Investigating the Components of Couples’ Interactional Empathy in Interpersonal Relationships Using Thematic Analysis Method

Introduction

Open, stable, and clear relationships are crucial features of healthy and strong families. A family whose members communicate well with each other can better solve their problems and are more satisfied with their relationship (Heavy et al., 1996). Couples’ relationship is a multidimensional structure that includes both objective characteristics of a marital relationship such as companionship, communication, affection, trust, and conflict, and subjective aspects of a marital relationship such as the level of marital satisfaction or the level of happiness (John et al., 2017). Furthermore, high quality of couples’ relationship is a vital factor in happiness, well-being, and efficiency of the family as an entity, while its low quality causes numerous social and family problems (Tao et al., 2012).

Empathy is an effective element in couples’ relationship. This is the ability of an individual to understand the feelings of others in such a way that he or she put himself or herself in the other person’s place (Shuper Engelhard, 2019). In addition, empathy is the understanding of how a life partner thinks, feels, and imagines (Busby & Gardner, 2008). Numerous studies (Cramer & Jowett, 2010; Rosen et al., 2016; Plopa et al., 2019; Ulloa et al., 2017) demonstrated that empathy can improve the quality of interpersonal relationship between couples, strengthen their adaptability, and ultimately promote better health and efficiency in the family.

In a qualitative study, Shirvani et al. (2022) showed that empathy is one of the interpersonal factors affecting the success and satisfaction of couples. In another research, Zulfiqari Kahkesh (2022) showed that Olson’s couple enrichment training and Johnson’s training model improve emotion regulation and marital empathy in couples. Also, Azadi Fard et al. (2020) in a qualitative and descriptive phenomenological research, introduced empathy as one of the factors of improvement and quality of marital relationship. Alimohammadi and Aghajani (2021) found in their quantitative research that there is a positive and direct relationship between empathy and the quality of married life. In another quantitative research, Ramezani et al. (2020) argued that empathy plays a crucial role in maintaining the compatibility of relationships between couples. In another quantitative research, Cramer and Jowett (2010) concluded that the relationship between perceived empathy and satisfaction with marital relationship was positive, while the relationship between perceived empathy and depression caused by marital conflicts was negative.

Most of the studies in the field of empathy have been performed using quantitative methods, while the issue of empathy in couples’ relationship has many complexities, requiring the use of qualitative research methods for a deeper understanding. Additionally, most of the conducted research have explained the influence of various variables on empathy between couples, while the nature of empathy as a real concept has not been investigated. By adopting a qualitative approach, the current study tried to investigate the meaning of empathy between couples, identify the components of interactional empathy between them, and create an understandable thematic network for them. Thus, the main question this study addresses is: what are the components and themes of the interactional empathy of couples and how are these themes connected in a thematic network?

Methods

This study applied thematic analysis based on Attride-Stirling’s thematic network approach (2001). This was done through coding method in a six-step process, in which the basic concepts of the study were initially extracted, and then by summarizing and reducing these concepts, the basic themes were identified and extracted. Later, by summarizing the basic themes, organizing themes were obtained and ultimately, the global themes of the study were extracted by summarizing the organizing themes. In the end, the network of study themes was drawn and interpreted. Deductive-inductive logic was employed in the analysis of the research data. Applying the existing theoretical and experimental literature, a general understanding of the empathy and interpersonal relationships of couples was obtained, and primary categories were extracted. In the next step, using the conducted interviews, empirical coding was done in an inductive manner and finally, these two approaches were connected to each other.

The participants were university teachers of communication and counseling fields, as well as family counselors, with more than 10 years of work experience in Isfahan in Iran. Semi-structured interviews were conducted with 15 participants. Entry criteria included:

1. Having expertise in at least one of the fields of couples counseling, psychology, cognitive science, and communication
2. Work experience of more than 10 years
3. Willingness to participate in research.

Considering that the participants were only present in one interview and the participation time was short, there was no tangible change in the participants during the research. As a result, the exclusion criteria for this research could not be defined. A purposive sampling method was utilized; the study subjects were selected purposefully, and semi-structured in-depth interviews were conducted to collect data.

Member checking, triangulation, and external audits and evaluators (Creswell & Miller, 2000) were used to secure the quality and validity of the research results. First, the accuracy of the research findings was approved by a number of subjects under study. Second, using the triangulation technique, two other coders were asked to code some of the interviews so that the researchers could ensure the accuracy and validity of their coding. Furthermore, as external audits and evaluators, two other (methodological and content-related) experts in this field examined the process of coding, extraction of themes, and network of themes, and confirmed the final results.

Findings

In the present study, the interviews were initially reviewed, and the basic concepts were extracted (68 concepts/items). Then, by combining them, 13 basic themes in the first stage, five organizing themes in the next stage, and finally one global theme were extracted. The corresponding findings are reported in the following Table (Table 1).

Table 1

The process of coding and categorizing data and extracting themes

According to the results, the obtained global theme is “interactive empathy”. In most theories, empathy has two dimensions: cognitive (participation in the other person’s mental viewpoint) and emotional (emotional responses provided to the other person) (Ramezani et al., 2020). These two dimensions have a holistic and complementary nature in the seventh model of the Smith’s (2006) theory. The thematic coding of the interviews showed that some of the obtained themes cannot be clearly categorized under any of these two dimensions. For example, conscious acceptance has both a cognitive and an emotional nature. On the other hand, it seems that although empathy is a subjective phenomenon, at the same time, it is an important factor in regulating the behavior and framing the actions of couples in everyday life. Furthermore, empathy is of interactional nature, even when a person empathizes with himself or herself. In this case, also, the person puts a self-made character against his or her real self, empathizes with that, and adjusts his or her mental orientations based on the responses received from it. Thus, empathy is necessarily an interactive phenomenon. Creating interactional empathy requires that a person first acquires the ability to empathize with himself, and then gains the ability to empathize with the others. Based on the coding results, interactional empathy, as a global theme, consists of five organizing themes: empathic intra-action, empathic interaction, purposeful identification, communicative framing, and conscious acceptance. The interaction of these themes with each other forms the thematic network of interactive empathy. In the following sections, these themes are examined.

Empathic Intra-Action

The first organizing theme of interactional empathy is empathic intra-action. Empathy cannot be considered to be only related to the understanding of the emotional situation of the “other” by the “self”, but it can be said that part of it is related to the understanding of the emotional situation of the “self”. In this situation, an individual interacts with the constructed image of himself or herself, talks with it, understands it, and generally empathizes with his or her own self. This can lead to the recognition of one’s own emotional and psychological capacities and capabilities, and can also strengthen an individual’s ability to empathize with “others”. Empathic intra-action has three dimensions: self-attention, self-empowerment, and self-control.

In self-attention, couples pay attention to themselves, their own feelings, mentality, interests, etc. They seek to understand their own personality system. As a result, they constantly talk and interact with themselves and try to understand their own self. This process can both give a person mental and spiritual peace and provides him or her with a deeper and more consistent basis for understanding and interacting with his or her life partner. In this situation, a person finds more mental openness to understand others. Therefore, self-attention is regarded as a significant aspect of interactional empathy. One of the interviewees expressed his idea as follows: “Couples should be aware of their own feelings. If they can’t empathize with themselves, they won’t be able to have this feeling and understanding towards the other.”

In addition, couples need self-empowerment skills, which is the emotional and psychological ability to control themselves. Such individuals are able to manage their emotions in different situations, have the skill of restraining emotions, and enjoy the ability of self-observation. Thus, self-empowerment is the result of self-attention and empathic understanding on the part of couples, which can ultimately strengthen their empathic intra-action. The following idea was stated in one of the interviews: “When people have mental flexibility, self-control, and self-observation, they can have more empathy.”

Self-control is another dimension of empathic intra-action, the prerequisite of which is knowing and understanding one’s personality system. When couples know their personality systems well, they can have more control over their emotions in critical situations. When they see others who are suffering or who need help, they maintain their inner peace, control their behaviors, and adjust them. Applying this in the relationship with the life partner leads to control over different affairs and ability to manage common issues. It was stated in an interview that:

One of the signs of empathy is self-control and self-observation, so that a person can control his or her emotions, be aware of his or her own and others’ feelings and thoughts, and ratiocinate how to implement its executive functions.

Empathic Interaction

The second theme of interactive empathy is empathic interaction. In empathic intra-action, couples express empathy with their own selves, but here, in empathic interaction, they empathize with their life partner. During this process, they pay attention to and understand the emotional and personality system of their life partner and by creating an interaction between them and their own emotional and personality system, they try to understand his or her emotions, needs, and behaviors. The result of this process is empathic interaction, according to which couples display empathy toward each other. Empathic interaction has three dimensions: altruism, sympathy, and relationship.

Altruism is a concept based on which couples pay attention to their partner’s emotions and support him or her; they don’t look at each other as an object to be exploited; in contrast, the important element for them is the emotional, psychological, sexual, and social satisfaction of their life partner. Thus, altruism means giving importance to the life partner and his or her personality, emotional, and psychological system. It was argued in one of the interviews that: “Empathy means understanding and sharing the emotional states of each other and respecting them.”

In addition, couples need to deploy sympathy for each other; this requires a complete understanding of each other’s emotional and personality system. Taking into account the theme of sympathy, couples should have listening skills and be able to listen and understand their partner without judging or blaming him or her. Sympathy is sympathetic understanding and expressing emotional support for the life partner when experiencing unpleasant events on his or her part. This requires the formation of trust between couples so that a person does not feel that expressing personal issues can cause negative consequences in his or her married life. It was stated in an interview that:

Empathy means guiding and not judging while listening. It means that I should only actively listen to my spouse’s words and allow him or her to tell me his or her pains and tensions freely and without fear of being blamed.

Another theme in empathic interaction is relationship, the basis of which is couple’s effort to strengthen their interaction and communication and prevent its erosion. Couples with verbal and non-verbal skills can effectively communicate with their partners and use dialogue to resolve conflicts. In order to create an empathetic relationship, it is essential for couples to have a proper understanding of each other’s emotional and personality systems. This leads to efficient relationships and more empathy towards each other. One of the comments made in the interviews is as follows:

For effective communication, tone of voice and body language are more important than words. When words are accompanied by hypocrisy, the contradiction among words, tone, and body language becomes visible and the audience, especially a woman, notices this contradiction.

Purposeful Identification

The third theme of interactional empathy is purposeful identification, where couples put themselves in their partner’s place and adjust their behavior accordingly. Based on thematic coding, purposeful identification consists of two dimensions: imagination and mental imagery.

Imagination is creating an image of the life partner in mind in order to understand him or her better. Couples need to initially imagine the incidents they have experienced with their partner, engage with them, and finally be able to draw an imaginary system of their married life and its experiences. To this aim, it is essential for the couples to put themselves in their partner’s place and see the issues from his or her viewpoint. One of the interviewees stated that:

Empathy generally means putting yourself in the place of another, and its border is emotions and feelings; if it enters the domain of reason and logic, it will actually move from sympathy to empathy. In empathy, couples should empathize and mentally place themselves in the place of the other in various issues, understand him or her, and form their expectations accordingly.

In addition to imagination, it is necessary for couples to have mental imagery skills so that they can obtain accurate images of themselves, their married life, and the mental-emotional system of their partner, and create coherent narratives from them. In this situation, couples build up a mental image of their life partner in various issues, which is a good basis for objective behaviors in life. Mental imagery creates a better, more realistic, and more interactive understanding of issues. The ideal situation is one in which the couples’ individual narratives eventually become a common narrative so that they achieve a better understanding of each other and put aside temporary conflicts in favor of an imagined narrative of the future. It was stated in an interview that:

To understand each other, couples must be able to comprehend how their spouse thinks. It means putting themselves in his or her place. This can be achieved by practicing. For example, they should try to put themselves in the place of the characters of a series or movie and understand the story from that character’s position. Gradually, they can do the same for their spouse.

Communicative Framing

The fourth theme of interactive empathy is communicative framing. Communication is the foundation of empathy. If couple’s communication system is not coherent and integrated and if it is not formed based on the interaction of their emotional and personality systems, their communication will also face problems. When the couple’s relationship is broken, not only will there be no empathy, but many incompatibilities will be demonstrated. According to thematic coding, communicative framing has three main dimensions: awareness, viewpoint, and continuity.

The first dimension of communicative framing is awareness. In order to create an efficient and coherent communicative framework, couples need to have a detailed understanding of the psychological, emotional, and moral characteristics of themselves and their life partner. They also need to be aware of each other’s cognitive and emotional limitations and capabilities and create a real image of their own and their partner’s capabilities. This way, the first step is formed, which is awareness about emotional and cognitive bases required for creating an efficient communicative framework. One interviewee mentioned that: “Empathy comes from recognition. Empathy is achieved when we get to know the other party and have a proper understanding of all his or her emotional and psychosocial dimensions.”

The next theme corresponding to communicative framing is the viewpoint. Couples should have coherent and real views towards themselves and their life partner. Before making a decision, they should listen to their partner’s viewpoint and consider it; they should spend enough time to listen to his or her reasons for opposing or agreeing to a decision; they should be able to accept their opposite viewpoints and look at issues from different aspects. Nonetheless, the viewpoint must enjoy a common nature, not a dogmatic one. Otherwise, the couple’s relationship will become one-sided and they will gradually move away from each other. It was argued in an interview that:

When we want to do something or make a decision, we have to look at the problem from both our point of view and the viewpoint of the other party in order to arrive at the same understanding; this way, our spouse would not think that we have ignored his or her opinion.

Another important issue in creating a communicative framing is continuity. That is to say that couples should try to maintain their high-quality relationship, meaning that the passage of time and the decrease in emotional passion should not cause its erosion. They should be able to know each other’s limitations and communication capabilities and try to maintain the high-quality of their relationship, accordingly. Furthermore, they should have a suitable threshold of tolerance and should not allow everyday problems to harm the quality of their relationship. It was stated in an interview that:

There are problems, such as economy, addiction, inappropriate moods, etc., that create tension for couples. Couples should not let these issues weaken their relationship. They should control their behavior and speech as these issues are fleeting.

Conscious Acceptance

The fifth theme of interactive empathy is conscious acceptance. Acceptance means that couples should show acceptance towards each other without considering each other’s distinctive emotional and behavioral characteristics and that such differences do not take them apart. The prerequisite for this is proper recognition and understanding of each other and their cognitive and personality systems. If this recognition is comprehensive, couples do not consider each other’s emotional and behavioral limitations, which are natural, as an obstacle to accepting each other. Conscious acceptance is a fundamental factor for creating and strengthening interactive empathy, which has two dimensions based on coding: understanding and acceptance.

To create conscious acceptance, couples’ understanding of each other is of fundamental importance and is considered a prerequisite for acceptance. It is essential for couples to fully understand each other’s emotional and non-emotional needs, respect each other, and adjust their economic, sexual, and emotional expectations based on their partner’s conditions. If necessary, they should be ready to change their beliefs and attitudes in order to maintain their married life. It was argued in an interview that:

Empathy means if a person does not have favorable economic conditions, his life partner adjust her demands according to his financial conditions and accept that her husband’s condition is different from that of the others.

Understanding, as one of the dimensions of conscious acceptance, can lead to the formation of couples’ “acceptance” ability. Acceptance means couples accept the differences (in terms of values, behaviors, emotions, etc.) they have with each other; it also implies that couples do not try to eliminate those differences for their own benefit. In addition, they should accept responsibility for their behaviors and be ready to make changes in themselves if needed. The higher the couples’ acceptance, the higher their empathy is likely to be. One of the ideas expressed in an interview is that:

Empathy in marital relations means a person deals with the messages he or she receives from his or her spouse in an accepting and open manner, rather than responding to them in an offensive or defensive way.

The network of the themes of couples’ interactive empathy in interpersonal relationships is presented in Figure 1.

Figure 1

The network of the themes of couples’ interactive empathy in interpersonal relationships

Discussion and Conclusion

The present study tried to identify the themes and components of interactive empathy in couples’ interpersonal relationships. Couples’ empathy is significant in the sense that its lack can have many negative consequences, at the micro (couple relationships), institutional (family), and macro level (society). Strengthening empathy between couples can be effective in reducing these negative consequences. The prerequisite for this efficiency is investigating the empathy and identifying its dimensions. Although various theoretical models are presented in this field, due to the cultural differences between Iranian society and Western ones, these models may not be quite effective. The results of the current research demonstrated that interactional empathy (as a global theme) consists of five organizing dimensions: empathic intra-action, empathic interaction, purposeful identification, communicative framing, and conscious acceptance. When connected with each other, these themes and dimensions form the thematic network of interactive empathy of couples. Separating each of these dimensions from the others will weaken the overall nature of interactive empathy. In fact, these dimensions and themes always interact with each other.

The overall results of the study can be seen in line with Smith’s (2006) theoretical view on empathy, which considers empathy to have two main dimensions, namely cognitive and emotional, that interact with each other. Some dimensions, including empathic intra-action, empathic interaction, and purposeful identification, can be placed in Smith’s (2006) emotional empathy dimension and communicative framing; in addition, conscious acceptance can be categorized under the cognitive empathy. Of course, this division is only an analytical matter, and the five dimensions of empathy that were extracted in the present study are connected with each other, as cognitive and emotional dimensions systematically interact with each other in the theoretical studies of Smith (2006).

In order to establish interactive empathy, it is essential for couples to have empathetic intra-action. This means that they need to have a precise and coherent understanding of their emotional and personality system, pay attention to their feelings and emotions, and try to fully identify their emotional, psychological, social, and communicative abilities. This type of self-knowledge can be regarded as a central factor in empathic interaction. Based on this concept, couples first try to know the behavioral, emotional, communicative, and personality system of their life partner and get informed about its dimensions. They endeavor to look at the problems from their partner’s viewpoint, give importance to his or her needs, feel sympathy with him or her when problems arise, prioritize communication and interactions with his or her partner, and generally put themselves in place of their life partner. As mentioned, this is not possible without empathic intra-action and understanding of one’s emotional and personality system. Ultimately, what is important is that these two emotional and personality systems and emotional understandings are placed next to each other to create a common understanding, which strengthens the interpersonal relationships of couples. The results of this part of the study are in consistent with those of Ulloa et al. (2017) and Abdi et al. (2011). The general results of these studies demonstrate the effect of empathy established through couples’ mutual understanding on the quality of their interpersonal relationships.

In order to strengthen this common understanding and turn it into interactional empathy, it is essential for couples to establish a specific framework for their communicative system. Communication and interaction are the foundations of empathy, and interaction is formed through dialogue. Couples need to pay attention to each other’s views when making decisions and make joint decisions by taking into account various issues. In addition, they should use any means to continue the relationship and interaction between themselves and not allow inconsistency and temporary tensions to wear out their relationship. Establishing a framework for communication can be a fundamental factor in this context. Such an issue leads to the formation of a communicative pattern for lively couples, which was discussed by Fowers and Olson (1992). In this pattern, couples are highly satisfied, have the ability to express their feelings and problems, solve them collaboratively, establish constructive communication and interaction with each other, and enjoy being with each other. This is the very result that is obtained from communicative framing as a dimension of interactive empathy.

In order to continue the relationship and strengthen communicative framing, which is a fundamental factor in the empathy of couples, purposeful identification and conscious acceptance can be two central strategies. Couples need to have a high level of imagination, put themselves easily in the place of their life partner, and consider and interpret issues from the partner’s viewpoint. At the same time, they should be able to build up a coherent image of each other’s relationships, interactions, mental and emotional systems, issues, concerns, plans, etc., which can ultimately develop the narrative and story of their future life. This narrative can be a basis that does not allow temporary incompatibilities and tensions to distance them from each other, because the goal is realizing this narrative. In addition to this, couples need to have a high level of acceptance, understand each other, and accept each other despite being aware of the differences in values, emotions, moods, and behaviors. The results of this part of the study are consistent with the findings of Ramezani et al. (2020), Naderi and Hosseini (2014), and Alaeddini et al. (2017). The overall results of these research indicated that understanding the life partner and accepting him or her as a part of empathy can enhance the quality of relationship between couples.

In conclusion, it can be said that interactive empathy can improve the quality of couples’ relationships through intra-action, interaction, and formation of a communicative framework. Purposeful identification and conscious acceptance are two other fundamental strategies for realizing interactive empathy. Strengthening interactive empathy between couples can be a prelude to improving the efficiency of the family, as an entity, and solving many social and cultural issues.

References

Abdi, M. H., Nejati, V., Zabihzadeh, A., Mohseni, M., & Mohammadi, R. (2011). A comparison of empathy and mind-reading abilities in divorce applicants and normal couples. Thought and behavior in clinical psychology, 7(25), 67-76. https://jtbcp.roudehen.iau.ir/journal/about?lang=en

Alaeddini, Z., Moeini, Sh., & Kajbaf, M. B. (2017). The effect of inducing cognitive and emotional empathy on obvious conflict behaviors in couples and their perception of the outcome of the conflict. Contemporary Psychology, 13(2), 130-139.

Alimohammadi, F., & Aghajani, A. (2021). Predicting quality of marital life based on couples commitment, and empathy in married students of Islamic Azad University, Qom Branch. Cognitive Psychology and Psychiatry, 8(4), 135-145. http://shenakht.muk.ac.ir/article-1-1182-en.html

Attride-Stirling, J. (2001). Thematic networks: An analytic tool for qualitative research.  Qualitative research, 1(3), 385-405. https://doi.org/10.1177/146879410100100307

Azadi Fard, S., Mazal, K., Khojaste Mehr, R. and Aman Elahi, A. (2020). Investigating the lived experience of vulnerability in a marital relationship: A descriptive phenomenological study. Journal of Disability Studies, 0(0). https://jdisabilstud.org/article-1-2864-fa.html&sw

Busby, D. M., & Gardner, B. C. (2008). How do I analyze thee? Let me count the ways: Considering empathy in couple relationships using self and partner ratings. Family Process, 47(2), 229-242. https://doi.org/10.1111/j.1545-5300.2008.00250.x

Cramer, D., & Jowett, S. (2010). Perceived empathy, accurate empathy and relationship satisfaction in heterosexual couples. Journal of Social and Personal Relationships, 27(3), 327-349. https://doi.org/10.1177/0265407509348384

Creswell, J. W., & Miller, D. L. (2000). Determining validity in qualitative inquiry. Theory into practice, 39(3), 124-130. https://doi.org/10.1207/s15430421tip3903_2

Engelhard, E. S. (2019). Embodying the couple relationship: kinesthetic empathy and somatic mirroring in couples therapy. Journal of Couple & Relationship Therapy, 18(2), 126-147. https://doi.org/10.1080/15332691.2018.1481801

Fowers, B. J., & Olson, D. H. (1992). Four types of premarital couples: An empirical typology based on PREPARE. Journal of Family Psychology, 6(1), 10-21. https://doi.org/10.1037/0893-3200.6.1.10

Heavey, C. L., Larson, B. M., Zumtobel, D. C., & Christensen, A. (1996). The Communication Patterns Questionnaire: The reliability and validity of a constructive communication subscale. Journal of Marriage and the Family, 58(3), 796–800. https://doi.org/10.2307/353737

John, N. A., Seme, A., Roro, M. A., & Tsui, A. O. (2017). Understanding the meaning of marital relationship quality among couples in peri-urban Ethiopia. Culture, Health & Sexuality, 19(2), 267-278. https://doi.org/10.1080/13691058.2016.1215526

Naderi, L., Molavi, H., & Nouri, A. (2017). The prediction of marital satisfaction of couples in Isfahan based on empathy and forgiveness. Quarterly Journal of Knowledge and Research in Applied Psychology, 16(4), 69-75. https://jsr-p.isfahan.iau.ir/article_533992.html?lang=en

Plopa, M., Kaźmierczak, M., & Karasiewicz, K. (2019). The quality of parental relationships and dispositional empathy as predictors of satisfaction during the transition to marriage. Journal of Family Studies, 25(2), 170-183. https://doi.org/10.1080/13229400.2016.1211550

Ramezani, A., Ghamari, M., Jafari, A., & Aghdam, G. F. (2020). The effectiveness of a ToM training program in promoting empathy between married couples. Journal of Couple & Relationship Therapy, 19(1), 1-25. https://doi.org/10.1080/15332691.2019.1620145

Rosen, N. O., Bois, K., Mayrand, M. H., Vannier, S., & Bergeron, S. (2016). Observed and perceived disclosure and empathy are associated with better relationship adjustment and quality of life in couples coping with vulvodynia. Archives of Sexual Behavior, 45(8), 1945-1956. https://doi.org/10.1007/s10508-016-0739-x

Shirvani, E., Akhtari, Z., Heydarinia, M., & Etehadpour, A. (2022). Phenomenology of successful lived experience of couples on factors affecting marital satisfaction in Shiraz. Rooyesh-e-Ravanshenasi Journal(RRJ),11(9), 165-176. https://frooyesh.ir/browse.phpa_id=3770&sid=1&slc_lang=en

Smith, A. (2006). Cognitive empathy and emotional empathy in human behavior and evolution. The Psychological Record, 56(1), 3-21. https://doi.org/10.1007/BF03395534

Tao, P., Coates, R., & Maycock, B. (2012). Investigating marital relationship in infertility: A systematic review of quantitative studies. Journal of Reproduction & Infertility, 13(2), 71–80. https://www.jri.ir/article/487

Ulloa, E. C., Hammett, J. F., Meda, N. A., & Rubalcaba, S. J. (2017). Empathy and romantic relationship quality among cohabitating couples: An actor–partner interdependence model. The Family Journal, 25(3), 208-214. https://doi.org/10.1177/1066480717710644

Zolfaghari Kahkesh, M., Shahbazi, M., Koraei, A. & Alavi, S. Z. (2022). Effectiveness of Olson’s Enrichment Training Program and Johnson’s Relationship Enrichment on Emotion Regulation and Empathy in Maladjusted. Journal of Research & Health. 12(6), 415-424. http://dx.doi.org/10.32598/JRH.12.6.1949.2