1. The study examines an integrated treatment method using embodiment techniques like imitation and synchronization to improve empathy, relationship satisfaction, and conflict resolution in couples therapy. 2. The treatment combines cognitive and affective schema work to increase understanding of partners' hidden emotions and intentions, with an emphasis on how the body can aid in generating and regulating emotions. 3. It is hypothesized that the treatment group will show significant increases in empathy, relationship satisfaction, and decreases in depression compared to the waitlist control group, demonstrating the effectiveness of incorporating embodiment into traditional cognitive and behavioral relationship therapies.

1. Imitation and Synchronisation
in Schema Work with Couples
Developing a new love strategy

2. Our Team & Expertise
© Pietrzak, Lohr, Hauke, Jahn (2016)
3 with PhDs
2 with masters
Dr Christina Lohr:
Munich
Dr Tania Pietrzak:
Melbourne
Leanne Kennedy:
Melbourne
Beverly Jahn:
Leipzig
Dr Gernot Hauke:
Munich

3. Aims
 To foster emotional regulation, multifaceted empathy and
conflict resolution in conflicted couples using an integrated
treatment method to improve partner satisfaction.
 Emotional activation + embodied cognition + cognitive
affective schemas
 We aim to increase understanding of couples’ previous
hidden emotion and intentions.
© Pietrzak, Lohr, Hauke, Jahn (2016)

4. Models of Effective Relationship Therapy &
Limitations
 Behavioural (Johnson & Greenberg 1985): Do not address cognitive or
affective processes by couples.
 CBT (Davidson & Horvath 1997): cognitive distortions leading to
problematic behavioural patterns, controlling emotions using reason
(cognitive change).
 EFT (Johnson 1999): emotions essential to problem solving, changes in
affect towards partner occurs by focusing on understanding partners
emotional experience.
 All martial therapies neglect embodiment – role of body in shaping
cognitions and emotions.
© Pietrzak, Lohr, Hauke, Jahn (2016)

5. Definition of Embodiment (Shapiro 2011)
“Refers to both embedding of cognitive processing in brain circuitry and to
the origin of these processes in an organisms sensory motor experience,
THUS ACTION AND PERCEPTION are closely linked”
“Emotions and cognitions & motivational processes are following body
activities, for example posture, movement, gesture”
“Feel emotions with the aide of the body” .
Rationale: Conflicted couples (who are flooding or immobilised) find it
difficult to access language to express felt emotions.. Therefore the body can
aide in the generation and regulation of emotions.
© Pietrzak, Lohr, Hauke, Jahn (2016)

6. Embodiment as an adjunct to relationship
therapy
 Traditional martial therapies view cognitions and emotions as
’amodal’ and not embedded within the body. (Top down-
therapist helps couples use language to express cognitions
and emotions & to assist them to re-interpret their
experiences using language only)
 Neuroscience inspired research shows that cognitions are
emotions are embodied and modal (bottom up). (Barsalou
2011; Damasio 2011)
© Pietrzak, Lohr, Hauke, Jahn (2016)

7. Empathy
 Empathy seen as a multidimensional construct (Fuchs & Koch, 2011; Kim et al.,
2013)
 Affective empathy, e.g. emotional sharing/ contagion or mirroring the feelings of another
person.
 Cognitive empathy, e.g. inferring mental states and intentions of another person.
 Kinesthetic empathy, imitation, moving in synchrony
© Pietrzak, Lohr, Hauke, Jahn (2016)

8. Kinesthetic empathy
Is a motor theory of empathy (Gallese 2009)
Imitation and synchronization of body movements,
gestures, facial expressions, vocalizations, etc. in a couple
Explains increase of affiliation, cohesion, prosocial
behaviours, higher levels of cooperation
Better outcomes in psychotherapy with higher levels of
synchrony (Ramseyer & Tschacher 2010, 2011)
© Pietrzak, Lohr, Hauke, Jahn (2016)

9. Aims and Hypotheses
1. The treatment group will show statistically significant and clinically
meaningful increases in measures of empathy, relationship
satisfaction, a more secure attachment style.
2. The treatment group will show statistically significant and clinically
meaningful decreases after treatment in measures of depression.
3. Increases will occur in participants understanding of their emotions
and core schemas during conflict and understand their partner’s
intentions and hidden emotions.
4. The wait list control group will show no statistically significant or
meaningful improvements over time.
© Pietrzak, Lohr, Hauke, Jahn (2016)

10. Screeners
 No Domestic Violence
 In a committed relationship with clarity around a defined
problematic situation (both want to stay and improve the
relationship)
 Self selected, voluntary
© Pietrzak, Lohr, Hauke, Jahn (2016)

11. Materials
Interpersonal Reactivity Index (IRI, Davis 1983): Affective and Cognitive components
of empathy.
 Personal Distress: the tendency to have feelings of discomfort and concern when
witnessing others’ negative experiences.
 Empathic Concern: ‘other’ orientated feelings of sympathy and concern
 Perspective Taking: adopting the psychological point of view of others
 Fantasy: imagining the feelings and actions of fictitious characters
Relationship Assessment Scale (RAS, Hendrick 1988)
 Measure of general relationship satisfaction
© Pietrzak, Lohr, Hauke, Jahn (2016)
A
C

12. Materials
Experience in Close Relationships (ECR-R, Fraley et al. 2000): Measures
attachment related anxiety and avoidance in close relationships (not partner
specific).
Brief Patient Health Questionnaire (B-PHQ, Kroenke et al. 2001): DSM-IV
measure of depression
© Pietrzak, Lohr, Hauke, Jahn (2016)

13. Procedure
 Participants self selected, voluntary, advertisement through internet,
GP clinics, PHCNs, community centers, psychology practices.
 Initial and follow up interview, assessment, informed consent,
relationship ax feedback
 Treatment group given 20 hours intervention
 Wait list control group offered relationship assessment results only
 2 months between baseline and post treatment
 Measures for treatment group taken 2 weeks post treatment
© Pietrzak, Lohr, Hauke, Jahn (2016)

14. • Sensitisation of body
interaction
• Introduction to the group:
Sharing of pictures.
• Same-boat-exercise- What do
I need from the group, what
do I give to the group?
• Psychoeducation:
• Ice-berg – metaphor
• Scar-metaphor
Establish Group
Cohesion
Focus on Self
• Mindfulness – self, spouse,
group.
• Partners separated:
• Own Survival strategy &
Emotional field
• Other group members
give feedback, imitate to
show embodied empathy
and can support as
representatives
• Individual behavioural
action goals
• 3 levels of movement pattern: closenes
distance, intensity/speed and up-
down
• Couple Mindfulness
• Sharing of individual emotional surviva
strategy + imitating secondary & prim
emotions
• Frustrated partner dance choreogrpahe
by couples
• Synchronization & embodied cooperati
in motion to the solution
• Love strategy – meta cognitive analysis
couple projects
Focus on Interaction

15. Definition of Survival Strategy (Sulz &Hauke):
cognitive affective schema
 Problematic situations between couples are highly emotionally charged leading to
interaction of ‘survival’ mode (maladpative schemas), negative sentiment over-ride
results.
 Describing how central needs are met in a relationship and balanced with approach and
avoidance.
 Learnt from childhood no longer functional as a healthy adult for emotional survival
 => explore survival strategies, reaction chain: primary and secondary emotions
 Every couple problematic situation is associated with a network
 of different affects and often distinguishable emotions with opposite action impulses
 and emotionally charged fragments of learning history
 To get the full picture: Emotional Field from Emotional Activation Therapy (EAT, Hauke
& Dall‘Occhio, 2013).
© Pietrzak, Lohr, Hauke, Jahn (2016)

16. SHE
HE
Interacting survival strategies
What do I need from you?
What scares me about you?
What makes me angry about you?
Peace, harmony, feeling safe, not frighten me
SHE Being ignored , not listened to
Her harshness and unrealistic and unfair demands
SHE
Being left financially and emotionally alone
Physical fight, being left
HE
HE
HER
Only if I always (show a specific
behaviour): keep my power &
punish in front of weak people
and putting myself down &
feeling ashamed in front of
strong people
Never (forbidden impulses):
show my real feelings or
vulnerabilities, fear of being
rejected
Keep (central needs):
Acceptance for being herself
Avoid (central anxieties):
being rejected and feeling lonely.
HIM
Only if I always (show a specific
behaviour):
Pacify, avoid conflict, perform,
sacrifice.
Never (forbidden impulses):
Set limits, stand up for my needs
Keep (central needs):
Security and peace
Avoid (central anxieties):
Counter aggression, failure, being
alone
Being seen, accepted and desired
© Pietrzak, Lohr, Hauke, Jahn (2016)

17. Demographics of Participants (n.s.)
© Pietrzak, Lohr, Hauke, Jahn (2016)
Total sample
(N=20)
Treatment group
(N=14)
Control group
(N=6)
Age M=49.3 (SD= 9.32) M= 49.64 (SD=9.52) M= 48.5 (SD=9.65)
Education 10% post grad; 30%
undergrad; 25%
diploma/trade; 10%
year 12; 10% year 10;
5% year 12.
14.3% post grad; 28.6%;
35.7% diploma/trade;
7.1% for years 10-12.
33.3% undergrad;
16.7% year 11; 16.7%
year 10; 33.3% missing.
Gender 9 males; 11 females 6 males; 8 females 3 females; 3 males
Years in relationship M=12.94 (SD=1.55) M=13 (SD=9.64) M=10.63 (SD=11.10)
Mental illness
(depression)
M= 6.9 (SD=6.12)
Below clinical cut off
M=6.64 (SD=5.27)
Below clinical cut off
M=7.5 (SD=8.34)
Below clinical cut off

18. Score Treatment
group
Control group Total group
N=13 N=6 N=19
Interpersonality Reactivity Index (IRI)
IRI-Perspective Taking (pre) M=17.61
(SD=4.37)
M=20.67
(SD=4.32)
M=18.58 (SD=4.48)
IRI-Perspective Taking (post) M=19.08
(SD=4.15)
M=18.67
(SD=2.42)
M=18.95 (SD=3.63)
IRI-Fantasy (pre) M=17.62
(SD=5.55)
M=14.33
(SD=2.05)
M=16.58 (SD=4.97)
IRI-Fantasy (post) M=17.62
(SD=4.89)
M=14.33
(SD=3.93)
M=16.58 (SD=4.76)
IRI-Empathic Concern (pre) M=23.85
(SD=4.79)
M=24.17
(SD=3.54)
M=23.95 (SD=4.34)
IRI-Empathic Concern (post) M=24.85
(SD=4.78)
M=22.83
(SD=4.92)
M=24.21 (SD=4.78)
Results for Empathy - study sample data (mean (SD))
© Pietrzak, Lohr, Hauke, Jahn (2016)

19. Pre treatment graph of empathy between groups
Time x Measure x Group (F(1,17)=4,920; p<.040)
Cohen’s d = 1.139
ScoreofIRI
IRI
perspective
taking
IRI
fantasy
IRI
empathic
concern
IRI
personal
distress
Results - Repeated Measure Multivariate ANOVA
Treatment
Control

20. Post treatment graph of empathy between groups
Time x Measure x Group (F(1,17)=4,920; p<.040)
Cohens d = 1.139
IRI
perspective
taking
IRI
fantasy
IRI
empathic
concern
IRI
personal
distress
Results - Repeated Measure multivariate ANOVA
Treatment
Control
ScoreofIRI

21. Score M pre M post M change SD t p
Relationship Assessment Scale
Treatment
group
(N=14)
25.43 27.50 -2.07 2.23 -3.47 .004
Control
group
(N=6)
22.33 26.17 -3.83 5.23 -1.8 .133
Results for Relationship Satisfaction -
Paired Sample t-test

22. Qualitative Comments
Most Useful:
 Finding solutions for the relationship (3)
 Focusing on our problem situation and the emotions behind it
(4)
 Group Cohesion (3)
Take home messages:
 Behaviour change for self and relationship (9)
 Emotions in self and partner (3)
 Undertanding self and partner (3)

23. Discussion
1. Hypothesis 1 partially confirmed for treatment group
compared to control for significant and meaningful increases
with intervention in satisfaction and empathy.
2. No significant change in treatment group‘s depression and
attachment style in general close relationship.
3. Potential ceiling effects for depression in a non
psychopathological baseline treatment group.
4. No change in attachment style possibly due to it being how
participants generally experience their relationships (not
intervention specific), or not enough time to follow up
generalistion of new skills with other people they are close to.

24. Discussion
5. Personal distress upon seeing negative emotions of others
(including partner) increased significantly for the treatment
group and not the control group. This suggests that as we do
deep emotional work initially and our partner embodies these
emotions via imitation. Emotional contagion may have occurred.
6. However as the couples were more satisfied with
intervention it suggests couples could stand experiencing
increases in personal distress about their partners suffering.
Further follow up testing will clarify whether the PD measure is
a reaction to experiencing their partners previously hidden high
emotions

25. For further information
 Pietrzak T., Hauke, G. & Lohr, C.: Connecting Couples Intervention: Improving
couples’ empathy and emotional regulation using embodied empathy mechanisms
in European Psychotherapy 2016/2017 pp66-96
© Pietrzak, Lohr, Hauke, Jahn (2016)