CHAPTER

Empathy and emotion

regulation: An integrative
account
Nicholas M. Thompsona, Andero Uusbergb,c, James J. Grossc,
12
Bhismadev Chakrabartia,*
a
School of Psychology & Clinical Language Sciences, University of Reading, Reading,
United Kingdom
b
Institute of Psychology, University of Tartu, Tartu, Estonia
c
Department of Psychology, Stanford University, Stanford, CA, United States
*Corresponding author: Tel.: 0118-378-5551, e-mail address: b.chakrabarti@reading.ac.uk

Abstract
How we understand and respond to others’ emotions (i.e., empathy) may be influenced by the
regulatory processes that are used to shape which emotions we and others have (i.e., emotion
regulation). Empathy and emotion regulation are complex multidimensional constructs and
the relationship between their component processes is not well characterized. To enable future
work to examine their relationship more closely, this chapter presents an integrative frame-
work of empathy and emotion regulation. We begin by delineating the component processes
that underlie empathy and emotion regulation, and the neural underpinnings of these pro-
cesses. We then present an integrative framework describing the processes of empathy and
how these may be acted upon by distinct regulatory strategies. We conclude with a brief
consideration of contextual influences on empathy and emotion regulation using a reward-
based heuristic.

Keywords
Empathy, Emotion regulation, Cognitive, Affective, Neuroscience

Empathy and emotion regulation are both processes that are vital for effective social
functioning and emotional well-being (Decety and Lamm, 2006; Gross, 2002, 2015).
Broadly speaking, empathy refers to understanding and/or sharing another’s emotion
(Chakrabarti and Baron-Cohen, 2006; Decety and Jackson, 2004; Preston and
de Waal, 2002), and emotion regulation refers to the processes by which one
manages emotions (Gross, 1998, 2015). While empathy and emotion regulation
largely have been considered separately, there is growing evidence that these
processes may be intrinsically related. Consider a situation in which somebody

Progress in Brain Research, Volume 247, ISSN 0079-6123, https://doi.org/10.1016/bs.pbr.2019.03.024

© 2019 Elsevier B.V. All rights reserved.
273
274 CHAPTER 12 Empathy and emotion regulation

has upset or angered you. Trying to see things from that person’s perspective and
understand the motivations behind their actions can often help to regulate any neg-
ative emotions you felt as a result of their behaviors. Or think of a parent whose child
is in pain. Empathic processes can allow the parent to share and understand their
child’s distress. However, if they are unable to sufficiently regulate this emotional
state, such distress could impede the parent’s ability to support their child appropri-
ately. These everyday examples illustrate how empathy can be involved in emotion
regulation as well as how emotion regulation can be involved in empathy. Despite the
increasing awareness that emotion regulation may influence empathic processes, and
vice versa, the nature of the interactions between these constructs is not currently
well characterized.
Our primary goal in this chapter is to bridge the conceptual divide between
empathy and emotion regulation by presenting an integrative framework to examine
their relationship. We begin by describing the core processes that comprise empathy
and emotion regulation, drawing upon neuroscience evidence to highlight the distinct
component processes that underlie these phenomena. We then present an integrative
framework for empathic processes, which incorporates a theoretical model of emotion
regulation to highlight how different regulatory strategies can influence the component
processes of empathy. Finally, we briefly discuss how contextual modulation of these
processes can be conceptualized through a reward-based heuristic.

1 Component processes of empathy

While many theoretical accounts use the term empathy to refer to the end-state(s)
associated with understanding and/or sharing another’s emotion, we suggest that
empathy is best conceptualized not as the outcomes per se, but as the processes that
mediate these outcomes. As such, empathy is not an emotional state (e.g., sadness,
happiness), but a set of processes through which these emotion-states are generated
and/or cognitively represented in response to observing another conspecific. The
rationale for a departure from the conventional framing of the term empathy as an
emotional state is that such use of the term can conflate it with other experiences,
such as “sympathy,” which is often specific to observing others in certain negative
emotion states. On the other hand, empathic processes are used to understand and
respond to both the positive and negative emotional states of others, and as such
represent processes rather than end-states. Here, we present a model of empathic
processes highlighting three core components: (1) perception (perceptual mechanisms
that facilitate the detection of relevant emotion cues), (2) mimicry/embodiment
(mechanisms that can elicit spontaneous resonance with another’s emotions), and
(3) cognitive processes (mechanisms that enable the observer to make inferences
about another’s experience and manage the co-active self- and other-related represen-
tations) (Fig. 1).
The empathic components described in this model reflect separable mechanisms
mediated by distinct neural networks, each of which contributes to the understanding
 1 Component processes of empathy 275

FIG. 1
Component processes of empathy: Perceptual processes facilitate the detection of relevant
emotion cues; mimicry/embodiment mechanisms can elicit spontaneous resonance with
another’s emotions; cognitive processes enable the observer to make inferences about the
other’s emotional state and distinguish self from other. The color grading on each component
reflects the temporal gradient of these processes: for example, perceptual processes are
active very early in response to a stimulus, whereas cognitive processes come online at a later
stage. While the three component processes reflect separable mechanisms that operate on
different timescales and can act independently, they often operate in parallel.

or sharing of another individual’s emotional response as it unfolds. An affective

reaction to another’s emotional state has the potential to be elicited in response to
whatever cues are available to the perception of the observer. Importantly, different
emotion cues may act upon the observer in different ways. When concrete cues
such as facial, bodily, or vocal expressions can be perceived, the empathic process
can be mediated by mimicry/embodiment processes, which may result in sharing of
emotion. In the absence of any concrete emotion cues, abstract cues can enable an
understanding of another’s emotion via inferential cognitive processing. As many
situations offer a mixture of both types of cues, many empathy-induced reactions
arise from a dynamic combination of cognitive and mimicry-related processes.
While real-world empathy reflects a bi-directional process, in which the state
of the other and the state of the observer may both change in response to one another,
for the sake of parsimony, in this chapter we focus only upon how the emotion state
of the other affects that of the observer. It is also important to note that an individual’s
understanding of, and response to, another’s emotions reflects both their capacity as
well as their propensity to engage these empathic processes (Cameron et al., 2017;
Zaki, 2014). Our framework helps to understand both sources of variance. In partic-
ular, we will consider the differences in capacity throughout this chapter and focus on
the role of the motivational (i.e., propensity) dimension in the final section.
In this section, we discuss behavioral and neural evidence in support of the
delineation between the three components of empathy described in this model.
We draw upon relevant empirical evidence to demonstrate the critical role these
processes play in the ability to understand and/or share another’s emotion.
276 CHAPTER 12 Empathy and emotion regulation

1.1 Perception
Crucial to understanding and responding to another’s emotion is the ability to attend
to relevant cues pertaining to their emotional state (Enticott et al., 2008). One of the
primary means through which human emotions are communicated are facial expres-
sions (Adolphs, 2002; Balconi and Bortolotti, 2013; Balconi and Pozzoli, 2009;
Smith et al., 2005). A human face expressing an emotion represents a highly salient
cue that is often processed in a prioritized manner. Efficient detection of facial
expressions of emotion has been demonstrated using various paradigms (Fox
et al., 2000; Sweeny et al., 2012; Yan et al., 2017). For example, in attentional blink
tasks the inability to detect a second target face when it is preceded by another target
with a short stimulus onset asynchrony (within 200–400 ms; Fox et al., 2005) is
reduced when the second face is emotional (Yerys et al., 2013). Event related poten-
tial (ERP) studies have demonstrated that relative to neutral faces, emotional faces
are associated with enhanced positivity of fronto-central components, with this
difference observed as early as 180 ms after stimulus onset (Eimer and Holmes,
2007). Such findings suggest that salient emotional information may be processed
at an early stage of perception on a relatively implicit level.
The importance of perceptual processes for empathy is evident in studies of trait
empathy. Within our framework, self-report measures of trait empathy can be
viewed as measuring the extent of effective use of the component processes of em-
pathy. Studies using the aforementioned attentional blink paradigms have shown
that higher trait empathy correlates with improved detection of sad facial expres-
sions during the “attentional blink period” (Kang et al., 2017). Higher trait empathy
is also associated with more fixations on the eye-region during face perception
(Cowan et al., 2014) and a greater ability to infer complex mental/emotional states
from images of just the eye-region (Vellante et al., 2013). The eyes appear to hold a
special status in human social perception (Darwin, 1872) and attention to the eye-
region of the face plays an important role in the perception component of empathy
(Baron-Cohen et al., 1997). This view is further supported by evidence that indi-
viduals with autism spectrum conditions (ASC), a group of disorders characterized
by deficits in social functioning and understanding others’ mental/emotional states,
fixate less on the eye-region when viewing social stimuli than typical controls (Klin
et al., 2002).
The neural substrate of emotional face perception includes activity in visual
(fusiform gyrus, lingual gyrus, inferior occipital gyrus) and temporal (superior
temporal sulcus; STS) regions involved in early configurational processing of faces
(Chakrabarti et al., 2006; Kanwisher et al., 1997; Lee et al., 2008; Rossion et al.,
2003, 2012), as well as activations in specific subcortical structures, including
the amygdala, ventral striatum, and insula (Adolphs, 2002; Breiter et al., 1996;
Chakrabarti et al., 2006; Morris et al., 1996, 1998; Wicker et al., 2003). Amygdala
activations have been reported even when the emotional content of faces is task-
irrelevant (Vuilleumier et al., 2001), and with very short presentations of face stimuli,
often below the threshold of conscious awareness (Whalen et al., 1998).
 1 Component processes of empathy 277

The amygdala has been shown to modulate activity in various brain regions, in-
cluding those involved in face processing (e.g., fusiform gyrus) (Morris et al., 1998;
Vuilleumier and Pourtois, 2007). In addition to enabling the rapid response to salient
emotional stimuli, the amygdala may also support emotion recognition via interac-
tions with other regions (such as the orbitofrontal cortex; OFC), which integrate
perceptual representations of faces with knowledge regarding the emotions being
displayed (see Adolphs, 2002). Amygdala responses to emotional faces have
also been directly implicated in empathy. For instance, it has been demonstrated
that the amygdala response to faces can facilitate the recognition of complex
emotional/mental states (Adolphs et al., 2002; Stone et al., 2003), and that individuals
with ASC show reduced activations in the amygdala when viewing emotional facial
expressions (Ashwin et al., 2007; Baron-Cohen et al., 1999; Critchley et al., 2000).
As the research discussed above highlights, the perception of facial cues pertain-
ing to another’s emotion is a core component process of empathy. While we have
focused specifically upon facial expression of emotion, another’s emotions can be
communicated in a variety of ways, such as through bodily posture, prosody, or
verbal mediation through language (Coulson, 2004; Scherer, 2003; Wallbott,
1998). All emotion cues are not necessarily as “concrete” as facial and bodily expres-
sions: we routinely have to respond to abstract emotion-relevant cues from our
environment. Systematic consideration of the various kinds of information that
can function as an abstract cue falls beyond the scope of this chapter. As we go
on to discuss, while concrete emotion cues can spontaneously elicit a response
in the observer through mimicry/embodiment mechanisms, abstract cues may
require more elaborate cognitive processing (Bird and Viding, 2014; Coplan and
Goldie, 2012).

1.2 Mimicry/embodiment
Humans display an inherent predisposition to spontaneously mimic the behaviors
of others, including their facial expressions, body language, and vocalizations
(Chartrand and Bargh, 1999; Chartrand and Dalton, 2009; Dimberg et al., 2000;
Hess and Blairy, 2001; Niedenthal et al., 2001; Wallbott, 1991). Spontaneous
facial mimicry (SFM) has been extensively studied using facial electromyography.
Perception of emotional facial expressions elicits activity in congruent muscle
groups in the observer; e.g., the Corrugator supercilii in response to angry faces
and the Zygomaticus major in response to happy faces (Dimberg and Petterson,
2000; Dimberg and Thunberg, 1998; Hess et al., 1998; Rymarczyk et al., 2018;
Sims et al., 2012). Crucially, SFM can be triggered rapidly and automatically
(Dimberg and Thunberg, 1998), even when the observer is not consciously aware
of the presence of the face (Bornemann et al., 2012; Dimberg et al., 2000).
The lack of need for high-resolution stimulus representations in triggering SFM,
as well as evidence of such spontaneous mimicry in young children who have not
yet developed efficient cognitive control mechanisms (Nadel, 2002), suggests that
these processes are recruited early in the hierarchy of empathy-related responses.
278 CHAPTER 12 Empathy and emotion regulation

Further, evidence of resonance/contagion of emotions from rodent models suggests

that these mechanisms may operate without the need for higher-order cognitive
processes (see Panskepp and Lahvis, 2011; Panskepp and Panskepp, 2013 for reviews).
Spontaneous mimicry is consistent with the common neural coding between
perception and action (Prinz, 1997), whereby the perception of a behavior
automatically activates the motor representations that participate in the first-hand
enactment of that behavior (Dijksterhuis and Bargh, 2001; Preston and de Waal,
2002). This principle has been associated with the putative mirror neuron system
(MNS), a network of brain regions activated by both the observation and execution
of a given action. The MNS includes the inferior frontal gyrus (IFG), inferior
parietal lobule (IPL), superior/middle temporal sulcus/gyrus (STS/MTG), and the
anterior insula (AI) (Casile et al., 2011; Iacoboni and Dapretto, 2006; Iacoboni
et al., 1999; Rizzolatti and Craighero, 2004). It is thought that the MNS maps
the perceived behavior onto the observer’s own motor and affective systems
(Bernhardt and Singer, 2012; Stevens et al., 2000). In the context of others’
emotional displays, this neural overlap between self and other can evoke in the
observer an emotional state isomorphic to that of the perceived other (de Waal
and Preston, 2017; Preston and de Waal, 2002). This set of processes thus poten-
tially enables a quick route to sharing another individual’s emotion. This rudimen-
tary embodiment of another’s emotion may also facilitate emotion recognition
by enabling the observer to draw upon the experience of the other mirrored in
his or her own brain and body to better understand the other’s state (Adolphs,
2002; Bastiaansen et al., 2009; Carr et al., 2003; Chartrand and Bargh, 1999;
Dimberg et al., 2000; Goldman and Sripada, 2005; Hatfield et al., 1993; Jabbi
and Keysers, 2008; Niedenthal et al., 2001; Preston and de Waal, 2002).
In support of the role of mimicry/embodiment processes in empathy, the magni-
tude of SFM has been found to be positively related to the extent of self-report emo-
tion shared between the observer and the observed other (Sato et al., 2013, though see
Hess and Blairy, 2001), and also to trait measures of empathy (Dimberg et al., 2011;
Sonnby-Borgstrom, 2002). Similarly, activation of structures in the MNS has been
noted consistently across a range of paradigms measuring empathic processes (Carr
et al., 2003; Chakrabarti et al., 2006; Kaplan and Iacoboni, 2006; Lamm et al., 2011).
Individual differences in MNS activation have also been related to trait empathy.
For instance, IFG activity during the perception of emotional faces and bodily
movements is positively correlated with trait empathy (Kaplan and Iacoboni,
2006; Pfeifer et al., 2008). Meanwhile, lesions in MNS regions are associated with
deficits in emotion recognition and a reduced capacity to share others’ emotions
(Adolphs et al., 2000; Shamay-Tsoory et al., 2009).
In sum, mimicry/embodiment represents component processes within empathy
that enable a direct mapping of another individual’s emotion on to the motor system
of the observer, without an explicit need for complex cognition. These processes
occur at an early stage of stimulus decoding and are largely automatic in nature.
Further, mimicry/embodiment processes may often, although not always, interact
with the cognitive processes of empathy described in the following section.
 1 Component processes of empathy 279

1.3 Cognitive processes

The cognitive component of empathy encompasses various processes that enable the
observer to take the perspective of another individual and make inferences about
their mental/emotional states, based on knowledge of the context, and estimations
of the other’s beliefs and intentions (Frith and Frith, 2003). These processes have
been given various labels, such as perspective-taking and mentalizing, and are often
considered synonymous with the construct of theory of mind (ToM) (Batson,
2009; Decety, 2011; Frith and Frith, 2003; Premack and Woodruff, 1978). When
concrete emotion cues are available, cognitive processes often interact with mimicry/
embodiment processes. In the absence of concrete emotion cues, this cognitive-
inferential route may in itself be sufficient to enable an understanding of, and
response to, another’s emotion (Fehr and Fischbacher, 2003; Singer and Lamm,
2009; Walter, 2012).
In contrast to the relatively automatic nature of mimicry/embodiment processes,
the cognitive component reflects more effortful processing. It relies upon various
facets of cognitive control which enable the observer to simultaneously represent
their own and the other’s state, and inhibit their default egocentric perspective in
order to take the perspective of the other (Chakrabarti and Baron-Cohen, 2006;
Coplan and Goldie, 2012; O’Connell et al., 2013). The cognitive component of
empathy is associated with a largely cortical network including the medial prefrontal
cortex (mPFC), the temporoparietal junction (TPJ), the superior temporal sulcus
(STS), and the anterior temporal pole (TP) (Frith and Frith, 2006; Ruby and
Decety, 2004; Saxe et al., 2004; Van Overwalle and Baetens, 2009), with activations
in these regions reported across a range of tasks that involve inferring another’s
mental/emotional state (Atique et al., 2011; Corradi-Dell’Acqua et al., 2014; Goel
et al., 1995; Lamm et al., 2011; Morelli et al., 2014; Van Overwalle, 2009). Here,
we describe in greater detail two subcategories of processes relevant to the cognitive
component of empathy: (1) inferential processing and (2) self-other control.

1.3.1 Inferential processing

Emotional responses to a given stimulus/situation depend on how one appraises it
in relation to their goals (Buhle et al., 2014; Kross and Ayduk, 2011; McRae,
2016; Moors et al., 2013). Thus, in order to accurately represent and respond to
another’s emotions, the observer must make inferences about the knowledge, goals,
and appraisals of the other in a given situation (Frith and Frith, 2003, 2006; Singer,
2006). While mimicry/embodiment mechanisms provide an efficient route to
state-matching, this can lack the finer detail necessary to accurately represent the
other’s state. Inferential processes enable the observer to understand not only the
emotion the other is experiencing, but also the situation and appraisals that triggered
this state. Thus, they can facilitate the “fine-tuning” of more implicit empathic
processes, supporting the ability to better understand the range of diverse and
complex emotional states of others. At the most basic level, such inferences can
be drawn from situational cues using simple social scripts. For example, knowing
280 CHAPTER 12 Empathy and emotion regulation

that a student has missed the school bus may enable an observer to infer that he or she
must be feeling anxious about being late to school. Critically, the accuracy of these
inferential processes is dependent upon the knowledge of the observer (Coplan and
Goldie, 2012). One who is not familiar with school buses and the education system
might find it difficult to make the inference relative to another who is more embed-
ded within this socio-cultural milieu.
The inferential processes involved in empathy consistently recruit the medial
PFC (mPFC), posterior cingulate cortex (PCC), and the posterior STS/TPJ (Saxe
et al., 2006). These structures have been implicated in a range of socio-emotional
and self-referential processes (McGuire et al., 1996; Reiman et al., 1997), such as
imagining the experiences of another individual (Hassabis et al., 2014; Krienen
et al., 2010), making judgments about another’s emotional state (Haas et al.,
2015), as well as forming and applying social script knowledge (Barbey et al.,
2009; Van Overwalle, 2009).
The mPFC may process information pertaining to another’s mental/emotional
state based on both concrete and abstract emotion cues (Lombardo et al., 2010;
Peelen et al., 2010; Skerry and Saxe, 2014) allowing it to play a key role in repre-
senting others’ affective states (Takahashi et al., 2015). The ventral mPFC (vmPFC)
is functionally linked to brain regions associated with the processing of various forms
of internal and external information, including the OFC (Carmichael and Price, 1995;
Reiman et al., 1997) and various subcortical regions (Barbas and Blatt, 1995; Laurita
et al., 2017; Sevinc et al., 2017). These dense connections suggest that the vmPFC
could be involved in integrating affective and cognitive inputs for the purposes of
decision-making (Bechara et al., 1994; Elliott et al., 2000), and that it may influence
activity within subcortical structures based upon stimulus appraisals (Ledoux, 2000).

1.3.2 Self-other control

Empathic processes can often lead to co-active representations of self and other
(Decety and Sommerville, 2003; Osborn and Derbyshire, 2010; Santiesteban
et al., 2012). In attempting to represent another’s state via inferential processes,
failures in self-other control can result in egocentric interference, whereby the
observer’s own knowledge, beliefs, and states can affect how accurately he or she
is able to infer another’s state (Camerer et al., 1989; Derbyshire et al., 2013; Epley
et al., 2004; Krueger and Clement, 1994; Niedenthal et al., 2000; O’Connell et al.,
2015; Ross et al., 1977; Schmid and Schmid Mast, 2010; Silani et al., 2013; Todd
et al., 2015; Vorauer and Ross, 1999). Similarly, where spontaneous mimicry/
embodiment of another’s emotion is elicited by concrete emotion cues, self-other
control is necessary for the observer to subsequently represent the other’s emotion
as distinct from his or her own (Decety and Chaminade, 2003; Preckel et al., 2018).
Therefore, maintaining self-other distinction is an important cognitive process within
empathy, which enables an understanding of another’s emotion state (Jackson
et al., 2005; Lamm et al., 2007).
Higher-order cognitive control processes, such as inhibitory control, are thought
to be critical for self-other control and agency (Ferstl and von Cramon, 2002).
 2 Component processes of emotion regulation 281

These cognitive control processes are mediated largely by the PFC (Barresi and
Moore, 1996; Decety and Chaminade, 2003). In addition, the TPJ and supramarginal
gyrus (SMG) have been posited as playing a key role in self-other control processes
(Kanske et al., 2015; Santiesteban et al., 2012; Silani et al., 2013). The TPJ is
functionally connected to control-related regions in the PFC and cingulate cortex
(Mars et al., 2013; Steinbeis, 2016; Steinbeis et al., 2015), and is consistently
activated across a range of tasks involving understanding others’ mental/emotional
states (Decety and Lamm, 2007; Sperduti et al., 2011; Van Overwalle, 2009).
In sum, cognitive processes represent the most elaborate and complex set of
empathic processes. They involve switching between the representations of self
and other in service of inferences based on concrete and/or abstract cues that require
temporal binding of the available information. Understandably, these processes need
more cortical resources and time, and as such, cognitive empathic processes occur
later and emerge over a longer timescale than the other sets of empathic processes
described above.

2 Component processes of emotion regulation

We have suggested that empathic processes can be understood in terms of three broad
components. To understand how these component processes interact with emotion
regulation, one also needs to understand the component processes of emotion
regulation. Emotion regulation, which refers to the diverse set of processes employed
to influence one’s own and others’ emotions, is a critical ability with important
implications for social functioning and emotional well-being (Aldao et al., 2010;
Gross, 1998, 2002; Gross and John, 2003; Livingstone and Srivastava, 2012;
Ochsner and Gross, 2005). Emotion regulation comprises diverse processes that
transform a goal to experience a different emotion into distinct strategies that attempt
to bias the unfolding of emotion in the desired direction (Aldao et al., 2014; Goldin
et al., 2008; Gross, 1998). In order to highlight the various regulatory processes by
which one can manage their emotions, here we refer to the extended process model of
emotion regulation (EPM; Gross, 2015).
The EPM suggests that in order to understand how emotions can be regulated, it is
useful to consider how emotions are generated in the first place. According to the
EPM, emotion generation is a cybernetic process in which a situation in the world,
once perceived, is evaluated during appraisal processes, leading to various changes
in emotional response systems such as facial expressions, autonomic activity, or
subjective feelings (Fig. 2). Emotion regulation begins when a regulation goal to
experience a different emotion is activated by a discrepancy between the generated
emotion and some desired emotion state. While regulation goals are often hedonic in
a proximate sense (e.g., increase immediate pleasure, reduce immediate pain), they
can also be considered hedonic in a more ultimate sense (e.g., facilitate relationships
with others) (Tamir, 2015).
282 CHAPTER 12 Empathy and emotion regulation

FIG. 2
Schematic of the Extended Process Model of emotion regulation (Gross, 2015). The emotion
generation process comprises a situation (world), which once perceived (perception) is
subject to evaluative processes (valuation) which determine the emotional response (action).
Each stage in this emotion-generative cycle can be targeted by different regulation strategies,
thereby altering the emotional response the situation elicits.

A regulation goal often leads to the selection and implementation of a regulation

strategy to attain the goal state. Emotion regulation strategies can broadly be
categorized based on which stage of emotion generation they primarily intervene:
world, perception, valuation, or action (Gross, 2015). For instance, imagine a situ-
ation in which one is feeling anxious about an upcoming presentation. To regulate
this emotion by intervening in emotion generation at the world stage, one could
cancel the upcoming talk (situation selection) or engage in thorough preparation
and practice to reduce the associated feelings of anxiety (situation modification).
Alternatively, one could intervene at the perception stage by taking one’s mind off
the situation (attentional deployment). Another option would be to intervene at the val-
uation stage and change one’s appraisals of the situation, for instance, by telling one-
self that everything will most likely go according to plan, and even in the worst-case
scenario, delivering a bad talk would not be the end of the world (cognitive change).
Finally, one could attempt to alter one’s actual responses, for instance, by trying
to suppress the associated experience/expression of emotion or engaging in deep-
breathing exercises to attenuate one’s physiological arousal (response modulation).
We now discuss in greater detail each of the strategies described by the EPM,
highlighting evidence regarding the neural substrates by which they are mediated,
and the typical affective outcomes they entail.
 2 Component processes of emotion regulation 283

Situation selection and modification act upon the earliest stage of the emotion
generation process. Situation selection often entails avoiding emotion-eliciting situ-
ations and has been found to be an effective way to manage one’s emotions
(Aspinwall and Taylor, 1997). While situation selection typically refers to avoiding
being exposed to an emotion-eliciting stimulus in the first instance (Diefendorff
et al., 2008), this strategy could also involve removing oneself from an ongoing
situation. Situation modification involves attempts to directly change the emotion-
eliciting situation such that its affective influence is altered (Gross, 1998, 2015).
While the neural bases of other regulation strategies have been well characterized,
situation selection and modification have received relatively little attention from
imaging studies. This is predominantly due to the difficulty in developing paradigms
that would enable these strategies to be studied effectively in the laboratory environ-
ment (Ochsner et al., 2012).
Attentional deployment refers to controlling the way in which attention is
allocated to different features of a stimulus/situation in order to alter its emotional
impact. This could entail distraction, wherein attention in entirely directed away
from the emotion-eliciting stimulus in an external (e.g., looking away) or internal
(e.g., thinking about something incongruent with the emotional stimulus) manner.
In addition to entirely distracting oneself, one may also attend to less emotionally
relevant aspects of the situation (Gross, 1998, 2015; Gross and Thompson, 2007).
Diverting attention toward non-emotional features has been shown to be effective
in downregulating emotional intensity (Ferri et al., 2013; Isaacowitz et al., 2009;
Nix et al., 1995). Conversely, one’s emotional response may be heightened when
more emotional features are attended (Ochsner et al., 2004).
Attentional deployment relates to activations in prefrontal (including dorsolateral
and dorsomedial PFC) and parietal control regions, which downregulate activity in
subcortical structures such as the amygdala (Ferri et al., 2013). Given that emotional
stimuli may capture attention in a reflexive manner (see Carretie, 2014), the activation
in these PFC regions likely reflects the effortful processing required to disengage
attention following bottom-up capture by emotional stimuli (Ferri and Hajcak, 2015).
Cognitive change strategies involve modifying the way in which one thinks
about the emotion-eliciting stimulus, such that the emotional response it elicits is
altered in the desired direction (Gross, 1998, 2002; Sheppes and Gross, 2011).
The most commonly studied cognitive change strategy is reappraisal, which is often
operationalized either as semantic reappraisal or reappraisal via perspective taking
(Webb et al., 2012). Semantic reappraisal refers to a cognitive-linguistic strategy in
which the meaning adhered to an emotional stimulus is altered (Goldin et al., 2008;
Gross, 1998; Hajcak and Nieuwenhuis, 2006; Phan et al., 2005; Sheppes and
Gross, 2011). Reappraisal via perspective taking involves adopting the perspective
of a detached observer in order to cognitively distance oneself from an emotional
stimulus/state, without necessarily changing its meaning (Erk et al., 2010;
Koenigsberg et al., 2010; Messina et al., 2015; Webb et al., 2012). When participants
are instructed to use these forms of reappraisal in laboratory studies, they experience
significant reductions in negative emotional experience based on self-report,
284 CHAPTER 12 Empathy and emotion regulation

psychophysiological, and neural measures (Jackson et al., 2000; Ray et al., 2010; Shiota
and Levenson, 2012; Wallace-Hadrill and Kamboj, 2016; for reviews, see Kalisch,
2009; Messina et al., 2015; Webb et al., 2012). Furthermore, the habitual use of reap-
praisal strategies is associated with various favorable outcomes, such as increased
trait positive affect, more effective interpersonal functioning, and increased
emotional well-being (Brans et al., 2013; Gross, 2002; Gross and John, 2003).
Reappraisal has been shown to recruit a distributed network of brain regions
associated with cognitive control, attention, and verbal processing, including the
anterior cingulate cortex (ACC), vlPFC, mPFC, OFC, and dorsolateral PFC (dlPFC)
(Kalisch, 2009; Phan et al., 2005; Wager et al., 2008). Functional connectivity
analyses have demonstrated that activity in these PFC regions is inversely related
to amygdala activation (Diekhof et al., 2011; Goldin et al., 2008; Ochsner et al.,
2012; Urry et al., 2009), most likely reflecting a diminished emotional response
following top-down regulation (Banks et al., 2007; Wager et al., 2008). Temporal,
inferior parietal, and ventromedial prefrontal regions activated during reappraisal
tasks (Buhle et al., 2014) are considered part of the “semantic system” (Binder
et al., 2009; Patterson et al., 2007) and may reflect the recovery and application
of contextual and socio-emotional knowledge necessary to reappraise the meaning
of the emotional stimulus (Neumann and Lozo, 2012; Zahn et al., 2007). While there
is overlap between the brain regions associated with semantic reappraisal and reap-
praisal via perspective taking, there is evidence to suggest that the latter may be less
reliant upon cognitive control processes mediated by the PFC, and is primarily
associated with activations in temporal regions, such as the right inferior parietal
lobule (a region of the TPJ) and left superior temporal gyrus (Messina et al., 2015).
Response modulation strategies act directly upon the emotional state itself. The
most commonly studied form of response modulation is expressive suppression
(henceforth suppression), which involves efforts to inhibit behaviors associated with
the expression of emotion (e.g., facial expressions) (Gross, 1998, 2015). Suppression
is broadly considered to be a maladaptive emotion regulation strategy, with evidence
that it is associated with increased sympathetic/cardiovascular activity (Gross and
Levenson, 1997), increased acoustic startle response (Hagemann et al., 2006), and
sustained activations in the amygdala and insula (Goldin et al., 2008). While
some studies have found evidence of reduced self-reported negative emotion during
suppression, this could be due to the redirection of attention necessary to control
one’s facial muscles, which may inherently reduce attentional resources allocated
to the emotional stimulus/experience (Goldin et al., 2008).
Task measures of suppression, wherein participants are instructed to inhibit their
facial muscle responses when viewing emotional stimuli, have demonstrated the late
recruitment of a cortical network including the right ventrolateral PFC (vlPFC)
(Goldin et al., 2008), a region implicated in inhibitory control of motor-responses
(Garavan et al., 2006; Rubia et al., 2003). The late enhancement of PFC activity is
likely to reflect the top-down control necessary to inhibit the prepotent muscular facial
responses to emotion stimuli, and/or the increased cognitive demand associated with
attempts to modulate the input from subcortical structures involved in emotion proces-
sing (Goldin et al., 2008).
 3 A framework for integrating empathy and emotion regulation 285

In sum, emotion regulation comprises various strategies that enable the individ-
ual to manage their emotional responses by targeting different stages of the emotion
generation process. Different regulation strategies vary in their short-term efficacy in
modulating emotion; they may also differ in terms of their longer-term conse-
quences. Consider again the example of feeling anxious about an upcoming presen-
tation. Efforts to distract oneself from the situation (i.e., attentional deployment) may
reduce feelings of anxiety, but at the expense of long-term emotional adaptation
(Paul et al., 2016; Uusberg et al., 2016). While trying to think differently about
the situation (i.e., cognitive change) may be somewhat less effective than distraction
in terms of its short-term influence on the emotion state, this strategy may facilitate
long-term adaptation, enabling the individual to more effectively deal with the affec-
tive impact of similar situations in the future (MacNamara et al., 2011).

3 A framework for integrating empathy and emotion

regulation
In this section, we present an integrative framework that bridges the conceptual
divide between empathy and emotion regulation. The fundamental premise of this
framework is that the emotional state elicited in the observer as a function of
empathic processes can be subject to emotion regulatory processes. Not only is this
premise suggested by previous theoretical accounts (e.g., Decety, 2010; Zaki, 2014),
but there is also a strong overlap in the neural implementation of the component
processes of empathy and emotion regulation. In particular, the processes and
neural architecture associated with reappraisal show significant overlap with those
involved in the cognitive component of empathy (Kalisch, 2009; McRae et al.,
2010; Ozonoff and Mcevoy, 1994; Ozonoff et al., 1991; Sabbagh et al., 2006;
Urry et al., 2009). Additionally, self-report measures of one’s capacity to understand
others’ mental/emotional states are positively related to the habitual use of reapprai-
sal (Lockwood et al., 2014; Powell, 2018; Thompson et al., 2019). Similarly, the
self-reported capacity to take the perspective of others is positively related to
dispositional measures of emotion regulation (Contardi et al., 2016; Eisenberg
and Okun, 1996; Okun et al., 2000).
Given evidence of their close relationship, a framework that considers both
component processes of empathy and emotion regulation can offer an integrative
perspective on how an observer understands and responds to the emotions of others
in a dynamic, iterative manner.
The first step in integrating the models of empathy and emotion regulation
described in this chapter is to illustrate the common ground between these constructs.
We do this by conceptualizing empathy as a cybernetic emotion-generative process
akin to that portrayed by the EPM (Fig. 3—gray box in panel A and elaborated
in panel B). The emotional stimulus in this context is the emotional state of
another individual, as manifested through concrete cues such as facial/bodily/vocal
expression as well as any available abstract cues. The next step in this cycle reflects
the perceptual processing of relevant cues pertaining to the other’s state. Depending
FIG. 3
Panel A depicts the component processes of empathy as they unfold over time in the brain of the observer (at the right). While the linear
representation (as in Fig. 1) depicts a single run of these processes, the equivalent circular representation (gray in panel A and elaborated in panel
B) highlights the iterative nature of these processes. In the circular representation, concrete emotion cues can automatically trigger an emotional
response via mimicry/embodiment mechanisms. In the case of abstract emotion cues, an affective response can be elicited via cognitive
processes, which enables the observer to represent and understand the other’s emotional state. Panel B integrates the EPM with this model of
empathic processes, illustrating how various regulation strategies can act upon the different component processes of empathy and the affective
state they elicit in the observer.
 3 A framework for integrating empathy and emotion regulation 287

upon the nature of these cues (i.e., concrete or abstract), an emotional response can be
elicited in the observer by two separable but parallel mechanisms. In this framework,
mimicry/embodiment processes reflect a “hyperlink,” whereby the perception of
concrete emotion cues can directly and automatically elicit an isomorphic emotional
response in the observer. By contrast, cognitive processes reflect a more prototypical
cybernetic pathway whereby the perceived abstract emotion cues are combined with
prior knowledge to produce a representation of the emotional response of the other
through inference.
Representing empathic processes in this manner highlights the iterative nature
of real-world social interactions, wherein the observer’s perceptions, appraisals, and
resultant emotional state may change over time as the situation unfolds. Crucially
for current purposes, it also offers a simple heuristic to understand how different
regulation strategies can act upon each of the empathic processes (Fig. 3B). Consistent
with dual process models of emotion regulation (e.g., Gyurak et al., 2011), we propose
that the influence of these regulatory strategies on empathic processes can occur in both
an implicit and explicit manner. Next, we will discuss in further detail each regulation
strategy in relation to the empathic processes they can primarily target.

3.1 Situation selection/modification

Given that one must first of all come into contact with another’s emotion in order
for empathic processes to transpire, situation selection may regulate the earliest
component of empathy by controlling one’s exposure to situations in which another’s
emotions might be encountered (Hodges and Biswas-Diener, 2007). For example,
one could avoid becoming upset by the plight of the homeless people that line the
streets on their journey to work simply by taking an alternative route. In terms of
our integrative framework, this strategy targets the antecedent input to the compo-
nent processes of empathy without the need to directly alter any of the processes.
Situation modification similarly acts upon the antecedents of empathic processes,
but entails directly altering, rather than avoiding, an emotion-inducing stimulus.
Given that the stimulus in the case of empathy-induced emotion is another individ-
ual’s emotional state, situation modification in this context may be best conceptual-
ized as directly regulating the other’s emotion (i.e., interpersonal emotion regulation;
Zaki and Williams, 2013). As with the intrapersonal regulation strategies highlighted
by the EPM, interpersonal emotion regulation could act upon any stage of the
emotion generation process, albeit upon that of the other rather than the self. For
example, one could try to solve the problem the other is facing (interpersonal situ-
ation modification); take the other’s mind off the situation (interpersonal attentional
deployment); help them to reappraise the situation in a more positive light (interper-
sonal cognitive change); or encourage them to take a deep breath (interpersonal
response modulation). The most effective interpersonal regulation strategies are
likely those that are specifically targeted to a given individual and situation, and thus
associated with significant context-dependence.
288 CHAPTER 12 Empathy and emotion regulation

3.2 Attentional deployment

Attention to another’s emotion cues is a critical early component process in empathy.
Therefore, controlling the way in which one attends to such cues reflects a key mech-
anism by which empathic processes could be regulated. Such strategies could involve
outright distraction or more fine-tuned attentional deployment wherein one still attends
to the other’s emotional state but focuses upon less emotional features. For instance,
given that focusing upon an individual’s eye region is important for understanding and
resonating with their emotional state, diverting attention away from the other’s eyes is
likely to influence how the observer represents and responds to their emotion. Indeed,
a recent study demonstrated that when constrained to focus upon the eye-region,
there was increased activity in brain regions related to face processing (fusiform
gyrus, IOG), emotional processing (amygdala, OFC), “mentalizing” (dmPFC, STS),
the MNS (IFG, IPL), and affective embodiment (insula, anterior cingulate cortex)
(Hadjikhani et al., 2017). Thus, diverting attentional resources away from another’s
emotion cues can influence the early perception component of empathy, and result
in an attenuated emotional response in the observer (Shaw et al., 1994).

3.3 Cognitive change

An observer’s inferences about another’s emotional state, and its relevance to him/
herself, play a key role in determining their response. Hence, changing the way in
which the situation, or one’s relation to it, is appraised could drastically impact the
emotional state elicited through empathic processes. Semantic reappraisal could alter
the observer’s initial appraisals of the situation in both a self- and other-focused
manner; i.e., the observer could reappraise the other’s state as one of reduced negativity,
and/or recalibrate the relevance the other’s state has to him/herself (Zaki, 2014).
In addition to changing the meaning one attaches to the other’s emotion,
cognitive change could entail reappraisal via perspective taking, whereby the
observer distances the other’s emotion from his or her own through self-other control
processes. This could be conceptualized as modifying the extent to which the other’s
state is represented in a first- vs a third-person mode of processing (Cheng et al.,
2017). Representing another’s emotional state from a more detached perspective
can be useful in managing the distress that can arise from exposure to another’s
suffering (Batson et al., 1987, 1997; Eisenberg et al., 2000; Okun et al., 2000). For
example, in viewing other individuals experience the application of a painful stimulus,
participants instructed to imagine “how they would feel” in the other’s place reported
greater personal distress (and reduced sympathy/concern for the other) than participants
instructed to imagine “how the other feels” (Batson et al., 1997; Lamm et al., 2007).

3.4 Response modulation

Spontaneous mimicry and embodiment reflect fundamental processes in empathy,
which could be influenced in various ways by response modulation strategies such
as suppression. First, attempts to suppress the expression/experience of the affective
 3 A framework for integrating empathy and emotion regulation 289

state evoked via mimicry/embodiment processes would likely hinder one’s capacity
to share in another’s emotion. Indeed, there is evidence that the habitual use of sup-
pression is related to reduced self-reported tendency to share others’ emotions
(Lockwood et al., 2014; Powell, 2018), and has also been found to entail various neg-
ative consequences for social functioning (Butler et al., 2003). Further, considering
the previously discussed evidence of heightened physiological activity and sustained
activations in emotion-related brain regions during suppression, it is likely that this
regulation strategy might be associated with increased arousal and self-focused
distress in response to others’ negative emotions.
The sensorimotor information provided by spontaneous mimicry/embodiment
may also facilitate the recognition and understanding of others’ emotional states
(Chartrand and Bargh, 1999; Niedenthal, 2007; Preston and de Waal, 2002); thus,
suppression could interfere with one’s ability to accurately understand another’s
emotional experience. In partial support of this assertion, studies in which SFM
is blocked by inhibiting participants’ facial muscles (e.g., by biting down on a
pen) have demonstrated impairments in emotion recognition (Neal and Chartrand,
2011; Oberman et al., 2007; Stel and van Knippenberg, 2008).

3.5 Contextual influences

So far, we have discussed the relationship between emotion regulation and empathic
processes in a somewhat context-neutral manner. While a detailed exploration of
contextual influences is beyond the scope of this chapter, here we provide a brief
discussion of how contextual influences on these processes can be considered within
our proposed framework. The term “context” encompasses a myriad of variables
from interpersonal relationships (e.g., romantic couples vs siblings) to external
environments (e.g., work environment vs home environment). A more parsimonious
account of this multitude of contextual influences is to consider them operating
through a “final common pathway” that assigns a reward value to an observed
individual. According to this conceptualization, someone who is psychologically
closer to the observer has a higher reward value than someone more distant
(Trope and Liberman, 2010). An important insight of the present framework, which
we will go on to discuss, is that the reward-value attached to another individual can
influence both the empathic processes as well as the regulatory processes that act
upon them.
Reward value of an observed other has been shown to modulate the extent of
spontaneous mimicry (Sims et al., 2012) and related neural responses (Sims et al.,
2014; Trilla Gros et al., 2015) in an observer. At the neurobiological level, reward
value of a stimulus might therefore act as a “gain control” mechanism, increasing/
decreasing the extent to which different component processes of empathy are
activated. This reward-based conceptualization of context is also consistent with
a large body of literature on group membership and its effects on various empathic
processes. Reduced levels of sympathy and emotional/motor resonance for
outgroup members and those perceived as more socially distant have been consis-
tently reported (Avenanti et al., 2010; Azevedo et al., 2013; Bruneau et al., 2017;
290 CHAPTER 12 Empathy and emotion regulation

Contreras-Huertas et al., 2013; Gutsell and Inzlicht, 2012; Hein et al., 2010).
In contrast to processes related to mimicry/embodiment, far less work has tested
the influence of reward on cognitive empathic processes (for notable exceptions,
see Savitsky et al., 2011; Stinson and Ickes, 1992; Thomas and Fletcher, 2003).
Similarly to empathic processes, the choice, implementation, and efficacy of
regulatory strategies are also highly context dependent (Gross, 2015; Suri et al.,
2018). Adaptive emotion regulation is dependent not only upon the observer’s ability
to utilize a given strategy, but also their capacity to adaptively select an effective
strategy appropriate to the context in which an emotion occurs (Gross, 2015).
If reward can modulate the empathic processes as described earlier, it follows that
it can have an impact on the resultant emotional state of the observer. Further, within
this framework, we suggest that the reward value of the observed other can also
influence the choice and implementation of regulatory strategies. At a simple level,
we propose that the choice of if and how to regulate the emotional state induced by
empathic processes is determined by the relative reward value attributed to different
proximate (e.g., reduce current negative emotional state) and ultimate (e.g., facilitate
relationship with rewarding other) goals (see Cameron et al., 2017 for detailed
discussion of goal valuation in relation to empathy).

4 Conclusions and directions for future research

In this chapter, we have described a framework for integrating the component
processes of empathy and the emotion regulation strategies that can act upon them.
Given that different regulation strategies are associated with variable consequences,
this model would predict that different regulatory processes may influence an
observer’s response to another’s emotion in different ways. Recent work provides
some evidence to support this prediction (e.g., Grynberg and Lopez-Perez, 2018;
Lockwood et al., 2014; Powell, 2018; Tully et al., 2016). However, such work is cur-
rently limited to just a small number of regulatory strategies and has largely used
only self-report metrics. Future empirical work should seek to test the predictions
of this integrative framework using task-based measures of empathic and regulatory
processes, ideally with more objective metrics of emotional responding, such as
psychophysiology, functional MRI (fMRI), and electroencephalography (EEG).
Our framework acknowledges that the relationship between empathy and
emotion regulation is dependent on context and posits that the relative reward value
of an observed individual can provide a useful metric to quantitatively model this
relationship. Future work should seek to test this aspect of the model by examining
how the reward value of an observed other influences the interaction between
empathic and regulatory processes.
Our proposed framework is largely consistent with prior theoretical accounts of
empathy that highlight both implicit and explicit processes (e.g., Batson et al.,
1997; Decety and Jackson, 2004; Hooker et al., 2008). In alignment with prior
theories, we posit key roles of mimicry/embodiment, shared neural representations,
 References 291

inferences/appraisals, and self-other control in the capacity to understand and respond

to others’ emotions (Bird and Viding, 2014; Decety and Jackson, 2004; Preston and
de Waal, 2002). A key point of distinction between this and prior models is that we
explicitly conceptualize empathy as reflecting the processes that enable an under-
standing of and affective response to others’ emotions, whereas many previous models
refer to empathy as the end-states that result from these processes. Representing
empathy as a set of processes circumvents the issue of conflating empathy with related
constructs, such as sympathy, and can better account for the various outcomes that can
occur in response to the perception of another’s emotion, including those where the
resultant state of the observer is opposed to that of the other (e.g., schadenfreude).
Further, the cybernetic nature of this framework more accurately reflects the cyclic
nature of real-world empathy, wherein the state of the observer may change from
moment to moment as the situation unfolds and/or as a result of his or her own actions.
Our framework is most closely aligned with prior theoretical work that highlights
the role of emotion regulation in the empathic process (e.g., Decety, 2010; Decety and
Meyer, 2008; Gerdes and Segal, 2009), and in particular, the motivated account of
empathy (Zaki, 2014), which illustrates how different regulation strategies can act upon
various processes related to empathy. A key point of distinction between this frame-
work and the motivated account is regarding the conceptualization of the reward-
dependent nature of empathic processes. In the motivated account, what we describe
as reward-dependence is regarded as being a direct result of motivated emotion regu-
lation (Zaki, 2014). In contrast, our view is that the reward signal, and hence consequent
gain control of subsequent activation can occur earlier, given the fast subcortical route
that can be accessed for quick valence coding of faces (within the first 60ms, according
to Morel et al., 2012). A regulatory influence is likely to be acting later in the stimulus
processing pipeline, and reliant on feedback projections from cortical structures.
This divergence between these two theoretical accounts to some extent parallels
the debate within the emotion regulation literature regarding the boundaries between
emotional reactivity and regulation (see Gross and Feldman Barret, 2011). In light of
this theoretical divergence, we pose an important open question: does evidence for the
contextual modulation of empathy reflect the outcomes of regulatory processes per se,
or can the influence of reward on empathic processes be distinguished from that of
emotion regulation? Future work could seek to address this question by examining
the temporal dynamics of reward and regulatory influences on different component
processes of empathy; the high temporal and spatial resolution afforded by combined
EEG-fMRI (e.g., Bayer et al., 2017) could provide a useful method in this respect.

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