Study shows how patients and therapists are 'wired to connect'

February 13, 2007

Empathy is well known to be an important component of the patient-therapist relationship, and a new study has revealed the biology behind 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 first 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.

"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."

The researchers' next step is a longer-term study of how physiologic concordance relates to empathy over the course of psychotherapy. The ultimate goals of the project are to improve therapeutic techniques and to develop resources for teaching medical students and clinicians to be more empathic. Marci is an instructor at Harvard Medical School, and his co-authors are Jacob Ham, PhD, now at Mt. Sinai Hospital in New York, Erin Moran of MGH, and Scott Orr, PhD, of MGH and the VA Medical Center in Manchester, N.H. The study was supported by grants from the National Institutes of Health and the MGH Endowment for the Advancement of Psychotherapy.
-end-
Massachusetts General Hospital, established in 1811, is the original and largest teaching hospital of Harvard Medical School. The MGH conducts the largest hospital-based research program in the United States, with an annual research budget of nearly $500 million and major research centers in AIDS, cardiovascular research, cancer, computational and integrative biology, cutaneous biology, human genetics, medical imaging, neurodegenerative disorders, regenerative medicine, transplantation biology and photomedicine. MGH and Brigham and Women's Hospital are founding members of Partners HealthCare System, a Boston-based integrated health care delivery system.

Massachusetts General Hospital

Related Emotions Articles from Brightsurf:

Why are memories attached to emotions so strong?
Multiple neurons in the brain must fire in synchrony to create persistent memories tied to intense emotions, new research from Columbia neuroscientists has found.

The relationship between looking/listening and human emotions
Toyohashi University of Technology has indicated that the relationship between attentional states in response to pictures and sounds and the emotions elicited by them may be different in visual perception and auditory perception.

Multitasking in the workplace can lead to negative emotions
From writing papers to answering emails, it's common for office workers to juggle multiple tasks at once.

Do ER caregivers' on-the-job emotions affect patient care?
Doctors and nurses in emergency departments at four academic centers and four community hospitals in the Northeast reported a wide range of emotions triggered by patients, hospital resources and societal factors, according to a qualitative study led by a University of Massachusetts Amherst social psychologist.

The 'place' of emotions
The entire set of our emotions is mapped in a small region of the brain, a 3 centimeters area of the cortex, according to a study conducted at the IMT School for Advanced Studies Lucca, Italy.

Faking emotions at work does more harm than good
Faking your emotions at work to appear more positive likely does more harm than good, according to a University of Arizona researcher.

Students do better in school when they can understand, manage emotions
Students who are better able to understand and manage their emotions effectively, a skill known as emotional intelligence, do better at school than their less skilled peers, as measured by grades and standardized test scores, according to research published by the American Psychological Association.

How people want to feel determines whether others can influence their emotions
New Stanford research on emotions shows that people's motivations are a driving factor behind how much they allow others to influence their feelings, such as anger.

Moral emotions, a diagnotic tool for frontotemporal dementia?
A study conducted by Marc Teichmann and Carole Azuar at the Brain and Spine Institute in Paris (France) and at the Pitié-Salpêtrière Hospital shows a particularly marked impairment of moral emotions in patients with frontotemporal dementia (FTD).

Emotions from touch
Touching different types of surfaces may incur certain emotions. This was the conclusion made by the psychologists from the Higher School of Economics in a recent empirical study.

Read More: Emotions News and Emotions Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.