171 - Casey Kenyon Brown: Can Your Relationships Make You Depressed? (REAIR)

0:00Dr. Casey Kenyon Brown:Welcome to the Stanford Psychology Podcast, where leading psychologists come to share their most recent work. My name is Enna. I'm a PhD student at Stanford Psychology studying aging, emotion, and decision-making.

0:14Enna:This week, I'm very excited to chat with Dr.

0:17Dr. Casey Kenyon Brown:Casey Kenyon Brown, professor at Georgetown University in the Department of Psychology and the Interdisciplinary Program in Neuroscience. Casey's research examines how we share, understand, and influence one another's emotions. She's interested in how these interpersonal emotional processes are beneficial for health and how these processes may go awry and contribute to depression. Please join us today as Casey shares her journey in psychology, talks about her research on emotion and relationships, and provides advice on how we can build strong connections with people we love.

1:18Dr. Casey Kenyon Brown:Good morning, Casey. Thank you so much for joining us today. Thank you for having me. I'm excited to join you. Before we dive into this very interesting article that you recently published, first, could you share with us a bit about your path into psychology? My path into psychology?

1:36Enna:Yes. When I was an undergrad in college, I decided that I wanted to be a clinical psychologist and do therapy. And that seemed like a good idea because I really like people. I love talking to people. I even like hearing about people's problems and trying to help them. So therapy seemed like a good fit. And I was told by mentors that if I wanted to get into clinical psychology PhD programs, that the best way to prep for that was to get research experience. So as a sophomore in undergrad, I joined Joseph Allen's research lab that focused on adolescent development at the University of Virginia. And I quickly realized that I loved research.

2:31Enna:We were doing really cool things like watching interactions between adolescents and their parents and looking for specific behaviors that happened during these interactions. And I did something called an honors thesis, where you work with data to answer a particular research question. And I became pretty addicted to the process of analyzing data to learn something. And it was really very exciting, the process of discovering something on my computer that no one else would be aware of unless it was data. And so I decided that research actually seemed like a more exciting thing to me than the clinical work, even though I still wanted to go towards a clinical direction where I could help people with the research that I was doing.

3:22Dr. Casey Kenyon Brown:So how did you combine your interest in clinical work and research in your graduate studies?

3:29Enna:Oh, so in clinical psychology PhD programs, you actually get training in both research and clinical practice. So while you're doing a master's thesis and a dissertation, you're also doing clinical coursework and working with clients to gain experience in different modalities of psychotherapy. For example, I went to graduate school at University of California, Berkeley, and in their clinical psychology program, you get paired with supervisors from the community who are engaged in clinical practice. And you work with them as supervisors while you're seeing clients, and they help guide you through the process to ensure that you're providing good clinical care and improving your skills through that process.

4:23Enna:So it was actually a really great experience. And most clinical psychology programs end with a clinical internship where you go do full-time clinical practice for something like nine months to a year.

4:39Dr. Casey Kenyon Brown:That sounds really fun to be able to combine your research with clinical practice. I know that your current research primarily focuses on interpersonal emotional processes. Can you tell us a bit more about what those are and how do you study that in your research and explore that in your clinical practice? Yes. So interpersonal emotional processes really just refer to the emotions that unfold between people.

5:08Enna:I'm really interested in how we share emotions with other people, how we recognize their emotions, how we influence or change other people's emotional experience. and all of those things I believe are really relevant for mental and physical health especially as we age and in clinical work it's very relevant because I do work with couples and dyads and so learning about interpersonal emotional processes can really inform the work that I'm doing.

5:44Dr. Casey Kenyon Brown:and what initially made you interested in studying and observing emotions between people

5:49Enna:in my life I noticed that the people closest to me when I was growing up were a major source of emotional support they were the ones who could really help me cope with distress and manage tough situations. But at the same time, those people could also be a source of stress and positive and negative emotions. And I became fascinated with this idea that your closest relationships can really affect how you're doing emotionally in ways that might have long-term implications.

6:34Dr. Casey Kenyon Brown:So one of my favorite papers of yours is related to this, and it's on shared depression in relationships, which highlights when close relationships become challenging. I also linked this article in the notes for our listeners, so could you share with us some of the most important takeaways from this research?

6:53Enna:Yes, the paper you're referring to actually had two studies. So why don't I start by telling you about the first study in the paper? We were looking at a construct called empathic accuracy within heterosexual married couples. And empathic accuracy refers to how well you can identify a partner's emotions. And so to capture empathic accuracy, we have couples come into the lab and we essentially get them to argue with each other. They engage in a conversation on a topic that they disagree on. And then they watch a video playback of their conversation. And while they're watching the video, we have a little dial.

7:45Enna:It looks like a knob that they turn to indicate how they're feeling throughout the conversation. So they can say moments where they're feeling very bad, moments where they're feeling very good, or when they're somewhere in between feeling pretty neutral. And they watch the video twice. They rate their own emotions and they rate their partner's emotions. And so we can compare those ratings to see how accurately they rate their partner's emotions. And so we see that some people are really good at knowing what their partner is feeling, according to their ratings. But other people really struggle to accurately identify what their partner is feeling during these disagreements.

8:39Enna:And in addition to empathic accuracy, we're really interested in how empathic accuracy relates to mental health within these couples. And husbands and wives report on their levels of depressive symptoms and anxiety symptoms using well-validated questionnaires. and we thought that empathic accuracy would be beneficial in relationships. You would have better mental health if you were better able to understand your partner's emotions. However, we thought that if your spouse has high levels of depressive symptoms, accurately understanding their emotions might actually be problematic for your own mental health because you might share their depressive symptoms if you're better able to recognize their emotions and that's what we found in study one we saw that if you have a partner who's depressed having more accuracy in rating that partner's emotions means you share that partner's level of depressive symptoms but if your partner's not depressed you actually have lower depressive symptoms when you're more empathically accurate and i see that in study two you replicate the

10:16Dr. Casey Kenyon Brown:results from study one, but in relationships where people are already at higher risk for depression. Yes.

10:26Enna:So that was a sample of individuals with neurodegenerative disease and their close relatives who are caregivers.

10:36Dr. Casey Kenyon Brown:And what makes this population particularly meaningful in your research on emotion and relationships?

10:44Enna:Well, let me give you some background information on neurodegenerative disease. I think most people are familiar with Alzheimer's disease, which involves problems with cognition, for example, problems with memory. But there are many other types of neurodegenerative diseases that can lead to other kinds of impairments. For example, people might have challenges with motor skills in Parkinson's disease. You might see difficulties with language or speech in primary progressive aphasias. But there's another type of neurodegenerative disease called behavioral variant frontotemporal dementia, or BVFTD for short.

11:30Enna:And those individuals actually have difficulties with socioemotional functioning. And so empathy, deficits in empathy are often an early symptom of that disease. People can have disinhibited behaviors, changes in their eating and personality, and socially inappropriate behaviors are very common in BVFTD.

11:58Dr. Casey Kenyon Brown:And what do you mean by socially inappropriate behaviors?

12:02Enna:Socially inappropriate behaviors would be things that are atypical for what is normative social behavior. So for example, someone licking their plate at the dinner table or behaving in a way that attracts negative attention in public. Those would be examples of socially inappropriate behavior. So you can imagine that would be really difficult for close loved ones of those individuals.

12:32Dr. Casey Kenyon Brown:Yeah, I imagine that must be super challenging for their caregivers. And how common are these different types of disease?

12:42Enna:Some estimates suggest that one in nine adults over the age of 65 have Alzheimer's disease. And behavioral variant, frontotemporal dementia, is actually especially common in individuals who are younger under the age of 65. And these diseases are becoming even more common as our society is aging rapidly. And so there's going to be a higher and higher amount of individuals who are affected by these diseases. And as you can imagine, they're not only hard for the person suffering from a disorder, they're also difficult for close loved ones. And that's a really fulfilling and meaningful experience for a lot of people to be a caregiver.

13:34Enna:but it can also be taxing and burdensome. And a number of studies suggest that levels of depressive symptoms and anxiety are especially common in caregivers of individuals with dementia. Some estimates suggest two to four times the level of depressive symptoms of caregivers with dementia compared to same age individuals who aren't providing care. So there's a lot of research needed to understand how relational factors affect depressive symptoms in these dyads. And it's a really interesting population to understand the neural correlates of an emotional functioning and how those changes in emotional functioning affect relationships.

14:23Dr. Casey Kenyon Brown:Yeah, I see why this is such an important population to study, especially in terms of emotional relationships. And can you tell us a bit more about what you found in study two?

14:35Enna:Yes. Study two was a little different from study one in that caregivers rated videos of other people's conversations. So it was a standardized clip, a standardized set of clips that they were rating, which allowed us to ensure that their empathic accuracy scores reflected something about their empathic abilities rather than something specific to their relationship. And we found the same exact effects that we observed in study one, where caregivers had lower mental health symptoms if they were high in empathic accuracy and their partner wasn't depressed. but if a caregiver's partner had high levels of depressive symptoms empathic accuracy was associated with greater depressive symptoms for that caregiver so across these two studies we're consistently finding that having high levels of accuracy towards other people's emotions and really understanding what they're feeling typically is good unless you're in a social context where a partner has high levels of depressive symptoms.

15:53Enna:And then you're more likely to share your partner's depressive symptoms if you're really accurate about what other people are feeling. So there's a potential consequence of empathic accuracy here that we might be picking up on.

16:07Dr. Casey Kenyon Brown:I'm really curious about this experience of sharing negative emotions. In my own relationships, sometimes I think about whether it is beneficial for me to share negative emotions with my loved ones because it shows that we're really understanding each other and we're going through something difficult together. But at the same time, sharing negative emotions could be harmful because then one person's sadness or depression will also bring their partners down. So what do you find in research in terms of whether it's good or bad to share negative emotions?

16:48Enna:Well, there are some kinds of shared negative emotion that is problematic in relationships. So you can imagine if you and your partner are both angry at each other and yelling and hostile, probably not good for your relationship. And there's plenty of studies showing that kind of negative affect reciprocity is associated with relationship dissolution. People break up. But in the context of shared distress, where you're helping someone cope with or manage their negative emotions, we have studies that suggest sharing another person's negative affect is beneficial and can reduce that person's level of negative affect.

17:40Enna:So there are benefits of sharing negative emotion in some situations. One of the challenges in understanding whether it's good or bad to share negative affect is that you need to think about both people in an interaction. So while sharing someone's negative affect could be very beneficial in helping them overcome distress through emotion contagion or distress contagion, the person sharing the affect can take on some of that negative emotion. And so it's very important to understand how we can share people's negative affect in a way that's beneficial to both them and in a way that isn't detrimental to ourselves.

18:34Dr. Casey Kenyon Brown:I want to take a moment to talk about the methodology that you use here that you study both partners in a couple because a lot of times we just see one person reporting their own experiences but it's so cool to be able to observe two people interacting with each other. Can you talk a bit more about some interesting and challenging aspects of studying dieting directions?

19:01Enna:Well, it's always interesting. The challenging aspects of working with dyads often come in the realm of recruitment. It's harder to get two people to come into the lab than one person to come into the lab. It's interesting when you try to get couples to argue in the lab. Sometimes you have a couple that's, oh, we don't argue at all. and so we have to use approaches to come up with a shared topic of disagreement sometimes we'll give them each a piece of paper and have them list their top three areas of disagreement and even in the couples that say they don't argue usually there is similarity in their responses and so we can select a topic that they disagree on for them to discuss but most of our ongoing research doesn't necessarily use conversations on a topic of disagreement.

19:55Enna:We have other kinds of dyadic tasks in the lab that we use as well.

20:02Dr. Casey Kenyon Brown:So what are some common conflicts that people disagree on?

20:07Enna:Oh, money, finances, family affairs. So disagreements on children or other people in the family. Those are some very common topics of disagreement in marriages.

20:21Dr. Casey Kenyon Brown:And during these conflicts, what are some things that you notice that people do to make their relationships more problematic?

20:29Enna:There is a long history of research on the kinds of emotional behaviors that people do during conflict with partners that are problematic for their relationships. The first thing that comes to mind is John Gottman had a model where he talked about what he called the four horsemen of the apocalypse. And these were behaviors including contempt, criticism, defensiveness, and stonewalling. And these behaviors can be identified by observing interactions between people. So contempt, that would be behaviors that hurt or humiliate a partner, things that are belittling, so sarcasm or mockery or insults.