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The physiology of compassion in couples’ discussions about loss

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The physiology of compassion in couples’ discussions about loss

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Content Running head: PHYSIOLOGY OF COMPASSION IN COUPLES 1

The Physiology of Compassion in Couples’ Discussions about Loss
Geoffrey W. Corner
University of Southern California
August 2016
Master of Arts (Psychology)

PHYSIOLOGY OF COMPASSION IN COUPLES 2
Table of Contents
Abstract ........................................................................................................................................... 3
Introduction ..................................................................................................................................... 4
The Importance of Partners’ Interactions ................................................................................... 4
What is Compassion? .................................................................................................................. 5
The Physiology of Compassion and Couples’ Interactions ........................................................ 7
Potential Moderators of Physiological Responses to Compassion ............................................. 9
Measurement of Physiology ..................................................................................................... 12
Current Study ............................................................................................................................ 13
Method .......................................................................................................................................... 14
Overview ................................................................................................................................... 14
Participants ................................................................................................................................ 14
Procedure .................................................................................................................................. 15
Measures ................................................................................................................................... 18
Results ........................................................................................................................................... 20
Overview of Data Analysis ....................................................................................................... 20
The Physiology of Compassion ................................................................................................ 23
Moderators of the Association between Compassion and Heart Rate ...................................... 23
Discussion ..................................................................................................................................... 27
References ..................................................................................................................................... 35
Tables and Figures ........................................................................................................................ 43

PHYSIOLOGY OF COMPASSION IN COUPLES 3
Abstract
Compassion, a virtue across a variety of spiritual and cultural belief systems, is
commonly considered to originate in witnessing another person’s distress and to result in a desire
to help. Though compassion has been studied in individuals, little is known about how it
functions dyadically and in close relationships. The current study used a novel dyadic interaction
protocol, a “loss discussion,” to investigate the physiological profile of both experienced and
received compassion. In these loss discussions, “speakers” shared an emotionally salient loss
with their partner, the “listener.” Speakers’ perceptions of their partner’s compassion were
positively associated with their own heat rate, and listeners’ perceptions of their own compassion
were inversely associated with their own heart rate. Anxious attachment attenuated the positive
association between compassion and the speaker’s heart rate. For listeners, relationship
satisfaction and low attachment-related avoidance attenuated the inverse association between
compassion and heart rate. These results support the approach of studying compassion
dyadically, a unique feature of this study, and they are consistent with the idea that compassion
occurs in response to witnessing another person’s distress and that it differs from merely
internalizing that distress. However, they also suggest the importance of personal characteristics
in determining the physiology of compassion.
Keywords: compassion, couples, loss, support, heart rate, psychophysiology

PHYSIOLOGY OF COMPASSION IN COUPLES 4
Introduction
Compassion is widely regarded as a virtue across a variety of spiritual and cultural belief
systems, signifying its importance in human relationships. Although compassion is complex and
has been defined in diverse ways, it is commonly considered to originate in witnessing another
person’s distress and to result in a desire to help (Goetz, Keltner, & Simon-Thomas, 2010).
Based on this definition, compassion may be related to the construct of offering support, and it
could be particularly significant in close and intimate relationships. Research has demonstrated
that emotional support from a romantic partner can ameliorate suffering in response to
misfortune (Cutrona, 1996; Misri, Kostaras, Fox, & Kostaras, 2000; Pistrang & Barker, 1995).
Furthermore, marriage and social support have been tied to long-term health outcomes (Robles &
Kiecolt-Glaser, 2003; Uchino, Cacioppo, & Kiecolt-Glaser, 1996), and on a momentary level,
certain physiological reactions to stress can be maladaptive and are associated with poor health
(Brotman, Golden, & Wittstein, 2007; Manuck, 1994; Smith & Ruiz, 2002). Together, these
findings suggest the importance of human interactions, especially those with significant others,
and the relevance of momentary changes in physiology during these interactions. The present
research investigates the extent to which under-the-skin phenomena, specifically heart rate, are
associated with perceptions of compassion. By studying compassion dyadically and in close
relationships, we offer a nuanced understanding of the short-term physiological profile of
compassion in couples’ interactions about sadness and loss.
The Importance of Partners’ Interactions
When an individual encounters psychological hardship, emotional support from a
romantic partner can be valuable (Cutrona, 1996). For example, research has demonstrated the
importance of partner-provided support in both new mothers experiencing postpartum depression
PHYSIOLOGY OF COMPASSION IN COUPLES 5
(Misri, Kostaras, Fox, & Kostaras, 2000) and women who recently received a diagnosis of breast
cancer (Pistrang & Barker, 1995). Furthermore, marital quality is associated with fewer future
depressive symptoms in both men and women (Beach, Katz, Kim, & Brody, 2003), suggesting a
potentially protective influence of a well-functioning relationship in terms of mental health.
Emotional support in close relationships can even have a positive impact on immediate and long-
term health (Uchino, Cacioppo, & Kiecolt-Glaser, 1996), and conversely, marital conflict,
aggression, and hostility are associated with a host of negative health outcomes (Burman &
Margolin, 1992; Kiecolt-Glaser & Newton, 2001; Robles & Kiecolt-Glaser, 2003). More
generally, social support is related to lower levels of distress in bereaved individuals (Stroebe,
Zech, Stroebe, & Abakoumkin, 2005) and less psychological impairment in the general
population (Andrews, Tennant, Hewson, & Vaillant, 1978). Taken as a whole, the body of
research on close relationships suggests the importance of understanding how and when partners
are supportive. Exhibiting compassion, although different than offering social support, is part of
a potentially valuable supportive process between partners.
What is Compassion?
Although compassion has been conceptualized as including a variety of emotions (e.g.,
sympathy, love, empathy) and behaviors (e.g., attentiveness, providing care), compassion in the
current study is defined as “the feeling that arises in witnessing another’s suffering and that
motivates a subsequent desire to help” (Goetz, Keltner, & Simon-Thomas, 2001, p. 351).
However, differentiating what is and is not meant by compassion has been subject to
controversy. Some research supports a differentiation between empathy and distress (Batson,
Fultz, & Schoenrade, 1987), or between compassion and emotions related to sadness (Fultz,
Schaller, & Cialdini, 1988). Nonetheless, there is also reason to believe that many people view
PHYSIOLOGY OF COMPASSION IN COUPLES 6
compassion as similar to sadness or including a component of sadness (Shaver, Schwatz, Kirson,
& O’Connor, 1987), and empathy is sometimes defined as sharing in and actually experiencing
another person’s emotions, which would likely include distress or suffering (Duan & Hill, 1996).
Here, Russell’s (1980) conceptualization of emotions as “fuzzy sets,” existing and occurring
without sharp delineations and boundaries, can be useful. In this view, compassion can
encompass a wide range of related emotions and behaviors, and its operationalization is best
guided by how it functions and is perceived interpersonally rather than by a strict and rigid
conceptualization of what compassion is and is not. This flexible operationalization is important
to capture the complex and diverse ways in which people interact in real life.
Though research on compassion in couples is limited, the research on emotional support
may provide some insight. However, it is first important to consider the ways in which
compassion, which is not fully understood in terms of how it functions in couples’ interactions,
is distinct from social support, which has been researched extensively and is an integral part of a
well-functioning romantic relationship. One conceptualization of social support divides it into
three subcategories: social integration, esteem support, and emotional support (Cobb, 1976). Of
these three types of support, compassion is most closely related to emotional support, which
leads to feeling cared for and loved, and some overlap between these two constructs certainly
exists. However, compassion differs from emotional support in a few important ways. For one,
compassion is experienced in response to observed suffering (Goetz, Keltner, & Simon-Thomas,
2010), while emotional support is generally considered to occur in response to day-to-day life
stress (Cobb, 1976). Furthermore, compassion, relative to emotional support and as evidenced by
its close connection to empathy and its complex relation to distress (Batson, Fultz, &
Schoenrade, 1987; Goetz, Keltner, & Simon-Thomas, 2010; Shaver, Schwatz, Kirson, &
PHYSIOLOGY OF COMPASSION IN COUPLES 7
O’Connor, 1987), is associated with a deeper connection to and understanding of the emotional
state of another person who is suffering. Whereas this likely is an essential ingredient of
compassion, it is not necessary in offering emotional support. This may in part explain why
social support, although associated with better psychological adjustment after the death of a
loved one, has not been shown to moderate the negative impact of a loss (Andrews et al., 1978;
Stroebe et al., 2005). Perhaps, in these more extreme circumstances, compassion is a more
relevant support-related construct.
Overall, compassion is a complex and multifaceted emotion that is better understood by
its interpersonal function than by a checklist of different components that it needs to include. It is
also particularly relevant in close relationships and in cases of acute suffering that require a more
sophisticated response than just emotional support. The current study attempted to capture
compassion in this way, through self- and partner-provided behavioral ratings of compassion
exhibited in response to sharing a meaningful loss.
The Physiology of Compassion and Couples’ Interactions
Compared with conflict and aggression, less empirical attention has been given to
positive interactions and psychological states and their impact on physiology, which could be an
important topic to study. In the work that has been done, an association between psychological
well-being and lower diurnal cortisol output has been observed (Lindfors & Lundberg, 2002),
and other studies have demonstrated attenuated cortisol responses to stress in men after partner-
provided social support (Kirschbaum, Klauer, Filipp, & Hellhammer, 1995) and attenuated
cortisol and heart rate responses to stress in women after positive physical contact from a partner
(Ditzen et al., 2007).
Physiology of Compassion. Although the physiology of compassion in couples’
PHYSIOLOGY OF COMPASSION IN COUPLES 8
interactions has not yet been studied, findings on the physiology of compassion experienced in
individuals can provide a sense of what might occur in a dyadic context. Contrary to what one
might expect if compassion involved only observing and internalizing another individual’s
negative emotions, experimentally evoked compassion-related emotions are associated with
decreased arousal of the autonomic nervous system (Goetz, Keltner, & Simon-Thomas, 2010).
This includes 1) heart rate deceleration associated with greater self-reported sympathy in
response to a sympathy-evoking film and lower levels of skin conductance compared to levels
measured in response to a distress-evoking film (Eisenberg et al., 1991) and 2) heart rate
deceleration relative to baseline in response to recalling self-selected sympathy-evoking
memories (Eisenberg et al., 1988).
It will be important, however, to investigate the physiology of compassion specifically in
couples’ dyadic interactions. The involvement of two or more people is inherent in the definition
of compassion, which occurs in response to another person’s emotional state and includes a
component of helping behavior or a desire to help (Goetz, Keltner, & Simon-Thomas, 2010).
Thus, an inherent disconnect exists between our understanding of compassion as experienced by
individuals and its presentation and physiological consequences in the day-to-day reality of
couples.
Physiology of Couples’ Interactions. Despite a lack of research investigating couples’
compassionate interactions, many studies have explored physiological changes produced by
other kinds of dyadic exchanges between partners. To date, most research investigating the
physiology of partners’ interactions has focused on conflict (Burman & Margolin, 1992; Kiecolt-
Glaser & Newton, 2001; Murray-Close, Holland, & Roisman, 2012) rather than compassion, and
studies addressing partners’ supportive behaviors have typically concentrated on anxiety-
PHYSIOLOGY OF COMPASSION IN COUPLES 9
provoking situations (Feeney & Collins, 2011; Simpson, Rholes, & Nelligan, 1992) rather than
those that elicit softer, non-threat-based emotions (e.g., sadness, grief). One study that did
examine a social support interaction between partners specifically focused on negative behaviors
and their relation to marital distress (Pasch & Bradbury, 1998), and a similar study examined the
effects of stress on the provision of support in couples (Bodenmann et al., 2015).
Research using a conflict paradigm with couples has demonstrated an association
between conflict-related physiological reactivity and relational aggression, particularly when
partners are less satisfied with their relationship (Murray-Close, Holland, & Roisman, 2012).
This physiological response is associated with both emotional reactivity and aggressive behavior
(Scarpa & Raine, 1997). Complicating this relationship, physiological under-arousal to relational
stressors is also sometimes associated with aggression in close relationships (Murray-Close,
2011). Although extrapolating conflict-related findings into the realm of compassion is likely not
possible, several important points can be extracted from these results. First, the physiology of
couples’ interactions can be closely tied to partners’ behaviors, attitudes, and emotions. Second,
the association between physiological responses and partners’ behaviors is complex and not
necessarily linear or consistent for all people. Similar results can sometimes be found for both
high and low levels of arousal, and it is important to consider the influence of personal
characteristics in moderating this association.
Potential Moderators of Physiological Responses to Compassion
Physiological responses to expressed and received compassion in couples’ interactions
will likely differ depending on the characteristics of the partners involved. Although many
individual differences are relevant to this association, three specific potential moderators were
tested in the current study: gender, attachment style, and relationship satisfaction.
PHYSIOLOGY OF COMPASSION IN COUPLES 10
Gender. Men and women may have different preferences for support and different
physiological responses during interactions with their partners. For example, although men and
women both report the importance of emotional support in close relationships, females may
assign it greater significance (Burleson, 2003). This divergence could be related to differences
between men and women in the effectiveness of coping strategies that focus on processing
emotions, with women showing greater life satisfaction and decreased depressive
symptomatology when employing emotion approach coping (Stanton, Danoff-Burg, & Cameron,
1994). Prior work in a conflict paradigm also indicates that women may be more sensitive to
relationship quality and events, resulting in greater physiological reactivity in dyadic interactions
with their partners (Kiecolt-Glaser & Newton, 2001). Conversely, marriage appears to be more
closely linked to men’s life expectancy than to women’s, although greater life expectancy has
been observed for both married men and married women (Kiecolt-Glaser & Newton, 2001).
Despite these potential differences, diminished cortisol responses to the Trier Social Stress Test
as a result of partner-provided support have been shown in both men and women (Ditzen et al.,
2007; Kirschbaum, Lkauer, Filipp, & Hellhammer, 1995). Interestingly, men were responsive to
nonphysical “helping” behavior (Kirschbaum, Lkauer, Filipp, & Hellhammer, 1995), while
women were responsive to positive physical contact from their partner and not to verbal support
(Ditzen et al., 2007). It is possible that differences in the abilities of men and women to provide
support verbally contribute to these findings, and as such, a dyadic paradigm in which partners
provide their own on-the-ground ratings of compassion is particularly promising in examining
gender differences in the impact of compassion as a potentially supportive process.
Attachment Style. Attachment style is also a particularly relevant construct in close
relationships. The concept of adult attachment originates in Bowlby’s (1969; 1973; 1980)
PHYSIOLOGY OF COMPASSION IN COUPLES 11
attachment theory, which holds that childhood experiences and expectations with respect to the
availability of a caregiver give rise to a system of beliefs about relationships between the self and
others. As adults, individuals with a secure attachment style are able to make strong and stable
intimate connections with other people and trust that these individuals will be available and
responsive. There is evidence both for and against the stability of attachment across the lifespan,
and research suggests that attachment is best captured dimensionally rather than categorically
(Fraley, 2002; Fraley & Waller, 1998; Waters, Weinfield, & Hamilton, 2000). In relation to
compassion, a more secure attachment style is associated with a greater tendency to experience
compassion and a view of oneself as compassionate (Shiota, Keltner, & John, 2006).
Furthermore, in couples, secure attachment is tied to more readily offering support to a partner
who is anticipating an anxiety-provoking activity (Simpson, Rholes, & Nelligan, 1992), while
attachment-related anxiety and avoidance are associated with greater physiological stress
reactions to interpersonal conflict (Powers, Pietromonaco, Gunlicks, & Sayer, 2006).
Relationship Satisfaction. Relationship satisfaction and similar indicators of the
intimacy or quality of a romantic relationship have been shown to play an important role in the
physiology of couples’ dyadic interactions, and they may also be relevant to the construct of
compassion. In fact, relationship quality has been explored as a moderator of physiological
response in a conflict paradigm, and partners in poorer quality relationships appear to show a
stronger association between relational aggression and physiological reactivity (Murray-Close,
Holland, & Roisman, 2012). With respect to compassion, empathic concern is more readily
translated to helping behavior when it is experienced in response to suffering in an individual
with whom one is particularly close (Cialdini, Brown, Lewis, Luce, & Neuberg, 1997). In many
ways, this is consistent with an evolutionary perspective of compassion, which holds that
PHYSIOLOGY OF COMPASSION IN COUPLES 12
compassion serves the purpose of forming evolutionarily beneficial social and romantic bonds
(Goetz, Keltner, & Simon-Thomas, 2010). Importantly, however, it is possible that an intimate
partner’s suffering could be perceived as personally relevant, and greater self-relevance assigned
to another’s suffering could result in sadness or distress rather than a more sophisticated, higher
level compassionate response (Ortony, Clore, & Collins, 1988). This suggests a potentially
complex role for relationship satisfaction with respect to the physiology of compassion in
couples’ interactions, which the current study sought to disentangle.
Measurement of Physiology
The current study measured physiological activity through arousal of the autonomic
nervous system and specifically through changes in heart rate. The autonomic nervous system
has two components: the sympathetic and the parasympathetic nervous systems. Arousal of the
sympathetic nervous system is associated with a “fight or flight” response that promotes
mobilization in response to threat (Jansen, Nguyen, Karpitskiy, Mettenleiter, & Loewy, 1995).
This is an adaptive and evolutionarily beneficial response when threat is truly imminent, but
chronic unnecessary or inappropriate activation of this system threatens cardiovascular health
(Curtis & O’Keefe, 2002). On the other hand, the parasympathetic nervous system is responsible
for “rest and digest” processes, storing and conserving energy and regulating bodily responses
during periods of rest (McCorry, 2007). Heart rate is controlled by both the sympathetic and
parasympathetic components of the autonomic nervous system through the sinoatrial node
(Schmidt-Nielsen, 1997). The sympathetic nervous system is responsible for increases in heart
rate through norepinephrine released by the accelerans nerve, while the parasympathetic nervous
system is responsible for decreases in heart rate through acetylcholine released by the vagus
nerve (Schmidt-Nielsen, 1997). Heart rate is typically measured through the use of an
PHYSIOLOGY OF COMPASSION IN COUPLES 13
electrocardiogram (ECG), which involves the placement of electrodes on the body to measure
the time between heart beats as indicated by the intervals between R-waves (i.e., R-R intervals),
or peak electrical activity captured by an ECG (Porges & Byrne, 1992).
Current Study
To our knowledge, no prior studies have used dyadic interactions between partners to
investigate moment-to-moment physiological changes associated with compassion expressed in
response to talking about a personal loss. This gap in the literature represents a missed
opportunity to better understand the processes that take place in the provision and receipt of
compassionate support in close relationships. To begin to address this gap, the current study
aimed to investigate the momentary physiology of compassion in couples. It sought to achieve
this by examining their dyadic interactions and by flexibly operationalizing compassion in terms
of how it functions interpersonally and in the reality of the couple, rather than by applying a
strict definition of what compassion is and is not. To this end, we used a novel “loss discussion”
protocol in which each partner (as a “speaker”) had an opportunity to describe a personal,
emotionally salient loss, while the other partner (the “listener”) was instructed to understand and
respond to that experience. The first aim of the current study is to investigate the extent to which
the listener’s compassion, as rated separately by both the speaker and the listener, is associated
with physiological activity in each partner during these loss discussions. The focus will be on
participants’ own ratings of compassion and their own heart rate, although partner-provided
ratings will be analyzed in exploratory models. We hypothesize that the listener’s compassion
will be associated with lower levels of physiological arousal, i.e., slower heart rate, in both the
listener and the speaker. The second aim is to examine whether associations between the
listener’s compassion and physiological activity in each partner are moderated by gender,
PHYSIOLOGY OF COMPASSION IN COUPLES 14
attachment style, or satisfaction with the relationship. We hypothesize that the listener’s
compassion will be associated with lower physiological arousal in females, compared to males;
in partners with lower attachment-related anxiety and avoidance; and in partners who report
more satisfaction with their relationship.
Method
Overview
The current study is part of a larger, longitudinal research project on family and dating
aggression run through the University of Southern California Family Studies Project (FSP). The
FSP includes a large, ethnically diverse sample of young adults who were originally recruited in
late childhood or as adolescents. Having previously completed one or more laboratory visits for
different studies, these individuals were invited to return as young adults with a current,
opposite-sex dating partner for another wave of data collection. To increase our sample size,
additional participants were recruited through flyers and other advertisements posted in the Los
Angeles community. To participate, the couple had to have been dating for at least two months
and each partner had to be between the ages of 18- and 25-years-old, with no upper age
restriction for partners of returning participants from the larger study. All participants also
needed to be able to read, write, and complete all study activities in English. For additional
details on recruitment of the original FSP sample, see Margolin, Vickerman, Oliver, and Gordis
(2010).
Participants
A total of 96 partners from 48 couples participated in the current study. Seventeen of
these couples were identified through the larger FSP study, and the remaining 31 couples were
recruited in the Los Angeles community. At the time of the study visit, couples had been together
PHYSIOLOGY OF COMPASSION IN COUPLES 15
for an average of 2.7 years (SD = 2.0 years), ranging from 4 months to 8.3 years, and 35.4% of
couples (n = 17) lived together. Only two couples (4.0%) were married at the time of the visit,
and around half of participants’ parents were married and living together (n = 56, 58.3%). On
average, participants were 22.8-years-old (SD = 2.9 years), ranging from 18- to 41-years-old, and
10.4% identified as Asian (n = 10), 11.5% as African American/black (n = 11), 27.1% as
Hispanic or Latino/a (n = 26), and 23.5% as multi-racial (n = 23). Fifty-eight percent of
participants (n = 56) were students, and 74.0% (n = 71) were employed in some capacity, either
part-time or full-time.
Procedure
After the completion of informed consent procedures and approximately two hours into a
longer, lab-based study visit consisting of several dyadic interactions, couples engaged in two
10-minute “loss discussions,” with each partner separately describing a significant loss he or she
has experienced and its impact. During these exchanges, the “speaker’s” partner, as the
“listener,” had an opportunity to exhibit compassion in response to the shared loss. Specific
instructions provided to participants included:
“For the next bit of time, we’d like for you to talk with each other about [loss discussion
topic]. Because such events do play a role in close relationships, we have selected topics
that are important and meaningful and make you sad. You’ll each have 10 minutes to
discuss the topic you have selected, and we’ll start with [speaker] first. TO SPEAKER:
We would like for you to communicate why this was and still is an important and
meaningful event in your life and how it still affects you. TO LISTENER: We’d like you
to understand what your partner is saying – you can comment, ask questions, whatever
you want. This is a conversation, not a one-person presentation. TO BOTH: Any
PHYSIOLOGY OF COMPASSION IN COUPLES 16
questions for us? After I leave the room, you’ll have 10 minutes to discuss [speaker’s]
loss. I’ll knock on the door after 10 minutes. Later, [listener] will have a chance to
discuss [his/her] topic.”
The order in which partners shared their losses was randomly determined, and experimenters left
the room during all interactions. Participants filled out additional questionnaires before and after
each discussion and at the conclusion of their visit.
Capturing Physiological Data. Soon after the couple arrived in the lab and provided
consent, BioNomadix wireless, bio-signal monitoring equipment was applied to each participant
to collect psychophysiological data throughout the loss discussions as well as throughout other
parts of the lab procedures. The BioNomadix system includes a chest strap, a wrist strap, and
sensors attached to the chest, the lower rib cage, and the non-dominant hand. The chest strap is
worn under a participant’s clothes, and the BioNomadix system is designed for comfort and to
allow for sufficient mobility.
Selecting Loss Discussion Topics. In preparation for the loss discussions, partners
separately filled out questionnaires to identify what types of losses they have experienced. The
questionnaire included 12 items representing a wide range of potential losses for young adults,
including the death of a family member, parents’ divorce, illness or disability, and more. For
each item, participants indicated whether the event had occurred (“Has this event happened?”)
and the extent to which they were emotionally affected by it (“If yes, how does it make you
feel?”). Specific instructions include:
“Next, we are going to ask you to talk with your dating partner about a significant loss
that you have experienced before you were a couple. To help you think about things that
you might want to talk to your dating partner about, we’ve put together a list of personal
PHYSIOLOGY OF COMPASSION IN COUPLES 17
losses that are commonly experienced. For each item, please first rate whether you have
ever experienced this loss personally. Then indicate how significant that loss was for you.
So, “0” is not at all, “2” is somewhat, and “4” is very much. Do you have any
questions?”
Using the responses to this questionnaire as a guide, the experimenters conducted brief,
approximately 5-minute priming interviews with each partner, separately, to select topics that
represent significant losses for each partner. All partners were able to identify and describe a
salient loss. Losses discussed by participants are summarized in Table 1.
Compassion Ratings. Approximately one hour after the loss discussions and following
the completion of several intermediate tasks including filling out a battery of questionnaires,
partners separately watched and rated video recordings of their interactions. The two partners
were seated back-to-back, across the room from each other, and at separate computers that had
private screens. Both partners watched both loss discussions, and for each discussion watched,
partners were told to focus on the listener, which includes the listener focusing on him or herself.
Specific instructions included:
“Now you are going to watch when each of you discussed a loss. You will each be rating
[yourself/the other person]. Think about your view of compassion and whether that is
being communicated.”
A prompt placed at each computer reminded participants about what they were rating: “How
caring and compassionate [was your partner/were you] as a listener during this discussion?”
Using Noldus observation software and X-keys keypads, both partners continuously rated the
listener each time they detected a change in that person’s level of compassionate listening.
Participants were instructed to provide ratings at least every 30 seconds, even if they did not
PHYSIOLOGY OF COMPASSION IN COUPLES 18
observe a change in compassion.
Measures
Compassion. Participants rated the extent to which the listener was caring and
compassionate on a scale of -4 (“Not at all”) to +4 (“Very much”) using Noldus software and X-
keys keypads, which captured moment-to-moment ratings representing changes in the listener’s
behavior and the extent to which it appeared to be compassionate. For the purpose of analysis, a
MATLAB script was used to collapse compassion ratings into average ratings over thirty-second
intervals. See Figure 1 for sample compassion ratings across two 10-minute loss discussions and
Figure 2 for a spaghetti plot of compassion ratings for all couples group-centered by participant
and discussion.
Physiological Response. Participants wore wireless, bio-signal monitoring devices that
transmitted electromyogram data at a signal rate of 2,000 Hz, including electrocardiogram signal.
This device, the BioNomadix system, is designed by Biopac Inc. and has been used for a number
of other research studies monitoring physiological activity (Bekele et al., 2013; Winslow et al.,
2013). Electrocardiogram data were processed using AcqKnowledge software, which
automatically flagged peaks in electrical activity (i.e., R-waves). Visual presentations of
participants’ heart waves were then manually cleaned by two members of the research team to
ensure the accuracy of these data. R-wave time codes were then processed using a MATLAB
script to calculate average R-R interval, and subsequently average heart rate, over thirty-second
intervals. Due to interruptions or malfunctions in the signal provided by the BioNomadix system,
R-waves were occasionally unable to be flagged. To deal with these missing data, the MATLAB
script only calculated average heart rate for thirty-second intervals for which 15 or more seconds
of total R-R interval data were available. Finally, these data were synchronized with compassion
PHYSIOLOGY OF COMPASSION IN COUPLES 19
ratings provided across both loss discussions. See Figure 3 for sample heart rates across two 10-
minute loss discussions and Figure 4 for a spaghetti plot of heart rates for all couples group-
centered by participant and discussion.
Attachment Style. Adult attachment style was assessed with the Experiences in Close
Relationships – Revised (ECR-R) questionnaire, a 36-item measure of attachment styles across
romantic relationships (Fraley, Waller, & Brenan, 2000). The ECR-R provides two indicators of
attachment style, attachment-related anxiety and avoidance, each of which is assessed with a
separate subscale. Attachment-related anxiety refers to uncertainty about the availability or
responsiveness of a romantic partner. Attachment-related avoidance refers to discomfort in
closeness or intimacy with others. Individuals with less attachment-related anxiety and avoidance
are typically considered to have a more secure attachment style. Scores are based on a 7-point
Likert scale, ranging from 1 (“Strongly disagree”) to 7 (“Strongly agree”). Items are averaged for
each subscale and include statements such as “I often worry that my partner doesn’t really love
me” (attachment-related anxiety) and “I am nervous when partners get too close to me
(attachment-related avoidance). The ECR-R has demonstrated high 3-week test-retest reliability
(85% shared variance between assessments) and convergent validity with diary ratings of anxiety
and avoidance in a romantic relationship (30% to 40% explained variance; Sibley, Fischer, & Lu,
2005). Both subscales have typically demonstrated high internal consistency, above or close to
.90 (Eberhart & Hammen, 2010; Goldenson, Geffner, Foster, & Clipson, 2009; Kazarian &
Martin, 2004). Further, there is evidence for the two-factor conceptualization of the ECR-R,
which fit better than a single-factor solution in which attachment-related anxiety and avoidance
loaded onto a single latent factor of insecure attachment (Sibley, Fischer, & Lu, 2005).
Relationship Satisfaction. Relationship satisfaction was assessed with an adapted
PHYSIOLOGY OF COMPASSION IN COUPLES 20
version of the Quality Marriage Index (QMI) specifically for dating couples; this is a brief, 6-
item scale tapping into the “goodness of the relationship gestalt” with items positively describing
(e.g., “We have a good relationship”) and evaluating (e.g., “My relationship with my partner is
strong”) the quality of one’s romantic relationship (Norton, 1983, p. 143). The QMI has been
used extensively in this adapted form with unmarried couples, including young adults (Clark &
Grote, 1998; DiLillo & Long, 1999), substituting the word “relationship” for “marriage.” Scores
are based on the sum of five 5-point Likert items ranging from 1 (“Very strongly disagree”) to 7
(“Very strongly agree”) and one item 10-point scale from 1 (“Unhappy”) to 10 (“Perfectly
happy”). The QMI has demonstrated a high internal consistency above .94 (Callahan, 1996;
Heyman, Sayers, & Bellack, 1994) and adequate concurrent and convergent validity as
evidenced by high correlations other validated measures of relationship satisfaction and
sensitivity to attitudes about need for professional relationship help.
Results
Overview of Data Analysis
Descriptive statistics were calculated for the full sample and for male and female partners
separately. See Table 2 for participant and couple characteristics. The association between
continuous variables was assessed separately for male and female partners using bivariate
Pearson correlations. See Table 3 for a correlation matrix of all bivariate associations.
The primary analyses for the study were conducted using multilevel modeling (MLM),
which accounts for the interdependence of repeated observations and observations provided by
partners in a couple (Cook & Kenny, 2005). In the analyses for the current study, ratings of
compassion and physiological responses (Level 1) were nested by participant (Level 2), and
participants were nested by couple (Level 3). Models included random intercepts at Levels 2 and
PHYSIOLOGY OF COMPASSION IN COUPLES 21
3. Physiology and compassion, both averaged across 30-second time intervals, were tested for
time-linked associations, i.e., their association in a given interval. The first minute of each
discussion was excluded from these analyses to allow participants to physiologically acclimate to
the discussion and to make their first compassion rating, which typically occurred around a
minute into watching the discussion.
We tested Aim 1 with two multilevel models: the speaker’s rating of the listener’s
compassion predicting the speaker’s time-synchronized heart rate, and the listener’s self-rating of
compassion predicting her or his own heart rate. In order to isolate and examine within-person
covariation in compassion and heart rate, compassion ratings were group-centered for each
discussion and participant providing the ratings. As a result, adjusting for participant and couple
characteristics had no effect on the associations of interest. However, to control for the general
trend of heart rate over the course of the discussion, all models included time in the discussion
(i.e., the interval in which the observations occurred, coded as 1 to 18 representing the 18 thirty-
second intervals after removing the first minute of the discussion). Models in which a partner-
provided measure of a listener’s compassion was used as a predictor of an individual’s
physiology (e.g., speaker-provided ratings of compassion predicting the physiology of the
listener) were also explored. Prior to running these analyses for Aim 1, we examined gender as a
moderator of the association between compassion and heart rate to determine whether 3-level
models would be appropriate for these data. A significant gender x compassion interaction would
suggest that running analyses separately for male and female partners in 2-level models would be
appropriate.
Aim 2. The second aim of the current study was to determine whether differences in
gender, attachment style (i.e., attachment-related anxiety and avoidance), and relationship
PHYSIOLOGY OF COMPASSION IN COUPLES 22
satisfaction influence the associations tested in the first aim. These moderators were tested with
interactions in each of the aforementioned models (e.g., Listener-Rated Compassion,
Relationship Satisfaction, Time in the Discussion, and Listener-Rated Compassion x
Relationship Satisfaction predicting the Listener’s Heart Rate). Simple slopes analyses were
conducted for significant moderators to examine the association between compassion and heart
rate at different levels of the moderators.
Evaluating Missingness and Rating Variability. Missing data were tabulated using
descriptive statistics. Next, given that the primary analyses for the current study use group-
centered compassion ratings as a predictor, sets of ratings with zero within-person variability
were also of interest. Thus, we identified sets of ratings from participants who rated only once or
who provided only one rating multiple times. To evaluate the impact of these non-variable
ratings, the primary analyses were run again with non-variable sets of ratings entered as missing.
Subsequently, to reduce bias associated with potentially nonrandom missingness and to evaluate
the impact of missing data on the estimation of the associations of interest, the primary analyses
were run twice with datasets created using multilevel multiple imputation (Enders, 2010): once
with non-variable ratings included and again with these ratings entered as missing. All variables
used in the analyses described above (i.e., time in the discussion, participants’ own compassion
ratings for both loss discussions, heart rate as a speaker and as a listener, gender, attachment-
related anxiety, attachment-related avoidance, and relationship satisfaction) and relevant
participant and couple characteristics (i.e., time together as a couple and whether the couple was
living together) were included in two sequentially run imputation models: one for scale scores
and one for compassion, heart rate, and compassion x scale score interaction terms. A total of 20
datasets were imputed, and analyses were conducted using the imputed datasets, and results were
PHYSIOLOGY OF COMPASSION IN COUPLES 23
subsequently pooled to derive parameter estimates and confidence intervals.
The Physiology of Compassion
Preliminary analyses indicated that gender did not moderate the association between the
speaker’s compassion rating and his or her own heart rate (β = 0.03, 95% CI: -0.42 to 0.48, p =
.89) or listener’s compassion and his or her own heart rate (β = -0.08, 95% CI: -0.44 to 0.27, p =
.65). Proceeding with the 3-level model described above, an overall decline in heart rate was
observed for speakers (β = -0.12, 95% CI: -0.15 to -0.08, p < .001), and an overall increase was
observed for listeners (β = 0.09, 95% CI: 0.05 to 0.12, p < .001). In testing the study’s first aim,
speaker-rated compassion was significantly associated with increased heart rate for the speaker
(β = 0.24, 95% CI: 0.05 to 0.43, p = .01), and listener-rated compassion was significantly
associated with decreased heart rate for the listener (β = -0.33, 95% CI: -0.51 to -0.15, p < .001).
Neither removing time over the course of the discussion from these models nor switching
compassion and heart rate as the predictor and outcome changed the significance of these
observed associations. See Table 4 for a summary of results from these models. Models using
partner-provided indices of compassion did not reveal significant associations between
compassion reported by the listener and the speaker’s own heart rate (β = 0.11, 95% CI: -0.09 to
0.31, p = .29) or compassion reported by the speaker and the listener’s own heart rate (β = 0.02,
95% CI: -0.16 to 0.19, p = .82).
Moderators of the Association between Compassion and Heart Rate
As previously mentioned, the observed associations for speaker-rated compassion and the
speaker’s own heart rate and listener-rated compassion and the listener’s own heart rate were not
moderated by gender. However, significant moderation effects were observed for anxious
attachment, avoidant attachment, and relationship satisfaction. Anxious attachment moderated
PHYSIOLOGY OF COMPASSION IN COUPLES 24
the association between speaker-rated compassion and the speaker’s own heart rate such that a
weaker positive relationship was found for more anxiously attached individuals (β = -0.16, 95%
CI: -0.29 to -0.03, p = .02). Avoidant attachment and relationship satisfaction moderated the
association between listener-rated compassion and the listener’s own heart rate such that a
weaker negative relationship was found for less avoidantly attached individuals (β = -0.21, 95%
CI: -0.40 to -0.02, p = .03) and for individuals who were more satisfied with their relationship (β
= 0.03, 95% CI: 0.01 to 0.05, p = .006). However, an examination of relationship satisfaction
data revealed notable outliers (i.e., greater than three standard deviations below the sample
mean) for two female participants who both provided the lowest possible ratings for every item
on the scale. Thus, analyses were also run with relationship satisfaction for these two participants
entered as missing. This is not result in a change in the significance or direction of the effect of
the compassion x relationship satisfaction interaction (β = 0.05, 95% CI: 0.02 to 0.09, p = .003).
See Table 4 for a summary of results from these models along with previously described results
for gender as a moderator of the association between compassion and heart rate. Three-way
interactions (i.e., gender x moderator x compassion) were also tested for significant moderators
to determine whether these moderation effects differed by gender, and none of these interactions
were significant.
Figures 5 and 6 display results from simple slopes analyses of these significant
interactions, depicting slopes for the association between compassion and heart rate at low (1
standard deviation below the mean) and high (1 standard deviation above the mean) levels of the
moderators and estimates for heart rate at low (1 standard deviation below the mean) and high (1
standard deviation above the mean) levels of compassion. The slope for the association between
speaker-rated compassion and the speaker’s own heart rate was significant at low levels of
PHYSIOLOGY OF COMPASSION IN COUPLES 25
anxious attachment (β = 0.53, p < .001), but not at high levels (β = 0.12, p = .25). The slope for
the association between listener-rated compassion and the listener’s own heart rate was
significant at high levels of avoidant attachment (β = -0.48, p < .001), but not low levels (β = -
0.10, p = .50). Simple slopes analyses for the interaction between listener-rated compassion and
relationship satisfaction were conducted both with and without the inclusion of the outliers
mentioned above. Removing the outliers did substantially change any of the simple slope
estimates in significance, direction, or magnitude. However, inclusion of the outlier resulted in
an increase in the standard deviation of relationship satisfaction such that one standard deviation
above the mean was substantially above the maximum for the scale (i.e., 45.8 compared to 45.0),
whereas excluding the outlier more closely aligned these values (i.e., 45.1 compared to 45.0).
Therefore, simple slopes analyses were conducted using data excluding the relationship
satisfaction outlier to maximize the relevance and interpretability of slopes and estimates at high
values of relationship satisfaction (i.e., 1 standard deviation above the mean, approximately the
maximum value for the scale). The slope for the association between listener-rated compassion
and the listener’s own heart rate was significant at low levels of relationship satisfaction (β = -
0.43, p < .001), but not at high levels (β = 0.14, p = .37).
Missingness and Rating Variability
Due to data storage issues, including a failed hard drive, four participants (4.2%) from
three couples were missing compassion rating data. Three of these participants, including two
from the same couple, were missing data for both discussions, and one was only missing data
from when he rated his partner. In all, out of 192 possible sets of ratings (two per participant per
couple), seven (3.6%) were missing entirely. Additionally, one participant started rating more
than 75 seconds into his own loss discussion, and as a result, he was missing rating data for the
PHYSIOLOGY OF COMPASSION IN COUPLES 26
third thirty-second interval, the first used in the analyses presented above. Again due to data
storage issues, electrocardiogram data were not available from one loss discussion for one couple
and from both loss discussions for another couple (3.1% of all discussions). Data were also
missing for various thirty-second intervals due to uninterpretable electrocardiogram signal
provided by the BioNomadix system. The number of missing thirty-second intervals for each
participant and discussion ranged from none (0) to all (18) intervals with an average of 1.0
missing intervals per participant per discussion (SD = 3.3). Twenty-six participants’ discussions
(13.5%) were missing at least one interval, and 9 (4.7%) were missing more than half. Including
discussions for which no electrocardiogram data were stored, 276 intervals were missing an
average heart rate out 3,456 total possible intervals (8.0%). Of note, 24 of these intervals were
missing due to a discussion that ended prematurely, at approximately 6 minutes, as a result of
experimenter error. Finally, one participant was missing all questionnaire data (i.e., relationship
satisfaction and attachment), an additional nine participants were missing relationship
satisfaction data because the QMI was not initially part of the assessment battery, and one
additional participant declined to respond to the QMI. In all, a relationship satisfaction score was
missing for eleven participants (11.5%) from nine couples, and attachment style was missing for
one participant (1.0%). With regard to compassion rating variability, a total of thirteen
participants (13.5%) from ten couples did not change their rating of compassion throughout one
(n = 10) or both (n = 3) loss discussions. Thus, out of 185 provided sets of ratings, 16 (8.6%) had
zero within-person variability.
Running the analyses with non-variable rating data entered as missing did not result in a
substantial change in the estimated association between compassion as rated by the speaker and
his or her own heart rate (β = 0.24, 95% CI: 0.05 to 0.43, p = .02) or the association between
PHYSIOLOGY OF COMPASSION IN COUPLES 27
compassion as rated by the listener and his or her own heart rate (β = -0.33, 95% CI: -0.51 to -
0.15, p < .001). Similarly, it did not result in a substantial change in the moderation effects of
anxious attachment (β = -0.16, 95% CI: -0.30 to -0.03, p = .02), avoidant attachment (β = -0.21,
95% CI: -0.40 to -0.02, p = .03), or relationship satisfaction (β = 0.03, 95% CI: 0.01 to 0.05, p =
.006). Analyses conducted with multiple imputation and all available data, including non-
variable rating data, did not substantially change the estimated association between speaker-rated
compassion and his or her own heart rate (β = 0.18, 95% CI: 0.00 to 0.35, p = .05) or listener-
rated compassion and his or her own heart rate (β = -0.29, 95% CI: -0.45 to -0.12, p < .001).
They also did not substantially change the estimated moderation effects of anxious attachment (β
= -0.18, 95% CI: -0.30 to -0.06, p = .003), avoidant attachment (β = -0.18, 95% CI: -0.35 to -
0.01, p = .04), or relationship satisfaction (β = 0.03, 95% CI: 0.00 to 0.05, p = .02). Finally, when
using imputed datasets created with non-variable ratings entered as missing, the association
between speaker-rated compassion and his or her own heart rate was only marginally significant
(β = 0.16, 95% CI: -0.01 to 0.33, p = .07) but similar in magnitude and direction, and the
moderation effect of avoidant attachment was smaller and no longer significant (β = -0.11, 95%
CI: -0.29 to 0.06, p = .20). However, there were no substantial changes to the association
between listener-rated compassion and his or her own heart rate (β = -0.27, 95% CI: -0.44 to -
0.10, p = .002), or the moderation effects of anxious attachment (β = -0.17, 95% CI: -0.29 to -
0.05, p = .005) or relationship satisfaction (β = 0.02, 95% CI: 0.00 to 0.04, p = .02).
Discussion
The current study’s results illuminate the moment-to-moment physiological profile of
compassionate exchanges between romantic partners. There was support both for and against our
first hypothesis. As expected, self-rated compassion was associated with lower heart rate for the
PHYSIOLOGY OF COMPASSION IN COUPLES 28
person exhibiting and rating it. This is consistent with prior studies on the physiology of
compassion with individuals (Eisenberg et al., 1988; Eisenberg et al., 1991) and with a view of
compassion as distinct from distress. Researchers have used a variety of approaches to more
clearly delineate the boundaries of compassion as an emotion. Factor analysis of self-report
ratings of emotions experienced while witnessing another person’s sadness or grief demonstrated
a differentiation between the constructs of empathy and distress (Batson, Fultz, & Schoenrade,
1987). Ratings of feeling compassionate, sympathetic, moved, tender, warm, or softhearted
loaded onto one common factor, while feeling alarmed, upset, disturbed, distressed, worried, or
perturbed loaded onto a separate factor. Thus, compassion is best characterized by processing
another person’s adversity rather than simply internalizing it. Similarly, the current study’s
findings suggest that people view themselves as being most compassionate when they are less
physiologically aroused. This is in line with an evolutionary perspective of compassion, which
considers its utility and function in the survival of the human species as a motivator of prosocial
behavior aimed at forming alliances and romantic bonds. In this view, compassion is separate
from distress and sadness by necessity; a self-focused emotion like distress or sadness would
signal the need for attention to oneself and withdrawal from helping behavior rather than an
orientation toward another’s needs (Goetz, Keltner, & Simon-Thomas, 2010).
However, for individuals sharing an emotionally salient loss, perceiving their partner as
compassionate was actually associated with higher heart rate. Understanding compassion as a
potentially supportive process, given that it includes a component of helping behavior (Goetz,
Keltner, & Simon-Thomas, 2010), it was expected that receiving compassion would have a
calming effect, resulting in a lower heart rate. Even so, it is important to remember that
compassion is defined as occurring in response to witnessing another person’s distress. Thus, it is
PHYSIOLOGY OF COMPASSION IN COUPLES 29
possible that the speakers’ physiological arousal was reflective of them delving into and
expressing their emotions with respect to the significant losses they were sharing. In response,
their partners were able to experience and exhibit compassion. Importantly, the observed
associations persisted when switching compassion and heart rate as the predictor and the
outcome in models tested and when removing time during the discussion as a covariate.
Alternatively, it is also possible that compassion exhibited by the listener facilitated the speaker’s
ability to and comfort in talking about the more emotionally distressing aspects of their loss.
When their partners were not being compassionate, perhaps the speakers less readily experienced
and shared their emotions. It is notable, however, that despite the observed within-interval
compassion and heart rate associations, speakers experienced an overall decline in heart rate
while listeners became gradually more physiologically aroused over the course of the discussion.
Thus, being in the position of receiving compassion may actually down-regulate the autonomic
nervous system overall, while expressing compassion may be emotionally demanding and result
in increased autonomic nervous system activity.
Partially consistent with our second hypothesis, we found that the association between
compassion and heart rate differed by several participant characteristics. However, not all of the
hypothesized moderators were significant, and not all of the significant moderation effects were
in the hypothesized directions. First, the association between compassion and heart rate did not
significantly differ by gender for either speakers or listeners. Although there is reason to believe
that men and women may prefer different kinds of support (Ditzen et al., 2007; Burleson, 2003;
Kirschbaum, Lkauer, Filipp, & Hellhammer, 1995; Stanton, Danoff-Burg, & Cameron, 1994),
some studies suggest that gender differences in support preferences could actually be smaller
than assumed (Burleson et al., 1996). The use of participant-provided ratings of compassion,
PHYSIOLOGY OF COMPASSION IN COUPLES 30
broadly defined, may minimize the relevance of these preferences, regardless of their magnitude.
It is possible that using an outside observer’s ratings of compassion may have produced different
results. Furthermore, examining physiological response rather than an index of “satisfaction”
with support received may have reduced reporting biases with regard to these preferences, tying
an objective biological response to the perception of compassionate support.
Next, with regard to attachment styles, avoidant attachment moderated the association
between compassion and heart rate for listeners, with stronger negative associations for less
securely attached individuals, which was not in the expected direction. When listening to their
partner share a loss, individuals who are high in attachment-related avoidance may more readily
disengage during emotionally charged moments, even when they are exhibiting compassion.
There is also reason to believe that different models of attachment may be evoked or intensified
depending on the situation (Baldwin & Fehr, 1995; Baldwin, Fehr, Keelan, Enns, & Koh-
Rangarajoo, 1996). Therefore, it is possible that avoidant attachment strategies may be activated
in listeners who are physiologically aroused, and these partners are then less willing to express
compassion. Additionally, anxious attachment moderated the association between compassion
and heart rate for speakers, with stronger positive associations for more securely attached
individuals. When sharing a loss, individuals who are high in attachment-related anxiety may
experience high levels of physiological arousal regardless of their partners’ compassionate
behavior. Consistent with this belief, they may also delve into and deeply experience their loss-
related emotions in an effort to engage and receive support from their partner, regardless of what
he or she is doing in the moment.
Finally, we found that relationship satisfaction moderated the association between
compassion and heart rate for listeners such that individuals who were less satisfied with their
PHYSIOLOGY OF COMPASSION IN COUPLES 31
relationship showed a greater decline at higher levels of compassion. Partners who were highly
satisfied with their relationship demonstrated higher heart rate while exhibiting more
compassion, although this simple slope was not significant. This suggests that a view of
compassion that conceptualizes it as entirely distinct from sadness and distress may not capture
the complexity with which it presents in real life. In a study in which participants were instructed
to sort emotions into different categories by their degree of similarity, compassion, tenderness,
and caring fell under a broader category of “love,” while sympathy was typically sorted under
“sadness” (Shaver, Schwatz, Kirson, & O’Connor, 1987). This suggests that although emotions
that fall under the general umbrella of “compassion” are different than distress- and sadness-
related emotions in many ways, these two categories are not mutually exclusive. Thus,
compassion likely also includes some feelings of concern or sadness, even if it is a separate
construct. The current study’s results suggest that the level of intimacy present in a satisfying
close relationship may result in greater internalization of the distress exhibited by an individual
talking about a loss by his or her partner, which in turn leads to greater physiological arousal
(Cialdini et al., 1997; Levenson, 1992; Ortony, Clore, & Collins, 1988). An alternative
explanation of this finding is that participants who are more satisfied with their relationship more
readily offer compassionate support, even when they are experiencing high levels of distress and
physiological arousal.
This study had a number of notable strengths. To our knowledge, this was the first study
to investigate the physiological correlates of compassion in dyadic interactions between partners
in close relationships. This approach enabled the investigation of individuals both expressing and
receiving compassion. Nearly all prior studies of compassion have been conducted with
individuals, and most studies using couples’ dyadic interactions have focused on conflict, marital
PHYSIOLOGY OF COMPASSION IN COUPLES 32
dysfunction, or support offered in response to anxiety or general life stressors. The current study
used a novel “loss discussion” paradigm, which was specifically designed to elicit compassion in
couples through conversations about prior losses. Although the kinds of losses selected varied,
they were all emotionally salient to the individuals sharing them. Furthermore, the current
study’s operationalization of compassion represented a unique strength. Participants themselves
provided ratings of compassion exhibited by the individuals listening to a shared loss. This
flexible approach to defining compassion, as compared with having an outside observer rate
partners with a more stringent definition in place, should provide an on-the-ground indicator of
compassion as it functions in the couples’ reality. Finally, the current study’s focus on young
adults enabled the investigation of dyadic compassion processes in early, yet serious
relationships with diverse levels of intimacy. For the most part, people at these ages are only just
developing their relationship styles, and having emotionally charged conversations about
significant losses may have been challenging. These are also ages at which conversations about
loss with peers might be rare, and various social support structures will often be absent or in flux.
As a result, compassion offered by intimate partners in loss-related discussions is perhaps
particularly important for young adults. It is therefore vital to better understand these difficult
and critical interactions.
Despite these strengths, there also are limitations to the current study. The decision to
restrict participants to opposite-sex couples was made to facilitate statistical exploration of
gender differences and aid in the interpretation of these results, as well as to reduce any
unexpected variability introduced by differences in compassion processes between same- and
opposite-sex couples. Future studies should investigate compassion processes in same-sex
couples to determine the ways in which they are similar to or different than the processes we
PHYSIOLOGY OF COMPASSION IN COUPLES 33
discovered. Additionally, loss discussions took place as part of a larger protocol of dyadic
interactions between partners. However, it is hoped that the presence of the loss discussion
among various kinds of interactions was actually more representative of couples’ real life
conversations about loss and adversity, which do not occur in a vacuum. Furthermore, the length
of the lab visit will have hopefully enabled couples to acclimate to the setting in which their loss
discussions took place; ideally, this will facilitate a naturalistic conversation that is minimally
influenced by observation.
Overall, the current study fills an important gap in our understanding of compassion in
close relationships. These results can potentially be a first step in informing the development of
psychoeducational or psychotherapeutic interventions for couples that teach or build upon
compassion-related skills, ultimately promoting resilience in response to loss and adversity
encountered by each partner. Specifically, our findings suggest the importance of attending to
personal characteristics including attachment style and relationship satisfaction, which could
influence perceptions of, receptivity to, or readiness to express compassion.
Furthermore, physiological states been tied to long-term health outcomes. For example,
although results are mixed, hypothalamic-pituitary-adrenal axis dysregulation, higher resting
heart rate, and cardiovascular reactivity have been linked to increased risk for coronary heart
disease, myocardial infarction, left-ventricular dysfunction, hypertension, and more (Brotman,
Golden, & Wittstein, 2007; Manuck, 1994; Smith & Ruiz, 2002). Brotman, Golden, and
Wittstein (2007) have proposed a model through which emotional and physical stressors impact
brain activation and endocrine activity, which results in changes in immune function, heart rate,
blood pressure, and other biological processes. Research with families also suggests that
partners’ short-term, day-to-day stressors can accumulate over time when they are associated
PHYSIOLOGY OF COMPASSION IN COUPLES 34
with repeated physiological arousal and chronic physiological stress (Repetti, Wang, & Saxbe,
2009). It is possible that this is also true for compassionate interactions and that the physiological
responses associated with compassion, both in the moment and overall, may have a cumulative
effect. This highlights the importance of understanding the physiology of couples’
compassionate interactions, which present an intriguing and complementary counterpoint to the
extensive literature implicating maladaptive marital processes (e.g., conflict, aggression,
hostility) in the development and maintenance of acute and chronic health conditions (Burman &
Margolin, 1992; Robles & Kiecolt-Glaser, 2003). The current study’s examination of under-the-
skin phenomena synchronized with compassionate interactional processes elicited by the loss
discussion protocol may be a first step in illuminating long-term health implications of close
relationships and patterns of compassionate behavior between partners.

PHYSIOLOGY OF COMPASSION IN COUPLES 35
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PHYSIOLOGY OF COMPASSION IN COUPLES 43
Tables and Figures
Table 1. Loss discussion topics.
Loss Discussion Topic

n (%)

Death 45 (46.9%)
Friend 15 (15.6%)
Family Member (Other than Parent) 14 (14.6%)
Parent 9 (9.4%)
Pet 4 (4.2%)
Teacher 3 (3.1%)
Physical or Mental Health Problems 22 (22.9%)
Family Member 15 (15.6%)
Friend 4 (4.2%)
Own 3 (3.1%)
Loss of Contact with Someone Close 10 (10.4%)
Family Member 5 (5.2%)
Friend or Friends (Including Moving Away) 5 (5.2%)
Divorce of Someone Close 10 (10.4%)
Parents 7 (7.3%)
Other Family Member 2 (2.1%)
Friend 1 (1.0%)
Career or Education Setbacks 6 (6.3%)
Other 3 (3.1%)

PHYSIOLOGY OF COMPASSION IN COUPLES 44
Table 2. Participant and couple characteristics.
All Participants
(n = 96)

Males
(n = 48)

Females
(n = 48)

Participant / Couple Characteristics

n (%)

n (%)

n (%)

Living Together 34 (35.4%) 17 (35.4%) 17 (35.4%)
Current Student 56 (58.3%) 26 (54.2%) 30 (62.5%)
Currently Working 71 (74.0%) 36 (75.0%) 35 (72.9%)
Race / Ethnicity
White non-Hispanic 27 (28.1%) 14 (29.2%) 13 (27.1%)
Black non-Hispanic 11 (11.5%) 7 (14.6%) 4 (8.3%)
Hispanic 26 (27.1%) 10 (20.8%) 16 (33.3%)
Asian 10 (10.4%) 5 (10.4%) 5 (10.4%)
Multi-Racial 22 (22.9%) 12 (25.0%) 10 (20.8%)
Parents’ Relationship
Living Together, Married 38 (39.6%) 22 (45.8%) 16 (33.3%)
Not Living Together, Unmarried 58 (60.4%) 26 (54.2%) 32 (66.7%)

M (SD)

M (SD)

M (SD)

Age in Years 22.8 (2.9) 23.4 (3.5) 22.2 (2.0)
Months Together 32.3 (24.1) 32.3 (24.1) 32.3 (24.1)
Compassion (Self) 2.1 (1.2) 2.1 (1.4) 2.1 (1.1)
Compassion (Partner) 2.5 (1.4) 2.8 (1.3) 2.2 (1.5)
Heart Rate (Speaker) 73.9 (12.3) 71.2 (14.1) 76.5 (9.6)
Heart Rate (Listener) 71.2 (11.6) 69.4 (12.9) 73.1 (10.0)
Anxious Attachment (ECR-R) 2.8 (1.3) 2.6 (1.2) 3.0 (1.4)
Avoidant Attachment (ECR-R) 2.2 (0.9) 2.3 (0.9) 2.1 (0.9)
Relationship Satisfaction (ECR-R) 39.1 (6.7) 39.6 (5.6) 38.5 (7.7)
Note: Compassion ratings and heart rate are averaged across whole discussions. Compassion (Self)
refers to when participants were rating themselves, and Compassion (Partner) refers to when
participants were rating their partner.

Running head: PHYSIOLOGY OF COMPASSION IN COUPLES 45
Table 3. Correlation matrix for continuous participant characteristics.
1 2 3 4 5 6 7 8 9
1. Compassion (Self) .442** .117 .106 -.061 -.136 .022 -.100 .338*
2. Compassion (Partner) .496** .021 .000 -.034 -.523** -.033 -.267 .570**
3. Heart Rate (Listener) .183 .062 .968** .214 -.110 .026 .255 .034
4. Heart Rate (Speaker) .214 -.006 .938** .243 -.111 .126 .397** -.057
5. Months Together .148 .002 .368* .384** .348* -.315* -.078 .011
6. Age in Years .012 .074 -.151 -.047 .337* -.053 .055 -.266
7. Anxious Attachment -.464** -.539** -.323* -.268 -.275 .094 .535** -.182
8. Avoidant Attachment -.402** -.420** -.305* -.204 -.256 -.045 .619** -.549*
9. Relationship Satisfaction .055 .472** .144 .083 .121 -.188 -.445** -.390*
Note: Correlations for male partners are reported above the diagonal, and correlations for female partners are reported below the diagonal.
Compassion ratings and heart rate are averaged across whole discussions. Compassion (Self) refers to when participants were rating themselves,
and Compassion (Partner) refers to when participants were rating their partner.

** p < .05, * p < .01

PHYSIOLOGY OF COMPASSION IN COUPLES 46
Table 4. Results from multilevel models testing Specific Aims 1 and 2.
Speaker-Rated Compassion Predicting
Speaker’s Heart Rate

Listener-Rated Compassion Predicting
Listener’s Heart Rate

Moderator / Variable

β

95% CI

p

β

95% CI

p

Main Effect Models
Compassion 0.24 0.05 to 0.43 .01 -0.33 -0.51 to -0.15 < .001
Time -0.12 -0.15 to -0.08 < .001 0.09 0.05 to 0.12 < .001

Moderator: Gender
Compassion 0.21 -0.18 to 0.60 .28 -0.28 -0.55 to -0.01 .04
Gender 5.77 1.16 to 10.38 .02 4.02 -0.36 to 8.40 .07
Compassion x Gender 0.03 -0.42 to 0.48 .89 -0.08 -0.44 to 0.27 .65
Time -0.12 -0.15 to -0.08 < .001 0.09 0.05 to 0.12 < .001

Moderator: Anxious Attachment (ECR-R)
Compassion 0.33 0.12 to 0.53 .002 -0.34 -0.53 to -0.15 < .001
Anxious Attachment 0.09 -1.83 to 2.00 .93 -0.79 -2.50 to 0.93 .37
Anxious Attachment x Compassion -0.16 -0.29 to -0.03 .02 0.02 -0.10 to 0.13 .76
Time -0.12 -0.16 to -0.08 < .001 0.08 0.05 to 0.12 < .001

Moderator: Avoidant Attachment (ECR-R)
Compassion 0.26 0.07 to 0.45 .009 -0.29 -0.47 to -0.10 .002
Avoidant Attachment 1.76 -1.14 to 4.64 .23 -0.05 -2.59 to 2.50 .97
Avoidant Attachment x Compassion -0.17 -0.38 to 0.05 .13 -0.21 -0.40 to -0.02 .03
Time -0.12 -0.16 to -0.09 < .001 0.08 0.05 to 0.11 < .001

Moderator: Relationship Satisfaction (QMI)
Compassion 0.21 0.00 to 0.42 .05 -0.16 -0.49 to -0.13 .10
Relationship Satisfaction -0.04 -0.43 to 0.36 .86 0.11 -0.25 to 0.47 .55
Relationship Satisfaction x Compassion 0.00 -0.03 to 0.02 .74 0.03 0.01 to 0.05 .006
Time -0.10 -0.14 to -0.07 < .001 0.09 0.05 to 0.12 < .001
Running head: PHYSIOLOGY OF COMPASSION IN COUPLES 47
Figure 1. Sample compassion ratings across two loss discussions.

Green Line = His Ratings | Blue Line = Her Ratings

PHYSIOLOGY OF COMPASSION IN COUPLES 48
Figure 2. Spaghetti plot of all compassion ratings.

Each Line Represents Ratings for a Different Participant

PHYSIOLOGY OF COMPASSION IN COUPLES 49
Figure 3. Sample heart rates across two loss discussions.

Green Line = His Heart Rate | Blue Line = Her Heart Rate

PHYSIOLOGY OF COMPASSION IN COUPLES 50
Figure 4. Spaghetti plot of all heart rates.

Each Line Represents Heart Rate for a Different Participant

Running head: PHYSIOLOGY OF COMPASSION IN COUPLES 51
Figure 5. Simple slopes analyses for significant moderators of the association between compassion and speaker’s heart rate.

L = Low (-1 Standard Deviation), M = Medium (Mean), H = High (+1 Standard Deviation)
Comp = Compassion, Anx = Anxious Attachment
* = Significant (p < .05) slope at a given level of the moderator
ns = Non-significant slope (p > .05) at a given level of the moderator

72.5
72.8
73.1
73.4
73.7
74.0
L Comp M Comp H Comp
Speaker's Heart Rate
Speaker-Rated Compassion
Simple Slopes for Anxious Attachment
L
Anx
H
Anx
* p < .001
ns
PHYSIOLOGY OF COMPASSION IN COUPLES 52
Figure 5. Simple slopes analyses for significant moderators of the association between compassion and listener’s heart rate.

L = Low (-1 Standard Deviation), M = Medium (Mean), H = High (+1 Standard Deviation)
Comp = Compassion, Avd = Avoidant Attachment, Sat = Relationship Satisfaction
* = Significant (p < .05) slope at a given level of the moderator
ns = Non-significant slope (p > .05) at a given level of the moderator
70.0
70.3
70.6
70.9
71.2
71.5
L Comp M Comp H Comp
Listener's Heart Rate
Listener-Rated Compassion
Simple Slopes for Avoidant Attachment
L
Avd
H
Avd
ns
* p < .001
70.0
70.3
70.6
70.9
71.2
71.5
L Comp M Comp H Comp
Listener's Heart Rate
Listener-Rated Compassion
Simple Slopes for Relationship Satisfaction
L
Anx
H
Anx
* p < .001
ns

Abstract (if available)

Abstract Compassion, a virtue across a variety of spiritual and cultural belief systems, is commonly considered to originate in witnessing another person's distress and to result in a desire to help. Though compassion has been studied in individuals, little is known about how it functions dyadically and in close relationships. The current study used a novel dyadic interaction protocol, a ""loss discussion,"" to investigate the physiological profile of both experienced and received compassion. In these loss discussions, ""speakers"" shared an emotionally salient loss with their partner, the ""listener."" Speakers' perceptions of their partner's compassion were positively associated with their own heat rate, and listeners' perceptions of their own compassion were inversely associated with their own heart rate. Anxious attachment attenuated the positive association between compassion and the speaker's heart rate. For listeners, relationship satisfaction and low attachment-related avoidance attenuated the inverse association between compassion and heart rate. These results support the approach of studying compassion dyadically, a unique feature of this study, and they are consistent with the idea that compassion occurs in response to witnessing another person’s distress and that it differs from merely internalizing that distress. However, they also suggest the importance of personal characteristics in determining the physiology of compassion.

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Asset Metadata

Creator Corner, Geoffrey W. (author)

Core Title The physiology of compassion in couples’ discussions about loss

School College of Letters, Arts and Sciences

Degree Master of Arts

Degree Program Psychology

Publication Date 07/11/2016

Defense Date 05/23/2016

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag compassion,Couples,heart rate,Loss,OAI-PMH Harvest,psychophysiology,support

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Advisor Margolin, Gayla (committee chair), Saxbe, Darby (committee chair), Prescott, Carol (committee member)

Creator Email gcorner@usc.edu,geoffcorner@gmail.com

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