Research has consistently demonstrated that therapist empathy is one of the most potent predictors of client progress in psychotherapy across every therapeutic modality.
However, although empathy is seen as the bedrock of psychotherapy, its power is often underestimated and not well understood.
There are numerous working definitions of empathy, including those from developmental science and social psychology, as well as from the psychotherapy literature.
“The best definition of empathy . . . is that it is the capacity to think and feel oneself into the inner life of another person” (Kohut, 1984, p. 82).
But how do we go about sensing the inner life of another person? Perhaps the familiar phrase, “to put oneself into the shoes of another,” best describes this process.
Simply stated, the analyst attempts to experience as closely as possible what the patient is experiencing (an approximation).
Let us consider this normal human process as it occurs regularly among people.
Each of us has an ongoing, continuous flow of inner experiences.
These may include our experience of a certain event or situation, such as a rainy day or a difficult task. They may include our experience of another person’s experiencing an event or situation. Our experiences also include our own experience of ourselves. And finally, they may also include our experience of others experiencing us as we experience them.
This intersubjective process is one that occurs whenever human beings interact, Let us use a simple example. Your female friend purchases a new car with all the extras such as air-conditioning, stereo sound system, sun roof, and power windows.
She is particularly thrilled with herself and her purchase because she has shopped around and feels she has gotten the best buy. She is excited to show you.
In turn, you have a series of impressions that are taken in with your senses and that include a total experience of the car itself and of your friend’s experience of her new car.
You see the glistening new paint and hear the quiet hum of the engine. You feel the plush upholstery and smell the scent of Fresh leather.
At the same time, you experience your friend’s pride in her new purchase and her boastfulness as she describes how she was able to get a good buy.
In turn, your friend may experience your being less excited than she is about her purchase.
She, in turn, begins to feel some disappointment.
Though this intersubjective flow ofexperiences may sound complicated in its description, it is a process that goes on in every human interaction. Unless one is a trained therapist, it is not something we think about consciously because our minds have the capacity to perceive and synthesise without our conscious awareness. Returning to the clinical setting, the analyst’s own focus remains consistently upon what the patient is experiencing. This encompasses not only the moment-to-moment experiences of the patient but also the continuous flow of these experiences over time.
Empathic immersion into the patient’s experience focuses the analyst’s attention upon what it is like to be the subject rather than the target of the patient’s
wishes and demands (Schwaber 1979).
The following brief vignettes exemplify this important distinction.
Mr. S., a middle-aged man with a history of work problems, rushed into the consulting room after tossing his rain-soaked coat upon one of the analyst’s newly upholstered office chairs.
The analyst was concerned about his chair and annoyed by his patient’s apparent lack of consideration. Initially viewing himself as the target of the patient’s unconscious projections, the analyst interpreted the act as an expression of displaced anger. Mr. s., in turn, became apologetic and immediately removed his coat from the chair.
Realizing in that moment that he had responded to the patients behavior (outside thepatient’s experience), the analyst shifted his attention to what Mr. S. was experiencing and away from himself as a target. From this “experience-near” vantage point, he recognized that his patient felt misunderstood and hurt by the interpretation. The analyst communicated this understanding and, furthermore, came to understand that Mr. S. had entered the office so excited and so preoccupied with his desire to share his good news about a job promotion that he had thoughtlessly tossed his coat. In turn, being understood allowed Mr. S. to arrive at an important awareness: namely, that his excitement in wishing to be recognized led, at times, to careless and inappropriate behavior that other people sometimes found offensive.
EMPATHY: SOME MISUNDERSTANDINGS
This process of thinking and feeling oneself into the inner life of another person can be open to a number of misunderstandings.
First, let’s emphasize that empathy is not a process by which we guess, intuit, or magically perceive what is occurring in the mind of another.
Second, empathy is not the same as we might feel if we were in a similar situation. For example, the therapist and patient may have experienced similar Iife circumstances. This does not mean, however, that the analyst’s particular experience of that situation is the same as the patient’s.
A third misunderstanding with regard to empathy is that, whereas every sensitive analyst will experience concern with whomever he or she works, placing oneself in
another’s experience does not mean becoming that person – that is, “taking over’ or “being flooded by,” the patient’s feelings. If, for example, a client becomes suddenly saddened while recounting the events of the funeral service, it would again be an error of empathy if, through identifying with that feeling, the analyst lost objectivity and began to commiserate with the patient. That is, entering into and becoming a participant in the sadness rather than being someone who understands the sadness can interfere with the analyst’s ability to be objective and helpful.
The use of empathy is not to be confused with being nice or appearing sympathetic or “curing through kindness.” The primary function of empathy was to make possible the painstaking unfolding of a patient’s inner experiences and the emergence of specific developmental needs (selfobject transferences).
It is this process that leads to in-depth understanding and interpretation, and to reliable psychological change.