Clients’ Emotional Experience as a Dynamic Context for Client–Therapist Physiological Synchrony

Objective: Client–therapist physiological synchrony has recently attracted significant empirical attention. Recent theoretical accounts propose that physiological linkages should not be considered a stable dyadic virtue but rather a dynamic process that depends on the situational context in which they transpire. The present study adopted a “momentary” (vs. “global”) approach that focuses on therapist–client physiological synchrony over relatively short periods of time. These temporal data served to examine the interplay between patterns of synchrony (in-phase vs. antiphase) and clients’ momentary emotional experiences (inhibited/ unproductive, productive, and positive). Synchrony was assessed by measuring respiratory sinus arrhythmia (RSA), an autonomic index that is known to be associated with interpersonal emotion regulation. Method: Data were drawn from 28 clients undergoing a 16-session supportive–expressive dynamic therapy for depression. Clients’ and therapists’ electrocardiography were recorded in five sessions; clients’ emotional experiences were coded at the speech-turn level. After each session, the clients also completed the session evaluation scale. Results: Client–therapist dyads had greater momentary RSA synchrony than would be predicted by chance. Compared to moments of unproductive emotional experience, greater antiphase synchrony was observed during moments of productive emotional experiences. In addition, compared to moments of unproductive emotional experience, greater in-phase and antiphase synchrony were observed during moments of positive emotional experiences. These patterns of synchrony were associated with clients’ favorable evaluations of the session. Conclusion: By considering the dynamic nature of synchrony, these findings provide a fine-grained picture of physiological synchrony and its potential effects on therapy.