200 Chapter 7 being confronted with their mental suffering on a daily basis might affect parents’ own wellbeing. These parents experience probably even more empathic distress when they see their child suffering compared to parents of non-depressed adolescents, which might negatively affect their capacity to engage in their role as a parent, and in turn, negatively affects the child. Moreover, depressed adolescents, especially those who are sensitive to the distress of their parent, might be more inclined to keep their (depressed) feelings to themselves, because they do not want to hurt or (further) upset their parents. Interestingly, this has indeed been mentioned by depressed adolescents in qualitative interviews within the RE-PAIR study. As a consequence, adolescents might shield themselves against the negative feelings of their parent, but also for their support. Parents, in turn, might feel hopeless as they cannot get through to their child anymore. This might bring the parent-child bond in a downward spiral and negatively affects the child’s well-being and interfere with clinical treatment of the child’s depression. Actively involving parents in the treatment of their child, boosting their parental self-efficacy, and support parents to appropriately cope with their empathic distress might help to break this downward spiral (Elzinga et al., 2022). In addition to the fact that sharing negative feelings with others may foster strong social bonds, sharing one’s joyful experiences with another person may just as well contribute to a stronger socio-emotional connection. While Chapter 5 investigated the neural and affective signatures of parents’ empathic responses to the suffering of their adolescent child, an interesting follow-up study could be to examine parents’ ability to share in the positive emotional state or joy of their child. In addition, it is of interest to investigate whether sharing in the happiness of their child would positively affect parents’ own mood and feelings of connectedness with the child as well as that of the child when they notice the vicarious joy of their parent. The idea that vicariously sharing in happy feelings might enhance feelings of socio-emotional connectedness between parents and children is consistent with the finding that parental warmth, which is also referred to as emotional closeness (Gladstone & Parker, 2005), is a crucial factor in the development of a strong sense of self and identity during adolescence and positive self-views (Erikson, 1968; McCranie & Bass, 1984). Another direction for future research and an extension of our findings on eye contact as an index of signaling empathy to others is whether receiving eye contact also contributes to feeling seen and understood by the sender. This is of particular interest in a patient-therapist setting, as this might be a feasible way to foster the quality of a therapeutic relationship. In addition, the emotionally laden and sensitive conversations in this setting showcase ideal circumstances to study the sending and receiving of empathy via eye contact. A useful method to study patients’ and therapists’ gaze responses during such conversations would be a virtual reality setup combined with eye tracking and the assessment of their accompanied feelings. Moreover, the flexible nature of virtual reality makes it possible to present patients and therapist with a wide
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