Zurich Open Repository and Archive University of Zurich Main Library Strickhofstrasse 39 CH-8057 Zurich www.zora.uzh.ch Year: 2012 Training the compassionate and the empathic brain Klimecki, Olga M Posted at the Zurich Open Repository and Archive, University of Zurich ZORA URL: https://doi.org/10.5167/uzh-93759 Dissertation Originally published at: Klimecki, Olga M. Training the compassionate and the empathic brain. 2012, University of Zurich, Faculty of Arts. Training the Compassionate and the Empathic Brain Thesis presented to the Faculty of Arts of the University of Zurich for the degree of Doctor of Philosophy by Olga M Klimecki of Poznan, Poland Accepted in the fall semester 2012 on the recommendation of Prof. Dr. Lutz Jäncke and Prof. Dr. Tania Singer Zurich 2012 [last pages Curriculum Vitae] ! Acknowledgments My deep gratitude goes to all the people who supported me throughout the inception, execution, and completion of my dissertation. The first part of my PhD thesis was carried out from October 2007 to August 2010 with Prof. Dr. Tania Singer at the Laboratory for Social and Neural Systems Research at the University of Zurich, Switzerland. In September 2010, I followed Prof. Singer to the Max-Planck Institute for Human Cognitive and Brain Sciences in Leipzig, Germany. First and foremost, my gratitude goes to Prof. Dr. Tania Singer for her scientific guidance and for inspiring me with her vision in the study of the neuronal and affective plasticity of compassion. During my time in her laboratory, I learned countless different skills pertaining to the planning and designing of cutting-edge experiments, applying for grants, conducting longitudinal intervention studies, and also analysis and publication of complex data sets. I very much appreciated the discussions we had, her methodological advice, and her detailed feedback throughout the writing process. Moreover, I am very grateful that, along with advancing in my scientific skills, I had the opportunity to grow personally on my spiritual path. At both hosting institutions I was extremely fortunate to work with people who happily shared their scientific and practical expertise. I thank all my colleagues in Zurich and Leipzig for their support and my colleagues in Maastricht (Dr. Bettina Sorger in particular) for their co- operation. My gratitude especially goes to Dr. Susanne Leiberg for her scientific advice and the discussions we had throughout all phases of the studies, and for conducting the experiments with me. I thank Prof. Dr. Claus Lamm, Dr. Boris Bernhardt, and Dr. Nikolaus Steinbeis for their methodological advice and Dr. Matthieu Ricard for sharing his first person perspective on contemplative practices. Dr. Ricard, along with Catherine Felder, Ariya Nani, Jotika Hermsen, and many other spiritual teachers greatly helped to advance my understanding of Eastern contemplative practices related to compassion. By teaching the participants involved in the presented studies, Catherine Felder, Ariya Nani, and Jotika i" " Hermsen made it possible for me to investigate the plasticity of compassion and empathy. Annette Rentz-Lühning was so kind to fly in twice from Berlin in order to teach the Method of Loci in Zurich. I thank all the teachers involved for sharing their skills and wisdom so openly. The practical expertise from the people working in administration, data management, and graphics helped to provide the infrastructure for this project and to improve its presentation. Finally, I am deeply grateful to the research assistants and interns who helped to conduct the multitude of studies and to the volunteers who participated in these studies. Lastly, my deep gratitude goes to Prof. Dr. Lutz Jäncke for kindly offering to head my PhD steering committee. Financially, this work was supported by the University of Zurich (“Neural Foundations of Empathy Learning”, Forschungskredit, grant number 53990601 to O.M.K.), grants to T.S. from the Neuroscience Center Zurich, the Swiss National Science Foundation (SNF NCCR Affective Sciences: “Neuronal and developmental mechanisms of human empathy”; SNF NCCR Neural Plasticity and Repair: “Plasticity of the empathic and attentional brain”), the Foundation for Research in Science and Humanities at the University of Zurich (“Neural foundations of empathy training”), and a Francisco J. Varela Research Award to S.L. from the Mind and Life Institute. The research leading to the results presented in this thesis has also received funding from the European Research Council under the European Community's Seventh Framework Program (FP7/2007-2013/ ERC Grant agreement number 205557 to T.S.). ii" " Summary English The main objective of the present thesis was to study plasticity in the social brain and to determine behavioral, affective, and neural changes induced by training compassion and empathy. In order to reliably measure longitudinal changes in this domain, two new tasks were developed and validated: the Zurich Prosocial Game (ZPG) as a novel implicit measure for helping behavior and the Socio-affective Video Task (SoVT) for measuring neural and affective responses to social stimuli. In Study 1, the ZPG was validated with a sample of 68 female participants. Results show that the game is sensitive to the manipulation of reciprocity, distress cues, and helping cost. Using the ZPG in a short-term intervention study revealed that compassion (n = 27), but not memory training (n = 32) increased prosocial behavior in a training-unrelated task. Furthermore, in the compassion group, inter-individual differences in practice duration were parametrically related to changes in helping behavior under the no-reciprocity condition. Study 2 introduced the SoVT and the results show functional neural and affective changes related to compassion training. The SoVT is composed of three video sets showing others in distress or everyday life situations. These video sets were matched based on a behavioral study with 265 healthy volunteers. A subsequent study with 94 female participants confirmed the matching and validated the SoVT on the neural and behavioral level. Using the SoVT, neural plasticity related to compassion training (n = 28) was studied in a pre-post intervention study with a matched active control group (n = 30). On the level of self-reported affect, compassion training increased empathy and positive affect, the latter even in response to others in distress. On the neural level, evidence for neural plasticity induced by compassion training was found in the medial orbitofrontal cortex, the putamen, the pallidum and the ventral tegmental area/ substantia nigra (VTA/SN). Converging evidence for the reliability of this network stemmed from two further independent compassion training studies (total N = 46). In addition, activations in these regions were observed in an expert meditation practitioner immersed in compassionate states. iii" " To dissect the neural substrates of empathy and compassion in Study 3, one group of participants was first trained in empathy and subsequently in compassion (n = 25). The comparison with an active control group (n = 28) provided evidence for neural plasticity in empathy and showed a clear dissociation between empathy and compassion on the neural and affective level. Empathy increased negative affect and neural activity in the insula and the anterior midcingulate cortex, extending cross-sectional meta-analytic findings that have shown the involvement of these regions in empathy for pain. Subsequent training of compassion reversed the increase in negative affect and fostered positive affect along with non-overlapping changes in a neural network that spans the medial orbitofrontal cortex, the ventral striatum and the pregenual anterior cingulate cortex. These findings extend the results from Study 2, as well as previous cross-sectional studies of compassion, by showing that, even after an augmentation in empathic distress, compassion training can induce a shift towards positive emotions. In Study 4, the covariance of cortical thickness was mapped, seeding from the anterior insula and the anterior midcingulate cortex, using data from 94 participants of Study 2. Seed regions were based on a recent functional empathy for pain meta-analysis. Firstly, functional connectivity patterns previously observed for these regions were be replicated. Secondly, structural covariance was related to trait and state measures of empathy. The results revealed that empathic states (empathy ratings in response to the SoVT) parametrically modulated anterior insula connectivity with inferior-frontal regions. This finding was specific for empathy as no such relation was observed for negative affective states in response to the SoVT. A similar, albeit weaker, relation was observed for questionnaire-derived empathic traits. This finding suggests that structural covariance analysis is a sensitive tool for mapping neural networks underlying social emotions. In summary, the results obtained point to plasticity in the social brain and to the clear distinction of empathy and compassion. Compassion emerged as a new potent coping strategy that benefits the self through strengthening resilience and helps others through iv" " increasing prosocial behavior. Finally, the presented data show that structural covariance analysis can determine specific neural networks related to empathy. v" "" Zusammenfassung Deutsch Das hauptsächliche Ziel dieser Dissertation war, Plastizität im sozialen Gehirn zu untersuchen und zu testen, welche Veränderungen in Verhalten,