It Takes Two to Empathize

Today we’re looking at a single study, available in full text, on empathy. Avnor, Atias, Markus & Shamay-Tsoory (2024) published “It Takes Two to Empathize: Interbrain coupling contributes to distress regulation” in Emotion. Here are highly edited excerpts:

While extant research on empathy has made significant progress in uncovering the mechanisms underlying the responses of an observer (empathizer) to the distress of another (target), it remains unclear how the interaction between the empathizer and the target contributes to distress regulation in the target. Here, we propose that behavioral and neural coupling during empathic interactions contribute to diminished distress. From November 2020 to November 2022, we recruited 37 pairs of previously unacquainted participants (N = 74) from multicultural backgrounds. They engaged in a 5 min face-to-face emotional sharing task, where one participant shared a distressing biographical experience with the other participant. We used functional near-infrared spectroscopy (fNIRS) to measure interbrain coupling in the emotion regulation system, specifically the dorsolateral prefrontal cortex (dlPFC), and the observation execution system, specifically the inferior frontal gyrus (IFG). Results indicate that during emotional sharing the target and the empathizer emotionally converge, such that the empathizer becomes sadder. Moreover, the levels of empathizers’ empathy predicted both emotional convergence and target distress relief. The neuroimaging findings indicate that interbrain coupling in the dlPFC, IFG, and premotor cortex, predicted distress relief in the target, and more critically that interbrain coupling in the dlPFC played a mediating role in the relationship between distress relief and the levels of empathy of the empathizer. Considering the role of the dlPFC in emotion regulation, we conclude that interbrain coupling in this region during emotional sharing plays a key role in dyadic coregulation of distress. 

Humans have an inherent inclination to respond to the distress of others. This is evident during the act of comforting a crying infant or providing support to an emotionally troubled friend. During these moments, a significant dyadic interaction unfolds, allowing one individual to relieve the distress of another. One of the critical human capacities that may contribute to the ability to regulate the other’s emotions is empathy. Empathy is a multifaceted construct representing the ability to share the emotional state of others and take their perspective and may consequently lead to the response of alleviating another’s negative emotions. While extensive research has focused on understanding the empathic response of an observer (the empathizer) to the distress of another (the target), there has been comparatively less emphasis on understanding the alleviation of distress of the target in response to an empathic response. Moreover, numerous studies tend to neglect the interpersonal aspect of empathy by isolating it from other concurrent emotional and cognitive processes, such as emotion regulation processes. Considering empathy’s fundamental and evolutionary purpose of relieving the distress experienced by a suffering target, there needs to be a shift in research allowing for a more integrative framework of understanding empathy and distress relief together as two tightly interrelated processes. 

Building on these studies, we propose a model according to which the distress relief of a target is linked to the empathizer’s response and facilitated through interbrain coupling in two possible neural systems: (a) observation execution and (b) emotion regulation. The observation execution system includes the inferior frontal gyrus (IFG), the inferior parietal lobule, as well as the premotor cortex. These brain regions have been demonstrated to function in a manner where the observation of an action in someone else has the capability to automatically trigger one’s own mental representations of that action. Importantly, the observation execution system has been implicated in understanding emotions, beliefs, and vicarious pain. These characteristics of the observation execution system suggest a significant role in enabling the empathizer to align their emotional state with the target. This emotional alignment between interacting individuals is commonly known as emotional contagion, a fundamental aspect of empathy.

Furthermore, empathy may alleviate distress in others by fostering a sense of “felt understanding,” wherein a target acknowledges that their interaction partner has genuinely grasped and responded to fundamental aspects of their emotional experience. While felt understanding is reported to diminish stress and boost positive affect among partners in close relationships, among strangers, felt understanding also decreases negative affect. This may be because feeling understood activates neural regions previously associated with reward and social connection.

Our findings that distress relief was associated with empathy levels during the emotional sharing task are in line with the previous studies which have also demonstrated empathy’s role in reducing other forms of distress, such as physical pain. 

The neuroimaging results showed that increased interbrain coupling in regions of the targets and empathizer’s observation execution system and emotion regulation network (L. dlPFC-R. dlPFC, R. dlPFC-R. premotor, R. IFG- R. IFG, R. IFG- R. premotor), significantly predicted sadness levels among targets during the emotional sharing task. Interbrain coupling in the IFG and premotor cortex, central regions of the observation execution system, were significant predictors of target distress relief. As these areas enable individuals to understand others’ actions and intentions through the generation of congruent representations of the other in the self (IFG) and are activated both in observation and imitation (premotor), it is possible that interbrain coupling within these regions represents blurring of the boundaries between the self and other. This blurring can evoke a sense of oneness and as a result, the target may begin to feel more like the empathizer, less sad. The target may also experience distress relief through the activation of the observation execution system as it has been shown that alignment (as seen in mimicry) induces positive affect by activating reward related processes in the brain.

While involvement of the observation execution system may facilitate distress relief in the target, it may also promote empathy in the empathizer. 

Furthermore, the involvement of the observation execution system may play a role in the execution of the emotional sharing task itself. Greater interbrain coupling within the dlPFC also significantly predicted distress relief of targets (reduced sadness levels). The current literature on emotion regulation points to both the right and left dlPFC as key players in exerting emotional regulation processes that are primarily through top-down cognitive mechanisms, as the dlPFC is also part of the executive network. In line with our results that the activation of the left dlPFC is associated with distress regulation, previous studies have shown the left dlPFC to be involved in the regulation of pain perception. 

While numerous intrabrain studies have demonstrated the dlPFC’s role in distress regulation, the question remains, how might interbrain coupling of the dlPFC between target and empathizer contribute to distress reduction in the target? One possibility is that the attunement of the empathizer to the emotions of the target contributes to dyadic coupling which allows coregulation of affective states during the emotional sharing. Furthermore, interbrain coupling between empathizer and target within the dlPFC might reflect the extent of cooperation to coregulate as previous hyperscanning studies that have linked dlPFC coupling with successful cooperative interactions between two individuals. Further supporting the dlPFC’s role in emotion regulation are the results of our mediation analysis, where interbrain coupling levels in the L. dlPFC-R. dlPFC partially mediated the effect that state empathy levels had on target distress relief. While the dlPFC is commonly known for its role in emotion regulation, it has been also previously involved in the formation of cognitive empathic responses. Interbrain coupling in the L. dlPFC-R. dlPFC might serve a mechanistic role in the link between empathic processes and distress regulation in the target. It is thus possible that during empathetic interactions, the IFG plays a critical role in enabling the participants to share emotions and diminish the distinction between their individual experiences. At the same time, interbrain coupling within the dlPFC regions may support the collaborative regulation of emotions between the target and the empathizer.

Our study reveals the emergence of emotional convergence during emotional sharing, where empathy assumes a pivotal role in shaping the sharing experience. Notably, we observed that interbrain coupling in the IFG, premotor cortex and in the dlPFC is associated with the extent of distress experienced after sharing. These findings suggest that interbrain coupling may serve as a mechanism of connectedness during emotional sharing, contributing to the emergence of attuned responses and ultimately influencing the levels of distress the target experiences. Since we did not explore the specific communication signals (e.g., facial expressions, prosody) contributing to these associations, future research can characterize the relationship between distinct behavioral signals and their contributions to reducing distress. Finally, it is imperative to investigate causality to ascertain whether the observed interbrain coupling genuinely influences the distress of the target.

I thought this study was important in its design and the use of unacquainted people. I found the data on the dorsolateral prefrontal cortex (dlPFC), inferior frontal gyrus (IFG), and premotor cortex helpful in supporting their hypothesis that interbrain coupling occurs during empathic exchanges. It makes sense to me that the observation execution system in the brain facilitates interbrain coupling. As usual, I also like the last sentence.