ToM and Empathy in Couples

McHugh et al. (2012) have defined ToM as an ability that underlies perspective-taking. Perspective-taking, in its own turn, has been defined as the ability to vicariously anticipate what another individual is thinking and to intellectually understand another’s condition without experiencing his/her emotions (Hogan, 1969). According to Gehlbach (2004), perspective-taking involves strategies that help us understand another’s thoughts and feelings and his/her appreciation of a given situation. It is an active cognitive process in which we overcome our egocentric point of view and try to imagine how the world appears to another. Without understanding the views of others in our social interactions, we may exhibit behaviours that are perceived by others as inappropriate. Several studies have found a significant relationship between ToM and empathy (Peloquin & Lafontaine, 2010; Abdi et al., 2012; Nejati et al., 2014; Wlodarski & Dunbar, 2014; Erle, 2016; Dodell-Feder, Felix, Yung & Hooker, 2016). The findings suggest that ToM engagement is associated with positive outcomes including physical and mental well-being in interpersonal (social and romantic) relationships.

There is increasing empirical evidence that perspective-taking is an important component of a well-adjusted marital/romantic relationship. According to Dodell-Feder et al. (2016), individuals who exhibit greater ToM engagement in relation to their partner are able to enact more adaptive interpersonal processes or strategies in the context of meaningful interpersonal interactions. These processes may include perspective-taking, empathy and acting altruistically – abilities which have previously been shown to neurologically correlate with ToM-related engagement in interpersonal situations (Waytz, Zaki & Mitchell, 2012; Dodell-Feder, DeLisi & Hooker, 2014; Dodell-Feder, Tully, Lincoln & Hooker, 2014). Interestingly, individuals who exhibit high ToM engagement may deploy strategies that have positive, measurable and longer-lasting consequences for their partner. In contrast, individuals who fail to show ToM-related engagement or do so less effectively are apparently using a different strategy during meaningful encounters with their partner that may not involve perspective-taking, empathy or other processes that are associated with ToM engagement (Dodell-Feder et al. 2016).

Davis and Oathout (1987) also found out that relationship satisfaction is positively related to the self-reported perspective-taking of the partner. Without adequate perspective-taking, romantic partners/married couples respond to their partner/spouse from an egocentric point of view. Thus, high levels of perspective-taking by one spouse/partner are predictive of the other’s marital/romantic adjustment and inadequate perspective-taking by one spouse/partner predicts the other’s thought about divorce (Long & Andrews, 1990; Long, 1993a; Epley, Keysar, Van Boven & Gilovich, 2004; Wlodarski & Dunbar, 2014; Dodell-Feder et al., 2016). Overall, these findings highlight the importance of the neurocognitive ToM network in relation to positive outcomes in romantic relationships and suggest that individuals who exhibit high ToM engagement may enact more adaptive social behaviour that have measurable real-world consequences for their partner. However, it must be noted that, according to Long (1990), training couples for perspective-taking skills can improve marital adjustment only when it is focused on the context of marriage. In the same line, Dodell-Feder et al. (2016) suggest that one’s high degree of closeness/intimacy with the other may account for higher ToM activation.

Empathy

Whereas deficiencies in empathy, whether for neurological defects or for poor interpersonal skills, set couples against one another, high empathic concern improves marital/romantic intimacy and adjustment (Long, Angera & Hakoyama, 2006). Understanding differences and the ability to nurture empathy and intimacy in one’s marital/romantic relationship are characteristic of well-adjusted couples (Edwards & Klockars, 1981). Failure to identify the mental states and feelings of another, especially those of the spouse/romantic partner, impedes the maintenance of an intimate relationship and fossilizes the image that one has of his/her spouse/partner (Dodell-Feder et al., 2016). Previous studies suggest that ToM deficiencies can be associated with cognitive distortions, poor communication skills, low self-esteem, lack of empathy and intimacy (Ward, Keenan & Hudson, 1999) as well as with aggression, impulsivity and psychopathic/antisocial behaviours (Richell et al., 2003). Also, researchers have found that ToM abilities have a significant relationship with empathy, adjustment and continuity in marital/romantic relationships (Dodell-Feder et al., 2016; Wlodarski & Dunbar, 2014). Lack of empathy has been found to be connected with negative predisposition and prejudice, which are characteristic of low-adjustment romantic relationships/marriages (Blair, 2008; Abdi et al., 2012).

ToM Trainability

ToM is a fundamental skill used throughout the life span, with important implications for social communication abilities and social relationships (Henry et al., 2013). The relative success of some ToM training studies in accelerating the acquisition of ToM understanding in adults, especially in romantic partners, suggests that the development of this ability is at least to some extent experience-driven (Surtees et al., 2012; McHugh et al., 2012; Lecce et al., 2014a&b; Cavallini et al., 2015; Williams, 2015; Erle, 2016). As suggested by Lecce et al. (2014b), cognitive interventions have proven effective in preserving adequate cognitive and metacognitive functioning among older adults through structured experience in situations demanding specific skills such as cognitive and/or metacognitive trainings. This led us to hypothesize that ToM abilities may also help nurture empathy in married couples/romantic partners.

Few studies have so far investigated ToM understanding in romantic/marital relationships. For instance, Dodell-Feder et al. (2016) studied the effects of ToM engagement on partner well-being and Wlodarski & Dunbar (2014) studied the effects of romantic love on mentalising abilities. The present study, however, aims to take a step further by investigating the effectiveness of a ToM training program in improving empathy between married couples/romantic partners.

Methods and Procedures

The present study uses a quasi-experimental (pre-test/post-test control group) design. The statistical population includes all married heterosexual couples visiting counselling centres of Rasht, Iran, for specialized assistance in marital conflict in the first half of 2018. At first, ten centres were randomly selected from a list of active counselling centres in Rasht, Iran. 73 couples visiting for counselling services showed their willingness to complete a questionnaire for research purposes. 32 couples were identified to meet the research criteria, including: (1) experience of living together for at least one year with interruption periods of no longer than a week, occurring for no more than once a month; (2) a minimum age of 25 and a maximum of 51; (3) a minimum degree of high school diploma; and (4) not being diagnosed with any psychiatric condition, confirmed through the Millon Clinical Multiaxial Inventory, Third Edition (MCMI-III; Millon, Davis & Millon, 1997). Potential participants were randomly assigned to experimental and control groups and were invited to take part in our experiment. After that, the first 16 couples (eight for each group) who volunteered before the others were included in the program. Descriptive statistics for age and duration of marriage are presented in Table 1.

As shown in Table 1, members of the experimental group were between 28 and 51 years of age with a mean score of 37.87 years (SD=7.08) and had been involved in their current marital relationship for a period of 5 to 15 years with a mean score of 9.37 years (SD=3.38). Members of the experimental group were between 25 and 50 years of age with a mean score of 38 years (SD=6.32) and had been involved in their current marital relationship for a period of 4 to 17 years with a mean score of 9.62 years (SD=3.72). The results confirm the homogeneity of the two groups in terms of age and duration of marriage.

Data Collection Instruments

The Interpersonal Reactivity Index for Couples (IRIC)

The Interpersonal Reactivity Index for Couples was adapted by Péloquin and Lafontaine (2010) from the Interpersonal Reactivity Index (Davis, 1980), a measure of general cognitive and emotional empathy, to assess cognitive and emotional empathy within the context of intimate relationships. The IRIC includes 13 items in two subscales: dyadic perspective-taking (6 Items) and dyadic empathic concern (7 Items). Items are evaluated on a five-point Likert scale ranging from 0 (does not describe me well) to 4 (describes me very well) and each subscale score is obtained by summing its respective items. Higher scores are indicative of greater perspective-taking and empathic concern.

Péloquin and Lafontaine (2010) reported the reliability coefficients for IRIC subscales (dyadic perspective-taking and dyadic empathic concern) in three independent samples of individuals involved in romantic relationships: (1) young adults involved in heterosexual relationships (α=0.84 and 0.74, respectively); (2) older adults involved in same-sex romantic relationships (α=0.81 and 0.63, respectively); and (3) older and cohabiting partners of heterosexual couples (α=0.76 and 0.60 for males; 0.80 and 0.73 for females, respectively). Since the psychometric properties of the IRIC had not been previously evaluated among Iranian couples, we followed rigorous forward-backward translation procedures to ensure the cross-cultural, conceptual and linguistic/literal equivalence of the IRIC in Persian. Face and content validity were confirmed by four professors of counselling and psychology. Also, in order to ascertain construct validity, we conducted a confirmatory test of the two-variable measurement model of empathy presented by Péloquin and Lafontaine (2010) using confirmatory factor analysis (CFA) with LISREL. The resulting model fit measures are presented in Table 2.

As shown in Table 2, goodness of fit measures are within the appropriate range. We obtained reliability coefficients of 0.89, 0.84 and 0.80 for the overall IRIC scale and the two subscales of dyadic perspective-taking and dyadic empathic concern, respectively. Therefore, it can be concluded that Péloquin and Lafontaine’s hypothesized two-variable model of empathy (2010) fits the data from our sample of Iranian couples.

Training Procedures

Before the commencement of the training program, the couples who voluntarily completed the study questionnaire were randomly assigned to experimental and control groups and were invited to take part in our experiment. After that, the first 16 couples (eight for each group) who volunteered before the others were included in the program. The couples in the experimental group (n=8) received eight 90-minute sessions of ToM training on a weekly basis while those in the control group received no training. At the post-test, the couples in both groups were asked to complete the questionnaires once again. A summarized description of the ToM training program is presented in Table 3.

Overall, the main framework and contents of the training sessions were adapted from Lalonde and Chandler (2002), McKay et al. (2006), White et al. (2009), Surtees et al. (2012), Gehlbach et al. (2012), Koenig et al. (2013), Yung et al. (2013), Lecce et al. (2014a&b), Cavallini et al. (2015) and Erle (2016).a