how connection developsA partner's hand was the same hand before and after couples therapy. What changed was how women responded while holding it as they waited to learn whether they would receive a mild electric shock. After therapy, partner contact felt more pleasant and less arousing. Several measures of threat-related brain activity also changed differently during that contact than when the women faced the task alone.
In their 2013 study, Susan Johnson and colleagues examined whether the comfort available through an established relationship could change. The couples were experiencing relationship distress and took part in emotionally focused therapy, often called EFT. The researchers used handholding to examine their responses before and after that work. The central question concerned the relationship behind the gesture, rather than touch considered apart from the person offering it.
Working on the relationship behind the contact
The couples had been together for an average of seventeen years. They were married or cohabiting, and the women and men were in their mid-forties on average. Both partners took part in therapy, but only the women underwent brain scanning. The paper reports twenty-three complete datasets after exclusions and dropouts.
EFT focused on recognizing and de-escalating negative patterns between partners, expressing needs for closeness and reassurance, and consolidating different ways of responding to one another. The couples received an average of about twenty-three sessions, with considerable variation in how long treatment lasted. This was sustained therapeutic work, not a brief instruction to hold hands or think more positively about a partner.
Before and after therapy, each woman entered a scanner and saw cues signaling either safety or the possibility of a shock. She completed the task while holding her partner's hand, holding an unfamiliar man's hand, and holding no hand. These comparisons helped separate responses to a particular partner from responses to another person's presence and from facing the task alone.
All the couples received EFT. There was no separate group receiving another therapy or waiting for treatment, so the changes cannot be attributed to EFT alone. Time, expectations, repeated exposure to the task and the attention involved in therapy remain possible contributors. The study's contribution is the pattern of change across those different relational situations.
Partner contact became a different experience
After therapy, the women reported lower arousal and greater pleasantness during partner handholding. The experience of contact with a stranger did not follow the same pattern. Arousal during stranger handholding increased, while pleasantness changed little. Simply having someone available to hold a hand did not describe the whole result.
The couples' reported relationship quality was also higher after treatment. In the analysis reported for that measure, the average score rose from about eighty-one to ninety-six on a scale ranging from zero to one hundred and fifty. The change in the relationship questionnaire and the changed experience of partner contact supplied different kinds of information. One concerned the relationship more broadly, while the other concerned what it felt like to face a particular threat with that partner present.
The brain measurements added another comparison. In several regions, the difference in activity between threat cues and safety cues became smaller during partner handholding after therapy. During the same task performed alone, that difference became larger. The findings included areas involved in responding to threat and in regulating emotion, although no single region can be read as a direct meter of trust or fear.
This distinction matters when interpreting the images. The study did not show every part of the brain becoming quieter or measure a percentage reduction in fear. It showed that the response to a possible threat depended differently on the social setting after the period of therapy. The same external event was being faced with different available support.
Where relationship quality entered the pattern
Some of the largest changes appeared among women reporting lower relationship quality. In the researchers' models, the difference between being alone and holding a partner's hand became especially pronounced at those lower scores. This pattern appeared both in an overall analysis of previously identified threat-responsive areas and in several regional analyses.
That finding gives the study particular interest. The couples did not all need to begin with a highly satisfying relationship for partner contact to be associated with a changed response later. Within this selected group, greater reported difficulty was compatible with substantial change in the measured pattern.
It does not follow that the most severely distressed couples will benefit most, or that remaining together is always the appropriate goal. Participants were selected for moderate relationship distress. The study excluded current relationship violence and histories of physical or sexual abuse, as well as several other clinical circumstances. Its lower relationship-quality scores describe variation within that selected sample, not every situation in which a relationship feels difficult or unsafe.
The regional results also came from many comparisons in a small sample. They identify promising patterns to investigate, rather than a precise forecast of how any particular couple's brain responses will change.
A stranger offered a different comparison
The stranger results were more complicated than the researchers had expected. Among participants with lower relationship-quality scores, some neural responses during stranger handholding also decreased relative to being alone after therapy. In other regions, however, partner and stranger contact moved in opposite directions. The stranger's presence was neither uniformly ineffective nor equivalent to the partner's.
The authors proposed that changes in a close relationship might make support from other people more available too. That is one possible explanation for the stranger findings, not something the experiment directly established. The women did not report a general increase in comfort with strangers during the task, and the study did not follow their relationships with other people outside the laboratory.
Keeping those results together gives the partner finding more definition. Contact was studied in the context of who was offering it, the quality of the existing relationship and the kind of response being measured. A single conclusion that touch calms everyone would lose those distinctions.
Support and being alone were not opposites
The increased activity in some regions when women faced the task alone could sound as though therapy had made solitude harder. Their ratings did not support that simple account. Arousal while alone decreased after therapy, and pleasantness remained much the same.
The researchers suggested that participants might have become more able or willing to regulate their own responses when a partner was unavailable. They also interpreted reduced activity during partner contact as a possible sign that less individual regulatory effort was needed. Those explanations fit parts of the pattern, but the study did not directly measure the mental effort involved or establish either process as the mechanism of improvement.
There is an important difference between receiving useful support and losing the capacity to manage without it. This study did not show those possibilities to be the same. Its reports of experience and its brain measurements need to be read together, rather than assuming that more activation always means greater distress.
The research also needs to be read with its 2014 disclosure correction. Johnson was a developer of EFT and directed an organization that helped fund the work, and she participated in the study's design and manuscript preparation. Another author was an EFT therapist and supervisor. The correction did not change the numerical findings, but those professional interests reinforce the importance of independent, controlled studies.
Within its scope, the study makes comfort between partners something that can be examined across change, rather than treated as a permanent quality a relationship either possesses or lacks. The women faced the same kind of threat with the same partners before and after therapeutic work. Their reported experience of that contact, and several features of their neural response, were different. The relationship behind the hand was part of what the researchers were learning to see.
Sources
Johnson, S. M., Moser, M. B., Beckes, L., Smith, A., Dalgleish, T., Halchuk, R., Hasselmo, K., Greenman, P. S., Merali, Z., & Coan, J. A. (2013). Soothing the Threatened Brain: Leveraging Contact Comfort with Emotionally Focused Therapy. PLOS ONE, 8(11), e79314. Includes supplementary Table S1.
Johnson, S. M., and colleagues (2014). Correction: Soothing the Threatened Brain: Leveraging Contact Comfort with Emotionally Focused Therapy. PLOS ONE, 9(8), e105489.