Love, Empathy and Altruism, and Their Clinical Implications

  • Chiara Ruini


The focus of this chapter is on positive interpersonal relationships, from couple to parenting, to therapeutic alliance and finally to altruism. The final message is that from significant dual relationships (such as marriage and parenting) to larger social interactions, it seems that human beings are capable of bonding together and helping each other. More interestingly, these capacities are deeply embedded in our brain, where specific circuits make us able to feel empathy and sympathy for other human beings. Psychotherapy and healing settings could be considered ideal places to observe and promote these phenomena. The majority of clinical problems are in fact concerned with impairments in social functioning. Psychologists, social workers, and practitioners could help their clients to develop empathy, compassion, and altruism. This would improve their patients’ social functioning and, in turn, this may trigger a process of maturation and growth, connected to resilience and to a better recovery from their disorders. Importantly, these benefits could be extended to therapists and clinicians as well, throughout the process of vicarious resilience and vicarious growth.


Love Empathy Altruism Positive couple therapy Vicarious resilience 


  1. Alessandri, G., Caprara, G. V., Eisenberg, N., & Steca, P. (2009). Reciprocal relations among self-efficacy beliefs and prosociality across time. Journal of Personality, 77(4), 1229–1259.CrossRefPubMedPubMedCentralGoogle Scholar
  2. Arnold, D., Calhoun, L. G., Tedeschi, R., & Cann, A. (2005). Vicarious posttraumatic growth in psychotherapy. Journal of Humanistic Psychology, 45(2), 239–263.CrossRefGoogle Scholar
  3. Ashton, M. C., Paunonen, S. V., Helmes, E., & Jackson, D. N. (1998). Kin altruism, reciprocal altruism, and the Big Five personality factors. Evolution and Human Behavior, 19, 243–255.CrossRefGoogle Scholar
  4. Balancho, L. F., & Marujo, H. (2006). Family-focused interventions to promote happiness. Abstract Book, European Conference on Positive Psychology, Braga, Portugal, 3–6 July 2006.Google Scholar
  5. Batson, C. D., & Shaw, L. L. (1991). Evidence for altruism: Toward a pluralism of prosocial motives. Psychological Inquiry, 2(2), 107–122.CrossRefGoogle Scholar
  6. Batson, C. D., Ahmad, N., & Lishner, D. A. (2002). Empathy and altruism. In C. R. Snyder, & S. J. Lopez (Eds.), Handbook of positive psychology (pp. 485–498). New York: Oxford University Press.Google Scholar
  7. Batson, C. D., Bolen, M. H., Cross, J. A., & Neuringer-Benefiel, H. E. (1986). Where is the altruism in the altruistic personality? Journal of Personality and Social Psychology, 50(1), 212–220.CrossRefGoogle Scholar
  8. Baumann, D. J., Cialdini, R. B., & Kendrick, D. T. (1981). Altruism as hedonism: Helping and self-gratification as equivalent responses. Journal of Personality and Social Psychology, 40(6), 1039–1046.CrossRefGoogle Scholar
  9. Belas, M. L. (2008). Review of when marriages fail: Systemic family therapy interventions and issues. A tribute to William C. Nichols. The Family Journal, 16(1), 96–97.CrossRefGoogle Scholar
  10. Berscheid, E. (1994). Interpersonal relationships. Annual Review of Psychology, 45, 79–129.CrossRefGoogle Scholar
  11. Bishop, D. S., Epstein, N. B., & Levin, S. (1978). The McMaster model of family functioning. Journal of Marriage and Family Counselling, 4, 19–31.Google Scholar
  12. Bodenmann, G., Cina, A., Ledermann, T., & Sanders, M. R. (2008). The efficacy of the Triple P-Positive Parenting Program in improving parenting and child behaviour: A comparison with two other treatment conditions. Behaviour Research and Therapy, 46, 411–427.CrossRefPubMedGoogle Scholar
  13. Caprara, G. V., Alessandri, G., Di Giunta, L., Panerai, L., & Eisenberg, N. (2010). The contribution of agreeableness and self-efficacy beliefs to prosociality. European Journal of Personality, 24(1), 36–55.CrossRefGoogle Scholar
  14. Caprara, G. V., Alessandri, G., Eisenberg, N., Kupfer, A., Steca, P., Caprara, M. G., … Abela, J. (2012). The positivity scale. Psychological Assessment, 24(3), 701–712.Google Scholar
  15. Carr, A. (2002). Positive psychology. The science of happiness and human strengths. New York: Brunner-Routledge.Google Scholar
  16. Clark, M. S., & Mills, J. (1979). Interpersonal attraction in exchange and communal relationships. Journal of Personality and Social Psychology, 37(1), 12–24.CrossRefGoogle Scholar
  17. Cohen, K., & Collens, P. (2012). The impact of trauma work on trauma workers: A metasynthesis on vicarious trauma and vicarious posttraumatic growth. Psychological Trauma: Theory, Research, Practice, and Policy. Retrieved from
  18. Conoley, C. W., & Conoley, J. C. (2009). Positive psychology and family therapy: Creative techniques and practical tools for guiding change and enhancing growth. Hoboken, NY: Wiley.Google Scholar
  19. Conoley, C. W., Pontrelli, M. E., Oromendia, M. F., Bello, C., Del, B., & Nagata, C. M. (2015). Positive empathy: A therapeutic skill inspired by positive psychology. Journal of Clinical Psychology, 71(6), 575–583.CrossRefPubMedGoogle Scholar
  20. Costa, P. T., & McCrae, R. R. (1985). The NEO personality inventory manual. Odessa, FL: Psychological Assessment Resources.Google Scholar
  21. Coutinho, J. F., Silva, P. O., & Decety, J. (2014). Neurosciences, empathy, and healthy interpersonal relationships: Recent findings and implications for counseling psychology. Journal of Counseling Psychology, 61(4), 541–548.CrossRefPubMedGoogle Scholar
  22. De Dreu, C. K., Greer, L. L., Van Kleef, G. A., Shalvi, S., & Handgraaf, M. J. (2011). Oxytocin promotes human ethnocentrism. Proceedings of the National Academy of Sciences, 108(4), 1262–1266.CrossRefGoogle Scholar
  23. Driver, J. L., & Gottman, J. M. (2004). Daily marital interactions and positive affect during marital conflict among Newlywed Couples. Family Process, 43(3), 302–314.CrossRefGoogle Scholar
  24. Dunlop, W. L., Walker, L. J., & Wiens, T. K. (2015). The redemptive story: A requisite for sustaining prosocial behavioral patterns following traumatic experiences. Journal of Constructivist Psychology, 28, 1–15.CrossRefGoogle Scholar
  25. Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180.CrossRefGoogle Scholar
  26. Epstein, N., Baucom, D. H., & Rankin, L. A. (1993a). Treatment of marital conflict: A cognitive-behavioral approach. Clinical Psychology Review, 13(1), 45–57.CrossRefGoogle Scholar
  27. de Fátima Perloiro, M., Neto, L. M., & Marujo, H. Á. (2009). We will be laughing again: Restoring relationships with positive couples therapy. In G. W. Burns (Ed.), Happiness, healing, enhancement: Your casebook collection for applying positive psychology in therapy. Hoboken, NJ: Wiley.Google Scholar
  28. Ferguson, E., Farrell, K., & Lawrence, C. (2008). Blood donation is an act of benevolence rather than altruism. Health Psychology, 27(3), 327–336. doi: 10.1037/0278-6133.27.3.327.
  29. Figley, C. R. (2002). Compassion fatigue: Psychotherapists’ chronic lack of self care. Journal of Clinical Psychology, 58(11), 1433–1441.CrossRefPubMedGoogle Scholar
  30. Figley, C. R., & Stamm, B. H. (1996). Psychometric review of compassion fatigue self test. In B. H. Stamm (Ed.), Measurement of stress, trauma and adaptation. Lutherville, MD: Sidran Press.Google Scholar
  31. Fincham, F. D., Bradbury, T. N., & Beach, S. R. (1990). To arrive where we began: A reappraisal of cognition in marriage and in marital therapy. Journal of Family Psychology, 4(2), 167–184.CrossRefGoogle Scholar
  32. Fredrickson, B. L. (1998). What good are positive emotions? Review of General Psychology, 2, 300–319.CrossRefPubMedPubMedCentralGoogle Scholar
  33. Fredrickson, B. L., & Joiner, T. (2002). Positive emotions trigger upward spirals toward emotional well-being. Psychological Science, 13, 172–175.CrossRefPubMedGoogle Scholar
  34. Gable, S. L., & Haidt, J. (2005). What (and why) is positive psychology? Review of General Psychology, 9(2), 103–110.CrossRefGoogle Scholar
  35. Gable, S. L., Reis, H. T., Impett, E., & Asher, E. R. (2004). What do you do when things go right? The intrapersonal and interpersonal benefits of sharing positive events. Journal of Personality and Social Psychology, 87(2), 228–245.CrossRefPubMedGoogle Scholar
  36. Gable, S. L., Strachman, A., & Gonzaga, G. C. (2006). Will you be there for me when things go right? Supportive responses to positive event disclosures. Journal of Personality and Social Psychology, 91(5), 904–917.CrossRefPubMedGoogle Scholar
  37. Gold, J. M., & Rogers, J. D. (1995). Intimacy and isolation: A validation study of Erikson’s theory. Journal of Humanistic Psychology, 35, 78–86.CrossRefGoogle Scholar
  38. Gottman, J. M., & Levenson, R. W. (1999). What predicts change in marital interaction over time? A study of alternative models. Family Process, 38, 143–158.CrossRefPubMedGoogle Scholar
  39. Gottman, J. M., & Levenson, R. W. (2002). A two-factor model for predicting when a couple will divorce: Exploratory analyses using 14-year longitudinal data. Family Process, 41, 114–129.Google Scholar
  40. Gottman, J. M., Coan, J., Swanson, C., & Carrere, S. (1998). Predicting marital happiness and stability from newlywed interactions. Journal of Marriage and the Family, 60, 5–22.CrossRefGoogle Scholar
  41. Gottman, J. M., Levenson, R. W., & Carstensen, L. L. (1993). Long-term marriage: Age, gender, and satisfaction. Psychology and Aging, 2, 301–313.Google Scholar
  42. Graziano, W. G., Bruce, J., Sheese, B. E., & Tobin, R. M. (2007). Attraction, personality, and prejudice: Liking none of the people most of the time. Journal of Personality and Social Psychology, 93(4), 565–582.CrossRefPubMedGoogle Scholar
  43. Greenberg, L., & Goldman, R. N. (2008). Positive emotion in couples therapy. In L. S. Greenberg, & R. N. Goldman (Eds.), Emotion-focused couples therapy: The dynamics of emotion, love, and power (pp. 351–363). New York: Guilford.CrossRefGoogle Scholar
  44. Harvey, J., & Wenzel, A. (Eds.) (2001). Close romantic relationships: Maintenance and enhancement. Mahwah, NJ: Erlbaum.Google Scholar
  45. Hendrick, C., & Hendrick, S. S. (1986). A theory and method of love. Journal of Personality and Social Psychology, 50(2), 392–402.CrossRefGoogle Scholar
  46. Hendrick, S. S., & Hendrick, C. (1989). Research on love: Does it measure up? Journal of Personality and Social Psychology, 56(5), 784–794.CrossRefGoogle Scholar
  47. Hendrick, S. S., & Hendrick, C. (2002). Linking romantic love with sex: Development of the perceptions of love and sex scale. Journal of Social and Personal Relationships, 19, 361–378.CrossRefGoogle Scholar
  48. Herman, J. L. (1995). Trauma and recovery. London, UK: Pandora.Google Scholar
  49. Hernandez, P., Gangsei, D., & Engstrom, D. (2007). Vicarious resilience: A new concept in work with those who survive trauma. Family Process, 46, 229–241.CrossRefPubMedGoogle Scholar
  50. Hyatt-Burkhart, D. (2014). The experience of vicarious posttraumatic growth in mental health workers. Journal of Loss and Trauma, 19(5), 452–461.CrossRefGoogle Scholar
  51. Johnson, S. M. (2007). A new era for couple therapy: Theory, research, and practice in concert. Journal of Systemic Therapies, 26(4), 5–16.CrossRefGoogle Scholar
  52. Joseph, S. (2015). Positive therapy: Building bridges between positive psychology and person-centered psychotherapy. London: Taylor & Francis.Google Scholar
  53. Kelley, H. H., & Braiker, H. B. (1979). Conflict in the development of close relationships. In R. L. Burgess, & T. L. Huston (Eds.), Social exchange in developing relationships (pp. 135–168). New York: Academic.Google Scholar
  54. Keyes, C. L. M. (1998). Social well-being. Social Psychology Quarterly, 61, 121–140.CrossRefGoogle Scholar
  55. Lee, J. A. (1977). A typology of styles of love. Personality and Social Psychology Bulletin, 3, 173–182.CrossRefGoogle Scholar
  56. Levenson, R. W., Carstensen, L. L., & Gottman, J. M. (1994). The influence of gender on affect, physiology, and their interrelations: A study of long-term marriages. Journal of Personality and Social Psychology, 67(1), 56–68.CrossRefPubMedGoogle Scholar
  57. Lucas, M., & Wagner, L. (2005). Born selfish? Rationality, altruism, and the initial state. Behavioral and Brain Sciences, 28(6), 829–830. doi: 10.1017/S0140525X05360146.
  58. Lucas, R. E., & Clark, A. E. (2006). Do people really adapt to marriage? Journal of Happiness Studies, 7(4), 405–426.CrossRefGoogle Scholar
  59. MacFarlane, P., Anderson, T., & McClintock, A. S. (2015). Empathy from the client’s perspective: A grounded theory analysis. Psychotherapy Research, 7, 1–12.Google Scholar
  60. Maio, G. R., Thomas, G. R., Fincham, F. D., & Carnelley, K. B. (2008). Unraveling the role of forgiveness in family relationships. Journal of Personality and Social Psychology, 94(2), 307–319.CrossRefPubMedGoogle Scholar
  61. Malouff, J. M., Thorsteinsson, E. B., Schutte, N. S., Bhullar, N., & Rooke, S. E. (2010). The five-factor model of personality and relationship satisfaction of intimate partners: A meta-analysis. Journal of Research in Personality, 44(1), 124–127.CrossRefGoogle Scholar
  62. Margolin, G., & Weiss, R. L. (1978). Comparative evaluation of therapeutic components associated with behavioral marital treatments. Journal of Consulting and Clinical Psychology, 46(6), 1476–1486.CrossRefPubMedGoogle Scholar
  63. Maslach, C., & Goldberg, J. (1999). Prevention of burnout: New perspectives. Applied and Preventive Psychology, 7(1), 63–74.CrossRefGoogle Scholar
  64. McNulty, J. K., James, K., O’Mara, E. M., & Karney, B. R. (2008). Benevolent cognitions as a strategy of relationship maintenance: “Don’t sweat the small stuff”....But it is not all small stuff. Journal of Personality and Social Psychology, 94(4), 631–646.CrossRefPubMedGoogle Scholar
  65. Midlarsky, E., & Kahana, E. (1994). Altruism in later life. Thousand Oaks, CA: Sage.Google Scholar
  66. Mikulincer, M., Shaver, P. R., Gillath, O., & Nitzberg, R. A. (2005). Attachment, caregiving, and altruism: Boosting attachment security increases compassion and helping. Journal of Personality and Social Psychology, 89(5), 817–839.CrossRefPubMedGoogle Scholar
  67. Miller, I. W., Ryan, C. E., Keitner, G. I., Bishop, D. S., & Epstein, N. B. (2000). The McMaster approach to families: Theory, assessment, treatment and research. Journal of Family Therapy, 22, 168–189.CrossRefGoogle Scholar
  68. Mitchell, A. E., Castellani, A. M., Herrington, R. L., Joseph, J. I., Doss, B. D., & Snyder, D. K. (2008). Predictors of intimacy in couples’ discussions of relationship injuries: An observational study. Journal of Family Psychology, 22(1), 21–29.CrossRefPubMedGoogle Scholar
  69. Moyers, T. B., & Miller, W. R. (2013). Is low therapist empathy toxic? Psychology of Addictive Behaviors, 27(3), 878–884.CrossRefPubMedGoogle Scholar
  70. Nuttman-Shwartz, O. (2014). Shared resilience in a traumatic reality a new concept for trauma workers exposed personally and professionally to collective disaster. Trauma, Violence, & Abuse, 166(4), 466–475.Google Scholar
  71. Oakley, B., Knafo, A., Madhavan, G., & Wilson, D. S. (Eds.) (2012). Pathological altruism. Oxford: Oxford University Press.Google Scholar
  72. Park, N., Peterson, C., & Seligman, M. E. P. (2005). Strengths of character and well-Being. Journal of Social and Clinical Psychology, 23, 603–619.CrossRefGoogle Scholar
  73. Pearlman, L. A., & Saakvitne, K. W. (1995). Trauma and the therapist: Countertransference and vicarious traumatization in psychotherapy with incest survivors. New York, NY: WW Norton.Google Scholar
  74. Peterson, C., & Seligman, M. E. (2004). Character strengths and virtues: A handbook and classification. New York, NY: Oxford University Press.Google Scholar
  75. Reis, H. T., & Aron, A. (2008). Love: What is it, why does it matter, and how does it operate? Perspectives on Psychological Science, 3(1), 80–86.CrossRefPubMedGoogle Scholar
  76. Robbins, B. D. (2015). Building bridges between humanistic and positive psychology. In S. Joseph (Ed.), Positive psychology in practice (2nd ed., pp. 31–45). New York: Wiley.CrossRefGoogle Scholar
  77. Rogers, C. R., & Dymond, R. F. (1954). Psychotherapy and personality change. Chicago: University of Chicago Press.Google Scholar
  78. Rubin, Z. (1970). Measurement of romantic love. Journal of Personality and Social Psychology, 16, 265–273.CrossRefPubMedGoogle Scholar
  79. Rushton, J. P. (1980). Altruism, socialization, and society. Englewood Cliffs, NJ: Prentice-Hall.Google Scholar
  80. Rushton, J. P. (1989). Genetic similarity, human altruism, and group selection. Behavioral and Brain Sciences, 12(03), 503–518.CrossRefGoogle Scholar
  81. Ryff, C. D. (1989). Happiness is everything, or is it? Explorations on the meaning of psychological well-being. Journal of Personality and Social Psychology, 6, 1069–1081.CrossRefGoogle Scholar
  82. Ryff, C. D. (2014). Psychological well-being revisited: Advances in the science and practice of eudaimonia. Psychotherapy and Psychosomatics, 83, 10–28.CrossRefPubMedGoogle Scholar
  83. Samios, C., Abel, L. M., & Rodzik, A. K. (2013). The protective role of compassion satisfaction for therapists who work with sexual violence survivors: An application of the broaden-and-build theory of positive emotions. Anxiety, Stress and Coping, 26(6), 610–623.CrossRefGoogle Scholar
  84. Sanders, M. R., Kirby, J. N., Tellegen, C. L., & Day, J. J. (2014). The Triple P-Positive Parenting Program: A systematic review and meta-analysis of a multi-level system of parenting support. Clinical Psychology Review, 34(4), 337–357.CrossRefPubMedGoogle Scholar
  85. Schulz, M. S., Cowan, C. P., & Cowan, P. A. (2006). Promoting healthy beginnings: A Randomized Controlled Trial of a preventive intervention to preserve marital quality during the transition to parenthood. Journal of Consulting and Clinical Psychology, 74(1), 20–31.CrossRefPubMedGoogle Scholar
  86. Shiota, M. N., & Levenson, R. W. (2007). Birds of a feather don’t always fly farthest: Similarity in Big Five personality predicts more negative marital satisfaction trajectories in long-term marriages. Psychology and Aging, 22(4), 666–675.CrossRefPubMedGoogle Scholar
  87. Silveira, F. S., & Boyer, W. (2015). Vicarious resilience in counselors of child and youth victims of interpersonal trauma. Qualitative Health Research, 25(4), 513–526.CrossRefPubMedGoogle Scholar
  88. Snyder, C. R., & Lopez, S. J. (2007). Positive psychology: The scientific and practical explorations of human strengths. Thousand Oaks, CA: Sage.Google Scholar
  89. Sprecher, S., & Hendrick, S. S. (2004). Self-disclosure in intimate relationships: associations with individual and relationship characteristics over time. Journal of Social and Clinical Psychology, 23(6), 857–877.CrossRefGoogle Scholar
  90. Sternberg, R. J. (1986). A triangular theory of love. Psychological Review, 93, 119–135.CrossRefGoogle Scholar
  91. Sternberg, R. J. (1997). Construct validation of a triangular love scale. European Journal of Social Psychology, 27, 313–335.CrossRefGoogle Scholar
  92. Stolk, M. N., Mesman, J., Vanzeijl, J., Alink-Lenneke, R. A., Bakermans, M. J., Koot, H. M., et al. (2008). Early parenting intervention: Family risk and first-time parenting related to intervention effectiveness. Journal of Child and Family Studies, 17, 55–83.CrossRefGoogle Scholar
  93. Stutzer, A., & Freya, B. S. (2006). Does marriage make people happy, or do happy people get married? The Journal of Socio Economics, 35(2), 326–347.CrossRefGoogle Scholar
  94. Tobin, R. M., Graziano, W. G., Vanman, E. J., & Tassinary, L. G. (2000). Personality, emotional experience, and efforts to control emotions. Journal of Personality and Social Psychology, 79(4), 656–669.CrossRefPubMedGoogle Scholar
  95. Tone, E. B., & Tully, E. C. (2014). Empathy as a “risky strength”: A multilevel examination of empathy and risk for internalizing disorders. Development and Psychopathology, 26(Special Issue 4 Pt 2), 1547–1565.
  96. Vishnevsky, T., Quinlan, M. M., Kilmer, R. P., Cann, A., & Danhauer, S. C. (2015). “The keepers of stories” personal growth and wisdom among oncology nurses. Journal of Holistic Nursing, in press, doi: 10.1177/0898010115574196.
  97. Vollhardt, J. R. (2009). Altruism born of suffering and prosocial behavior following adverse life events: A review and conceptualization. Social Justice Research, 22(1), 53–97.CrossRefGoogle Scholar
  98. Vollhardt, J. R., & Staub, E. (2011). Inclusive altruism born of suffering: The relationship between adversity and prosocial attitudes and behavior toward disadvantaged outgroups. American Journal of Orthopsychiatry, 81(3), 307–315. doi: 10.1111/j.1939-0025.2011.01099.x.
  99. Wampold, B. E., & Imel, Z. E. (2015). The great psychotherapy debate: The evidence for what makes psychotherapy work. New York, NY: Routledge.Google Scholar
  100. Watson, J. C., Steckley, P. L., & McMullen, E. J. (2014). The role of empathy in promoting change. Psychotherapy Research, 24(3), 286–298.CrossRefPubMedGoogle Scholar
  101. Weng, H. Y., Fox, A. S., Shackman, A. J., Stodola, D. E., Caldwell, J. Z., Olson, M. C., … Davidson, R. J. (2013). Compassion training alters altruism and neural responses to suffering. Psychological Science, 24(7), 1171–1180.Google Scholar
  102. Widiger, TA., Presnall, J. (2012). Pathological altruism and personality disorder. In Oakley, B., Knafo, A., Madhavan, G., & Wilson, D. S. (Eds.). Pathological altruism (pp. 85–93). Oxford: Oxford University Press.Google Scholar
  103. Worthington Jr., E. L., Berry, J. W., Hook, J. N., Davis, D. E., Scherer, M., Griffin, B. J., … Sharp, C. B. (2015). Forgiveness-reconciliation and communication-conflict-resolution interventions versus retested controls in early married couples. Journal of Counseling Psychology, 62(1), 14–17.Google Scholar
  104. Zahn-Waxler, C., & Radke-Yarrow, M. (1990). The origins of empathic concern. Motivation and Emotion, 14(2), 107–130.CrossRefGoogle Scholar

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© Springer International Publishing AG 2017

Authors and Affiliations

  • Chiara Ruini
    • 1
  1. 1.Department of PsychologyUniversity of BolognaBolognaItaly

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