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What if you had to Pass an Empathy Test?

Posted Sep 13 2008 3:07am

How long before we are doing therapy with our clients in an MRI scan. Interesting news just out today on neurophysiological measures of empathy in both clients and clinicians. Hat tip: Eureka. As a total aside Eureka is one of the best news feeders I have found for keeping up to date with breaking science news.

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.

I suppose it is not surprise really to think that we mirror physiologically as much as psychologically Wiredhead with our patients but this seems to be a first step in actually beginning to be able to measure it. Actually measuring empathy is something new. Is this yet another of the clinician’s arts falling to science. The idea of therapists having to pass an “empathy test” to practice in the future is an interesting and scary thought.

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.

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.”

One of the things that comes to mind is that you could utilise this as a biofeedback mechanism to help clinicians improve their empathy. The other interesting note was that when we talk we become less empathetic. I wonder is this is even when we are making an empathic statement? The other question to wonder about is, will we see the same physiological correlates to empathy when clinicians are delivering other sorts of therapy?

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