Document Type



Empathy and empathic response are receiving greater attention in pain research as investigators acknowledge that other forms of interaction may impact the pain process. The purpose of this study was to examine validation and invalidation as forms of empathic and nonempathic responses in chronic pain couples. Participants were 92 couples in which at least one spouse reported chronic musculoskeletal pain. Each couple participated in two videotaped interactions about the ways in which the pain has impacted their lives together. Trained raters then coded interactions for each partner’s use of validation and invalidation. Couples also completed surveys on spouse responses to pain, marital satisfaction, and perceived spousal support. Correlations demonstrated validation by spouses of persons with pain was associated with punishing, solicitous, and distracting spouse responses to pain, marital satisfaction, and perceived spousal support. In contrast, spouses’ invalidation scores were correlated with punishing spouse responses. Exploratory factor analyses were then conducted to determine the extent to which spouses’ responses to pain and spouse validation and invalidation loaded on similar factors. Results indicated that validation and invalidation are more closely related to punishing spouse responses than to solicitous or distracting spouse responses. These results have implications for theoretical and clinical work on spouse responding.


Counseling Psychology | Psychology | Social and Behavioral Sciences


This article is the author's manuscript and was previously published in final edited form as: Clin J Pain. 2008 October ; 24(8): 678–684. doi:10.1097/AJP.0b013e31816753d8.