Skip to main content

Emotional Understanding: Examining Alexithymia as a Mediator of the Relationship Between Mindfulness and Empathy

Abstract

The positive mental health correlates of mindfulness have become increasingly well-established. Recent literature has documented an association between the present-moment awareness and attention that is characteristic of mindfulness, and the capacity to adopt the emotions, cognitions, and perspectives of another individual, as displayed in empathy. The mechanisms underlying this relationship, however, are still poorly understood. This study aimed to examine alexithymia—or the difficulty identifying, labeling, understanding, and processing one’s own emotions—as a mediator of the relationship between five facets of dispositional mindfulness (i.e., observing, describing, acting with awareness, nonjudging, and nonreacting) and empathy in a sample of 616 undergraduate college students. Results revealed that alexithymia mediated the relationships between the describing and acting with awareness domains of mindfulness and cognitive empathy, while accounting for the effects of the other mindfulness subscales and participant sex. These findings suggest that the relationship between specific mindfulness skills and greater understanding of another individual’s emotional and cognitive experiences may be explained in part by one’s emotional self-awareness.

This is a preview of subscription content, access via your institution.

References

  • Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13, 27–45. doi:10.1177/1073191105283504.

    Article  PubMed  Google Scholar 

  • Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the Five Facet Mindfulness Questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342. doi:10.1177/1073191107313003.

    Article  PubMed  Google Scholar 

  • Bagby, R. M., Taylor, G. J., & Parker, J. D. A. (1994). The twenty item Toronto Alexithymia Scale-II: convergent, discriminant, and concurrent validity. Journal of Psychosomatic Research, 38, 33–40. doi:10.1016/0022-3999(94)90006-X.

    Article  PubMed  Google Scholar 

  • Beddoe, A. E., & Murphy, S. O. (2004). Does mindfulness decrease stress and foster empathy among nursing students? Journal of Nursing Education, 43, 305–312. doi:10.3928/01484834-20040701-07.

    PubMed  Google Scholar 

  • Beitel, M., Ferrer, E., & Cecero, J. J. (2005). Psychological mindedness and awareness of self and others. Journal of Clinical Psychology, 61(6), 739–750. doi:10.1002/jclp.20095.

    Article  PubMed  Google Scholar 

  • Bird, G., Silani, G., Brindley, R., White, S., Frith, U., & Singer, T. (2010). Empathic brain responses in insula are modulated by levels of alexithymia but not autism. Brain: A Journal of Neurology, 133(5), 1515–1525. doi:10.1093/brain/awq060.

    Article  Google Scholar 

  • Birnie, K., Speca, M., & Carlson, L. E. (2010). Exploring self-compassion and empathy in the context of mindfulness-based stress reduction (MBSR). Stress and Health: Journal of the International Society for the Investigation of Stress, 26(5), 359–371. doi:10.1002/smi.1305.

    Article  Google Scholar 

  • Block-Lerner, J., Adair, C., Plumb, J. C., Rhatigan, D. L., & Orsillo, S. M. (2007). The case for mindfulness-based approaches in the cultivation of empathy: does nonjudgmental, present-moment awareness increase capacity for perspective-taking and empathic concern? Journal of Marital and Family Therapy, 33(4), 501–516. doi:10.1111/j.1752-0606.2007.00034.x.

    Article  PubMed  Google Scholar 

  • Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84, 822–848. doi:10.1037/0022-3514.84.4.822.

    Article  PubMed  Google Scholar 

  • Cash, M., & Whittingham, K. (2010). What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology? Mindfulness, 1(3), 177–182. doi:10.1007/s12671-010-0023-4.

    Article  Google Scholar 

  • Coffey, K. A., Hartman, M., & Fredrickson, B. L. (2010). Deconstructing mindfulness and constructing mental health: understanding mindfulness and its mechanisms of action. Mindfulness, 1(4), 235–253. doi:10.1007/s12671-010-0033-2.

    Article  Google Scholar 

  • Davis, M. H. (1986). Measuring individual differences in empathy: evidence for a multidimensional approach. Journal of Personality and Social Psychology, 44(1), 113–126. doi:10.1037/0022-3514.44.1.113.

    Article  Google Scholar 

  • Davis, M. H. (1996). Empathy: A Social Psychological Approach. Boulder: Westview Press.

    Google Scholar 

  • de Bruin, E. I., Topper, M., Muskens, J. G., Bögels, S. M., & Kamphuis, J. H. (2012). Psychometric properties of the Five Facets Mindfulness Questionnaire (FFMQ) in a meditating and a non-meditating sample. Assessment, 19(2), 187–197. doi:10.1177/1073191112446654.

    Article  PubMed  Google Scholar 

  • Decety, J., Jackson, P. L., Sommerville, J. A., Chaminade, T., & Meltzoff, A. N. (2004). The neural bases of cooperation and competition: an fMRI investigation. NeuroImage, 23(2), 744–751. doi:10.1016/j.neuroimage.2004.05.025.

    Article  PubMed  PubMed Central  Google Scholar 

  • Desrosiers, A., Vine, V., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mindfulness and emotion regulation in depression and anxiety: common and distinct mechanisms of action. Depression and Anxiety, 30(7), 654–661. doi:10.1002/da.22124.

    Article  PubMed  PubMed Central  Google Scholar 

  • Eberth, J., & Sedlmeier, P. (2012). The effects of mindfulness meditation: a meta-analysis. Mindfulness, 3, 174–189. doi:10.1007/s12671-012-0101-x.

    Article  Google Scholar 

  • Feldmanhall, O., Dalgleish, T., & Mobbs, D. (2013). Alexithymia decreases altruism in real social decisions. Cortex: A Journal Devoted to the Study of the Nervous System and Behavior, 49(3), 899–904. doi:10.1016/j.cortex.2012.10.015.

    Article  Google Scholar 

  • Fritz, M.S., & MacKinnon, D.P. (2007). Required sample size to detect the mediated effect. Psychological Science 18(3), 233–239. doi:10.1111/j.1467-9280.2007.01882.x

  • Fulton, C. L., & Cashwell, C. S. (2015). Mindfulness-based awareness and compassion: predictors of counselor empathy and anxiety. Counselor Education and Supervision, 54(2), 122–133. doi:10.1002/ceas.12009.

    Article  Google Scholar 

  • Galantino, M. L., Baime, M., Maguire, M., Szapary, P. O., & Farrar, J. T. (2005). Association of psychological and physiological measures of stress in health-care professionals during an 8-week mindfulness meditation program: mindfulness in practice. Stress and Health, 21, 255–261. doi:10.1002/smi.1062.

    Article  Google Scholar 

  • Gallese, V. (2003). The roots of empathy: the shared manifold hypothesis and the neural basis of intersubjectivity. Psychopathology, 36(4), 171–180. doi:10.1159/000072786.

    Article  PubMed  Google Scholar 

  • Gallup, G. J., & Platek, S. M. (2002). Cognitive empathy presupposes self-awareness: evidence from phylogeny, ontogeny, neuropsychology, and mental illness. Behavioral and Brain Sciences, 25(1), 36–37. doi:10.1017/S0140525X02380014.

    Google Scholar 

  • Garland, E. L., Fredrickson, B., Kring, A. M., Johnson, D. P., Meyer, P. S., & Penn, D. L. (2010). Upward spirals of positive emotions counter downward spirals of negativity: Insights from the broaden-and-build theory and affective neuroscience on the treatment of emotion dysfunctions and deficits in psychopathology. Clinical Psychology Review, 30, 849–864. doi:10.1016/j.cpr.2010.03.002.

    Article  PubMed  PubMed Central  Google Scholar 

  • Gilbert, P., McEwan, K., Gibbons, L., Chotai, S., Duarte, J., & Matos, M. (2012). Fears of compassion and happiness in relation to alexithymia, mindfulness, and self-criticism. Psychology and Psychotherapy: Theory, Research and Practice, 85(4), 374–390. doi:10.1111/j.2044-8341.2011.02046.x.

    Article  Google Scholar 

  • Goerlich-Dobre, K. S., Lamm, C., Pripfl, J., Habel, U., & Votinov, M. (2015). The left amygdala: a shared substrate of alexithymia and empathy. Neuroimage, 12220–32. doi:10.1016/j.neuroimage.2015.08.014.

  • Goldman, A. I. (2006). Simulating Minds: The Philosophy, Psychology, and Neuroscience of Mindreading. New York: Oxford University Press.

    Book  Google Scholar 

  • Greason, P. B., & Cashwell, C. S. (2009). Mindfulness and counseling self-efficacy: the mediating role of attention and empathy. Counselor Education and Supervision, 49(1), 2–19. doi:10.1002/j.1556-6978.2009.tb00083.x.

    Article  Google Scholar 

  • Grynberg, D., Luminet, O., Corneille, O., Grèzes, J., & Berthoz, S. (2010). Alexithymia in the interpersonal domain: a general deficit of empathy? Personality and Individual Differences, 49(8), 845–850. doi:10.1016/j.paid.2010.07.013.

    Article  Google Scholar 

  • Guttman, H., & Laporte, L. (2002). Alexithymia, empathy, and psychological symptoms in a family context. Comprehensive Psychiatry, 43(6), 448–455. doi:10.1053/comp.2002.35905.

    Article  PubMed  Google Scholar 

  • Hölzel, B. K., Lazar, S. W., Gard, T., Schuman-Olivier, Z., Vago, D. R., & Ott, U. (2011). How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science, 6(6), 537–559. doi:10.1177/1745691611419671.

    Article  PubMed  Google Scholar 

  • Jonason, P. K., & Krause, L. (2013). The emotional deficits associated with the Dark Triad traits: cognitive empathy, affective empathy, and alexithymia. Personality and Individual Differences, 55(5), 532–537. doi:10.1016/j.paid.2013.04.027.

    Article  Google Scholar 

  • Kooiman, C. G., Spinhoven, P., & Trijsburg, R. W. (2002). The assessment of alexithymia. A critical review of the literature and a psychometric study of the Toronto Alexithymia Scale-20. Journal of Psychosomatic Research, 53, 1083–1090. doi:10.1016/S0022-3999(02)00348-3.

    Article  PubMed  Google Scholar 

  • Lau, M. A., Bishop, Z. V., Segal, T., Buis, N. D., Anderson, L., Carlson, L., et al. (2006). The Toronto Mindfulness Scale: development and validation. Journal of Clinical Psychology, 62(12), 1445–1467. doi:10.1002/jclp.20326.

    Article  PubMed  Google Scholar 

  • Luberto, C. M., Cotton, S., McLeish, A. C., Mingione, C. J., & O’Bryan, E. M. (2013). Mindfulness skills and emotion regulation: the mediating role of coping self-efficacy. Mindfulness, 5, 373–380. doi:10.1007/s12671-012-0190-6.

    Article  Google Scholar 

  • Lutz, A., Slagter, H. A., Dunne, J. D., & Davidson, R. J. (2008). Attention regulation and monitoring in meditation. Trends in Cognitive Sciences, 12(4), 163–169. doi:10.1016/j.tics.2008.01.005.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lyvers, M., Makin, C., Toms, E., Thorberg, F. A., & Samios, C. (2014). Trait mindfulness in relation to emotional self-regulation and executive function. Mindfulness, 5, 619–625. doi:10.1007/s12671-013-0213-y.

    Article  Google Scholar 

  • McDonald, H. M., Sherman, K. A., Petocz, P., Kangas, M., Grant, K., & Kasparian, N. A. (2016). Mindfulness and the experience of psychological distress: the mediating effects of emotion regulation and attachment anxiety. Mindfulness, 7(4), 799–808. doi:10.1007/s12671-016-0517-9.

    Article  Google Scholar 

  • New, A. S., Rot, M. H., Ripoll, L. H., Perez-Rodriguez, M. M., Lazarus, S., Zipursky, E., et al. (2012). Empathy and alexithymia in borderline personality disorder: clinical and laboratory measures. Journal of Personality Disorders, 26(5), 660–675. doi:10.1521/pedi.2012.26.5.660.

    Article  PubMed  Google Scholar 

  • Park, T., Reilly-Spong, M., & Gross, C. R. (2013). Mindfulness: a systematic review of instruments to measure an emergent patient-reported outcome (PRO). Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 22(10), 2639–2659. doi:10.1007/s11136-013-0395-8.

    Article  Google Scholar 

  • Pepping, C. A., Davis, P. J., & O’Donovan, A. (2013). Individual differences in attachment and dispositional mindfulness: the mediating role of emotion regulation. Personality and Individual Differences, 54(3), 453–456. doi:10.1016/j.paid.2012.10.006.

    Article  Google Scholar 

  • Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments and Computers, 36(4), 717–731. doi:10.3758/BF03206553.

    Article  Google Scholar 

  • Reniers, R. P., Corcoran, R., Drake, R., Shryane, N. M., & Völlm, B. A. (2011). The QCAE: a questionnaire of cognitive and affective empathy. Journal of Personality Assessment, 93(1), 84–95. doi:10.1080/00223891.2010.528484.

    Article  PubMed  Google Scholar 

  • Santarnecchi, E., D’Arista, S., Egiziano, E., Gardi, C., Petrosino, R., Vatti, G., et al. (2014). Interaction between neuroanatomical and psychological changes after mindfulness-based training. PloS One, 9(10), e108359.

    Article  PubMed  PubMed Central  Google Scholar 

  • Shapiro, S. L., Brown, K. W., Thoresen, C., & Plante, T. G. (2011). The moderation of mindfulness-based stress reduction effects by trait mindfulness: results from a randomized controlled trial. Journal of Clinical Psychology, 67(3), 267–277. doi:10.1002/jclp.20761.

    Article  PubMed  Google Scholar 

  • Sifneos, P. E. (1973). The prevalence of ‘alexithymic’ characteristics in psychosomatic patients. Psychotherapy and Psychosomatics, 22(2–6), 255–262. doi:10.1159/000286529.

    Article  PubMed  Google Scholar 

  • Tabachnick, B. G., & Fidell, L. S. (2007). Using Multivariate Statistics. Boston: Allyn & Bacon/Pearson Education.

    Google Scholar 

  • Teixeira, R. J., & Pereira, M. G. (2015). Examining mindfulness and its relation to self-differentiation and alexithymia. Mindfulness, 6(1), 79–87. doi:10.1007/s12671-013-0233-7.

    Article  Google Scholar 

  • Tran, U. S., Glück, T. M., & Nader, I. W. (2013). Investigating the Five Facet Mindfulness Questionnaire (FFMQ): Construction of a short form and evidence of a two-factor higher order structure of mindfulness. Journal of Clinical Psychology, 69(9), 951–965. doi:10.1002/jclp.21996.

    Article  PubMed  Google Scholar 

  • Trent, N. L., Park, C., Bercovitz, K., & Chapman, I. M. (2016). Trait socio-cognitive mindfulness is related to affective and cognitive empathy. Journal of Adult Development, 23(1), 62–67. doi:10.1007/s10804-015-9225-2.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

HZM: collaborated on designing and executing the study, analyzed the data, and wrote the paper. JLP: collaborated on designing and executing the study, collaborated in the writing and editing of the manuscript.

Corresponding author

Correspondence to Helen Z. MacDonald.

Ethics declarations

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

MacDonald, H.Z., Price, J.L. Emotional Understanding: Examining Alexithymia as a Mediator of the Relationship Between Mindfulness and Empathy. Mindfulness 8, 1644–1652 (2017). https://doi.org/10.1007/s12671-017-0739-5

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12671-017-0739-5

Keywords