in the topic that you are discussing?  If they are, they should be listening, responding and sharing the conversation, asking questions and commenting.  If they are not interested, then there may be less eye contact and the other person may seem unwilling to develop the theme.  There may be many reasons for this or they may be distracted by something else, but you could try to introduce a new topic of conversation.  To do this, think about the tips in Starting a conversation.

Joining a group conversation

Earlier, we explored the non-verbal ways to indicate you wish to join a conversation, but how do you go about actually joining in?  Before you start speaking, listen to what the group is talking about, rather than changing the subject.  When you feel you have a comment to make, try the following:

  • Wait for a natural lull or a pause in the flow and then speak
  • Make eye contact with the speaker and nod to indicate you have something to say
  • Step forward slightly into the group.

Remember to acknowledge what other people say, and share your experiences and thoughts, even if you are asking a question. Here are some examples:

‘I know, his last film was rubbish. Has anyone seen the one he made previously?’

‘Talking about holidays, we went to…’

‘You’re right about playing sport; I would really like to play more…’

‘It’s interesting that you say that; when I was at school…’

Other people feel awkward too

It is important to remember that most people find talking to someone new quite difficult.  You may feel that an awkward conversation is due to your looks, but it may just be your own, or the other person’s, lack of confidence or communication skills – or both!  Try not to assume that it is your disfigurement that is getting in the way of a good conversation.

“I’ve developed a lot of skills over the years, through trial and error. I’ve also realised that people who do not have physical difference can also be worried about social situations” Alison

Being prepared

It can be useful to think about a social situation before you go.  This may help you to feel more in control and confident about your conversation skills.  Try making a list of possible subjects before you get there.  Here are some useful things to consider:

  • Who is likely to be there?
  • What are their interests likely to be?
  • What might you have in common?
  • What interesting things have happened to you recently?
  • What is happening in the world at the moment?
  • What news stories are current?

Practise your communication skills

Learning to manage a conversation is a skill. Like learning any skill, it takes practise. People who are good at conversation have most likely had a lot of opportunity to develop their communication skills. Learn by watching and listening to these people. Practise regularly – go to social events and try out the techniques described here. Take notice of the things that work for you. If you think you might not remember, it may be good to write them down first. If something doesn’t work on more than one occasion, try to think why and how you can approach it differently. Try some of the exercises below. And there is more help and opportunities to develop your skills and practise in Communicating with confidence Part 2.

Give yourself time

If you feel communication and social events are a struggle for you, it is natural it will take time to develop your skills. Try to be patient, and reassure yourself if things seem to go wrong. Confide in friends or family about difficult or challenging times, and listen to their support and advice. Try reassuring yourself that things might go better next time. Although it might seem difficult at times, it is worth persevering. The more positive social experiences you have, the more confident you will feel.

“I have found small talk to be a brilliant ice breaker and have built up a library in my head of things to talk about with different people. It might be a book I’ve just read, an interesting news story or something funny that happened to me.” Alison

Changing Faces can offer support to help you improve your skills. Talk to one of our Practitioners or attend our workshops Reach Out or Beauty Inside and Out.


  • Make eye contact and smile
  • Be aware of your feelings
  • Nod, gesture and use sounds to indicate you are listening
  • Stand tall with your head up
  • Be aware of the tone, pitch and speed of your voice
  • Wear something that makes you feel good
  • Show your interest in what other people have to say
  • Ask open questions
  • Share your own experiences
  • Be prepared.

Try it Out

The exercises are to help you to think about how some of the things we have discussed might work for you – and may help you to feel confident and prepared when you are next in a social or public setting.  Best to do these exercises when you have read this guide – and it might help to refer back to the information you’ve read.  To get even more helpful tips, try reading Communicating with confidence, Part 2: Handling other people’s reactions as well.

Here are some examples of situations that you may find yourself in – try thinking about a few answers for each situation.

It might help to print this page out and write down your answers.