THEEMS

Date

-.- ..‘- ougbg.VM.—«- -8 ".I‘:. NHI’ .

a: If

u
‘w

t
- “‘vxj‘vqmy
. . . .

This is to certify that the

thesis entitled

PSYCHOPHYSIOLOGICAL CORRELATES
OF MEASURES OF EMPATHY

presented by

Michael Gary Lieberman

has been accepted towards fulfillment
of the requirements for

 

Ph.D. degree in Coungeling and
Educational Psychology

 

//., /z- - r/I/

 

0-7639

ll“\\\\\|\\\\llllllllll“ll\l \lllllllllllll

3 1293 10499 4615

 

 

 

RETURNING MATERIALS:
MSU Place in 500E arOp to
1133 remove this checkout from
$ your record. FINES will
be charged if book is

 

returned after the date
stamped below.

 

on ‘)
. [faves 3"
Ail-C 5 "P.

\. ' $‘
J‘AAM 1‘4”“?

"390 0 283 .

O
><
3;-
\ul
\J'l
u

 

 

© 1982

MICHAEL GARY LIEBERMAN

All Rights Reserved

PSYCHOPHYSIOLOGICAL CORRELATES

OF MEASURES OF EMPATHY

BY

Michael Gary Lieberman

A DISSERTATION

Submitted to
Michigan State University
in partial fulfillment of the requirements
for the degree of

DOCTOR OF PHILOSOPHY

Department of Counseling and Educational Psychology

1981

ABSTRACT

PSYCHOPHYSIOLOGICAL CORRELATES
OF MEASURES OF EMPATHY

BY
Michael Gary Lieberman

Psychologists have paid considerable attention to the
"helping relationship“. One aspect of this relationship is
the concept of empathy. One conceptualization of empathy
which was used in the study is Barrett-Lennard's concept.
Barrett-Lennard viewed empathy as a tri-pasic process.

PsychoPhysiologists have studied the correlates of an
organism's accepting and/or rejecting environmental stimuli.
This study was an attempt to investigate the relationship
between three measures of empathy and the hypothesized
psychOphysiological correlates of an individual's
involvement/non-involvement with environmental stimuli.

Three physiological systems were analyzed. They were:
1) cardiovascular, 2) electrodermal, and 3) respiratory.
The research literature suggested when an individual
attended to environmental events that cardiac activity would
decelerate; conversely, when attention was focused in-

ward cardiac activity would accelerate. One hypothesis of

Michael Gary Lieberman

this study, therefore, was that when a subject was involved
with filmed stimulus vignettes heart rate would become less
labile.

Research literature suggested that when an individual
was involved in environmental tasks electrodermal
activity would increase--become more labile. A second
hypothesis, therefore, was that when an individual was
involved with a filmed stimulus vignette skin conductance
would be labile.

An additional hypothesis concerned bilateral skin
conductance assymetry. Recent psychophysiological research
has demonstrated bilateral assymetric differences of autonomic
processes. This study hypothesized that there would be
significant differences in bilateral skin conductance activity
measured simultaneously from on the palmar surface of both
hands.

Sixty students in the first year class in the College
of Human Medicine volunteered for an alternative laboratory
experience. Students were showntnunseries of affect
stimulus vignettes in which an actor or actress looks directly
into the camera and makes an affect laden statement;
simultaneously, their physiological responses were recorded.
In addition, the students conducted weekly interviews with
patient models. During the seventh week of their Doctor-
Patient Relationship class, students conducted an interview
with a patient-model who presented a sexual dysfunction

problem. These interviews were rated by trained raters on

Michael Gary Lieberman

The Carkhuff Empathic Understanding Scale which measured the
student's ability to make empathic responses. This scale
is a 5—point Lickert scale. Each patient rated the student
on the Barrett-Lennard Relationship Inventory which measured
the student's ability to be perceived as empathic. All
students took the Affective Sensitivity Scale, a filmed test
which measured the student's ability to identify the emotion
of the person in the recorded scene.

Two canonical analyses were carried out on this data.
The first canonical analysis correlated the three empathy
measures with heart rate peak score. Results indicated that
heart rate was positively correlated with the empathy measures.
This correlation was significant, but in a direction opposite
to that hypothesized. The second canonical analysis
correlated two of the three empathy measures with respiration
amplitude, resPiration frequency, right hand skin conductance
magnitude, and left hand skin conductance slope. A
significant correlation was found in the hypothesized
positive direction.

Four matched-pair t-tests were carried out on the four
bilateral skin conductance measures. .Results indicated
that there were significant differences on all four measures.

The results of this study were discussed, along with
implications for future research. Results gave no indication
of cardiac quiesence during environmental involvement, in

fact, the converse was found. The electrodermal and

Michael Gary Lieberman

respiratory results confirmed the research hypothesis.

There was a significant positive relationship between the
empathy measures and respiratory and electrodermal activity.
Finally, this study found significantly greater electrodermal

activity on the right hand compared to the left hand.

DEDICATION

This volume is dedicated to the memory of
my parents, Frank and Thelma, who made me
human an instilled in me a set of values

which made the last four years possible.

ACKNOWLEDGEMENTS

I would like to express my appreciation to the members

of my guidance and dissertation committee - had it not been

for these individuals this piece of research would never

come to fruittion.

Norm Kagan - who believed in and encouraged me
my stay at MSU. To Norm I owe thanks for providing
environment which allowed me to grow intellectually
personally, for allowing me "creative input" in his
providing financial and emotional support, and most

being there when I needed him.

during
an

and

lab, for
of all

J. Bruce Burke - who helped me believe in my capabilit—

ies, who listened with compassion and support during many

critical periods of my doctoral candidacy, for nurturing and

sharpening my philosophical thought, and for teaching me how

to write without "split-infinities".

Gary Stollak - who taught me how to "be with" and

"experience" children and families, who taught me how to put

things in their proper perspective, and most of all,

caring.

John Schneider - who provided me with guidance, direction,

for

and support in my excursion into the field of Health Care

Psychology, for agreeing to serve on my committee simply

iii

because he found my ideas intriguing, and for treating me
with respect.
Bob Matson - fellow research assistant who patiently
transalted my ideas and hypotheses into computer programs.
Russell E. Hogan - fellow research assistant and

simply my friend.

iv

TABLE OF CONTENTS

Page
LIST OF TABLES O C O O O O O O O O O O O O O O O O O Vii

LIST OF FIGURES O O O O O O O O O O O O O O O O O O . Viii

Chapter
I. THE PROBLEM. . . . . . . . . . . . . . . . . 1
Introduction . . . . . . . . . . . . . . . 1
Need . . . . . . . . . . . . . . . . . . . 6
Purposes . . . . . . . . . . . . . . . . . 8
Hypothesis . . . . . . . . . . . . . . . . 8
Theory . . . . . . . . . . . . . . . . . . 9
Overview . . . . . . . . . . . . . . . . . 31
II. REVIEW OF THE LITERATURE . . . . . . . . . . 32
Electrodermal Activity (EDA) . . . . . . . 32
Heart Rate . . . . . . . . . . . . . . . . 45
Respiratory Rate . . . . . . . . . . . . . 51
Measurement of Empathy . . . . . . . . . . 53
Summary. . . . . . . . . . . . . . . . . . 56
III. METHODOLOGY. . . . . . . . . . . . . . . . . 58
Sample . . . . . . . . . . . . . . . . . . 58
Procedure. . . . . . . . . . . . . . . . . 59
The Laboratory Experience. . . . . . . . . 59
Electrodermal Recording. . . . . . . . . . 62
Cardiovascular Recording . . . . . . . . . 63
Respiration Recording. . . . . . . . . . . 65
Computer Interface . . . . . . . . . . . . 66
Physiological Measures . . . . . . . . . . 68
Psychological Measures . . . . . . . . . . 72
Stimulus Films . . . . . . . . . . . . . . 74
Design . . . . . . . . . . . . . . . . . . 76
Analysis . . . . . . . . . . . . . . . . . 78
Experimental and Null Hypotheses . . . . . 79
Summary. . . . . . . . . . . . . . . . . . 79
IV. Analysis . . . . . . . . . . . . . . . . . . 81
Summary. . . . . . . . . . . . . . . . . . . 89

Chapter

V.

Page

SUMMARY, CONCLUSIONS, DISCUSSION, AND
IMPLICATIONS C O O O O O O O O O O O O O O O O 90

Summary . . . . . . . . . . . . . . . . . . 90
Conclusions . . . . . . . . . . . . . . . . 93
Discussion. . . . . . . . . . . . . . . . . 95
Personal Observations . . . . . . . . . . . 102
Implications for Future Research. . . . . . 103

APPENDICES O O O O O O O O O O O O O O O O O O O I O O 107

A.

B.

C.

D.

E.

F.

G.

Medical Vignettes - Series 1 . . . . . . . . 108
Medical Vignettes - Series 2 . . . . . . . . 110
Basic Neurophysiology . . . . . . . . . . . . 112
Procedures for Equipment Operation. . . . . . 118
Barrett-Lennard Relationship Inventory. . . . 121
Carkhuff Empathic Understanding Scale . . . . 125

Consent for Participation . . . . . . . . . . 129

BIBLIOGMPHY O O O O C O O O O O O O O O O O O O O O O 131

vi

LIST OF TABLES

Table Page
4.1 Correlation Matrix. . . . . . . . . . . . . 82
4.2 Canonical Correlations. . . . . . . . . . . 85
4.3 Canonical Correlations. . . . . . . . . . . 87
4.4 Matched-Pair t-tests . . . . . . . . . . . 88

vii

LIST OF FIGURES

Figure Page
3.1 Design Diagram. . . . . . . . . . . . . . . 76
3.2 Design Diagram. . . . . . . . . . . . . . . 77

viii

CHAPTER I

THE PROBLEM

Introduction

 

In its broadest sense this is a study of the relation-
ship of "body" and "mind". By themselves in conventional
usage, the words "mind" and "body" are easy to understand.
Webster's dictionary defines body as "the whole physical
substance of a man, animal,.or plant". The word "mind" has
a more equivocal meaning. Webster's dictionary defines
mind as "memory or rememberance; what one thinks: what one
intends or wills; and that which thinks, perceives, feels,
etc." However, the concept "mind/body integration" is
both complex and perplexing.

Throughout the ages, noted philosophers and scientists
have debated the relative merits of either the separateness
or relatedness of the mind and body. The ancient Greeks
debated the difference between "nous" the mind and "psyche'"
the soul and their relation to the body. Aristotle, in

On the Soul, wrote, "Probably all the affections of the soul

 

are associated with the body-anger, gentleness, fear, pity,

courage, and joy, as well as loving and hating; for when

they appear the body is also affected" (Hett translation,
1936). Plato, who was a dualist, saw the soul as a separate
enity from the body. What is both interesting and contradic-
tory in Plato's writings is that he also wrote "all the
different aspects of things dealt with by the several sciences
must be correlated if we are to know reality in its fullness"
(Blakewell translation, 1928). Socrates was reported to
believe that there were some illuminating similarities between
good bodily states, such as health and strength, and good

soul states, such as virtue and happiness; or at least, that
good soul states should be thought of on the model of good
bodily states (Santas, 1979). ‘Two thousand years later,
Descarte wrote on the concept of dualism. He considered mind
and body to be totally separate. Descarte tried to establish
that physiological causes do not rob the mind of a power of
self-determination. Writing in 1637 on his dualistic
philosoPhy, he remarked, "this ego, that is, the soul by
which I am.what I am, is entirely distinct from the body,

and it is even easier to know that the body, and even if the
body did not exist, the soul would not cease to be what it is"
(Morris transaltion, 1971). Nietzsche, who has been perceived
incorrectly as a dualist, repudiated any strict division of
flesh and spirit, insisting that the two could be understood

only in their inextricable togetherness (Kaufmann, 1968).

Even as late as the 1800's, an English physician named Tuke
(1884) wrote an extensive volume titled Illustrations of the
Influence of the Mind upon the Body. In this work he concluded:

We have seen that the influence of the

amind on the body is no transient power;

that in health it may exalt sensory functions,

or suspend them altogether; excite the nervous

system so as to cause the various forms of

conclusive actions of the voluntary muscles....
Finally, Planck (1931) spoke of the-need for a wholistic
approach to the study of all systems saying, "...it is
impossible to obtain an adequate version of the laws for
which we are looking unless the physical system is regarded
as a whole" (Restak, 1971).

During the last hundred years, the predominant approach
of the scientific community has been to study the mind and
body in isolation relative to each other. Study of the
behavior of the body has been classically the domain of the
biological sciences. Rapid advancements in observational
techniques have led to rapid growth in the discovery of bodily
phenomena. As these discoveries occurred, the theories and I
laws of the biological sciences were questioned and revised.
Many of these discoveries led to an increase in the blurring
of the boundaries between the disciplines. What is interest-
ing is that for many years this led to subdivisions or sub-
specialties within the separate disciplines rather than an

increased interrelationship between the disciplines. The

development of subspecialties has led to an even more rapid

expansion of the reservoir of knowledge concerning the
behavior of the human body. This trend toward subspecializa-
tion has unquestionably led to a significant improvement in
the quality of the human condition. Only recently, however,
have scientists realized that the more they discover within
their respective fields the more they must rely on discoveries
from the other disciplines to try to explain adequately the
phenomena they observe.

A developmental process of a similar nature occurred in
the study of the mind, however, in the social sciences there
was a degree of sharing of information. As in the development
of the study of the body, observational and measurement
techniques improved and our reservoir of knowledge grew.
Theories and laws were questioned and revised to fit the new
body of information. Subspecialties developed within the
separate disciplines of the social sciences. Unlike the
biological sciences, however, there was a somewhat earlier
sharing of ideas and information between the disciplines.

An example of the "separate" approach to the study of
the body and mind is to be found in the study of the brain
and the mind. The study of the brain and its biological
functions are the domains of the neuroanatomist and the
neurologist; whereas the mind is the domain of the psychologist.
Within the last fifteen years, the development of the field
of psychobiology, with its emphasis on how the brain

influences our perceptions of the world, how we know

5
ourselves and the nature of reality, is an illustration of
the re-emergence of interdisciplinary c00peration between
the biological and social sciences. PsychOphysiology is an
example of another c00perative effort between the sciences.
In general, these interdisciplinary efforts occur at points
of logical compatibility between the disciplines. Psycholo—
physiology developed from human physiology and experimental
psychology. This led eventually to other subspecialties
exploring the relationships between their domains and
disciplines which seem incompatible.

This study is one which falls into this last type of
relationship where seemingly incompatible subspecialties
explore the relationships between their domains. This study
combines the disciplines of counseling psychology, psycho-
physiology, and physiology. The nature and sc0pe of such an
undertaking poses some unique problems. Because this study
involves more than one discipline, the research encompasses a
large body of related literature. In addition, the dis-
ciplines often use different language and terminology to
describe concepts which are similar. These concepts then
must be transformed into a form which makes the different
terminologies compatible. This study requires, also, the
integration of theoretical constructs, measurement techniques,
and application procedures from diverse areas such as
physiology, psychophysiology, biomedical engineering,

computer science, psychology, and counseling psychology.

Comparison of the volume of literature which exists in
these separate fields to the literature concerning the
relationships between these fields reveals the latter

volume to be sparse.

Need

There is a need to continue to explore the relation-
ship between mind-body relationships. This study attempts
to explore two specific aspects of this relationship. The
first aspect is the relationship between psychophysiological
responsiveness,“ and the psychological concept of empathy.
The second aspect of the mind-body relationship which this
study will explore is that of bilateral differences in
electrodermal activity.

This study has practical implications. Over
the last thirty years, the exploration of the "helping
relationship" has been a major area of endeavor for both
counseling and clinical psychologists. Theorists and
practitioners from the various schools of thought (Rogers,
1957; Barrett-Lennard, 1962; Paul, 1969, Sullivan, 1953;
and Fromm-Reichmann, 1950) have postulated numerous
characteristics or skills which the effective "helper" must
possess. Empathy is one of the more thoroughly researched
characteristics (Rogers, 1950, 1957; Barrett-Lennard, 1976;
Fish, 1970; Guerney, et. a1. 1968; WOgan, 1969; and Carkhuff,

1969).

Rogers (1957, 1961), writing on the necessary
characteristics which the counselor/psychotherapist must
possess and exhibit to effect change in the therapeutic
relationship, presented the earliest global statement on
empathy, saying:

Can I let myself enter fully into the
world of his feelings and personal
meanings, and see these as he does? Can I
step into his private world so completely
that I lose all desire to evaluate or
judge it? Can I enter it so sensitively
that I can move about it freely....Can I
extend this understanding without limit?
(Rogers, 1957, p. 98)

Underscoring the importance of empathy in the therapeutic
process, Rogers cites the research of Fiedler (1950)
in which items such as the following placed high in the
description of the relationships created by experienced
therapists:

The therapist is well able to under-

stand the patient's feelings. The

therapist is never in any doubt about

what the patient means. The therapist's

remarks fit in just right with the

patient's mood and content. The

therapist's tone of voice conveys the

complete ability to share the patient's

feelings (Rogers, 1966, p. 4).

If a relationship between empathy and physiological

responsiveness could be established, it might then be
possible to improve a therapist's empathic ability by

providing him/her with information about his/her

physiological concomitants of empathy in various inter-
personal situations. A prerequisite to the use of such a
technique would be to first establish the psychOphysiological
correlates of empathy. This study addresses the need to

establish these psychophysiological correlates.

Purposes

The purpose of this study was to explore the relation-
ship between psychophysiological responsiveness to affective
stimuli, using cardiovascular, electrodermal, and pulmonary
responses and the psychological concept of empathy. A
second purpose of this study was to clarify the relationship
between bilateral electrodermal differences in skin

conducatnace and empathy.

Hypotheses

 

It is expected that there will be a positive
correlation between physiological response to affective
stimuli, as measured by electrodermal and pulmonary
responses and three measures of empathy (Carkhuff Empathic
Understanding Scale, Affective Sensitivity Scale, and
Barrett-Lennard Relationship Inventory). It is hypothesized
that there will be a negative correlation between
cardiovascular response to affective stimuli and the

three empathy measures. The final hypothesis is that

electrodermal response to affective stimuli will be greater

on the right hand than on the left hand.

Theogy

Why would one expect to find a relationship between
empathy and physiological responsiveness? Why would one
expect to find this relationship in the particular
responses hypothesized? In the preceeding sections, an
historical overview of the relationship between body and
mind was presented. This section will provide a theoretical
basis for the relationship between mind and body. There are
two tOpics in this section which are particularly critical
to the building of this theory. One topic concerns the
nature of empathy. Empathy involves the ability to be
sensitive to another's feelings, to communicate that
sensitivity, and to be perceived by the other as sensitive
or empathic. One component of empathy, therefore, is the
ability to become involved with and attend to the communicat-
ions of others. The other topic concerns the physiological
response patterns. Research will be presented which relates
the direction and magnitude of a physiological response (to
affective stimuli) to environmental intake and involvement.
If one component of empathy is the ability to become intensely

involved with another person, and degree and magnitude of a

10

physiological response is evidence of increased environmental
involvement; then, there should be a relationship between
degree of empathic ability and the direction and magnitude
of physiological response.

This study bears directly on four theoretical constructs.
The first concerns the Interpersonal Process Recall model.
The second concerns the nature of empathy. The third concerns
the psychophysiological response patterns of cardiovascular,
electrodermal, and pulmonary activity. The fourth and final
construct concerns the nature of bilateral differences in
electrodermal activity.

This research evolved from a National Institute of
Mental Health grant to study further model development of
the Interpersonal Process Recall process. The data for
this study was collected as part of this further model
development. This fact makes the discussion of the
Interpersonal Process Recall (I.P.R.) model a logical
point to start. The I.P.R. process was conceived at
Michigan State University, in 1962, by Kagan and his
associates (Kagan, Krothwohl, and Miller, 1963; Kagan,
Krothwohl, and Farquhar, 1965; Kagan and Krothwohl, 1967).
During the intervening years, the I.P.R. model has been

applied in a multitude of different settings. These settings

11

range from its use to accelerate client growth, to its
use in urban schools, to the training of residence hall
assistants (Tomary, 1979; Kagan and Burke, 1976; Dendy,
1971). One of the most innovative applications of the
I.P.R. model is in the area of medical education. The
model is used to increase the interpersonal effectiveness
of medical students during patient interviews (Jason, Kagan,
Werner, Elstein, Thomas, 1971; Elstein, Kagan, Schulman,
Jason, and Loupe, 1972; Werner and Schneider, 1974).
I.P.R. is used extensively now, throughout the world,
to facilitate medical students' interactional skills
(Robbins, Kraus, Heinrick, Abrass, Dreyer, and Clyman,
1979; Blair and Fretz, 1980).

Interpersonal Process Recall (I.P.R.) is a method
used for influencing human interaction (Kagan, 1975, 1979).
The goal of the process is to increase awareness of one's
own experience as well as one's awareness of the experience
of others during a given interaction. A video or audio
tape is made of an interaction between two or more
individuals. The tape is then played back to one or more
of the individuals who participated in the interaction.
With the help of an "inquirer" the individua1(s) "processes"
the reactions they experienced during the interaction. The

inquirer is trained in the I.P.R. model and facilitates

12

the "recall" (discussion) of the participant(s) reactions
to the interaction. The audio or videotape of the initial
interaction is used as a stimulus for recall. The
participant(s) is encouraged to recall the thoughts,
feelingsrimages, and fantasies experienced during the
recall. They then discuss these with the inquirer. The
inquirer's main function is to ask open-ended questions
regarding the reactions which the participant(s) discloses.

Kagan and his colleagues, in an extension of his
work, developed filmed "stimulus vignettes" (Kagan and
Schauble, 1969; Kagan and Van Noord, 1976). In these
vignettes, actors or actresses look directly into the
camera and make some type of emotionally-laden statement
(e.g. It's you, and pe0ple like you who cause most of the
misery and suffering in the world...). The purpose of the
vignettes is to simulate potentially evocative inter-
personal situations. Vignettes have been developed to
evoke such affective states as anger, fear, helplessness,
sexual arousal etc.....Kagan refers to the use of these
vignettes as "a type of interpersonal allergy test".
Students are videotaped while watching these vignettes,
and the tapes are then used in the recall process.

A physiological feedback component was added to the
stimulated recall process, as a result of updating and

experimenting with different procedures to increase the

13

effectiveness of the recall process (Archer, Fiester, Kagan,
Rate, Spierling, and Van Noord, 1972). Measures of various
physiological activity were recorded, videotaped, and
then played back to the subject. The goal was to provide
the individual with an additional basis for exploring his/
her interpersonal behavior. Archer et.a1. saw the
potential to use this physiological response data in the
facilitation of the counseling process; ”it seemed logical
and desirable to provide...not only an opportunity to
study his physical and verbal reactions to a real or
simulated interpersonal engagement but to permit him.to
see what his internal responses were as well". A similar
potential is' seen for the use of this technique in the
facilitation of the development of empathic skills. The
first step toward achieving that goal is establishing
that a relationship does exist between empathic ability and
physiological response to affective stimuli.

The physiological data for this study was collected
in the laboratory which was developed for the physiological
feedback component of the I.P.R. process. The data was
collected during an ongoing I.P.R. medical education train-
ing project. It is important to note that this setting
offered the opportunity to collect data in a setting quite
unlike the settings in which most psychophysiological

research is conducted. In most research of this type, the

14

subject is in a sterile environment, the purpose of which
is to control any irrelevant stimuli. The subject is then
presented some type of psychophysical stimuli such as
ringing bells, flashing lights, cold pressor tests, shocks,
etc. These stimuli are considered, by the particular
researchers, as affective stimuli. The subjects
physiological response to these stimuli are recorded and
evaluated. In this study, because of the physiological
feedback laboratory, participants were presented a form
of affective stimuli, filmed vignettes, of a person
"looking at" the subject and apparently talking to the
subject. This situation approximates more closely the
complex interpersonal situations of real life. Since this
form of presentation approximates more closely the real
world, the individual's physiological response to these
vignettes should reflect more closely their true
physiological response to affective situations. Chapter III
contains a detailed discussion of this laboratory procedure.
The second topic of concern in this study is empathy.
Empathy is one of the most researched concepts in
phenomonological psychology. A review of the gggrggl_g§

Counseling Psychology alone, reveals that there is

 

at least 3-6 articles in each of the last ten years
exploring some aspect of empathy. These articles range from

research on techniques for improving empathic ability

15

(Fridman and Stone, 1978; Shaffer and Hummel, 1979;
Caracena and Vicory,, 1969), to the effects of empathic
ability on client progress (Grater and Claxton, 1976), to
test instruments to measure empathy (Hill and King, 1976),
to position papers on the theoretical conceptualization
of empathy (Barrett-Lennard, 1981).

The word empathy is directly traceable to the Greek

word Empatheia. Empatheia means affection with suffering.

 

The prefix gm means "in" or ”into". Barrett-Lennard (1981)
traces the modern usage of empathy to the German
psychologist Theodor Lipps. "Lipps used the term
Einfuhlung to refer to the process of becoming totally
absorbed in an external object...". Barrett-Lennard also
traces the concept, if not the use of the word itself, to
Alfred Adler. "...Adler had written with simple eloquence
of the vital importance in his system of the helper possess-
ing 'to a considerable degree, the gift of putting himself
in the other person's place'".

The term empathy is associated closely with Carl
Rogers (1950, 1957). Rogers speaks of empathy as "an
individual's experiencing an understanding of another's
internal frame of reference and endeavoring to communicate
this experience to the other individual. To sense another's
private world as if it were your own, but without ever
losing the 'as if' quality, this is empathy, and this

seems essential to the helping relationship". Dymond (1949)

16

defined empathy as the imaginative transposing of oneself
into the thinking, feeling, and acting of another. Truax
and Carkhuff (1967) defined empathy as a process of
experiencing what another is experiencing. Goldstein
(1973), who is a staunch behaviorist, underscored the
importance of empathy in the therapeutic process, stating,
“..if any therapeutic intervention is to be effective...
the therapist must establish that (l) he understands and
accepts the patient, and (2) that the two of them are work-
ing together."

Barrett-Lennard (1962, 1963, 1976, 1981) provides one
of the most in-depth recent theoretical conceptualizations
of the process of empathy. Barrett-Lennard views the
empathic cycle as a five step process. He states these five

steps as follows:

Ste 1. 'A' is actively attending (with an empathic
set; to 'B', who is in some way expressive of his/her
own experiencing (and concomitantly expecting,
hoping, or trusting that 'A' is receptive).

Step 2. 'A' reads or resonates to 'B' in such a
way that directly or indirectly expresses aspects
of 'B's' experience become experientally alive,
vivid, and known to 'A'.

Step 3. 'A' expresses or shows in some communicative
way a quality of felt awareness of 'B's' experiencing.

Ste 4. 'B' is attending to 'A's' response
suffic1ently at least to form a sense or perception
of the extent of 'A's' immediate personal understanding.

Step 5. 'B' then continues or resumes visible self
expression in a way that also carries feedback
elements for 'A'... (pgs. 93-94).

17

He further goes on to say that once the process has been
initiated, that relational empathy is tri-phasic. Each
phase differs in locus and content. The first phase is the
inner process of empathic listening, resonation and personal
understanding. The second phase involves expressed

empathic understanding. The third stage is received empathy,
or empathy based on the experience of the person empathized
with. Given this tri-phasic conceptualization, one must

tap all three phases in order to represent accurately an
individual's empathic ability. This study used Barrett-
Lennard's model to conCeptualize the process of empathy.

A standardized psychological test was used to measure each
phase of the empathy process.

In summary, then, the relevant points discussed here
concerning the nature of empathy are: 1) there is a long,
and still very active, history of the study of the role
of empathy in the therapeutic change process, 2) the major
theme which pervaded all of the conceptualizations about
empathy was the theme of an individual's ability to become
involved in the phenomonological world of another, 3) pp;
component of empathy is the ability to become involved
with and attend to the communication of other individuals
in the external world, 4) empathy is a tri-phasic process
which includes: listening, resonation, and personal under-
standing; expressed empathic understanding; and received

empathy, empathy based on the experience of the person

18

empathized with, and 5) in order to represent adequately
an individual's empathic ability, all three phases of the
empathic process must be measured.

The remaining topics to be discussed in this section
are the physiological response mechanisms. All physiological
processes in the human body are under the control of neural
mechanisms. Through the process of neural activation,
messages are received from and transmitted to the brain
from all viscera and soma. This process of activation and
transmission guides the organism through an ocean of
external stimuli.

Readers of this study will have varying degrees of
familiarity with these neural mechanisms. A reader who
is familiar with this basic neurophysiology need only
continue on to the next sections. For the reader who would
like to refresh him/herself a review of basic neuro-
physiology is presented in Appendix C.

The third concept which this study is based upon is
the relationship between physical and emotional events in
the human body. While the idea has been with us since
antiquity that emotional and physical events in the body
are related, the scientific inquiry into this relationship
is a recent phenomona.

Webster's dictionary defines emotion as, "a

physiological departure from homostasis that is subjectively

19

experienced in strong feelings and manifests itself in
neuromuscular, respiratory, cardiovascular, hormonal, and
other bodily changes preparatory to overt acts which may or
may not be performed". According to this definition,
emotional and physical states interact. But how? The
James-Lange and Cannon-Bard theories are two of the oldest
attempts to explain this interaction.

William James and Carl Lange, independently, proposed
a theroy which hypothesized that environmental stimuli
automatically arouse and set off various physiological
patterns. These patterns are identified by the brain as
patterns of specific emotions. The brain then labels these
patterns (James, 1884). According to this theory, the
brain acts as a passive receptor, scanning all neural input
from the viscera. When it identifies a specific pattern,
such as sweating palms and a tightening of the stomach , it
goes through an algorithmic chain such as, 'stomach tight,
hands sweaty, I am anxious'. For this theory to be correct,
each emotion must therefore be physiologically distinct.
The Cannon-Bard (1927) theory of emotional arousal disputes
the James-Lange theory. Cannon's View is referred to
classically as the "fight or flight" theory. Cannon's
theory pays particular attention to the evolutionary role
which strong emotions play in the preparation of the organism

for activity during an emergency. In this theory, the

20

brain (especially the hypothalamus) both initiates and

plays an integral part in an emotionally arousing
experience. In the Cannon-Bard theory, the brain is much
more than a passive interpreter of visceral information.
Cannon demonstrated, experimentally, that when input from
the viscera is surgically cut off below the brain, an animal
is still capable of behaving "emotionally". Cannon also
argued that different emotional states have similar visceral
changes. Lindsley (1951) was influenced greatly by research
on the role of the brain's reticular formation in maintain-
ing alertness. He hypothesized that the level of arousal
was responsible for the type of emotion experienced. He
argued that emotion can be viewed as a one dimensional
continuum. This continuum ranges from coma at one end to
extreme emotion at the other end. The major weakness of
this theory is that it can not differentiate clearly between
emotions of similar intensity. Lindsley believed, but was
never able to substantiate, that different emotions could

be detected in EEG rhythms of the brain. Other theorists
have proposed numerous other explanations for the relation-
ship between emotional arousal and physical states of the
body. Duffy (1934) proposed a theory of "energy
mobilization". Hebb (1955) proposed a two factor model
which involved a "cue" which gave the emotion a direction.
Schacter (1964) prOposed a theory involving undifferentiated

autonomic patterns and cognitive states.

21

Numerous theorist and researchers (Clemens, 1957;
Dykman, et. a1., 1959, 1968; Malmo and Davis, 1956, Lacey
and Lacey, 1958) have pointed out that there are low
correlations typically found both among physiological
measures themselves and physiological measures and emotions.
Results, more often than not, prove inconclusive,
paradoxical, and contradictory.

Lacey (1956, 1959, 1963, 1974) tries to account for
the low correlations found among both physiological
measures and emotional states. Lacey (1959) hypothesized
that acceptance of the environment or attention to external
tasks is associated with cardiac deceleration. On the other
hand, rejection of the environment or attention directed in-
ward to internal cues is asociated with cardiac acceleration
according to Lacey. He states:

"...where cardiac deceleration is the
rule, the subject is required primarily
to note and detect the environment...
At the other end, where cardiac
acceleration is the rule, one can at
least speculate that the Opposite of
environmental intake is called for.
In a sense, then, the acceleration or
deceleration of the heart could be
considered to be something like an
instrumental act of the organism,
leading either to increased'ease of
environmental intake or'a form of
"rejection of the environment". (Lacey,
1959).

If Lacey's hypothesis is correct, then a decelerated

heart rate would be indicative of environmental involvement

or intake. If heart rate decelerates during times of

22

environmental intake, then it would be reasonable to assume
for this study that a smooth non-labile heart rate might
also be indicative of environmental intake. Lacey (1963)
later stated that "environmental rejection" (thinking) led
to phasic heart rate increases, while "environmental intake"
(attention to external events) led to phasic heart rate
decreases. Lacey measured subjects' skin conductance and
heart rate while they were involved in different tasks.
These tasks included: thinking, enduring physical pain,
visual attention, and empathic listening. Lacey hypothesized
that thinking and enduring physical pain would require the
subject to be non-involved in his/her environment-to reject
environmental stimuli. Visual attention and empathic
listening were believed to require environmental involvement.
Results showed that heart rate reactivity either increased
or decreased in the hypothesized directions. What was
interesting, however, was that skin conductance reactivity
increased during all four tasks. In order to explain
adequately this discrepancy, Lacey proposed the phenomena
of “directional fractionation". Directional fractionation
of response is involved in situations where physiological
systems do not covary in an arousal like fashion. The

idea of directional fractionation directly confronts the
"arousal" theories of emotion which were presented earlier.

Directional fractionation, however, provides a plausible

23

explanation for the low correlations which are usually
found between different physiological systems. Lacey
(1967) proposed an underlying biophysiological mechanism
to explain this heart rate phenomena. He believes that
heart rate increases lead to feedback which inhibits
cortical activity. He described neurophysiological studies
which traced the pathways from carotid sinus stretch
receptors to brainstem.mechanisms. This neurophysiological
foundation demonstrated that blood pressure changes mediated
by baroreceptors in both the aortic arch and carotid sinus
produce alterations in reticular formation activity and in
cortical excitability.

Dell (Dell,et- a1., 1954; Dell, 1957) suggested that
the stretch receptors of the carotid sinus produce an
inhibitory effect on central vasomotor tone and adrenal
secretian by way of Hering's nerve. They demonstrated that
sectioning of Hering's nerve abolished the inhibitory effect
produced by an injection of epinephine. Bonvallet and
Allen (1963) showed that interruption of cardiovascular
afferent input leads to a prolonged EEG activation pattern
following reticular formation stimulation. Bonvallet and
Allen suggested that the normal inhibitory action of the
carotid sinus reflex was lost due to interruption of the
feedback information on which this inhibitory influence

normally depends.

24

Electrodermal activity was one of the first
physiological processes to be explored by psychologists.
Jung (1907) used galvanic skin response (GSR) in attempting
to understand unconscious processes. He saw this measure
as an objective window to the unconscious. Jung's study
was the first to relate the magnitude of GSR to the
magnitude of an emotional experience. The more deeply an
affective image affected you, the more the needle moved
around. Archer, et. al. (1972) reported the results of
a number of research studies concerning the relationship
between skin response and interpersonal situations. From
these studies, they concluded..."have reported studies showing
relationships between physiological skin responses and
various interpersonal situations, and higher response levels
may be associated with, or evidence of, increased environmental
intake by the organism" (emphasis added). Seligman (1973)
found that negative skin potential responses in her subjects
were accompanied by feeling described as pleasant. Positive
skin potential responses were associated with unpleasant
feelings. Edwards and Alsip (1969) explored the effects on
heart rate and skin resistance (the inverse of conductance
of.intake-rejection, verbalization and affect. This research
was based on Lacey's theories of intake-rejection and direct-

ional fractionation. They presented subjectS‘with fourstimulus

25

intake tasks and four stimulus rejection tasks. Each task
was administered twice. Once using verbal instructions and
once using nonverbal instructions. One month later, subjects
were asked to rank order the tasks on a pleasantness-
unpleasantness continuum. Two of the intake tasks involved
viewing a picture of an attractive scantilly clad girl and
viewing a picture of a pile of concentration camp bodies.
Results showed significant changes, in the hypothesized
directions, for both intake and rejection tasks. No
relationships were found between ranking on the pleasant-
unpleasant continuum and physiological change. The two
intake tasks which involved the viewing of the pictures
yielded results which showed directional fractionation of
response. Hare et. a1. (1971) researched the effects of
affective visual stimulation on autonomic responses.
Subjects were shown color slide pictures of different
situations. These pictures varied in intensity. The
purpose was to evoke differentialflevels of affective
arousal. Results of the study showed an increase in skin
conductance and a decrease in heart rate in response to

the slides. These responses were evident at all levels of
stimulus intensity. Blaylock (1972) reports the effects

of intake—rejection, verbalization requirements, and

threat of shock on heart rate and skin conductance.

Subjects were assigned to either an intake or rejection task

26

group. These groups were sUbdivided into either threat of
shock or no threat of shock groups. Results of this study
also tended to support the theory that during environmental
intake skin conductance increases and during environmental
rejection it decreases. Heart rate during environmental
intake decreased; whereas, during environmental rejection
it increased.

In summary, then, the relevant points discussed here
concerning the physiological correlates of emotion are:

l) the arousal theories of emotion cannot account for
certain aspects of physiological response patterns of
emotion, 2) Lacey's concept of directional fractionation

is an attempt to account for the low correlations found
between physiological systems and emotion, 3) environmental
intake or rejection affects the magnitude and direction of
heart rate and skin conductance, and 4) heart rate and

skin conductance are responsive to affective visual
stimulation.

The last concept which this study bears upon is the
relationship between bilateral skin conductance which is
measured concomitantly from both hands. The issue of
bilateral or asymmetric autonomic activity has recently
been receiving much attention (wyatt and Tursky, 1969;
Varni, Doerr, and Franklin, 1971; Giddon and Franklin,

1970). Varni et. a1., (1975) stated that it had become

27

increasingly clear that both sides of the body have varying
degrees of autonomic activity. Electrodermal activity is
clearly the most researched autonomic activity which occurs
bilaterally. Numerous investigators have studied recently
these bilateral differences (Ketterer and Smith, 1977;

Bull and Gale, 1975; Varni, Doerr, and Varni, 1975; Christ,
1963). Varni, et. a1. (1975) explored the relationship
between asymmetrical skin conductance levels and awareness
of body side. He reports a relationship between awareness
of body side and skin conductance level of the contralateral
side. Results showed, "when a subject has pppp reliable
bilateral differences in tonic skin conductance and reliable
awareness of one body side it is likely that the side of
the body reported as the side of awareness will also be

the body side of greater tonic skin conductance". An
important aspect of this study worth noting is that the
skin conductance measure used was the tonic level rather
than phasic response. Ketterer and Smith (1977) examined
the effects of sex and hemispheric activation on bilateral
skin conductance activity. To accomplish this, both a
right hemisphere (music) task and a left hemisphere(verbal)
task were administered to male and female subjects.

Results of this study were not supportive of the findings
of Myslobodsky and Rattok (1975) that stimulation of one

hemisphere produces greater electrodermal activity on the

28

contralateral side. An additional finding of the Ketterer
and Smith study involved bilateral variation in skin
conductance level with a formula of: handedness x sex inter-
action. Tonic levels were higher on the right hand in males
and higher on the left hand in females. As in the Varni

et. a1. study, tonic level of skin conductance was measured
rather than phasic response. Bull and Gale (1976) measured
response magnitudes, response latencies, recruitment times,
and recovery quotients concomitantly from subject's two hands.
They found substantial left-right differences on all
measures. There was, also, a high linear relationship
between concomintant response magnitudes.

All of the articles referenced so far have one thing
in common. They all relate observed bilateral skin
conductance differences to hemispheric activation of the
brain. An alternative hypothesis is presented by Lacroix
anc Comper (1979). They state:

"Electrodermal activity is regulated

in part by cortical centers, and
although the evidence remains exiguous,
it seems that both excitatory and
inhibatory centers are found at the
cortical level. Moreover, it appears
that the influence of excitatory centers
may be exerted bilaterally, whereas,
that of inhibatory may be lateralized,

with the inhibatory effects manifested
primarily on the contralateral side".

29

They hypothesized that differential activation of both
hemispheres by behavioral manipulation would cause a

lower level of arousal on the contralateral side. This
differential activation of the hemispheres was achieved
by requiring subjects to perform verbal tasks (left
hemisphere activation) and visual-Spacial tasks (right
hemisphere activation). Their results showed that in
dextral subjects, cognitive tasks which were intended to
produce differential activation of the hemispheres were
accompanied by different patterns of bilateral differences
in the amplitude of skin conductance responses. These
bilateral differences were opposite in direction with
tasks that are strongly lateralized in the different
hemispheres. They suggest, finally, that electrodermal
measures of differential hemispheric activation may
constitute reasonably stable indices of relative hemispheric
activation.

Restak (1979) related the work of Galin, who believes
that the performance of the right hemispheneis very
similar to the Operation of unconscious processes. Galin
presents two points. The first is that both the
unconscious and the right hemisphere deal with images which
ordinarily cannot be verbalized. The second point is that

both depend more on Gestalt formations rather than logical

30

analysis. Restak goes on further to quote Galin, writing:
"It is important to emphasize that
what most characterizes the hemispheres
is not that they are specialized to
work with different types of materials
rather, each hemisphere is specialized
for a different cognitive style - the left
for an analytical, logical mode in which
words are an excellent lead, and
the right for a holistic, Gestalt mode,
which happens to be particularly
suitable for special relations".
Restak also presents the work of Suberi who has shown,
experimentally, the subjects favor the right hemisphere
for the memory storagecufemotionally charged material.

In the IPR lab during the two years prior to this current
study, what appeard to be a noticable difference in bilateral
electrodermal activity was observed in many subjects. No
attempts were made to quantify or determine statistically
whether these differences were significant. Before students
were scheduled into the lab, they had already been to
a number of I.P.R. sessions in the classroom. During
these sessions, the purpose of the stimulus vignettes,

i.e. "the interpersonal allergy test" was explained. In
the lab, the students are asked to view the vignettes
as if the person on the screen was speaking directly and

personally to them. These vignettes frequently triggered

the students rememberances of similar emotional events

 

 

in thier lives. These observations and the research

literature on bilateral differences seemed to suggest that

31

further exploration of these differences might prove
fruitful.

In summary, then, the relevant points in this section
are: l) bilateral differences in electrodermal activity
have been reported in the literature, 2) these differences
maybedue to differential hemispheric activation, and
3) some research suggests that hemispheric activation

causes contralateral inhibition of electrodermal activity.

Overview

In Chapter II, the literature most relevant to relating
cardiovascular, electrodermal, and respiratory activity
is presented. Methodology, instrumentation, procedures,
analysis techniques, and research hypotheses are described
in Chapter III. The results of the study, with the
appropriate statistical analyses applied are given in
Chapter IV. In Chapter V the conclusions and implications

of this study are discussed.

CHAPTER II
REVIEW OF THE LITERATURE

This chapter contains a review of the literature re-
garding the three physiological variables which are pertinent
to this study and a review of the literature on the measure-
ment of empathy. The physiological measures reviewed are
electrodermal activity, cardiovascular activity, and
respiratory activity. Electrodermal and cardiovascular
activity are two of the physiological systems studied most
frequently by psychophysiologists.‘ The literature on
respiratory activity is considerably more sparse. This
chapter is divided into four parts. The first part reviews
the literature pertaining to the interpretation of
electrodermal activity, the second review is of cardiovas-
cular activity, the third review concerns respiratory
activity, and the last review concerns the measurement of

empathy.

Electordermal Activity (EDA)
Electrodermal activity was one of the first
physiological processes to be studied by psychologists. As
early as 1907, Carl Jung used galvanic skin response in

trying to understand unconscious processes (Hassett, 1978).

32

33

Since its first reported use in 1888 by Férefl there has
been little standardization in the techniques used to
measure electrodermal activity (Lykken and Venables, 1971).
Early reports almost exclusively used the term galvanic
skin response (GSR) to describe any electrodermal activity.
The term GSR incorrectly came to represent all electrodermal
activity. Galvanic Skin Response was measured by placing
a subject between a recording amplifier and a bridged
circuit. Through the use of a variable resistor, resistance
fluctations in the subject were recorded (Lang, 1971). It
was assumed for many years that all the procedures which were
used to measure electrodermal activity were measuring the
same phenomena. Tursky and O'Connell (1966) revealed that
early research rarely reported the type of measurement
used. It was not until the recording devices used to
measure EDA became more sophisticated was it shown
that a particular event measured simultaneously by two
different methods yielded two distinctly different patterns
of activity (Burnstein, Fenz, Bergeran, and Epstein, 1965;
Forbes, 1964; Kirkpatrick, 1972; Simons and Perez, 1966).
Skin resistance (SR) and skin conductance (SC) are
the two most popular methods used to measure EDA. Skin
resistance is an exosomatic process which requires the
introduction of an outside current onto the skin to

measure EDA. Skin conductance is an endosomatic process.

34

Skin conductance involves the measurement of the voltage
changes in the skin without the introduction of an outside
current. Tursky and O'Connell (1966) surveyed researchers
in psychophysiology and found little consistency not only
in whether exosomatic or endosomatic techniques were used,
but also found little consistency in electrode. placement,
pretreatment of skin surface, type of electrode, type of
contact medium, or room temperature and humidity control.
There was agreement on one ideal requirement of a recording
system - "it be low cost".

Before continuing the review of electrodermal activity,
two points still need to be mentioned. The first point!
concerns the terminology used to describe a particular EDA
event. The term "level" means that relatively long periods
of time are analyzed (tonic activity), and "response"
refers to short duration changes (phasic activity) that
occurs in response to a specific stimulus. The final
point concerns the relationship between skin resistance and
skin conductance. Lykken and Venables (1971) suggest that
the use of skin conductance is superior to the use of skin
resistance. Treager (1966) showed that sweat glands act
like resistors in parallel. As such, an increased
conductance gave a directly proportional representation of
the number of activated sweat glands. Skin conductance

responses also tend to be more normally distributed than

35

skin resistance responses. In this review, the specific
type of measurement (i.e. SC, SR, GSR, etc.) will be used
unless the article itself is unclear. In that event, the
term EDA will be used.

Edelberg (1972) acknowledged that the plantar and
palmar surfaces of the body were recognized as responding
primarily to emotional and ideational stimuli, and that the
majority of the remaining sweat glands in the body were for
the purpose of thermal regulation. Sweat gland activity is
believed by many to be an indication of sympathetic arousal.
Unlike other systems under sympathetic control, the neural
transmitter of the sweat glands is acetylcholine (normally
a parasympathetic neurotransmitter). It is believed that
sweat gland secretion is phasic in nature, occurring as
a response to a stimulus. Kuno (1950) proposed another
theory arguing that secretion was continuous with sweat
being stored in the lumen of the glands until it was
forcibly expelled by contraction of the myoepithelial
cells. Myoepithelial cells are adrenergic. What is
interesting in this theory is that the neurotransmitter is
norepinephrine. Since atrophine will block sweating,
the production of sweat must therefore be under neural
control in Kuno's theory. Another hypothesis of sweat
gland activation concerned the role of the vascular system in

activation. Lader and Montague (1962) in a series of

36

controlled experiments set out to dispell the belief that
vascular activity was responsible for sweat gland activity.
They introduced atropine (a cholenergic blocking agent)
into the skin and were able to successfully block skin
resistance responses without affecting vascular integrity.
In a second experiment they introduced an adrenergic
blocking agent which produced marked vascular change but no
change in electrodermal activity. They interpreted their
results as proof that the vascular system did not play a
major role in sweat gland activation. Martin and Venables
(1967) proposed that sweat gland activity was responsible
for skin resistance responses. They based their conclusions
on the high correlations frequently reported between sweat
gland activity and conduction plus the observation that
cholenergic blocking agents abolish both sweat production
and skin resistance response. Darrow and Gullickson (1970)
viewed the sweat glands as a source of potential changes
both positive and negative but also implicated other
structures as well. They believed neural impulses caused
increases in the permeability of the epidermus and corneum,
as well as sweat gland activity.

Edelberg (1972) provided what is probably one of the
most in—depth theories of the neurophysiological mechanism
of electrodermal activity. Edelberg remarked that both

sympathetic and parasympathetic activation have been

37

implicated as mediators of electrodermal activity. He
believed generally that control was sympathetic with

many parasympathetic characteristics. Acetylocholine as
the neural mediator at the neuroeffector site was only one
example of the parasympathetic nature of sweat gland
activity. Anatomically, there are at least two separate
pathways from the brain to the sweat glands. One pathway
from the cortex and the other pathway from structures deep
inside and brain, including the hippocampus, pons, medulla,
hypothalamus, and the reticular system. Interestingly,
production of EDA by electrical stimulation of the
hypothalamus was accomplished not by stimulation of the
posterior nuclei,which are known to be associated with
sympathetic effects,but rather by stimulation of the anterior
region. Stimulation of the anteria region also produced a
slowing of the heart, loss of blood pressure, increased
gastrointestinal activity, and other parasympathetic
reSponses. Thus, control of EDA is paradoxical in nature.
Edelberg postulated that the reason for this might lie in
the dual function of the sweat glands. In addition to the
emotional characteristic of sweat gland activity, sweating
for thermoregulation purposes exerted a cooling effect that
is trophotropic or vegetative in nature, having a routine
homeostatic function. Edelberg felt that,more often than
not,the vegetative role of the sweat glands is de-emphasized

in comparison to the emotional arousal component.

38

Edelberg and Wright (1964) tested the hypothesis that
the palmar galvanic skin response involved the sweat glands
and the epidermus,each responding preferentially according
to the demands of the behavioral situation. The relative
contribution of each were determined by comparing
simultaneous GSR's from areas with high vs. low concentrations
of sweat glands. The stimuli used in the study were tones
and lights which were either alterting signals or execution
signals for a perceptual or a motor (reaction time) task.
Surprisingly, subjects showed greater relative sweat
response to the alerting signal for the reaction time task
than to the associated execution signal. Some subjects
showed significant differences between alerting and
execution signals for the perceptual task. Edelberg
interpreted his results as "supporting the hypothesis
that two components present in palmar GSR manifest stimulus
response specificity, but were inconclusive regarding the
nature of the class of stimuli to which each responds". He
further concluded "that the differences can not depend on
preparation for motor as opposed to non-motor activity".

The research literature has paid much attention to the
relationship between EDA and the orienting re3ponse (Furedy
and Poulous, 1977; Siddle, O'Gorman, and Wood, 1979;
Connolly and Frith, 1978; Grahm, 1973; Kimmel, 1973). The

orienting response involves the lowering of sensory

39

thresholds, arresting Of Ongoing physical activity, and
muscle tone increases in preparation for action. Bernstein
(1969) argued that the fact that there are individual
differences in the OR to stimulus change indicates that the
perception Of stimulus plays a significant role in the OR
mechanism. According to Bernstein, "the detection of

change is a necessary but not sufficient condition to elicit
an OR, and the change must be followed by a judgement Of
significant or important". Siddle et. a1. (1979) reported
results Of an experiment showing that stimulus change alone
was sufficient tO produce an increase in SCR,amplitude.

They believed "that stimulus change alone was sufficient to
produce an increase in OR amplitude, and that the relation-
ship between stimulus change and stimulus significance is
additive rather than multiplicative". Whether Bernstein's
hypothesis is correct or whether Siddle et. a1. is correct,
clearly, the presentation Of a stimulus triggers some degree
Of EDA.

The nature Of the relationship between "emotional"
experience and EDA is still very much Open to debate.
Seligman (1975) measured the skin potential responses Of
six college students during ten counseling sessions. The
Moody Adjective Checklist was administered at least five
times during each session, at points where the counselor

saw distinctive patterns Of skin potential responses.

40

Results showed that negative skin potential responses were
accompanied by feelings described as pleasant. Positive
skin potential responses were associated with unpleasant
feelings. A study by Kaplan (1963) reported similar results.
He measured GSR activity during an interaction between three
women and found that increased reactivity occurred at times
when there was a negative quality to the interaction.

Flanagan (1967) addressed the relationship between
GSR and the startle response. He cited studies showing
higher levels Of emotional response being associated with
smaller GSR's and studies showing that epinephrine, which
is also secreted during emotional arousal, also diminished
EDA. He used these as evidence to indicate that EDA is
associated with attention rather than emotion. Learmonth
et. a1. (1959) reported a negative correlation between
expressivity and increases Of palmar skin potential. The
higher the palmar skin potential increase the lower the
expressivity.

Hastrup and Katkin (1976) tried to develop a self-
report inventory which would predict electrodermal lability.
One hundred and twenty male subjects were administered an
inventory which contained 478 items. The subjects were
subsequently tested for electrodermal lability level: Chi-
square and correlational analyses were employed to identify

items which were significantly related to electrodermal

41

lability. They initially identified 34 items which were
significant predictors Of EDA lability. A Split-sample
analysis, however, suggested that the predictors would not
replicate. They concluded that although EDA lability is a
stable individual difference variable, which predicts
certain behavior, subjects cannot identify any attributes
Of themselves which are related to their differing lability
levels. In another study, however, Crider and Lunn (1971)
found that electrodermally labile subjects were more
introverted than stabile subjects, as assessed by the Welsh
R-scale Of the MMPI. Lazarus and Alfert (1964) used the
MMPI K-scale to identify subjects who had a tendency to not
admit to affective disturbances. They showed their subjects
films of upsetting scenes and found that these subjects'
level Of electrodermal reactivity was high.

The three final articles tO be discussed in this section
are stuides which involve both electrodermal and heart rate
responses. The measurement of simultaneous electrodermal
and heart rate responses tO stimuli is a common practice in
psychophysiology research. Two of the studies used filmed
stimuli and one study looked at the effects Of visual
attention on heart rate and skin conductance.

Lazarus, Speisman and Mordkoff (1963) explored the
relationship between heart rate and skin conductance as

indicaters Of stress. In this study subjects were shown

42

motion pictures with varying degrees of stressful material.
Continuous recordings Of heart rate and skin conductance
were made while the subjects watched two films. One film
was considered a stress film the other a control film. From
these recordings, they derived both intra-individual
correlations and inter-individual correlations. Results
showed significant differences between the effects Of the
stressor film and the control film. The control fihm
produced a relaxed state, whereas, the stressor film
produced significant increases in both skin conductance and
heart rate. Within the stressor film, increases in both
heart rate and skin conductance were greatest at points when
a crude surgical Operation was taking place. The skin
conductance response at these points was more variable than
heart rate. Lazarus, et. a1. computed inter-individual
correlations between heart rate and skin conductance for
both films. The correlation for the control film was +.301
and the correlation for the stressor film was +.162.
Results Of intra-individual correlations between heart rate
and skin conductance were significantly higher. The
correlation for the control film was +.242 and the
correlation for the stressor film was +.545. The author's
present two conclusions based on these results. First,
"there is a reasonable degree Of agreement between two of

the most widely used indexes Of autonomic nervous system

43

reactivity, heart rate and skin conductance". Secondly,
"we need not abandon the conviction Of many decades that
there is substantial generality to autonomic nervous system
reactions, and that it is not altogether inappropriate to
employ single measures Of autonomic reactivity".

Goldstein (1976) studied the physiological responses
Of repressers, midliners, and sensitizers tO affective
stimulus vignettes. He also analyzed the physiological
responses Of the subjects when they were involved vs.
non-involved in the vignettes. Subjects were classified
as suppressers, midliners, and sensitizers based on their
scores on the Byrne Revised Repression-Sensitization Scale.
Subjects were shown a series Of stimulus vignettes while
their cardiac and electrodermal responses were measured.
Goldstein taped the IPR recalls Of each subject then had
raters rate the recall Of each vignette for level Of
involvement with the vignette. His results showed
significant differences between the represser and sensitizer
groups on skin conductance. A second result Of the study
showed that there were significant difference between those
vignettes in which the subject was rated non-involved and
those in which they were rated involved. When a subject was
rated as uninvolved s/he had significantly lower skin
conductance than when s/he were rated as involved. NO

significant differences were found for heart rate.

44

Campos and Johnson (1966) studied the effects of
verbalization instructions and visual attention on heart
rate and skin conductance. Their purpose was to test
Lacey's (1959) theory Of directional fractionation Of
reaponse. Subjects were given three levels of instruction
to test the effects of verbalization on heart rate and
skin conductance. One level involved subjects merely
Observing the stimuli presented with no verbalization. The
second level involved the subjects being told to Observe
with the knowledge that they would be required to talk about
the stimuli later. The third level involved the subjects
being told to Observe and describe the stimuli audibly.
Visual attention was varied using stimuli of increasing
complexity. Subjects viewed a landscape, a hidden figures
puzzle, and a maze puzzle. Results Of the study did not
confirm Lacey's directional fractionation theory. In only
two of the nine experimental conditions did heart rate
decrease and skin conductance increase and neither of
the two were significant. Heart rate decreases were Obtained
in all of the non-verbalization conditions but none were
significant. The imposition Of a requirement to speak
reversed the direction of heart rate change regardless Of
the stimulus presented. These increases were significant
in four Of the six conditions. Verbalization also caused

increases in skin conductance but none were significant.

45

Heart Rate

Lacey's (1959) theory of environmental intake and
rejection along with his concept Of directional fractionation
Of response was discussed in detail in Chapter I. In
addition, his theory Of the neurophysiological mechanism
by which heart rate decelerates during environmental intake
was also presented. Research has been presented, both in
Chapter I and in the first half Of this chapter, some Of
which supported the Lacey hypotheses and some which dis-
confirmed the hypotheses.

Christ (1963, 1970; Obrist et. a1. 1974) presents a
theory Of cardiac-somatic coupling which stresses the common
sense fact that the heart will beat faster to meet the
demands Of the tissues for blood. Obrist believes that
psychophysiological researchers incorrectly view the
biological processes that are involved in the control Of
behaviorally relevant cardiovascular events as a separate
entity from the basic metabolic functions Of the
cardiovascular system. (This idea is similar to the
significance which Edelberg attaches to the vegetative
role Of the sweat glands). Smith (1954) even argued that
the metabolic functions of the cardiovascular system are in
essence artifacts of the system. There has been little
research conducted to shed any light on the distinction

between what might be imply metabolically relevant vs.

46

behaviorally relevant cardiovascular events. Obrist
prOposed that the metabolically relevant relationship be-
tween cardiac and somatic events is also relevant to
behavioral events in two respects. "First, understanding
the relationship between cardiac and somatic events is
important to any understanding Of the biological basis Of
certain behavioral processes. Second, understanding

this relationship provides a starting point or basis for
understanding how cardiovascular events can be influenced
by factors other than metabolic events".

Christ (1963) conducted a comprehensive study, the
purpose Of which was four-fold. One purpose was to
determine whether stimuli requiring continuall environmental
intake will decelerate heart rate. In this study he used
stimuli which had not been used in any previous studies.

A second purpose was to replicate the previously demonstrated
cardiac changes to conceptual tasks and noxious stimuli. A
third purpose was tO try tO determine whether a decrease in
afferent baroreceptor activity was indicated by aspects Of
cardiovascular activity other than heart rate deceleration.
The final purpose was to determine whether instances Of

heart rate deceleration are due either to baroreceptor
initiated increases in vagal tonus, as indicated by elevated
systolic blood pressure and peripheral vasoconstriction, or

loss Of sympathetic tonus as measured by skin resistance.

47

Results revealed that the environmental intake tasks
significantly decelerated heart rate, variability Of R-R
intervals, and systolic blood pressure. The noxious and
conceptual tasks initiated sympathetic-like activities in
most cardiovascular functions. Systolic blood pressure
increased, pulse pressure decreased, and heart rate increased.
NO evidence was found tO support the theroy that heart
rate decrease could be the result Of increased vagal tonus
due to afferent baroreceptor feedback to the bulbar
cardiovascular inhibitory centers. Blood pressure and blood
flow did not respond in the direction normally associated
with sympathetic activity. There was no evidence to
indicate that heart rate decrease could be attributed to
sympathetic tonus increase. Of special significance was
that heart rate decrease occurred in the absence Of any
indication Of baroreceptor reflex inhibition. Heart rate
decrease also occurred, at times, in the presence Of
sympathetic discharge via the sweat glands. Basically,
these results supported Lacey's hypothesis Of cardic
deceleration during environmental intake, but did not
support his theory Of the mechanism which causes this
cardiovascular event.

Klorman et. a1. (1975) studied the heart rate
responses Of subjects while they viewed neutral or aversive
stimuli. Forty-five females who were fearful Of snakes

were shown films Of ”seascapes or snakes. Findings revealed

48

that cardiac response habituated with repeated presentation
Of the feared stimuli. Hare and Blevings (1975) conducted
a similar experiment with women who had phobic fears Of
spiders and women who had no fear Of spiders. Presentation
of slides Of spiders caused cardiac acceleration in the
group who had a phobic fear Of spiders. NO significant
acceleration was found in the no fear group.

Rule and Hewitt (1971) studied the effects Of
frustration on cardiac responses. They asked subjects to
learn lists Of verbal material. During the sessions verbal
reinforcement was provided. Subjects were given either
an easy list with neutral reinforcement, a difficult list
with neutral reinforcement, or a difficult list with
derogatory feedback. The individuals who were subjected to
both frustration and insult did not show any significant
differences in heart rate (compared to the other groups)
during the learning period.

Klorman and Ryan (1980) exposed subjects who were low
in fear Of mutilation and subjects who were high in fear Of
mutilation to repeated presentations Of a 6-second tone
followed by slides depicting a mutilated body and a 6-second
tone Of a different frequency paired with a slide Of a
neutral scene. Their goal was tO study heart rate responses
during anticipation Of affective stimulation. The heart
rate reactions Of both groups during the anticipation period

included an early deceleration, acceleration, and a late

49

deceleration. For the high fear group both the acceleratory
and late deceleratory limbs were greater preceeding mutilation
than neutral slides. The low fear group lacked the
acceleratory reaction. They interpreted these results as
indicative Of "differential autonomic patterns Of anticipa-
tion Of affective stimulation as a function Of individual
differences in fear".

Malmo and Davis (1956) report the results Of a study
in which subjects were presented with a tracing task.
Results Of the study showed that as performance decreased
heart rate increased. Epstein et. a1. (1975) studied the
magnitude Of heart rate and electrodermal response as a
function Of stimulus input, motor output, and their inter-
action. Results Of the study led the authors tO draw
four conclusions: "(1) heart rate varies more directly and
reliably with motor output than skin conductance, (2) skin
conductance is more sensitive to small cognitive than to
small motor effects, (3) skin conductance is more reactive
to stimulus input than to motor output, while the Opposite
is true for heart rate, and (4) a strong familiar stimulus
presented by surprise elicits a marked heart rate
decelerative reaction, usually, but not always proceeded
by a smaller accelerative reaction". Bittker et. a1. (1975)
studied the cardiovascular correlates Of sensory intake and

rejection associated with interview behavior. Subjects

50

participated in a 15-minute interview during which heart
rate, blOOd pressure, pulse volume, and forearm blood flow
were measured. During the interview two Observers rated the
subjects as to whether they attended or not during the
interview. Subjects who were rated high on attention during
the interview showed cardiovascular patterns characteristic
Of peripheral sympathetic nerve discharge (forearm blood
flow decrease and decrease in blOOd flow). In interpreting
their results, they wrote the following:

"The concept Of attending and nonattending

during interviews or interpersonal relation-

ships deserve further attention. First Of all,

in an interview the subject needs to direct

his attention externally to the interviewer

in order to grasp both the content Of his

instructions and the emotional attitude
which will affect his responsiveness."—

In another experiment, Obrist (1970) used atrophine
on subjects in order to decrease reaction time in a reaction-
time task. Obrist hypothesized that if heart rate
deceleration causes improved performance, then the
pharmacological blocking should lead to longer reaction
times. However, if reaction time did not decrease it meant
that heart rate deceleartion is a by-product Of general
somatic adjustment. Results Of the study showed that
reaction time did not decrease. Obrist viewed this result
as confirmation that heart rate deceleration is linked to

somatic regulation.

51

Upon close examination Of both the Lacey and Obrist
hypotheses, two points stand out. The first point is that
both accept the hypothesis that attention to the environment
causes cardiac deceleration. The second point is that they
disagree over the mechanism.which causes the deceleration.
Lacey views the mechanism as involving baroreceptor
inhibition and cortical activation. Obrist views the
decrease as a reduction in the body's somatic activity.
Lacey sees heart rate as a cause Of central nervous system
change and Obrist sees it as a peripheral measure of somatic
activity. For the purpose Of this study, the mechanism
which causes cardiac deceleration is not as important as the
fact that there is agreement between the Lacey and Obrist
groups that attention to the environment causes cardiac
deceleration. What is curious, however, is that both groups
adhere to the environmental-cardiac-deceleration hypothesis
in spite Of contradictory research results. (Lazarus et. a1.,

1963; Goldstein, 1976; Campos and Johnson, 1966.

Respiratory Rate

 

Respiratory activity appears, to the uninitiated
Observer, to be one Of the most logical indicators Of
emotional involvement. Most people have had the
experience Of taking a deep breath when they feel themselves
becoming nervous. Respiratory activity in modern

psychophysiological research, however, has been used most

52

Often to control for artifacts (Hassett, 1974). The
research literature on the relationship between reSpiration
and emotion is sparse. It is interesting to note however,

that the first issue Of the Journal of Experimental

 

Psychology includes an extensive article on the relationship
between respiration and emotion (Feleky, 1916).

Feleky (1916) studied the respiratory changes
associated with six emotions. The emotions were: (1)
pleasure, (2) pain, (3) anger, (4) disgust, (5) wonder, and
(6) fear. Laughter and hatred were also investigated.

Three respiratory patterns were studied. There were:

(1) duration Of inspiration compared to duration Of
expiration, (2) depth or amplitude Of changes, and (3)
change in the amount Of work accomplished per/unit time.
Results showed that in normal breathing, the average time
Of the inspiration as compared to the expiration was about
4:5. Inspiration took less time than expiration. The
inspiration time for laughter was also less than expiration.
The Opposite ratio was true for disgust, pleasure, anger,
pain, wonder, and fear.

Burtt (1921) studied the inspiration/expiration ratio
during truth and falsehood. Subject were required in
specific instances to respond in truth or to lie to a number
Of different experimental manipulations. Their inspriations

and expirations during these periods were measured. The

53

average I/E ratio for the five breaths following the
subjects response was subtracted from the five breath I/E
ratio before the response. Burtt hypothesized that the
difference should be negative for lying and positive for
truthhood. Results showed that the average difference

in falsehood was -0.05 and +0.04 for truthhood.

Cohen et. a1. (1975) studied the effects of stress on
components Of the respiratory cycle. Subjects were shown
stressful films and their respiratory reactions were
measured. The respiratory patterns Of the subjects were
examined by computer. The computer examined inspiration,
expiration, and post expiration pause. While no stress
effects were Observed on the total inspiration/expiration
time, expiration times were longer and pause times
shorter during presentation of the stressor films.

Adams (1980) spoke Of the active process Of inhalation
and its relationship to affective responding. He believed
that when one is actively involved in a affective experience,
changes in the inhalation aspect Of respiration might

accurately reflect the level Of experience.

Measurement of Empathy

 

Dymond (1949) successfully devised one Of the first
psychometric instruments tO measure the construct Of empathy.
Dymond defined empathy as "the imaginative transposing Of

oneselfiJux>the thinking, feeling, and actions of another,

54

and so structuring the world of another in the process".
The instrument which she devised consisted Of four parts.
Each part contained six items. On the first part, an
individual was asked to rate her/himself on a five-point
scale, on each Of six characteristics. They were asked to
then rate some other individual on the same six
characteristics. S/he was then asked to rate the other
individual as s/he believed the other individual would rate
her/himself. Finally, s/he had to rate her/himself as s/he
thought the other individual would rate them.

The subjects in her test development were students in a
social psychology class. The students were broken down into
groups Of six or seven. The rating scale was administered
after the group had met three times. Based on the results
Of this administration, which were significant at the 0.01
level, Dymond concluded that the test measured the construct
Of empathy.

Truax (1963) constructed a scale for measuring empathy \//
entitled, "A Scale for the Measurement Of Accurate Empathy".
Truax believed that trained judges, using this scale, could
reliably rate the level of empathic understanding Of a
psychotherapist during a therapy session. In order to
achieve this, tape recordings were made Of psychotherapy
sessions. Sample segments Of these sessions were then

rated for level Of empathic response. The scale was designed

55

to measure a conceptualization of empathy which involved
sensitivity to current feelings, and the verbal ability
to communicate this understanding in a language which was
harmonious with the patients current feelings.

The scale was tested using psychotherapists who were
engaged in on-going psychotherapy with schizophrenics. Truax
found that the therapists of patients who were independently
rated as improved displayed a significantly higher degree
Of rated empathy than did the therapists Of patients rated as
deteriorated. Carkhuff (1969) modified the Truax scale
and it eventually became one Of the most widely used
instruments for assessing empathic ability.

Barrett-Lennard (1962) developed an inventory to assess
the overall relationship between counselor and client. One
subscale Of this inventory attempted to assess the level Of
empathy Of the counselor as perceived by the client. The
client was asked to rate the counselor on a scale from
one to six in response to questions such as "S/he understood
all of what I said to her/him". Barrett-Lennard believed
that the client was potentially the best judge Of the
counselor's empathic ability.

From the time of the initial attempts to measure the
concept Of empathy, the measurement Of empathy has been
fraught with one consistent major problem. Low correlations

have been found between most Of the instruments which

56

purport to measure the construct Of empathy (Caracena and
Vicory, 1969; Kurtz and Grummon, 1972; fish, 1970).

Kurtz and Grummon (1972), in addition tO using standard
empathy measurements, correlated what they labeled as
"predictive measures" of empathy with the more commonly used
measures. This approach involved asking a therapist to
predict how their client would respond to self-report
inventories and personality inventories. This approach
seemed to be based on the premise that if the therapist could
predict accurately the responses of the client then they
must also be empathic. The use Of this "predictive empathy"
concept was based on the work of Lester (1961) who found
no correlation between "predictive empathy" and the

therapists perception Of his own empathic ability.

Summapy

The research reviewed concerning electrodermal activity
essentially gave support to the hypothesis that when a
subject is involved in his/her environment electrodermal
activity increases. A number Of theories were presented which
tried to explain the mechanisms which cause electrodermal
activity.

The research on cardiac activity also gave support,

although not overwhelming, that cardiac deceleration was

57

associated with environmental involvement. Two rival
theories were presented tO explain this phenomona (Lacey
and Obrist).

For both cardiac and electrodermal activity the role
Of vegetative processes were also discussed.

The use of respiratory activity in the measurement

Of emotions and stress was also presented.

CHAPTER III

METHODOLOGY

Sample

Subjects for this study were drawn from the first year
class Of medical students in the College Of Human Medicine
at Michigan State University. The students were enrolled in
an initial course in Doctor—Patient Relationships during
the winter term, 1981. Eighty-five students were enrolled
in the class.

The students who participated in the study were all
volunteers. They were Offered the Opportunity Of an
alternative laboratory experience in which they were given
the chance tO study their own physiological responses to
affective stimuli (Archer, et. a1., 1972). Members Of the
class ranged in age from 20 to 41. The majority Of the
students had bachelors degrees. Undergraduate fields of
study were largely in the biological and physical sciences.

Seventy students volunteered for the alternative
laboratory experience. Only one person failed to show up
for his appointment. There were 36 males and 33 females in
the experiment. Complete sets Of data were collected On

60 subjects.

58

59

Procedure

 

The procedure for collecting the physiological data
will be presented in five sections. These sections are:
l) the laboratory circumstance under which the data was
collected, 2) the measurement of electrodermal activity,
3) cardiovascular measurement, 4) respiration measurement,
and 5) the use Of the computer for storing and analyzing

data.

The Laboratory Experience

 

The students who volunteered for the alternative
laboratory experience were scheduled for two two-hour lab
sessions. When the student arrived s/he was met by an
inquirer. The inquirer was trained in both the IPR model
and the physiological hook-up procedure. The student was
instructed to wash thoroughly with warm.water and soap
his/her hands and forearms. The student was then seated in
a chair in the subject room. The room temperature was
maintained between 72° — 740 degrees. The inquirer proceeded
to then connect the student to the physiological recording
devices.

Once the hook up procedure was completed (see next
section for this procedure), a second individual calibrated
the physiological recording devices which were housed in a

separate room. The inquirer remained in the room with the

60

student. The inquirer gave the student the following
instructions before the presentation Of the stimulus
vignettes. "Make an attempt to imagine that you are alone
with the person on the screen. See the person in whatever
context makes sense to you,but do your best to react as if
the person in the film were Speaking personally and privately
to you." The inquirer then left the room. The student sat
by him/herself in the room for two minutes before the
vignettes were projected onto the screen. This was done in
order tO record pre-stimulus baseline data. The student
was then shown the appropriate series Of vignettes. The
first series Of vignettes (lab session #1) consisted Of
eleven vignettes. The second series (lab session #2)
consisted Of eight vignettes. All vignettes were inter-
personally and/or medically oriented. (Typescripts of
these vignettes are found in Appendices A and B). These
vignettes varied in length from twenty to ninety seconds.
Between each vignette there was a twenty second rest period.
The rest period gave the student the Opportunity tO think
about the previous vignette.

A Sony video camera (Model AVC-3200) was placed above
a Grass Instruments (Model 73) five pen recorder. This
camera recorded the student's physiological responses to
the vignettes. A remote controlled marking devise was

used to distinguish the vignettes from the rest periods.

61

While the first camera was recording the movement Of the
pens, a second camera (which had been strategically placed
to be as inconspicuous as possible) recorded the student's
face and upper body as s/he watched the vignettes. A
mirrow was placed above and behind the student's head which
reflected the vignette that the student was viewing. The
reflection was picked up by this second camera. Both the
studentfisimage and the vignette were recorded with this
camera. The simultaneous inputs from each camera were
filtered through a special effects generator (Tel-$5241).
All three pieces Of feedback information, the physiological
recording, the student watching the vignette, and the
vignette itself were recorded simultaneously. on the same

8 inch Sony recording tape. _

While the Grass recorder was recording the physiological
responses on its paper, the responses were simultaneously
being transmitted to a Digital PDP 11-34 computer. This
data was stored for analysis. (The specific method by
which this interface was achieved will be discussed in a
later section).

After the vignettes were completed the inquirer returned
to the room and then conducted an IPR recall session. The
physiological information was used to facilitate the recall
process. The student watched the videotape on the playback

monitor. One half Of the screen contained the physiological

62

record as it was unfolding and the other half contained an
image Of both the student watching the vignette and the
vignette itself. At any point which the student chose to
stop the tape, s/he saw all three pieces Of information
simultaneously. A second monitor in the room displayed a
computer analyzed synopsis Of the physiological responses.
The synopsis contained information such as the mean and
viariance. A typescript was available for the student to

use during recall.

Electrodermal Recording

Electrodermal activity was recorded as skin conductance
response. Skin conductance reSponse was measured concom-
itantly from both hands.

The student had already washed his/her forearms and
hands with warm water and soap bofore entering the room.

By doing this in advance the student had partially prepared
their own skin surface for the application of the electrodes.
While applying the measuring devices the inquirer explained
the purpose of each device.

The electrodes used for skin conductance measurement
were re-usable Beckman silver/silver chloride. The diameter
Of the conductive surface Of the electrodes was 16mm. One
electrode was placed on the hypothenar eminance Of the palm.
The second electrode was placed on the pre—axial surface of
the flexor carpi radialus muscle Of the forearm. The

eccrine sweat glands in the hypothenar eminance are

63

innervated by the palmar cutaneous branch Of the ulnar nerve.
The sweat glands on the forearm are innervated by the
musculocutaneous nerve. Both Of these peripheral nerves
eminate from the brachial plexus Of the CNS.

The surface and cavity of the electrode must be clean
and dry before applying tO the skin. An adhesive collar
was carefully applied tO the electrode so that the center
hOle was directly over the cavity Of the electrode. The
center cavity was filled with conductive paste (Redux Paste-
Hewlett-Packard) making sure nO bubbles were introduced into
the cavity. The electrode was then affixed to the prepared
surface Of the skin. This procedure was repeated until
all four electrodes were firmly in place.

The lead wire from each electrode was inserted into
a metal box which was attached to the subject chair. The
output wire from the box was fed directly into a Hagfors
Skin Conductance Bridge located in another room. The
signal was then fed into a Grass Instruments Low-Level D.C.
Pre-Amplifier (Model 7P 13). The signal was then amplied
through a Grass Instruments D.C. Driver Amplifier (Model
7DAE). The Operation and calibration procedures for all

the physiological equipment is contained in Appendix D.

Cardiovascular Recording

 

The cardiovascular measure used in this study was

heart rate expressed in beats per minute. Heart rate is

64

the recording Of the electrical events associated with the
muscular contraction Of the heart. The rhythm and beating
Of the heart is controlled by the heart's internal
pacemakers; the sinoatrial (SA) and atrioventricular (AV)
nodes. The AV node discharges an electrical impulse which
forces the contraction Of the heart muscle walls. The
major nerve which innervates the heart is a branch Of the
vagas nerve.

Three electrodes were required for the recording of
heart rate. An electrode was placed on the pre-axial
side Of each wrist above the spot where the radius and ulnar
bones of the forearm are connected to the metacarpal bones
Of the hand. The third electrode was placed on the lateral
side Of the lower leg, choosing a spot where there is little
musculature between the skin and fibula bone. This place-
ment was used as a ground.

The electrodes used for the heart rate recording were
pregelled disposable silver/silver chloride EKG electrode
(Deseret CO., Model 415D). A small amount Of conductive gel
was rubbed on the surface Of the skin before thexelectrodes
was affixed. The conductive gel contained a mild abrasive.
By lightly abrading the skin, dead skin was removed from
the stratum corneum layer. This was intended to improve
the contact points. The conductive gel was wiped thoroughly

from the contact area with tissue paper. The electrode was

65

pressed firmly to the skin. The lead wires from all three
electrodes were inserted into the input connection box.
The output wires were fed directly into a Grass Instruments
EKG Tachograph Pre-Amplifier (Model #7P4D). The signal
was then amplified through a Grass Instruments D.C. Driver
Amplifier (Model #7DAE). The Operation and calibration Of

the tachograph and amplifier are described in Appendix D.

Respiration Recording

Respiration was recorded using a Grass Instruments
Volumetric Low Pressure Transducer (Model #PTS). A rubber
bellows was placed around the students' chest. The bellows
was linked to the volumetric pressure transducer by means
of a rubber tube. The bellows was used to transduce
respiratory movements into pressure changes. The pressure
changes were measured in the chambers Of the volumetric
pressure transducer. Two bonded strain gauges and a
diaphram are in the chambers of the unit. Pressure changes
in the chamber causes displacement Of the diaphram which
in turn activates a cantilever on which the strain gauges
are bonded. The strain gauges convert the movements into
changes Of electrical resistance. This electrical signal
is fed directly from the volumetric pressure transducer
into a Grass Instruments Low-Level D.C. Pre-Amplifier

(Model #7P1B). The signal is then amplified through a

66

Grass Instruments D.C. Driver Amplifier (Model #7DAE). The

Operation and caliberation is described in Appendix D.

Computer Interface

 

Each Of the four channels on the Grass Recorder -
the two skin conductances, the heart rate, and respiration
channels was connected to a Digital 11-34 computer. This
was achieved by running shielded electrical cables from
each Of the Grass Driver Amplifiers tO four separate
channels Of the computer's analog to digital converter.

The computer system used to transform, store, analyze,
and display the physiological data was a Digital Equipment
PDP 11-34. The confirguration Of the computer system
included: 1) an 11-34 central processor, 2) two RLOl disk
drives, 3) a Digital Decriter II, 4) a VTlOO console,

5) an AR-ll analog to digital converter, and 6) an RT-ll
v.4 Operating system.

The 11-34 central processor contained 64 K words Of
memory. One word with memory holds 16 bits Of information
which are binary coded. The two disk drives, RLOl, each
contain S-megabites Of memory. The VT-100 console is a
multi-purpose graphics display monitor on which the student
saw the synOpsized physiological feedback. After each
vignette a graphic representation Of the four physiological
measures plus intrapersonal statistical information was

displayed.

67

The AR-ll is a 16 channel, 10-bit analog to digital
converter. Only four Of the channels were used in this
study. The conversion process requires the AR-ll to
convert the four voltage readings from the Grass recorder
(analog) into digital representations using a binary code.
The AR-ll is a lO-bit converter, which means that the
voltage measures (the analog) are converted into an
apprOpriate digital number between 1-1024. Through this
process the voltage variations which cause the pens Of
the recorder to deflect on the paper also cause the analog
to digital converter to register proportional digital
variations.

The RT-ll v.4 is the Operating system real-time
executive. This is the component Of the computer system
through which all functions Of the system are carried out.
It is through this real-time executive that all the
differential parts Of the system are combined into a
logical and interactive whole.

The computer languages which are used to run the 11—34
system are Fortran IV and Macro-ll. In sampling the
physiological data for digital storage, different sampling
times were used. For heart rate the computer program
sampled once every second. The sampling time for skin
conductance response was four times per second. The

sampling rate for respiration was five times per second.

68

At the precise moment that the first vignette appeared
on the screen, the computer, by means Of the AR-ll analog
to digital converter, started to sample the physiological
data supplied to it by the Grass Recorder. The digital
data was stored temporarily in the 11-34 core memory while
the student was watching the vignettes. As soon as the
series Of vignettes was completed the computer stopped
sampling the physiological data and then moved the digital
data from.the 11-34 core memory to the RLOl disk for
indefinite storage. Once the data was stored on the RLOl
disk, it was manipulated and translated into the form that
was displayed on the VT-lOO monitor. Even though the
student saw a processed version Of the data on the display
monitor, the raw data remained stored in its digitalized

form on the RLOl storage disk.

Physiological Measures

 

Two measures were used to evaluate respiratory activity.
The first measure was respiratory amplitude. A problem in
the measurement of respiratory amplitude was posed by the
mechanical and electronic equipment which was used to record
respiratory activity. There were inherent differences in
amplitude among subjects due to a combination Of how
tightly a bellows was placed around a subject's chest and/or
the level Of sensitivity (on the preamplifier) required

to keep the recording needle in range. This problem was

69

ameliorated by expressing amplitude variability as a ratio.
This ratio was expressed as the standard deviation Of each
vignette divided by the mean for that vignette. The overall
standard deviation for all vignettes combined was then
calculated. This standard deviation was the measure Of
amplitude variability. The second measure was respiratory
rate or frequency. This measure also contained an inherent
problem. In trying to create a measure Of frequency
variability, initially, it seemed as though this could be
achieved easily by merely computing the variance Of the
instantaneous frequencies for each vignette. Upon closer
inspection, this idea contained one major flaw. Within a
given time span a subject who breathes slower will have a
greater inherent frequency variance. In order to control
for this problem, frequency variability was expressed also
as a ratio. The standard deviation for each vignette was
divided by the average frequency for the vignette. The
overall standard deviation for all vignettes combined was
then calculated. This standard deviation was the measure
Of frequency variability.

nymymeasures were used to evaluate cardiac activity.
The first measure was heart rate change score. This was
computed by subtracting the mean heart rate level during
the last four seconds Of the vignette from the mean heart
rate level during the first four seconds Of the vignette

(Goldstein, 1976). The standard deviation Of the change

70

scores for all vignettes combined was computed. This
standard deviation was the measure of cardiac change score
variability. The second measure used was peak rate smoothed.
This was computed by moving averages Of order three for
each vignette. TO compute a moving average Of order three
each data point, Ki, was averaged with the preceding and
succeeding data points, K£_1 and K£+l' to yield a smoothed
data point. The standard deviation Of the peak rate
smoothed scores was computed for all vignettes combined.
This standard deviation was the measure Of variability.
There is considerable debate in the field Of psycho-
physiology Over Wilder's (1931) Law Of Initial Values
(Benjamin, 1963).~ The Law Of Initial Values states that
the magnitude Of an autonomic response to a stimulus is
related to the pre-stimulus level. The law is believed to
be applicable to autonomic systems which have both
sympathetic and parasympathetic innervation (Hord et. a1.,
1964). The heart has both sympathetic and parasympathetic
innervations. Therefore, the Law Of Initial Values needs
to be addressed. Benjamin (1963) has shown that if the
correlation between pre-stimulus level and stimulus level
approaches zero, then the law is not in Operation. In
order to test this two correlations were computed. The
first correlation, between pre-stimulus heart rate level

and heart rate change score was —0.087. The second

71

correlation, between pre-stimulus level and heart rate

peak score was 0.015. Given these very low correlations

the assumption was made that the Law Of Initial Values was
not in operation. The fact that these correlations were

low should in no way effects the results Of the statistical
procedures. It simply means that on the basis Of the
pre-stimulus heart rate one could not reliably predict heart
rate peak score.

Four measures were used tO evaluate electrodermal
activity. Electrodermal activity was recorded in micromhos.
The sensitivity was calibrated so that one micromho equals
one-half centimeter.

The first electrodermal measure involved counting the
number of peaks throughout all the vignettes. A peak was
defined as at least a one micromho increase followed by
at least a one-half micromho decrease. The second measure
involved the computation Of area under the curve. For each
vignette, the lowest point during the first twenty percent
was calculated. This point was defined as baseline for
computing area under the curve. The areas for all vignettes
were added together to provide a total area under the curve.
The third measure involved the calculation Of slopes. For
each vignette, the steepest rise within a 1.5 second period
was calculated. This was referred to as the steepest lepe

for the vignette. The steepest slopes for each vignette

72

were then averaged. The last measure Of electrodermal
variability was magnitude of response. For each vignette,
the largest rise between adjacent minima and maxima was
calculated. The largest rises for each vignette were then
averaged. For the magnitude to be included it had to be
at least a 8 micromho increase. Eccrine sweat glands

have no parasympathetic innervation; therefore, there was

no need to test for the Law Of Initial Values.

Psychological Measures

Three psychological measures were used tO assess each
subject's empathic level. Each Of these measures was
chosen to assess one phase Of the empathic process. The
Affective Sensitivity Scale (A.S.S.) was chosen tO measure
the first phase Of the process. This phase is the inner
process Of empathic listening, resonation, and personal
understanding. The Affective Sensitivity Scale (Kagan and
Schneider, 1980) is a standardized norm referenced test
which is widely used and purports to assess an individual's
ability to detect and identify the affective state Of
others. The A.S.S. requires a viewer to watch a filmed
scene taken from an actual encounter between a physician
and patient, a teacher and student, counselor and client,
or any of several other natural or professional interactions.
After each scene, the viewer chooses from among a group Of

multiple choice items the one which describes best the last

73

affective state Of the filmed persons (Kagan, Werner, and
Schneider, 1977). Reliability coefficients for internal
consistency and test-retest are 0.75 and 0.65 respectively.
All students in the College Of Human Medicine were required
to take the A.S.S.

The empathy subscale of the Barrett-Lennard Relationship
Inventory (Barrett-Lennard, 1962) was chosen tO assess the
third phase Of the empathy process. The third phase is
received empathy, or empathy based on the experience Of the
person empathized with. This subscale consists Of specific
statements which the patient uses to rate the received
empathy Of the "helper"; whether it be a counselor,
psychotherapist, or physician. Statements such as "s/he
tried to see things through my eyes" are responded to on a
scale Of one to six. One being "Definitely Not True" and
six being "Definitely True". Split-half reliability is
(’= .86 and the test-retest reliability is (= .89 (Appendix
E contains a copy Of inventory). As a regular part Of the
student's Doctor-Patient Relationship course, students
conducted 10-minute interviews with patient-models at
various times in the course. The patient-models completed
the inventory immediately after the interview conducted
during the seventh week Of class. The physiological measures
were correlated with an interview that the students
conducted with the patient-models; all Of whom presented

a problem related to a sexual dysfunction.

74

The Carkhuff Empathic Understanding Scale (Carkhuff,
1969) was chosen tO assess the second phase Of the empathy
process. The second phase involves the expression Of
empathic understanding.. This scale is a subscale Of
Truax and Carkhuff's (1967) "A Scale for the Measurement
of Accurate Empathy". This scale is perhaps the most
widely used instrument for the measurement of empathy.

Each students' interview (sexual dysfunction interview)

was videotaped. These tapes were then given a global
rating from one to five depending on the level Of empathy
communicated to the patient. (The specific criteria for
rating the empathic understanding scale is contained in
Appendix F). This instrument has demonstrated considerable
ability to descriminate between empathy levels of various
groups in the expected direction. Four judges were used

to rate these interviews. Three judges were doctoral
students in counseling psychology at Michigan State
University and one judge was a non-matriculated student.

In order to train the judges how to rate an interview on this
scale four training sessions were conducted. Each training
session was approximately two hours in length. During this
time the judges practiced rating "dummy" tapes and came

to consentual agreement on what criteria to use as a basis
for rating the tapes. Each tape was rated independently

by two raters. The inter-rater reliability (using

Crohnbach's Alpha) was 0.894.

75

Stimulus Films
One of the major advances in the study Of the
relationship between physiological processes and emotion is
the use Of filmed stimuli (Lazarus and Alfert, 1964;
Davison, 1963; Averill and Lazarus, 1968, Kagan and
Schauble, 1969). Prior to the work Of Kagan etc.,
psychophysical stimuli were used to stimulate emotion. The
use Of filmed stimuli more closely approximates the affective
situations which occur in real life situations. Lazarus,
Speisman et. a1. (1963) used films Of car accidents and
sub-incision rites to provoke anxiety in their subjects.
Kagan (1978) describes the affect stimulus vignettes which
were developed to enhance the I.P.R. model. He states:
In numerous I.P.R. sessions we Observed that
people feared behaviors which, in all likelihood,
they would never be subject to....These inter-
personal nightmares were Often examined during
recall sessions if the student was introspective
enough and the encounter in the videotape
interview stimulated the nightmare sufficiently,
but it seemed to us that it might be possible to
create a more reliable way of helping people face
there interpersonal fears....A series Of filmed
vignettes were made....actors were instructed to
protray various types Of affect with varying
degrees Of intensity.....
The Kagan stimulus vignettes have been used in various
research settings with positive results by Goldstein (1976)

and Kagan et. al. (1980).

76

Design

This research was correlational in nature. The basic
question it was designed to answer was: what is the
relationship between the measures Of empathy and the

physiological measures? The design, Figure 3.1, was as

 

follows:
Figure 3.1 Design Diagram
V1 V2.000000vl9
M1 M2 M3 M4......M12 M1 M2 M3 M4.....M12
S1
ASS
EU
B-L
S2
ASS
EU
B-l
560
Where:
8 = Subject
V = Vignette
ASS = Affective Sensitivity Scale
EU = Carkhuff Empathic Understanding Scale
B—L = Barrett—Lennard Relationship Inventory
M1 = Heart rate change score
M2 = Heart rate peak score
M3 = Respiration Amplitude
M4 = Respiration Frequency
M5 = Skin Conductance Peaks (RT. Hand)
M6 = Skin Conductance Peaks (LF. Hand)

E! 3 E! 3 E! 3

Skin
Skin
Skin
Skin
Skin
Skin

The second

hypothesis

between the bilateral electrodermal measures.

Conductance
Conductance
Conductance
Conductance
Conductance
Conductance

77

Area (RT. Hand)
Area (LF. Hand)
Slope (RT. Hand)
Slope (LF. Hand)
Magnitude (RT. Hand)
Magnitude (LF. Hand)

purpose Of this research was to test the

that there would be significant differences

Figure 3.2, was as follows:

The design,

Figure 3.2 Desigp Diagram

 

 

Right Hand
M5, M7, M9, M11
S1
S2
S60
Where:
8 = Subject
M5 = Skin Conductance
M6 = Skin Conductance
M7 = Skin Conductance
M8 = Skin Conductance
M9 = Skin Conductance
M10 = Skin Conductance
M11 = Skin Conductance
M12 = Skin Conductance

Peaks (RT.
Peaks (LF.
Area (RT.
Area (LF.
Slope (RT.
Slope (LF.

M

Left Hand

 

Hand)
Hand)
Hand)
Hand)
Hand)
Hand)

6, M8,

M

10, M

12

Magnitude (RT. Hand)
Magnitude (LF. Hand)

78

Analysis

 

A matched—pair t-test was performed to test the
hypothesis that there were significant differences in
bilateral electrodermal activity. This technique was
chosen because it does not require that the sample be
robust with reference to the assumption Of independence.
The matched-pair t-test is designed specifically tO
treat dependent sets Of information.

TO test the hypotheses that the empathy scores would
be correlated to the physiological measures two Canonical
correlations were computed. Canonical correlation analysis
takes as its basic input two sets Of variables, each Of
which can be given theoretical meaning as a set. These
sets of variables are known as canonical variates. Rather
than trying to account for as much variance as possible
within one set Of variables, the aim is to account for a
maximum amount Of relationship between the two sets of
variables. Because physiological systems within the human
body are interrelated, psychophysiological data systems
must therefore be multivariate in nature (Van Egeren, 1973).
Canonical correlation is a multivariate statistical
procedure. ItS‘ use in this study was justified on this

basis.

79

Experimental and Null Hypotheses

I. H : There is no correlation between the three empathy
scores and the cardiac response scores.
H1: There is a significant correlation between the

three empathy scores and the cardiac response

scores.

II. Ho: There is no correlation between the three empathy
scores and the electrodermal and respiration
response scores.

H1: There is a significant correlation between the

three empathy scores and the electrodermal
and respiration response scores.

III. Ho: There are no significant differences between
right hand electrodermal activity and left hand

activity.

Right hand electrodermal activity is significantly

higher than left hand activity.

Summary
Seventy students in the College Of Human Medicine
volunteered for an alterantive laboratory expereince. They
were videotaped and had their heart rates, skin conductance
responses, and respiratopry responses recorded while watching
stimulus vignettes. The purpose Of the vignettes was to

evoke emotional reactions.

80

The students also conducted ten-minute interviews with
patient-models. These interviews were rated on the Barrett-
Lennard Relationship Inventory by the patient-model and
the Carkhuff Empathic Understanding scale. The students
also tOOk the Affective Sensitivity Scale. Their
physiological reactions to the vignettes which they watched
in the laboratory were correlated, by means Of a canonical
analysis, with their performance on the three empathy

measures .

CHAPTER IV

Analysis

The results Of this study along with the relevant
statistical analyses are presented in this chapter. The
first set Of results to be presented will be the correlation
matrix upon which the canonical correlations were based.
Next the results Of the two canonical correlations will be
presented. The final results presented are the matched-
pair t-tests which were performed on the four electrodermal
reSponse measures.

Table 4.1 contains the correlation matrix upon which
the canonical correlations were based. Canonical
correlation analysis takes as its basic input two sets Of
variables, each of which can be given theoretical meaning
as a set. The basic strategy Of canonical analysis is to
derive a linear combination from each of the sets Of
variables in such a way that the correlation between the
two linear combinations is maximized. Canonical correlation
analysis, rather than accounting for as much variance as
possible within one set Of variables, instead accounts
for a maximum amount Of relationship between two sets Of

variables (Warwick, 1975). Canonical analysis requires

81

.pcm: uwmqlopsuflcmmz mocmuosocoo :flxm u
:oxm u o<zam .occmlunmwm some mocmuospcoo :wxm u

Udzmq .pcmmHIOMMImpsuflcmmz oucmuosocou
oqmem .oems peanumaon moemuosoeoo chem

N OAmhA .Ucmm ummqlmmh< wocmuunocou Gflxm N dmmdmn .Ucmmuzmflmlmmum mocmuonpcoonfixmfl<mm¢em
.pcmm umoqllmxmmm mocmuosocou cexm u

.moaosownm coflumuommmm n Omaha .mpsuHHmEd GOwumHflmmmm u dram .muoom mmfiOOe—m some oumm
u some .moaum sufl>ouomemm m>euommom u

once: I Mdmmmm .mnoom omcmno comm uncom
mcwocmumumpco casuomEm mwsnxumo n >m .hnouco>cH motmcooumaom onmscmql.uumuumm u an

Mdmmmq .pcmm unmflmllmxmom mocmuosoaou cfixm

 

me «a ma NH an oH o o o o m a m N H

o.H moo. omo. omo. see. who. moo. Nam. ooor Hmor mom. ooo. moor ooH. mos.

o.H omm. moo. mom. ooo. omm. oHo. moor oeo. Hoo. ooo. smor Hoor moo.

o.H omm. ooh. Ham. omo. oom. omor Neor mom. moo. omor oom. ooo.

o.H oom. son. on. moo. moor smo. Amer moo. moor moo. ooor

o.H mam. ooh. mom. oom. moo. omo. omm. «mo. med. moo.

2 o.H poo. mom. was. How. oom. moo. «Hor_Hoo. odor
8. o.H mos. moo. mmor.oflo. omo. moo. ooa. How.
o.H mmo. oom. ~oo..aoo. Hoo. ooor.mmor

o.H mmo. «mo. Rom. onor.s~a. ohm.

o.H oom. mmfl. omo..aoa. How.

o.H mom. moap.o-. HNN.

o.H ooor.oeo. mmo.

o.H Hmo. aver.
o.H moo.
o.H

 

anumz cowumamuuoo

H.v manna

N Mdmmfim

mmfi .meom

"Mmm

042 mAImH
U<S Bmlva
04m WAIMH
Cam EMINH
<mm¢mAIHH
<mm¢BMIOH
Mfimmhqlm
MGNABMIm
OflfihMlh
mz<MIm
Mdmmmmlm
mummlv
mmfllm
DHIN
AQIH

83

that the individual canonical variates within each set

not be highly correlated with each other. When these
variates are highly correlated, redundant information enters
into the analysis. Depending on the nature Of this
redundancy, this can result in the eigenvalue for that
particular set Of variates to be greater than one.
Eigenvalues Of greater than one cause an immediate default
in the canonical analysis program. The exploratory nature
of this study made it difficult tO predict in advance which
respiration and electrodermal activity measures would nOt

be highly correlated with each other. The measures which
were used to characterize physiological lability in this study
were created specifically for this study (with one exception)
had not been used in past research. Therefore, by creating
an overall correlation matrix between all empathy and
physiological measures a more informed decision was made on
which Of the physiological variables were to be entered into
the canonical analysis.

Since there had been little previous research data on
the relationship between empathy and physiological response
measures, it was difficulty to decide in advance which
physiological measures and which empathy measures should
be used in the canonical analysis. The use Of the correl-
ation matrix was seen as a tool in the decision making

Operation.

84

Based on the correlation matrix contained in Table 4.1
the decision was made to include only the heart rate peak
score in the first canonical variate set because Of its
relationship to the empathy measures. The second canonical
variate set contained all three empathy measures. The
results Of the canonical correlation between the heart rate
score and the empathy scores is presented in Table 4.2.

The first half Of the summary table contains six
pieces Of information. The second column contains the
magnitude Of the eigenvalues. They are presented in
decending order and are equal in number to the number Of
variables in the smaller set (in this case the smaller set
is the heart rate data). The eigenvalues are the proportion
Of variance shared by the pair Of canonical variates tO
which they correspond. The third column contains the
canonical correlations. They are the square roots Of the
eigenvalues and their meaning is equivalent tO a simple
Pearson-Product moment correlation. The last four columns
contain information relative to the statistical significance
Of the canonical correlations. Wilk's Lambada is used tO
test the null hypothesis that there is no residual linear
association between the twO variable sets after the preceed-
ing canonical variates have been extracted. The chi-square
values, degrees Of freedom, and the actual significance
values are listed in the last three columns (Warwick, 1975).

The first canonical correlation in the table accounts for

85

the greatest linkage or relationship between the twO sets
Of variates. When there is a second canonical correlation
in the table it accounts for the degree Of relationship in
the reduced matrix after the primary relationship has been
extracted. The second half Of the table presents two
matrices Of standardized canonical variate coefficients,
one for each of the two variable sets entered into the
analysis. These give the exact information on the
composition Of the corresponding pairs Of canonical
variates which produced the canonical correlations given

in the first part Of the table. The size Of the coefficients
are indicative Of the relative contribution Of the original

variables in composing the canonical variates.

Table 4.2

Canonical Correlations

Eigen- Canonical Wilks Chi- .
Number Value Correlation Lambda.. Square D.F. Sig.

 

1 .12870 .35874 .87130 7.85245 3 0.049

Coefficients for Canonical Variables Of the First Set
CANVAR

BL .55165
EU .62233
ASS -.52662

COefficients for Canonical Variables Of the Second Set
CANVAR

HRPEAK 1.000

 

86

Hypothesis I: There is a significant correlation
between heart rate variability and the three empathy scores
at the 0.049 level. It was initially hypothesized that the
direction Of the correlation would be negative. Canonical
correlation analysis always produces a positive correlation.
In order to ascertain whether this correlation was in the
expected direction one must look at the initial correlation
matrix. Inspection of the matrix provides nO clear cut
answer to the question Of directionality. The matrix
contains both positive and negative correlations. However,
the magnitude Of the individual correaltions seems to indicate
that this relationship is positive rather than negative. A
plausible explanation for this result will be discussed in
Chapter V.

Based on the correlation matrix contained in Table 4.1
the decision was made to include both respiratory scores in
the canonical analysis, as the correlation between the two
was only 0.422. All Of the right hand skin conductance
measures were highly correlated to each other (from .859
to .910). In addition, all left hand skin conductance
measures were highly correlated to each other (from .760
to .962). The decision was made to therefore only include
one right hand and one left hand measure in the analysis.
Even though the skin conductance measures were highly
correlated they were not perfectly correlated. Because Of

this fact the decision was made to include in the canonical

87

analysis two different measures Of skin conductance. Right
hand skin conductance magnitude and left hand skin conductance
slope were the two measures included (correlation between
the two was .550). An additional decision was made to
exclude the A.S.S. from the other set Of canonical variates.
The correlation matrix.revealed that the A.S.S. was
negatively correlated to both the other empathy measures
and the physiological measures. TO therefore include the
A.S.S. in the analysis would possibly cause a "washout"
effect. A more detailed analysis Of the possible reasons
for this negative A.S.S. correlation and the "washout"
effect are contained in Chapter V. The results Of the

second canonical correlation are contained in Table 4.3.

Table 4.3

Canonical Correlations

 

Eigen- Canonical Wilks Chi-
Number Value Correlation Lambda.. Square D.F. Sig.

 

 

 

 

 

1 .16856 .41056 .77507 14.26865 8 .075
2 .06779 .26037 .93221 3.93123 3 .269
Coefficients for Canonical Variables of the First Set
CANVAR 1 'CANVAR 2
BL .42224 .90861
EU .88068 -.47776
Coefficients for Canonical Variables Of the Second Set
CANVAR 1 CANVAR 2
RAMP .55576 -.34115
RFREQ .22222 .93982
RTMAG -.62798 .80126

LFSLO .90403 -.45505

 

88

Hypothesis II: There is a significant correlation
between respiratory and electordermal variability scores
and the empathy scores at the 0.075 level. It was initially
hypothesized that the direction Of the correlation would
be positive. Inspection of the correlation matrix provides
clear cut evidence Of the positive nature Of this
correlation.

The results Of the matched-pair t-tests for each Of

the four electrodermal measures are contained in Table 4.4.

Table 4.4

Matched-Pair t-tests
Variable Mean S.D. D.F. t-value Sig.

 

Skin Conductance
Peaks 10.27 17.66 60 4.69 .0001

Skin Conductance
Area 996.45 1460.44 60 5.50 .0001

Skin Conductance
Slope 34.84 49.20 60 5.70 .0001

Skin Conductance
Magnitude 38.78 58.84 60 5.31 .0001

 

Hypothesislfljh There were a significant differences
between right hand skin conductance peaks, area, slope, and
magnitude and left hand skin conductance peaks, area, slope,
and magnitude. Given the fact that the four measures for
each hand.were highly correlated to each other it is not
surprising that significant differences were found on all

for measures.

89

Summary

The results Of the three research hypotheses were
presented in this chapter. The first hypothesis was that
there would be a significant correlation between the empathy
measures and heart rate variability. The canonical
correlation between these two sets Of variables was 0.35874.
The chi-square level Of significance for this correlation
was 0.049. The second hypothesis was that there would be a
significant correlation between the empathy measures and
respiratory and electrodermal variability. The canonical
correlation between the two empathy measures and the four
physiological measures was 0.41056. The chi-square level
Of significance for this correlation was 0.075. The third
hypothesis was that there would be significant differences
in bilateral electrodermal activity. The matched-pair

t-tests at the .0001 level indicated that this was true.

CHAPTER V

SUMMARY, CONCLUSIONS, DISCUSSION, AND IMPLICATIONS

Summapy

The exploration Of the "helping relationship" has been
a major area Of study in psychology. Theorists and
practitioners have postulated numerous characteristics or
skills which the effective helper must possess. The concept
Of empathy is one Of these characteristics. One con-
ceptualization Of empathy is that Of Barrett-Lennard
(1962, 1981). Barrett-Lennard viewed empathy as a tri—
phasic process. The first phase was the inner process Of
empathic listening and understanding. The second phase was
expressed empathy. The third phase was received empathy.

Psychophysiologists have devoted considerable attention
to the physiological correlates Of an individual's accepting
and/or rejecting environmental stimuli. This study was an
attempt to explore the relationship between the tri-phasic
concept of empathy described by Barrett-Lennard and its
psychophysiological correlates. Three physiological measures
were analyzed. The measures were heart rate, skin
conductance, and respiration. Lacey (1959) and Bittker et.
a1. (1975) have found that acceptance Of the environment

or attention tO external tasks is associated with cardiac

90

91

deceleration. Rejection Of the environment or attention
directed inward to internal cues is associated with cardiac
acceleration. A major hypothesis Of this study was derived
from Lacey. It was hypothesized that if an individual
attended to and was involved with filmed vignettes that
his/her heart rate would become consistant--less labile. If
an individual was uninvolved with the vignettes the converse
would be true, i.e. more labile.

The research Of Edelberg (1972) and Lazarus et. a1.
(1963) provided the theoretical basis for predicting that
involvement with the filmed vignettes would cause skin
conductance to be labile and reactive. Lazarus et. al.
(1963) showed that watching arousing motion pictures caused
electrodermal activity to become more labile.

It was hypothesized that a subject's global empathy
rating would be significantly correlated to his/her phys-
iological lability. A positive correlation was hypothesized
for skin conductance and respiration, and a negative cor-
relation was hypothesized for heart rate. An additional
hypothesis which was generated from this study was that
there would be a significant difference in bilateral
electrodermal activity. This hypothesis was based on the
work Of Lacroix and Comper (1979) and Myslobodsky and
Rattok (1975).

Sixty students from the first year class in the College

Of Human Medicine at Michigan State University volunteered

92

to participate in this study. They were Offered the
Opportunity of an alternative laboratory experience in
which they were given the chance to study their own
physiological responses to affective stimuli. Each subject
was scheduled for two two-hour sessions in the laboratory.
During the first session the subjects viewed eleven stimulus
vignettes. During the second session the subjects were
shown eight vignettes. While they were viewing the vignettes,
their heart rate, respiration, and skin conductance were
measured; simultaneously, this information was transmitted
to a computer where the data was stored for subsequent
analysis. In addition, students conducted weekly lO-minute
interviews with patient-models as part Of a course in
Doctor-Patient Relationships. During the seventh week Of
the class the students interviewed patient-models who
presented a problem about a sexual dysfunction. These
interviews were rated by trained raters on the Carkhuff
Empathic Understanding Scale. In addition, the patient-
models rated each subject on the empathy scale Of the
Barrett-Lennard Relationship Inventory. These two ratings
were used to assess the second and third phases Of the
empathy process respectively. All students in the College
Of Human Medicine were required to take the Kagan and
Schneider Affective Sensitivity Scale. The score from this
scale was used to assess the initial phase Of the empathy

process.

93

Three statistical analyses were performed on the data
tO assess the results Of this study. A canonical correlation
was calculated tO analyze the relationship between the three
empathy measures and the heart rate data. Results indicated
that there was a significant relationship between global
empathy and heart rate peak score. A second canonical
correlation was performed to analyze the relationship
between two Of the empathy measures and the respiration and
skin conductance data. Results indicated that there was a
significant relationship between two Of the components Of
global empathy and a combination Of the respiration and skin
conductance data. The final analysis involved the relation-
ship between right hand and left hand skin conductance
activity. A matched-pair t-test was used to analyze
each Of the four skin conductance measures. Results Of
these analyses indicated that there were significant
differences between right hand and left hand skin conductance

activity.

Conclusions

 

l. A significant correlation exists between a subject's
heart rate variability, as measured by heart rate peak

score, and'theglobal concept Of empathy, as measured by three
scales which purport to measure different aspects of empathy.
This correlation was in the positive direction; which was

Opposite to the hypothesized direction.

94

2. A significant correlation exists between a subject's
respiratory and electrodermal activity, as measured by
respiration amplitude and frequency and right hand skin
conductance magnitude and left hand slope, and empathy,

as measured by two of the three scales, the Barrett-Lennard
and the Carkhuff.

3. A significant difference exists between right hand

skin conductance response to affective stimulus vignettes
and left hand skin conductance response to the vignettes.
The characteristic Of skin conductance response measured

was number Of peaks.

4. A significant difference exists between right hand skin
conductance response to affective stimulus vignettes and
left hand skin conductance reSponse to the vignettes.

The characteristic Of skin conductance response measured was
area under the curve.

5. A significant difference exists between right hand

skin conductance response to affective stimulus vignettes
and left hand response to the vignettes to the vignettes.
The characteristic Of skin conductance response measured

was slope.

6. A significant difference exists between right hand

skin conductance response to affective stimulus vignettes
and left hand response to the vignettes. The characteristic
Of skin conductance response measured was magnitude Of re-

sponse.

95

Discussion

 

The hypothesis that heart rate would be related
negatively tO global empathy level was not substantiated.
It was, however, related significantly to global empathy
in a positive direction. There are any one Of a number Of
plausible explanations for this phenomena. One possible
explanation is that Lacey's hypothesis, which stated that
environmental involvement caused cardiac deceleration, was
incorrectly modified in this study. In this study, the
hypothesis was modified tO also equate environmental
involvement with a more stable--or less labile heart rate.
While it seemed logical that deceleration and stability
should be related, perhaps they are not related. It is
also quite possible that during the vignettes heart rate did
decelerate, but that the actual process Of deceleration was
measured as variability. Another plausible explanation lies
in the emotional content Of the vignettes. Most Of the
research literature on the environmental intake-cardiac
deceleration hypothesis used tasks such as visual attention,
tracking tasks, puzzles etc. tO stimulate subjects to
attend to the environment. In fact, the studies which used
either slides, films, or interviews which had strong
emotional events (Lazarus, 1963; Goldstein, 1976; Campos
and Johnson, 1966; Hare and Blevings, 1975; Bittker et. a1.
1977) either showed heart rate acceleration or no significant

deceleration. This might necessitate a reformulation Of the

96

Lacey hypothesis to be more specific as tO the type Of
environmental event. It is possible that emotionally
evocative external events require. the organism to prepare
for engagement in an external event, which in turn requires
an increase in cardiac response. A third plausible
explanation might be related to the Obrist (1970) cardiac-
somatic coupling hypothesis. Obrist stated that the
vegetative requirement Of the organism is the primary
determinant of cardiac acceleration and deceleration.
Maybe emotional environmental events increases muscular
activity, or increases gastrointestinal activity, or some
other physiological process that demands an increased need
for oxygen. These contrary results might merely have been
caused by an unknown "noise" in the recording system i.e.
an undetected fault in the equipment. Finally, one can not
rule out the possibility that Lacey's hypothesis that
cardiac deceleration is associated with environmental
involvement is simply in error.

The results Of this study with reference tO respiration
and skin conductance were significant in the hypothesized
direction. The magnitude of respiratory and electrodermal
lability was significantly correlated to global empathy
level. The greater the global empathy level the greater the

respiratory and skin conductance variability.

The Affective Sensitivity Scale was not included in

the global empathy rating for the correlation with

97

resPiratory and electrodermal lability. The A38 was
negatively correlated with the other two empathy measures

and with the respiratory and skin conductance measures. The
inclusion Of the ASS data in the canonical analysis would
create a possible wash-out effect. Therefore, the decision
was made to exclude it from the analysis. There appears tO be
two plausible explanations for the ASS being negatively
correlated to the other empathy measures and the physiological
data. The Barrett-Lennard data and the Carkhuff data, while
not correlated with each other, were derived from the same
interview. It is possible that although they were not
correlated with each other they still cannot be considered

as independent. Any twO sets Of information derived from

the same behavioral set might in some way be dependent on each
other. However, inspection of the data would not always re-
veal the nature Of this dependence. The ASS data was not
based on the patient-model interview. The second possible
explanation of the negative ASS correlation concerns the
circumstances surrounding the administration Of the ASS.

The ASS was administered to the students the term before

the Doctor-Patient Relationship class and the experiment

were conducted. There was a Zk-month lapse in time between
the administration Of the ASS and the collection of the
Barrett-Lennard and Carkhuff data. Many historical and
maturational events could have effected the internal

validity Of the analysis (Campbell and Stanley, 1963).

98

In addition, the A.S.S. was administered to the students the
day before their first-ever set Of final exams in medical
school. The anxiety level Of the students was higher than
normal. The effects of anxiety on performance are well
documented (Handler and Sarason, 1952; Spence and Farber,
1953; Spielberger, 1966). This could account for the A.S.S.
data being negatively related to all the other data. The
A.S.S. was not specifically designed to measure empathy per
se, but was designed to measure ones ability to accurately
perceive the feelings Of others. When an individual scores
high on the instrument, rather than being indicative of a
highly empathic level, it might be indicative Of a highly
developed adaptive defensive posture (a form Of vigilance--
a coping style). This might also account for the negative
correlation between the A.S.S. and the other empathy measures.
An additional finding Of this study concerns the relat-
ionship between the three empathy measures. The intercor-
relation between the three empathy measures was very low.
They ranged from -0.049 tO 0.062. The findings Of this
study are in keeping with the low correlations that are
typically reported between empathy measures (Caracena and
Vicory, 1969; Kurtz and Grummon, 1972: McWriter, 1973;
Fish, 1970; Lesser, 1961). Some Of the research in this
area has used the same three measures which were used in
this study. There have been basically two hypotheses

developed tO explain this apparent incongruity. One theory

99

relates it to the client's inability to discriminate in
interpersonal situations or the client's inability to
objectively view the therapist. Another view is that only
those capable of offering high levels of facilitative
conditions are able to discriminate accurately such
conditions in others (Boroto et. a1. 1978). The assumption
is made frequently that all the instruments are measuring
the same variable. This assumption is one of the major
shortcomings of research using these instruments. These
instruments are in all likelihood measuring different stages
of the empathic process. The empathic process can be viewed
as a develOpmental continuum.with successful completion of
one stage being contingent upon some degree of completion Of
the previous stage. An individual could conceivably
accurately perceive the affective experience of another but
be unable to communicate this to the other. Were the
experimenter to test both ability to accurately perceive

and also communicate empathy; this individual would score
higher on perceived than expressed empathy. When empathy is
viewed from this developmental paradigm the measures should
not be expected to be highly related. Another alternative
explanation of the low correlations typically found between
measures might be due to an independence rather than a related—
ness of the measures. Contrary to the above mentioned additive
developmental continuum, empathy might not be an additive

process. It might not necessarily build upon previous stages.

100

An individual who is weak in one sphere, for example the
ability to accurately perceive the feelings of others, might
compensate by responding to another in ways that are perceived
by the other as empathic.

Bilateral or assymmetric autonomic activity has received
considerable attention in recent psychophysiological
literature. Bilateral electrodermal activity is one Of the
more actively researched of the autonomic processes (Ketterer
and Smith, 1977; Bull and Gale, 1975; Varni et. al. 1975;
Obrist, 1973). The most popular explanation of this
asymmetric phenomena equates bilateral differences to
hemispheric activation. Hemispheric activation, in these
theories, leads to contralateral increases in electrodermal
activity (EDA). Lacriox and Comper (1979) presented a
rival hypothesis which stated that hemispheric activation
caused contralateral inhibitation of EDA. The results of
this study showed significantly greater EDA on the right
palmar surface while subjects watched affect stimulus
vignettes. This finding can be interpreted within the
context Of both the activation and inhibitation hypotheses.
The activation theorists would equate increased EDA on the
right palmar surface to left hemisphere activation.
Inhibition theorists would interpret these results to mean
that the right hemisphere was activated. There is little
disagreement amongst researchers that in all tasks there is,

some level of activation in both hemispheres. The task here

101

is to try to assess which hemisphere was the predominant

one during the task involving the viewing of affect laden
vignettes. Galin (in Restak, 1979) believed that the right
hemisphere is associated with unconscious processes and
deals with images which ordinarily cannot be verbalized.
Suberi (in Restak, 1979) showed experimentally that subjects
favor the right hemisphere for the memory storage of
emotionally charged material. The students in this study
were asked to view the vignettes as if the person on the
screen were speaking directly to them. In addition, the
students were given the analogy that the stimulus vignettes
were "an interpersonal allergy test". The vignettes
frequently triggered the students rememberences Of emotional
events which had occurred in the past. In light of the
results of this study, one cannot rule out the possibility
that the right hemisphere was the predominant one in
Operation during the viewing of the affect simulation
vignettes. One cannot rule out the possibility that if
there were right hemispheric activation it could have caused
contralateral electrodermal inhibitation. Future research
could verify contralateral inhibition by comparing left
palmar EDA during the vignettes to activity during baseline

and rest periods .

102

Personal Observations

Personal observations by the experimenter are presented
here.

The first Observation concerns the students who
participated in the project. The vast majority of the
students who participated in the alternative physiological
feedback lab reported favorably on the experience. They
truly seemed excited to be given the opportunity to view
their physiological reSponses in affective situations.
First year medical students were very conscious of time
requirements and to volunteer for a lab which too 4-hours
out of their neuoroanatomy and physiology study time is
atypical. The fact that seventy out of eight-five students
volunteered for the lab and took the 4-hours out of their
schedules, speaks well Of their enthusiasm for the projects.
Many of the students expressed desire to have the lab
made a required part Of the Doctor-Patient Relationship
course; rather than an optiaonl experience.

From a research standpoint, the use Of ambiguous
stimuli (the vignettes) more closely approximates events
in the real world than photic flashes and cold pressor tests.
Results Of a study which uses this type Of stimuli has
greater fact validity for interpersonal research than one

which uses the more traditional psychophysical stimuli.

103

Implications for Future Research

One future research need is to replicate this study.
Before this study was undertaken, the relationship between
the empathy measures and the physiological measures was
unknown. The relative contribution of each variable to the
relationship was unknown. The basic strategy Of canonical
analysis is to derive a linear combination from each of the
sets of variables in such a way, that the correlation
between the two linear combinations is maximized (Warwick,
1975). The canonical analysis determines the relative
contribution or weight of each variable. In the replication
of this study a predictive analysis procedure should be
used. A statistical procedure should be chosen which would
use the relative weights of the variables which were derived
from this study. These weights could then be assigned to
the variables in an a priori manner. Then, a Pearson-
Product correlation would be used to test the relationship
between the physiological data and the empathy data. If
these relative weights reflect accurately the true
contributions of the variables, then, a replication study
using these weights in an a priori manner should again
provide a correlation which is significant.

A second implication for future research concerns the
study Of physiological systems. Too often, researchers view

the systems which they study as univariate in nature.

104

Respiration is separate from electrodermal activity, which
is different from gastrointestinal activity, etc. The
human body is an exceptionally complex myriad Of inter-
related systems. What occurs in one system effects what
happens in other systems. Physiological systems of the
body are not independent of each other -- they are dependent.
They should, therefore, be treated as such. An example of
this was seen in the overall correlation matrix which was
created in Chapter IV. A review Of the matrix showed that
individually none of the physiological measures was
correlated significantly to any one of the individual
empathy measures. This lack of significance using
univariate interindividual correlations was in keeping with
the non-significance found typically in psychophysiological
research. This research, however, took the position, from
its inception, that physiological systems could not be
treated as separate entitles. The system had to be treated
as a whole. Therefore, a multivariate statistical analysis
was chosen; with the finding of statistically significant
relationships. In this study heart rate was, however,
treated separately. This decision was based on Lacey's
theory of cardiac deceleration. The hypothesis was made
that heart rate would be negatively correlated with the
empathy scores. The results of this study showed the
Opposite to be true. If this study were to be replicated

the heart rate data should be added to the respiration and

105

skin conductance data, then, the data could be analyzed to-
gether. A post-hoc analysis of this nature was performed
which did combine the heart rate measure with the respiration
and skin conductance measures. This analysis used only the
Barrett-Lennard and Carkhuff empathy measures in the
canonical correlation. Results of the post-hoc analysis
showed a correlation of 0.422. This correlation was
significant at the .134 level. What is interesting is that
this combined correlation was as high as the correlations

of the separate heart rate and respiration/skin conductance
analyses; however, the significance level appeared to be
related to the separate correlations in an additive manner.
The significance level of the initial heart rate correlation
was .049 and the significance level of the respiratory and
skin conductance correlation was .075. This was most likely
caused by the increase in the degrees of freedom which in
turn required a larger Chi-square value to reject the

null hypothesis.

Another conceivable area of endeavor for future explor-
ation, while highly speculative in nature, would involve a
modification of this procedure so that it might be used in
field training of counselors, therapists, parents, etc.

This procedure would involve connecting both counselor-
client or parent—child to the physiological recording devices
and measuring the physiological responses of both individuals

during the particular type of interaction. The session could

106

be video-taped and split-screen images of both individuals
physiological reSponses would be super-imposed on the screen.
After the interaction is completed, both parties would do a
mutual IPR recall with an inquirer who has knowledge Of both
the recall process and an understanding of the psycho-
physiological concomitants of empathy. During recall the
physiological measures could be used to identify possible
points in the interview where either one or both of the
participants report clinically significant empathic feelings.
They might then be able to provide each other with more
useful feedback as to what about the other's behavior made
them feel empathic or non-empathic toward the other.

The final implication for future research is the
measurement of variability. One result of this study was
the development of a number of ways to characterize the
physiological responses. Two characteristics were
developed to express heart rate variability, two to express
respiratory variability, and four to express skin
conductance variability. These eight measures are being
used, currently, in the development of cluster analysis

programs.

APPENDICES

107

APPENDIX A

MEDICAL VIGNETTES - SERIES 1

108

Older WOman:

 

Woman:

Young WOmen:

 

Young Man:

Older WOman:

 

Man in Chair:

 

Woman:

Older WOman:

 

Young Woman:

 

Young Womenzv

 

Young7WOmen:

 

109
APPENDIX A

Medical Vignettes
Series 1

Oh . . . you're the doctor? You're so young. (Pause) Could
I see someone, um . . . just a little older?

The tests are in. I . . . don't have cancer, do I? I don't
. . . I don't have cancer, do I?

You want to talk to me? I don't want to talk to you. I don't
want to talk to you. Leave me alone. Get away from me. Leave
me alone. (Screaming) .Np . . . I don't want to talk . . ..pp
leave me alone . . . no, no . . .

Alright I took your advice. Ha . . . your advice - now look
at the mess I'm in. Thanks a lot.

We've been to so many doctors who are just awful. But I'm
sure you'll be able to help us.

This is very hard for me. This is hard for me to talk about.
Even . . . to think about (gags, vomits).

What's the matter? I'm not good enough for you? (Pause)
You bastard!

Are you in charge? Are you really in charge? Oh, my God . . .

What are you? I mean . . . what, what's your background?
Well, you know what I mean. What are you? (Smiles)

Do you want me to level with you? Alright - I'll level with
you. You're just a slob - a goddamn slob.

I don't want to talk to you. Just stay away. Just stay
aw y. Just stay . . . (Screaming and tears off blouse).

APPENDIX B

MEDICAL VIGNETTES - SERIES 2

110

111
APPENDIX B

Medical Vignettes
Series 2

Man at Desk: The reason I wanted you to stop by is we've gotten into a
bad situation. We just got a phone call - the little Synder
boy - his father was just in a car accident . . . killed,
instantly. Now I think it's best if you tell him.

 

Men in Oh, hi, Glad you could make it. Say, would you mind taking
Conference: notes?

 

Man in Bar: Bitch. We know what she needs, huh? We know what she
needs . . .

 

WOman: Oh, don't give me that crap. You were in charge, dammit. You
were responsible. Just don't give me that crap.

WOman: What's the matter, grumpy? Wrong time of the month for you?
Young WOman: You want to know what I've been thinking about? I want you.

I've been thinking about it a lot. The way you smell. The
way that you touch me. I want to feel you.

 

Young Man: You know, you really make me feel very, very special. I
really look forward to having this time with you and to just
being able to let the whole day . . . melt away. I'm really
glad you're my friend. You really mean a lot to me. You
really do.

Younngan: I really like you. I really like . . . being with you. Uh .
. . do you have any idea what you do to me? I just want to
touch you. I just want to reach out and feel your warmth.

I want to smell you. Just like animals.

 

Older Man: Can you give me a minute? Something has been driving me
frantic. For the last few years I've found myself . . .
thinking about . . . little children. Wanting to touch them —
where I shouldn't. I know it's wrong, I know it's evil, I
know it's unnatural. I can't help myself. Please help me.
You've gpp to help me.

 

 

APPENDIX C

BASIC NEUROPHYSIOLOGY

112

 

113

APPENDIX C

Basic Neurophysiology

 

Virtually all body processes are controlled or influenced by neural
activity; therefore, a discussion of basic neurophysiology is presented in
this Appendix.

The nervous system is composed of billions of neurons (nerve cell
bodies and their processes). The sites of which the nerve cell bodies
and their processes contact each other are called synapses. At the

synaptic cleft chemical mediators called neurotransmitters are released.

 

These neurotransmitters transmit impulses between the cells. The process
by which the chemical neurotransmitter is released into the cleft is
called an "action potential". Action potentials are created by the
depolarization of the cell membrane. Action potentials occur when there is
a "depolarization" and then "repolarization" of the cell membrane. During
the depolarization phase the electrical charge of the membrane reaches a
point called the "threshold". At the threshold point the action potential
or "nerve impulse" occurs. It is at this point that the neurotransmitter
is released into the synaptic cleft. This is a simplified version of what
is a very complex interaction between electrical and chemical events in
the nerve cell. (Schmidt, 1978).

Nerves are composed of bundles of nerve fibers. The body's nervous
system is divided into two parts; the Central Nervous System (CNS) and
the Peripheral Nervous System (PNS).

The Central Nervous System consists of the brain, midbrain, pons,
medulla, spinal cord, and other anatomical divisions. The Central

Nervous System contains most of the body's nerve cells. The Central

114

Nervous System, through the brain, is the control center of the body.
The brain functions primarily as the site where neural information is
received, processed, integrated, and responses returned in the form
of motor signals. Electrical signals are transmitted at speeds up to
120 meters/second (Adams, 1980).

The Peripheral Nervous System consists of lZ-pairs of cranial nerves,

 

m
31-pairs of spinal nerves, and the large portions of the efferent autonomic '
nervous system and the accompanying afferents which lie outside the
cranial and spinal nerves. Branches of the cranial and spinal nerves
spread out and innervate almost all body structures. The primary function |

of the Peripheral Nervous System is to transmit sensory and motor infor-
mation to and from the Central Nervous System (Foley, 1977).

All spinal nerves tend to have four types of nerve fibers. The four
types of fibers are: (1) General Somatic Afferents, (2) General Visceral
Afferents, (3) General Visceral Efferents, and (4) General Somatic
Efferents. General Somatic Afferent (GSA) fibers transmit nerve impulses
from general body structures (skin, muscles, tendons, etc.) to the central
nervous system. These impulses may be interpreted centrally (consciously)
as pain, temperature, touch, pressure, etc. However, GSA impulses may,
without entering consciousness, activate reflexes or pass to the
cerebellum to aid in muscle coordination. General Visceral Afferent (GVA)
fibers transmit impulses from viscera (heart, stomach, blood vessel walls,
glands, etc.) to the central nervous system and may be interpreted
centrally (consciously) as poorly localized pain or even vague pain and

discomfort. They may also activate visceral reflexes. General Visceral

115

Efferent (GVE) fibers are autonomic (sympathetic or parasympathetic) and
transmit motor nerve impulses from the CNS to the vicera (smooth muscle

of blood vessel walls, intestinal walls, etc.; cardiac muscle, glands of
the skin, glands of the walls of the intestinal tract, salivary glands,
etc.). General Somatic Efferent (GSE) fibers transmit motor impulses

from the CNS to striate (voluntary) musculature of the body and extremities
(Foley, 1977).

The Peripheral Nervous System and the Central Nervous System are
usually broken down further into the Somatic Nervous System and the
Autonomic Nervous System. The Somatic Nervous System consists of nerves
which transmit signals to and from sensory and motor organs. This
system is sometimes called the voluntary nervous system, as it activates
the voluntary muscles (striated). Certain reflexes, however, which
are involuntary are under the control of the Somatic Nervous System. The
Autonomic Nervous System is referred to frequently as the involuntary
or visceral nervous system, as it innervates the internal organs (heart,
lungs, sweat glands etc.). Until recently,it was viewed as not being
under conscious control. Bodily functions such as temperature, heart rate,
blood pressure, breathing, and glandular secretions are under the control
of the Autonomic Nervous System. Recent investigations into relaxation,
biofeedback, and Eastern Mysticism (Brown, 1974; Green, 1970; Benson, 1974;
Pellatier, 1977) have shown that some autonomic functions can be placed
under voluntary control. The Autonomic Nervous System, which has been
the domain of the psychophysiologist is divided into the Sympathetic

Nervous System (SNS) and the Parasympathetic Nervous System (PNS). The

116

SNS is frequently called the thoracolumbar system because its ganglia meet
on the side of the spinal cord. The PNS is referred to often as the
craniosacral system due to its emergence from the cranial and sacral
regions of the spinal cord.

The Autonomic Nervous System, through the interaction of the SNS and
the PNS, plays a crucial role in the regulation of muscle, gland, and organ
function. This dynamic interaction between the PNS and the SNS is responsible
for maintaining life sustaining processes. These systems create a state
of dynamic equilibrum, whereby the various body processes are kept within
the narrow range of functioning needed to maintain life regardless of
the stresses placed on the individual (Adams, 1980).

The purpose of the PNS is to regulate and maintain an organ's function-
ing within its tolerable limits. This is called anabolism. The PNS is the
predominant system in a relaxed non-stressed individual. When an
individual becomes stressed and the various body processes are either
heightened or decreased, the PNS acts to return the processes to their
natural, tolerable, and homeostatic state. Compared to SNS activation,

PNS activation is localized and of relatively short duration (Adams, 1980).

The purpose of the SNS is to meet the body's demands in response to
actual or perceived environmental emergencies. This is called catabolosm.
SNS activation involves a complex series of responses which include dilation
of the coronary blood vessels, increased heart rate, increased blood
flow to the voluntary muscles, decreases of blood flow to skin and viscera,
and breakdown of glycogen in the liver, just to name a few. In addition,

the Central Nervous System transmits signals to the adrenal glands which

 

117

in turn releases epinephrine into the blood. Within seconds, the blood
carries the epinephrine to the body organs where it has effects similar
to the SNS (Adams, 1980). Cannon (1927) names this complex chain of
events the "fight or flight reaction". Compared to PNS action, the
SNS activation is diffuse and can be maintained for periods of up to

a few hours.

 

APPENDIX D

PROCEDURES FOR EQUIPMENT OPERATION

118

A.

119
APPENDIX D

When ready to run subjecp

 

1.

2.

3.

take rubber pad from under pens and put pens down on the paper
turn dial marked chart and pens from off to chart + pen setting

push chart drive from off to mm/min and numerical setting to 25

Operation of Heart Rate channel

 

turn driver amplifier from stand-by to on

 

turn polarity switch on driver amplifier from Up Cal to Use

 

turn selector switch on tachograph from off to Cal. Center and

 

label on the paper 80 bpm

turn same switch to -2 cm and label 40 bpm

turn same switch to +2 cm and label lgglppp

turn same switch to AC slow

achieve heart rate record by gently adjusting threshold,
dial until flahsing light comes on

make sure output display switch is in the tack position

make sure 60Mbutton is " in " on driver amplifier

Operation of Skin Conductance channel

 

1.

2.

3.

turn driver switch from stand-by to pp

 

turn driver amplifier polarity switch from Down Cal to Down Use

 

turn skin conductance bridge switch from off to pp; subject switch
by sure all "mm" switches are at zero (except for recorder
sensitivity switch)

turn sensitivity switch marked MV / CM to .05 and use zero

 

adjust knob on bridge to return needle to baseline

 

D.

.120

Operation of Skin Conductance channel - continued

6.

7.

9.

10.

turn sensitivityyswitch MV / CM back to 1 MV / CM

 

turn subject switch to ip and adjust pen back to recording range

 

by adding micro mho's on skin conductance bridge,

increase sensitivity on bridge (1,2,3, or 4) and/or MV / CM on
pre-amplifier until

‘pppk off 11nmho<xirecord using (++) umho switch to achieve this

record mm baseline on grass paper

Operation of Respiration channel

 

1.

turn driver amplifier switch from stand-by to pp_.

 

turn polarity switch on driver amplifier from Up Cal to Up Use

 

to bring pen in recording range, using the Balance Voltage controls
respiration should now be working

to increase or decrease sensitivity adjust the MV / CM switch

Grass paper speed

 

when ready to start experiment turn the paper speed to 100mm/min

APPENDIX E

BARRETT-LENNARD RELATIONSHIP INVENTORY

121

 

PLEASE NOTE:

Copyrighted materials in this document
have not been filmed at the request of
the author. They are available for

consultation, however, in the author's,
university library.

These consist of pages:
122-128

 

 

 

 

 

 

Uni '
mums
International

300 N. ZEEB RD., ANN ARBOR, Ml 48106 (313) 761.4700

 

 

 

122
Student APPENDIX E
Patient Relationship Inventory
Date

 

Although you had a very brief contact with the interviewer, please indicate
how you felt by answering the following questions (please circle the number
which is most appropriate to how you felt):

l. S/He tried to see things through my eyes.

1 2 3 4 5 6 I‘
Definitely Not True Probably Probably True Definitely
Not True Not True True True

2. S/He understood what I said but not the way I felt.

 

1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

3. S/He seemed interested in knowing what my experiences mean to pg.

1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

4. S/He seemed to know exactly what I meant.

I 2 3 4 ' 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

.5. At times s/he jumped to the conclusion that I felt more strongly or more
concerned about something than I actually did.

1 2 3 4 5 6

Definitely Not True Probably Probably True Definitely
Not True Not True True True

123
Relationship Inventory
Page 2

 

6. Sometimes s/he thought that I felt a certain way, because s/he felt

 

that way.
1 2 3 4 S 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True
7. S/He understood me. 1*
l 2 3 4 5 6
Definitely Not True Probably Probably True Definitely . r
Not True Not True True True
8. His/her own attitudes toward some of the things I said, or did, stOpped I

him/her from really understanding me.
1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True
9. S/He understood what I said but from a detached, objective point of view.
1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True
10. S/He appreciated what my experiences felt like to pg.
1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True
11. S/He did not realize how strongly I felt about some of the things we
discussed.
1 2 3 4 5 6

Definitely Not True Probably Probably True Definitely'
Not True Not True True True

 

I124

Relationship Inventory

 

Page 3

12.

13.

14.

15.

16.

17.

S/He responded to me mechanically.

l 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

S/He understood all of what I said to him/her.

l 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

When I did not say clearly what I meant, s/he still understood me.

1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

S/He seemed able to be deeply and fully aware of my painful feelings
without appearing distressed or burdened by them.

1 2 3 4 S 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

S/He was interested in how my physical health was affecting the rest
of my life.

1 2 3 4 5 6
Definitely Not True Probably Probably True Definitely
Not True Not True True True

S/He was interested in how any stress in my life was affecting my
physical health.

1 2 3 4 5 6

Defintely Not True Probably Probably True Definitely
Not True Not True True True

 

 

APPENDIX F

CARKHUFF EMPATHIC UNDERSTANDING SCALE

125

126
APPENDIX F

EMPATHIC UNDERSTANDING
Level 1
The verbal and behavioral expressions of the first person either do not
attend to or detract significantly from the verbal and behavioral expressions
of the second person(s) in that they communicate significantly less of
the second person's feelings than the second person has communicated
himself.
Examples: The first person communicates no awareness of even the most
obvious, expressed surface feelings of the second person.
The first person may be bored or uninterested or simply
operating from a preconceived frame or reference which
totally excludes that of the other person(s).
In summary, the first person does everything but express that he is
listening, understanding, or being sensitive to even the feelings of the

other person in such a way as to detract significantly from the communi-

cations of the second person.

Level 2

While the first person responds to the expressed feelings of the second

person(s), he does so in such a way that he subtracts noticeable affect

from the communications of the second person.

Examples: The first person may communicate some awareness of obvious
surface feelings of the second person, but his communications
drain off a level of the affect and distort the level of
meaning. The first person may communicate his own ideas of
what may be going on, but these are not congruent with the
expressions of the second person.

In summary, the first person tends to respond to other than what the

second person is expressing or indicating.

Level 3

The expressions of the first person in response to the expressed feelings

127

of the second person(s) are essentially interchangeable with those of
the second person in that they express essentially the same affect and
meaning.
Examples: The first person responds with accurate understanding of

the surface feelings of the second person but may not

respond to or may misinterpret the deeper feelings.
In summary, the first person is responding so as to neither substract from
nor add to the expressions of the second person; but he does not respond
accurately to how that person really feels beneath the surface feelings.

Level 3 constitutes the minimal level of facilitative interpersonal

functioning.

Level 4

The responses of the first person add noticeably to the expressions of

the second person(s) in such a way as to express feelings a level deeper

than the second person was able to express himself.

Examples: The facilitator communicates his understanding of the expres-
sions of the second person at a level deeper than they were
expressed, and thus enables the second person to experience
and/or express feelings he was unable to express previously.

In summary, the facilitator's responses add deeper feeling and meaning

to the expressions of the second person.

Level 5

The first person's responses add significantly to the feeling and meaning
of the expressions of the second person(s) in such a way as to (l)
accurately express feelings levels below what the person himself was able
to express or (2) in the event of on going deep self-exploration on the

second person's part, to be fully with him in his-deepest moments.

 

 

128
Examples: The facilitator responds with accuracy to all of the person's
deeper as well as surface feelings. He is "together" with
the second person or "tuned in" on his wave length. The
facilitator and the other person might proceed together to
explore previously unexplored areas of human existence.
In summary, the facilitator is responding with a full awareness of who the

other person is and a comprehensive and accurate empathic understanding of

his deepest feelings.

APPENDIX G

CONSENT FOR PARTICIPATION

129

130

APPENDIX C
MICHIGAN STATE UNIVERSITY

COLLEGE OF HUMAN MEDICINE
Videotape & Physiological Record Permission Form

Norm Kagan, Ph.D.

I Volunteer to participate in two lab
sessions in which physiological measures and videotape recording of myself

may be made.

I agree to this videotaping only under the following conditions:

1) None of these tapes will be shown to anyone other than myself, the
instructors, and the evaluation raters.

2) If any research is done with these tapes my anonymity will be

protected.

3) The project has been explained to me. I may withdraw at any time

without in any way jeopardizing my academic standing.

Witness Date

Signed Date

 

Your home phone during Winter Term:

 

CW Jan 81

BIBLIOGRAPHY

131

BIBLIOGRAPHY

Archer, J., Fiester, T. Kagan, N., Rate, L., Spierling,
T. and Van Noord, R. New methods for education,
treatment, and research in human interaction.
Journal of Counseling Psychology, 1972, ;g_(4),
275-281.

Aristotle, On the Soul (Translated by W. S. Hett)
Cambridge: Harvard University Press, 1936.

Barrett-Lennard, G.T. Dimensions of therapist response as
causal factors in therapeutic change. Psychological
Monographs, 1962, Z§_(43, Whole No. 562).

 

Barrett-Lennard, G.T. Significant aspects of a helping
relationship. Mental Hygiene, 1963, 21, 223-227.

Barrett-Lennard, G.T. Empathy in human relationships:
Significance, nature and measurement. Australian
Psychologist, 1976, 11, 173-184.

 

Barrett-Lennard, G.T. The empathy cycle: Refinement
of a nuclear concept. Journal Of Counseling
Psychology, 1981, 28, 91-100.

 

Benjamin, L.S. Statistical treatment of the law of initial
values (LIV) in autonomic research: A review and
recommendations. Psychosomatic Medicine, 1963, 2;,

556-566.

Benson, H. The relaxation response. New York: Avon Books,
1975.

Bernstein, A.S. To what does the orienting response
respond? .Psychophysiology, 1969, g, 338-350.

Bittker, T.E., Buchsbaum, M.S., Williams, R.B., and
wynne, L.C. Cardiovascular and neurophysiologic
correlates of sensory intake and rejection II.
Interview behavior. Psychophysiology, 1975, 12,
434-437.

132

V“.

 

 

 

133

Blair, M.C. and Fretz, B.R. Interpersonal skills training
for premedical students. Journal of Counselipg
Psychology, 1980, 21 (4), 380-384.

 

Bonvallet, M. and Allen, M.B., Jr. Prolonged spontaneous
and evoked reticular activation following discrete
bulbar lesions. Electroencephalography and Clinical
Neurgphysiology, 1954, 6, 119-144.

 

 

Boroto, D.R., Kalafat, J.D., Cohen, L.H. Client vs. rater
judgements Of counselor effectiveness. Journal of

 

Brown, B. New mind new body. Toronto: Bantam Books, 1974.

 

Bull, R.H. and Gale, M.A. Electrodermal Activity recorded
concomitantly from the subject's two hands.
Psychophysiology, 1975, 12, 94-97.

 

Burstein, K.R., Fenz, W.O., Bergeron, J. and Epstein, S.
A comparison of skin potential and skin resistance
responses as measures of emotional responsiveness.
Psychophysiology, 1965, 1, 14-24.

 

Burtt, H.E. The inspiration-expieration ratio during
truth and falsehood. Journal of Experimental
Psychology, 1921, 4, 1-23.

 

 

Campbell, D.T. and Stanley, J.C. Experimental and
quasi-experimental designs for research. Chicago:
Rand-McNally, 1966.

 

 

Campos, J.J. and Johnson, H.J. The effects of verbalization
instructions and visual attention on heart rate and
skin conductance. Psychophysiologyy 1966, g,
305-310.

 

Cannon, W.B. The James-Lange theory of emotion: A
critical examination and an alterantive theory.
American Journal of Psychology, 1927, 32, 106-124.

 

Caracena, P.F. and Vicory, J.R. Correlates of phe-
nomonological and judged empathy. Journal Of
Counseling Psychology, 1969, lg, 510-5I5.

Carkhuff. R-P- WW2... (2 vols.).
New York: Holt, Rinehart, and Winston, 1969.

 

Clemens, T.L. Autonomic nervous system responses related
to the Funkenstein test I. To epinephrine.
Psychosomatic Medicine, 1957, 19, 267-274.

 

 

134

Cohen, H.D., Goodenough, D.R., Witkin, H.A., Oltman, P.,
Gould, H. and Shulman, E. The effects of stress on
components of the respiration cycle. PsychOphysiology,
1975, 13, 377-380.

Connolly, J.F. and Frith, C.D. Effects of stimulus
variability on the amplitude and habituation Of the
electrodermal orienting response. Psychophysiology,
1978, 12, 550-554.

Costell, R.M. and Leiderman, P.H. Psychophysiological
concomitants of social stress: The effects of
conformity pressure. Psychosomatic Medicine, 1968,
‘gg, 398-310.

 

Crider, A. and Lunn, R. Electrodermal lability as a
personality dimension. Jourpsl of Experiemental
Research in Personality. 1971, s, 145-150.

 

Darrow, C.W. and Gullickson, G.R. The peripheral mechanism
Of the galvanic skin response. Psychophysiology,
1970, g, 597-600.

Davison, L.A. Adaptation of a threatening stimulus.
Unpublished doctoral dissertation. University of
California, Berkley, California, 1963.

 

Dell, P.C. Humoral effects on the brain stem reticular
formations. In H.H. Jasper, L.D. Proctor, R.S.
Knighton, W.C. Noshay, and R.T. Costello (eds.).
Reticular Formation pf the Brain. Boston: Little,
Brown and Company, 1957.

 

Dell, P., Bonvallet, M., and Hugelin, A. Tonus sympathique,
adrenaline et controle reticulaire de la motricite
spinale. Electroengephalogrgphy and Clinical
NeurOphysiOlogy, 1954, s, 599-618.

Dendy, R. A model for the training of undergraduate
residence hall assistants a paraprofessional counselors
using videotape techniques and interpersonal process
recall (I.P.R.). UnpubliShed'dOctora1_di3sertation,
Michigan State University, 1971.

 

Duffy, E. Emotion: An example of the need for re-
orientation in psychology. Psychological Review,
1934, 21, 184-198.

135

Dykman, R.A., Reese, W.G., Galbrecht, C.R. and Thomasson,
P.J. Psychophysiological reactions to novel stimuli
measurement, adaptation, and relationship of
psychological and physiological variables in the
normal human. Annals of New York Academy of Science,
1959, 12, 43-107.

 

Dymond, R.F. A scale for the measurement Of empathic
ability. Journal of Consulting Psychology, 1949,
lg, 127-133.

Edelberg, R. Electrical activity of the skin. In N.S.
Greenfield and R.A. Sternbech (eds.) Handbook of

Ph chO h siolo . New York: Holt, Rhinehart,
and Winston, I972.

Edelberg, R. and Wright, D.J. Two galvanic skin response
effecter organs and their stimulus specificity.
Psychophysiology, 1964, 1, 39-47.

 

 

Elstein, A.S., Kagan, N., Shulman, L., Jason, H., and
Loupe, M.J. Methods and theory in the study of
medical inquiry. Journal of Medical Education,
1972, 11, 35-92.

 

Epstein, S. Boudreau, L. and Kling, S. Magnitude of heart
rate and electrodermal responses as a function Of
stimulus input, motor output, and their interaction.
Psychophysiology, 1975, 12, 15-24.

 

Feleky, A. The influence of the emotions on respiration.
Journal of Experimental Psychology, 1916, 1, 218-241.

 

Fere, C. Note sur 1es modifications de la resistance
electrique sous 1' influence des excitations
sensorielles et des emotions. Comptes Rendus des
Seances de la Societe de Biologie, 1888, s, 217-219.

 

Fiedler, F. E. A comparison of therapeutic relationships
in psychoanalytic, nondirective, and Adlerian
therapy. gpurnal of Consulting Psychology, 1950,
11, 436-445.

 

Fish, J.M. Empathy and the reported emotional experiences
Of beginning psychotherapists. gournal of Consulting
and Clinical Psychology, 1970, 3;, 64-69.

136

Flanagan, J. Galvanic skin response: Emotion or attention?
Proceedings of the 75th Annual Convention of the
American Psychological Association, Washington, D.C.,

‘fi—

1967, 7-9.

Forbes, T.W. Problems in measurement of electrodermal
phenomena-choice of method and phenomena-potential,
impedence, resistance. Psychophysiology, 1964, 1,
26-30 0

Fridman, M.S. and Stone, S.C. Effects of training,
stimulus, context, and mode Of stimulus presentation

on empathy ratings. Jouranl of Counseling Psychology,

 

Fromm-Reichmann, F. Principles Of intensive_psychotherapy.
Chicago: University of Chicago Press, 1950.

Furedy, J.J. and Doulos, C.X. Short-interval classical
SRC conditioning and the stimulus-sequence-change-
elicited OR: The case of the empirical red herring.
Psychophysiology, 1977, 13, 351-358.

Goldstein, B. Behavior therapy. In R.J. Corsini (ed.)
Current Pychotherapies. Itasca, Ill.: Peacock
Publishers, 1973.

Goldstein, V. Electrical skin conductance and cardiac
responses of repressors, midliners, and sensitizers
to affective stimulus films. UnpubliShed doctoral
dissertation, Michigan State University, 1976.

 

 

Graham, F.K. Habituation and dishabituation of responses
innervated by the autonomic nervous system. In
H.V.S. Peeke and M.J. Herz (eds.) Habituation. Vol;_l
Behavioral Studies. New York: Academic Press, 1973.

 

 

Grater, H. and Claxton, D. Counselor's empathy level and
client tOpic changes. Jourpgl of Counseling
Psychology, 1976, 23 (4), 407-408.

 

Green, E.E., Green A.M. and Walters, E.D. Voluntary control
of internal states: Psychological and physical.
Journal of Transpersonal Psychology, 1970, g, 1-26.

 

Guerney, B., Stover, L. and Demeritt, S. A measurement of
empathy in parent-child interaction. Journal of
Genetic Psychology, 1968, 112, 49-55.

 

 

137

Hare, R.D. and Blevings, G. Conditioned orienting and
defensive responses. Psychophysiologyyyl975, l3:
289-297.

 

Hassett, J. A_primer of psychophysiology. San Francisco:
W.H. Freeman & Company, 1978.

Hastrup, J.L. and Katkin, E.S. Electrodermal lability: An
attempt to measure its psychological correlates.
Psychophysiology, 1976, lg, 296-301.

 

Hebb, D.O. Drives and the CNS (conceptual hervous system).
Psychological Reviewy 1955, g3, 243-254.

 

Hill, C.E. and King, J. Perceptions of empathy as a function
of the measuring instrument. Journal of Counseling
Psychology, 1976, 2; (2), 155-157.

 

Hill, F.A. Effects of instructions and subject's need for
approval on the conditional galvanic skin response.
Journal Of Experimental Psychology, 1967, 1;, 461-467.

 

Hord, D.J., Johnson L.C. and Lubin, A. Differential effect
of the law of initial values (LIV) on autonomic
variables. PsychOphysiology, 1964, 1, 79-87.

 

James, W. What is an emotion? Mind, 1884, 9, 188-205.

Jason, H., Kagan, N., Werner, A. Elsteip, A. and Thomas,
J.B. New approaches to teaching basic interview skills
to medical students. American Journal of Psychiatry,
1971, 121, 1404-1407.

Kagan, N. Interpersonal process recall: A method of
influencing human interaction. East Lansing: Michigan
State University, 1975.

 

Kagan, N. Counseling psychology, interpersonal skills, and
health care. In G. Stone, F. Cohen, and N.E. Adler
(eds.), Health Psyghology. San Francisco: Jossey-
Bass Publishers, 1979.

 

Kagan, N., Krathwohl, D.R. and Miller, R. Stimulated recall
in therapy using videotape: A case study. Journal of
Counseling_Psychology, 1963, 1Q, 237-243.

 

Kagan, N. and Krathwohl, D.R. Studies in human interaction:
Interpersonal process recall stimulated byyvideotape.
East Lansing: Educational Publications Services,
Michigan State University, 1967.

 

 

138

Kagan, N., Krothwohl, D.R., and Farquhar, W.W. Using IPR
to accelerate clientpsogress in counseling. East
Lasning: Educational Publications Services, Michigan
State University, 1965.

 

Kagan, N. and Schauble, P. Affect simulation in inter-
personal process recall. Journal of Counseling
Psychology! 1969, 1§_(4), 303-313.

 

Kagan, N., Werner, D., Schneider, J. Measuring individual
differences in emotional recognition and expression.
East Lansing: Michigan State University, 1977.

Kaplan, H.E. Local interaction an GSR activity during
group psychotherapy, Psychosomatic Medicine, 1963,
22, 449-4560

 

Kaufmann, W. Neetzsche: Philosopher,psychologist,

;

antichrist. New York: Vintage Books, 1968.

 

 

Ketterer, M.W. and Smith, E.D. Bilateral electrodermal
activity, lateralized cerebral processing and sex.
Psychophysiology, 1977, 14, 513-516.

 

Kimmel, H.D. Further analysis of GSR conditioning: A
reply to Stewart, Stern, Winokur and Fredman.
Psychological Review, 1964, 11, 160-166.

 

Kirkpatrick, D.G. Differential responsiveness of two
electrodermal indices of psychological stress and
performance of a complex cognitive task. Psychophys-
iology, 1972, s, 218-226.

Klorman, R., Wiensenfeld, A.R., and Austin, M. Autonomic
responses to affective visual stimuli. Psycho-
physiology, 1975, 12, 553-560.

 

Klorman, R. and Ryan, R.M. Heart rate, contingent negative
variation, and evoked potentials during anticipation
of affective stimulation. Psychophysiology, 1980,
11, 513-522.

 

Kuno, Y. Human perspiration. Springfield, Ill: Charles
C. Thomas,'1956.

Kurtz, R.D. and Grumman, D.L. Different approaches to
the measurement of therapist empathy and their
relationship to therapy outcome. Journal Of Clinical
and Consulting Psychology, 1972, i2! 106-115.

 

139

Lacey, J. The evaluation of autonomic responses: Toward
a general solution. Annals of the New York Academy
of Science, 1956, fig, 123-164.

 

Lacey, J. and Lacey, B.C. The relationship of resting
autonomic activity to motor impulsivity. Association
of Nervous & Mental Disease, 1958, is, 144-209.

 

Lacey, J. Psychophysiological approaches to the evaluation
of psychotherapeutic process and outcome. Research in
psychotherapy, Vol. 1. Proceedings of the American
Psychological Association Conference,_1958, Washington,
D.C., 1959.

Lacey, J. Somatic response patterning and stress: Some
revisions of activation theory. In M.H. Appley and
R. Trumbull (eds.) Psychological Stress: Issues
and Research. New York: Appleton-Centruy-Crofts, 1967.

 

Lacey, J. Kagan, J., Lacey, B., and Moss, H. The visceral
level: Situational determinants and behavioral
correlates of autonomic response patterns. In P.H.
Knapp (ed.) Expressions of the Emotions of Man.

New York: International Universities Press, 1963,
161-196.

Lacey, B.C. and Lacey, J. Studies of heart rate and other
bodily processes in sensorimotor behavior. In P.A.
Obrist, A.H. Black, J. Brener, and L.V. DiCara (eds.)
Cardiovascular PsychOphysiology. Chicago: Aldine-
Atherton, 1974.

Lacroix, J.M. and Comper, P. Lateralization in the
electrodermal system as a function of cognitive/
hemispheric manipulations. Psychophysiology, 1979,
16, 116-128.

Lader, M.H. and Montagu, J.D. The psycho-galvanic reflex:
A pharmacological study of the peripheral mechanism.
Journal of Neurology, Neurosurgery, and Psychiatsy,
1962, 35, 126-133.

Lang, P.J. The application of psychophysiological methods
to the study of psychotherapy and behavior modification.
In A.E. Bergin and S.L. Garfield (eds.) Handbook of
psychotherapy and behavior change. New York: Wiley
and Sons,'197l.

 

140

Lazarus, R.S., Spiesman, J.C., Mordkoff, A.M. and Davison,
L.A. A laboratory study of psychological stress
produced by a motion picture film. Psychological
Menographs, 1962, 16, 553, 1-35.

 

Lazarus, R.S. and Alfert, E. The short circirting of
threat by eXperimentally altering cognitive appraisal.
Journal of_Abnormal and Social Psychology, 1964,
gs, 195-205.

 

Learmonth, G.J., Ackerly, W. and Kaplan, M. The relationship
between autonomic indicators of psychological stress:
Hear rate and skin conductance. Psychosomatic
Medicine, 1959, 21, 150-157.

 

Lindsley, D. B. Emotions. In 5.5. Stevens (ed.) Handbook
of Experimental Psychology. New York: Wiley, 1951.

 

 

Lykken, D.T. and Venables, P.H. Direct measurement of
skin conductance: A proposal for standardization.
Psychophysiology, 1971, 8, 656-672.

 

Malmo, R.B. and Davis, J.F. Physiological gradients
and indicants of "arousal" in mirror tracing.
Canadian Journal of Psychology, 1956, 10, 231-238.

 

Mandler, G. and Sarason, S. A study of anxiety and learning.
Journal of Abnormal and Social Psychology, 1952, 51,
166-173.

 

Martin, I and Venables, P.H. Mechanisms of palmar skin
resistance and skin potentials. Psychological
Bulletin, 1966, 65, 347-357.

 

Morris, J.M. Descartes Dictionary. New York: Philosophical
Library Inc.,_1971.

 

Myslobodsky, M.S. and Rattok, J. Asymmetry of electrodermal
activity in man. Bulletin of Psychonomic Society,
1975, s, 501-502.

Obrist, P.A. Skin resistance levels and galvanic skin
response. Sciencsl 1963, 139, 227-228.

 

Obrist, P.A. Cardiovascular differentiation of sensory
stimuli. Psychosomatic Medicine, 1963, 3;, 450-459.

Obrist, P.A., Webb, R.A., Sutterer, J.R., and Howard, J.L.
The cardiac-somatic relationship: Some reformulations.
Psychophysiology, 1970, 6, 569-585.

141

Obrist, P.A., Black, A.H., Brener, J. and DiCara, L. (eds.)
Cardiovascular psychophysiology: Current issues
In response mechanisms, biofésgback, and methOdology.
Chicago: Aldine-Atherton, 1974.

 

 

Opton, E., Rankin, N.0., and Lazarus, R.S. A simplified
method of heart rate measurement. Psychophysiology,
1966, g, 87-97.

Paul, LeHers to Simon. New York: International University
Press, 1969.

 

Pelletier, K. Minds and healer, mind as slayer. New York:
Delta Book, 1977.

Peterson, F. and Jung, C. Psychophysical investigations
with the galvanometer and plethysmograph in normal
and insane individuals. Brain, 1907, 32, 153-218.

Plato, The Republic (transalted by C.M. Bakewell) New York:
Charles Schribner's Sons, 1928.

 

Restak, R.M. The brain: The last frontier. New York:
Warner Books, 1979.

 

Robbins, A.S., Kauss, D.R., Heinrich, R., Abrass, I.,
Dreyer, J. and Clyman, B. Interperaonsl skills
training: Evaluation in an internal medicine residency.
Journal of Medical Education, 1979, 51, 885-894.

 

Rogers, C.R. Client-centered therapy. Boston: Houghton
Mifflin, 1950.

 

Rogers, C.R. The necessary and sufficient conditions of
therapeutic personality change. Journal of Consulting

 

 

Rogers, C.R. On becoming a person. Boston: Houghton
Mifflin, 1961.

 

Rogers, C.R. Conditions of change from a client-centered
viewpoint. In B.G. Berenson and R.R. Carkhuff (eds.)
Sources of gain in counseling and psychotherapy.

New York: Holt, Rinehart, and Winston, Inc., 1966.

Santas, G.X. Socrates: Philospphy in Plato's early
dialogues. London: Routhledge and Kagan Paul, 1979.

 

 

142

Schacter, S. The interaction of cognitive and physiological
determinants of emotional states. In L. Berkowitz
(ed.) Advances in Experimental Social Psychology,

Vol. 1, New York: Academic Press, 1964.

 

Schmidt, R.F. Synaptic Transmission. In R.F. Schmidt
(ed.) Fundamentals of neurophsiology. New York:
Springer-Verlag, 1978.

 

Seligman, L. Skin potential as an indicator of emotion.
Journal of Counseling Psychology, 1975, 22, 489-493.

 

Shaffer, W.F. and Hummel, T.J. Three experiments using an
algorithm for empathic responses. Jourssl of
Counseling Psychology, 1979, gs (4), 279-284.

 

 

Siddle, D.A., O'Gorman, J.G., and WOod, L. The effects of
electrodermal lability and stimulus significance on
electrodermal response amplitude to stimulus A
significance. Psychophysiology, 1979, 16, 520-526.

Simons, D.G. and Perez, R.E. The Blgsr module: A combined
recording to present base skin resistance on galvanic
skin reflex activity patterns. Psychophysiology, 1966,
2, 117-124.

Smith, K. Conditioning as an artifact. Psychological

Spence, K.W. and Farber, I.E. Conditioning and extenction
as a function of anxiety. Journal of Experimental
Psychology, 1953, i5, 116-119.

 

 

Spielberger, C.D. Anxiety and behavior. New York:
Academic Press, 1966.

 

Stennetl, R.G. The relationship of performance level of
arousal. Journal of Experimental Psychology, 1957,
a, 54-61.

Stern, J.A. and Walrath, L.C. Orienting responses and
conditioning of electrodermal responses. Psychophys-
iology, 1977, 13, 334-342.

 

Sullivan, H.S. The interpersonal theory of psychiatry.
New York: Norton Publisher, 1950.

Tomory, R. The use of interpersonal process recall (IPR)
model videotape and stimulus film technigues in a
short-term counseling and psychotherapy. Unpublished
doctoral dissertation, Michigan State University, 1979.

143

Truax“ C.B. and Carkhuff, R.R. Toward effectiye counseling
and psychotherapy. Chicago: Aldine, 1967.

 

Tursky, B. and O'Connell, D.N. Survey of practice in
electrodermal measurement. Psychophysiology, 1966,
s, 237-240.

Varni, J.G., Doerr, H.D. and Franklin, J.R. Bilateral
differences in skin resistance and vasomotor activity.

 

Varni, J.G., Doerr, H.D., Varni, J.R. Relationship between
bilateral differences in body perception and bilateral
differences in skin conductance level. Psychophysiology,
1975, 12, 179-181.

Van Egeren, L.F. Multivariate statistical analysis.
Psyphophysiology, 1973, 10, 517-532.

 

Van Noord, R.W. and Kagan, N. Stimulated recall and affect
simulation in counseling: Client grwoth reexamined.
Journal of Counseling Psychology, 1976, g; (1), 28-33.

Warwick, P.V. Canonical correlation analysis. In N.Nie,
C.H. Hull, J.G. Jenkins, K. Steinbrenner, D.H. Bent
(eds.) Statistical package for the social sciences.
New York: McGraw-Hill, 1975.

Werner, A. and Schneider, J.M. Teaching medical students
interactional skills: A research-based’course in
doctor-patient relationship. New England Journal of
Medicine, 1974, 2_90, 1232-1237.

 

Wilson, G. D. GSR responses to fear-related stimuli.
Perceptual Motor Skills, 1967, 25, 401-402.

 

Wogan, M. Investigation of a measure of empathic ability.
Psychotherapy: Theory, research, and practice, 1969,
s, 109-112.

Wyatt, R. and Tursky, B. Skin potential levels in right
and left handed males. PsychOphysiology, 1969,
g, 133-1370