Study Examines Empathy During Psychotherapy
Chicago Tribune - March 07, 2007
CHICAGO - They're special, those moments of close connection when you become attuned to another person's mood, and it seems you can sense what he or she feels.
This "we're on the same wavelength" phenomenon is known as empathy, part of the emotional glue that helps bind people together. Now it's being studied with the tools of modern science, sophisticated neuro-imaging scans and physiological tests that track how people's brains and bodies respond during social encounters. The still-young field of scientific inquiry is called social neuroscience, and it's beginning to demonstrate that empathy has biological underpinnings as well as emotional dimensions.
The latest research comes from Boston, where Massachusetts General Hospital researcher Dr. Carl Marci has been examining empathy in the context of psychotherapy. His research appeared last month in the Journal of Nervous and Mental Disease. The study is the first to try to measure how patients and psychologists react to each other during a therapy session and how empathy plays out between them.
The major finding validates the depth of connection that can occur: The more in tune patients and therapists appeared to be emotionally, the more closely their physiological responses mirrored each other. "In other words, when we feel connected to someone, it's because we actually are experiencing something similar," said Marci, who worked with collaborators in New York City and New Hampshire. "Fundamentally, we're social beings, and our brains are wired to connect."
The physiological measurement used in the study was "skin conductivity," a sensitive indicator of arousal in the sympathetic branch of the autonomic nervous system. Researchers obtained readings by attaching electrodes to patients' and therapists' fingers and recording their responses to imperceptible electrical currents. Some 20 patient/therapist pairs were studied during a session averaging 45 minutes. All the patients had a diagnosis of depression or anxiety and had worked with the therapists for some time.
This part of the study showed significant "concordance," or similarity, between patients' and therapists' level of arousal about 50 percent of the time. That was highly significant and not due to chance alone, the researchers said. After the session, researchers asked patients to rate the degree of empathy demonstrated by their therapists, using a standardized questionnaire. The higher the level of perceived empathy, the higher the congruence in the pair's physical responses, researchers discovered.
In the last part of the study, two trained observers watched videotaped segments of therapy sessions when pairs were most and least closely aligned, according to physiological data. The purpose was to identify moments of apparent empathy by observing social and emotional interactions. This analysis showed that patients and therapists were, indeed, having more positive interactions when their skin conductivity measurements were most similar.
That comes as no surprise to Anne Alonson, a clinical professor of psychiatry at Harvard Medical School who directs the Center for Psychoanalytic Studies at Massachusetts General. "Everyone knows that emotions locate themselves in the body. What we're finding is, it's not just one person's body: People can join each other in feeling," she said. Alonson gave the example of a recent session with a man who appeared quite downhearted but seemed not to know it. "He's talking, and I'm realizing that I'm beginning to feel really sad so I say, 'I have a sense of sadness in myself, and I wonder if you feel it too.' At which point, he started to cry."
This kind of empathetic connection is fundamental to the therapeutic process, said Dr. Deborah Spitz, associate professor of psychiatry at the University of Chicago. "In working with someone, you need to know where they are, emotionally, in order to be able to help them," she explained. "You have to be able to meet them, and empathy helps you do that."
"I'm not at all surprised that is something we experience in our bodies as well as our brains," Spitz said. Indeed, human brains appear hard-wired to "perceive and share others' feelings," according to Jean Decety, a professor of psychology who joined the University of Chicago's faculty last year. Decety was quoted in a University of Chicago Magazine interview describing his groundbreaking neuro-imaging studies, which demonstrate that brain networks processing personal pain also light up when another person's pain is recognized. That's compelling evidence of a biologically grounded emotional overlap between self and other, experts suggest.
There are limitations to the new research out of Massachusetts General. The sample size is small, and there were no controls. Patients' perceptions of empathy could be influenced by their underlying mental conditions and treatment status. Still, Dr. K. Luan Phan, director of the brain imaging and emotions laboratory at the University of Chicago, believes the finding "that you can get a biological marker for a therapeutic relationship" is "very important and very exciting."
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