Help me if you can: Evaluating the effectiveness of interpersonal compared to intrapersonal emotion regulation in reducing distress

Highlights

• Innovative experimental design.

• Using a novel performance-based paradigm.

• Showing advantage of interpersonal compare to self emotion-regulation.

• Demonstrating the added value of cognitive but not emotional empathy of the regulator.

• Illuminating the benefit of non-professional help in reducing distress.

Abstract

Background and Objectives

Although humans have developed abundant strategies to down regulate their own negative emotions, at times of distress they frequently turn to significant others to seek comfort. In the present study we use a novel performance-based paradigm to evaluate the effectiveness of this interaction.

Methods

Forty-seven couples in a long-term relationship volunteered to participate in the study. In each couple the two partners were randomly assigned as either target or regulator. The target viewed pictures with negative valance. In response to each picture he/she was then instructed to choose and apply a regulatory strategy (i.e., intrapersonal emotion regulation) or to apply a regulatory strategy chosen by his/her partner, the regulator (i.e., interpersonal emotion regulation).

Results

We found that the outside perspective of the regulator helped reducing distress more effectively than intrapersonal emotion regulation. Moreover, the cognitive, but not the emotional, empathy of the regulator predicted the added value of interpersonal emotion regulation. Specifically, regulators with a better ability to understand their partners' point of view, selected regulatory strategies that reduced levels of distress more effectively.

Limitations

While the present study examined possible effects of depression, anxiety and the ability to identify and describe feelings, a larger sample is needed in order to optimally address their potential moderating effect.

Conclusions

The results illuminate the value of non-professional interventions and the importance of cognitive empathy in reducing distress. The study has significant clinical implications, providing a simple behavioral tool that can be used to decrease and prevent psychopathology.

Introduction

When Lennon and McCartney cried out for help in their famous song of the same name, they expressed our very basic tendency to rely on others in order to reduce distress (Walen & Lachman, 2000). However, it is not yet clear whether this tendency actually reflects an elevated value of interpersonal interaction in reducing distress. To date, empirical studies have focused mainly on intrapersonal emotion regulation, which refers to the way individuals choose and apply regulatory strategies so as to down regulate their own emotions. Interpersonal emotion regulation, which refers to the way a person (i.e., the target) applies strategies chosen by another person (i.e., the regulator), has been subject to limited investigation (Zaki & Williams, 2013). This is especially surprising due to the important implications of such investigation to the understanding and treatment of various psychopathologies, which involve impaired intrapersonal emotion regulation (Aldao et al., 2010, Marroquín and Nolen-Hoeksema, 2015).

The major aim of the present study was to empirically investigate the effectiveness of interpersonal emotion regulation, defined as the difference between levels of baseline distress and levels of distress after intrapersonal and interpersonal emotion regulation (Schmeichel, Volokhov, & Demaree, 2008; for a meta-analysis see Webb, Miles, & Sheeran, 2012). The secondary aim of the study was to test the possible contribution of the regulator's cognitive and emotional empathy to the added value of interpersonal emotion regulation. As will become evident below, we based our investigation on a recent approach to emotion regulation, which suggests that the effectiveness of different regulatory strategies depends on the context in which they are used (Troy, Shallcross, & Mauss, 2013).

The traditional approach in the field of emotion regulation tends to define certain strategies that involve engagement with emotional information processing such as reappraisal as inherently effective and other strategies that involve disengagement from emotional information processing, such as distraction, as inherently ineffective (for a relevant discussion and possible differences between long and short term effects see Coifman, Bonanno, Ray, & Gross, 2007; for reviews see Aldao et al., 2010, Bonanno, 2013, Park, 2010). However, a more recent approach suggests that the effectiveness of different regulatory strategies is not absolute and depends on various contextual conditions including the intensity of the aversive event (Sheppes et al., 2014), the controllability of the stressor (Troy et al., 2013) and the personality traits of the target (Xia, Gao, Wang, & Hollon, 2014).

Hence, a regulatory strategy that proves effective for one person in a specific context (e.g., reappraisal in low aversive conditions) can prove ineffective for another person, or for the same person in a different context (e.g., reappraisal in high intensity conditions). This approach highlights the importance of selecting the most appropriate regulatory strategy in response to a given context so as to effectively reduce the levels of experienced distress that may follow aversive events (Aldao, 2013, Bonanno and Burton, 2013, Bonanno et al., 2004, Gross, 2014, Sheppes et al., 2014, Troy and Mauss, 2011).

Studies of intrapersonal emotion regulation have shown that appropriate selection between reappraisal and distraction strategies decreases levels of distress in aversive situations (for reviews, see Gross, 2014, Sheppes et al., 2015). However, it is not clear whether interpersonal emotion regulation, in which the regulator chooses the regulatory strategy for the target, can at times be more effective and valuable than intrapersonal emotion regulation. Possible support for the added value of interpersonal emotion regulation relates to the regulator's outside perspective (for review, see Bishop et al., 2004). Specifically, since in interpersonal emotion regulation conditions the regulators are not directly involved with the aversive situation, they can better select highly adaptive and effective regulatory strategies. On the other hand, in conditions of intrapersonal emotion regulation direct emotional involvement may dilute the available cognitive resources that are required in order to select the most adaptive regulatory strategies (Opitz, Lee, Gross, & Urry, 2014). Therefore, we predicted an overall advantage of interpersonal, compared to intrapersonal, emotion regulation in reducing distress.

While the effectiveness of intrapersonal emotion regulation is strongly and exclusively related to the skills of the individual who has experienced the aversive event, in conditions of interpersonal emotion regulation, the skills of the regulator are also highly relevant. One such skill is the ability of the regulator to feel empathy. Empathy is a broad concept that refers to the reactions of one individual to the observed experiences of another (Shamay-Tsoory, 2011), and has evolved so as to promote helping behaviors in social animals (de Waal, 2007). Therefore, it is reasonable to assume that in conditions of interpersonal emotion regulation, greater levels of empathy would contribute to the selection of the most appropriate regulatory strategy and subsequently aid in reducing the distress experienced by the affected individual. However, as will be evident below we claim that this effect will be selective to cognitive, but not to emotional, empathy.

Recent studies have distinguished between two types of empathy that involve different behavioral and brain related mechanisms: Emotional empathy relates to the ability to experience affective reactions to the observed experience of another and involves emotional connotation, emotion recognition, as well as shared pain. Cognitive empathy, on the other hand, is the capacity to engage in a cognitive process of adopting another's point of view; this includes Theory of Mind (ToM), which is the ability to understand and predict the behavior of another by attributing mental states and knowledge (Decety & Jackson, 2004; for meta-analyses, see; Eres et al., 2015, Fan et al., 2011). The proposed dissociation between these two empathy systems is supported by neuroimaging, neurochemical, psychiatric and developmental studies (Gonzalez-Liencres, Shamay-Tsoory, & Brüne, 2013).

We predicted that in conditions of interpersonal emotion regulation, cognitive but not emotional, empathy would have a significant contribution in reducing distress. Hence, the regulator's cognitive empathy would result in a better understanding of the emotional situation experienced by the target and in this way improve his or her selection between different regulatory strategies. Concurrently, the ability to feel the distress experienced by the target does not provide a practical tool to improve regulation. Moreover, it may have a differential effect on behavior; In some individuals it may lead to egocentrically biased judgments (e.g., Silani et al., 2013), and hence may impair interpersonal emotion regulation, while in others it may contribute to pro-social tendencies (e.g.,Lockwood, Seara-Cardoso & Viding, 2014), which may improve interpersonal emotion regulation.

While many studies in the field of emotion regulation have used intrapersonal report questionnaires (e.g., d'Acremont and Van der Linden, 2007, Dragan, 2015, Gross and John, 2003) that are prone to multiple biases, in the current study we applied a novel, performance-based, emotion regulation paradigm. In this paradigm participants are required to choose between different regulatory strategies so as to down regulate negative emotions. This paradigm allows for the assessment of the interactive effects of the regulator's choices as well as his or her empathy on the levels of distress experienced by the target.

Since this is a pioneer study that evaluates the effectiveness of interpersonal emotion regulation, it was important to focus on people with a well-established relationship of at least one year. Therefore, in line with other related studies, we chose to focus on romantically involved couples (e.g., Ben-Naim et al., 2013, Parkinson et al., 2016, Richards et al., 2003), under the assumption that other types of relationships might be more varied and add more confounds to the study.

Each partner was randomly assigned as either target or regulator. The targets were asked to choose and implement a regulatory strategy (i.e., intrapersonal emotion regulation) or to implement a strategy that the regulator selected for them (i.e., interpersonal emotion regulation). Perceived levels of distress in both the intrapersonal and the interpersonal conditions were measured and compared to baseline feelings of distress. As stated above, we predicted that interpersonal emotion regulation would significantly lower the target's distress levels when compared to intrapersonal regulation. Furthermore, we hypothesized that the cognitive empathy of the regulator would predict the effectiveness of interpersonal emotion regulation.