Effective psychotherapy often hinges on development of a “connection” or shared empathy between patient and therapist. For the first time, researchers have found biological support for how patients and therapists “connect” during a clinical encounter.
In the February Journal of Nervous and Mental Diseases, researchers from Massachusetts General Hospital (MGH) report the physiologic evidence of shared emotions underlying the experience of empathy during live psychotherapy sessions.
The researchers found that, during moments of high positive emotion, both patients and therapists had similar physiologic responses and that greater levels of similarity were related to higher ratings of therapist empathy by patients.
The researchers’ goal is to learn how physiologic concordance relates to empathy over the course of psychotherapy. This knowledge will improve therapeutic techniques and help to develop resources for teaching medical students and clinicians to be more empathic.
“This research supports brain imaging data that shows humans are literally ‘wired to connect’ emotionally,” says Carl Marci, MD, director of Social Neuroscience in the MGH Department of Psychiatry and the paper’s lead author. “There is now converging evidence that, during moments of empathic connection, humans reflect or mirror each other’s emotions, and their physiologies move on the same wavelength.”
As part of an ongoing study of the role of empathy in psychotherapy, the MGH researchers videotaped therapeutic sessions of 20 unique patient-therapist pairs.
The patients were being treated as outpatients for common mood and anxiety disorders in established therapeutic relationships. The participating therapists practiced psychodynamic therapy, an approach that uses the therapeutic relationship to help patients develop insight into their emotions.
Throughout the therapy sessions, patients and therapists were “wired up” to record their physiologic responses using skin conductance recordings. Skin conductance is a commonly used measure of the activity of the sympathetic nervous system, which controls human arousal and provides a physiologic context for emotional experiences.
Following the sessions, the videotapes were edited to focus on moments of high and low physiologic concordance – that is, when patients’ and therapists’ levels of nervous system activity were most and least similar. Independent observers, blinded to the study’s goals and methods, reviewed randomly presented video segments to identify the types of emotions being expressed by both patients and therapists.
The observers’ data showed that both patients and therapists expressed significantly more positive emotions during moments of high physiologic concordance than during low concordance. In addition, patient’s ratings of therapist empathy corresponded to levels of physiologic concordance during the therapy sessions. Overall, the findings suggest that shared positive emotions and shared physiologic arousal contribute to an empathic connection during psychotherapy.
“We were pleased to find evidence for a biological basis to that feeling of connection,” Marci says. “Taken together with current neurobiological models of empathy, our findings suggest that therapists perceived as being more empathic have more positive emotional experiences in common with patients during the therapy session.” He adds another finding not reported in the published report – that there was much less physiologic concordance when therapists were talking than listening. “That suggests it is hard for clinicians to be empathic when they are talking.”
Source: Massachusetts General Hospital