The marriage counselor we see has commented several times on my "incongruous" affect and that I smile at times when I am stating I am upset. He said there was a learning curve for him in having to listen harder to what I actually say rather than how I look like I feel. He ignored what I was saying a couple of times because I didn't "look" like I was in as much pain as I said, and pushed me really hard and it didn't go well.

I don't think it's all that uncommon to smile or laugh while in discomfort. My daughter smiles when she's anxious or upset and trying not to cry.