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

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